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Wang E, Wroblewski KE, McClintock MK, Witt LJ, Pinto JM. Examining the Longitudinal Relationship Between Olfactory Dysfunction and Frailty in Community-Dwelling, older US Adults. Otolaryngol Head Neck Surg 2024; 171:261-268. [PMID: 38660882 DOI: 10.1002/ohn.685] [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: 08/10/2023] [Revised: 01/02/2024] [Accepted: 01/21/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Olfactory dysfunction is a "canary in the coalmine" for aging conditions. We evaluated olfactory dysfunction as a biomarker of early frailty in older adults living in the United States. STUDY DESIGN Prospective, longitudinal, nationally representative study. SETTING National Social Life, Health and Aging Project (NSHAP). METHODS We examined data from 1061 community-dwelling older US adults. Odor identification (5-item Sniffin' Stick) and frailty scores were measured at baseline and 5-year follow-up. Multivariate logistic regressions evaluated the association between olfactory dysfunction and frailty at baseline in cross-section and over time in the transition from robust to prefrail to frail, adjusting for confounding factors measured at baseline. RESULTS Older US adults who were anosmic at baseline were more likely to be frail 5 years later compared to normosmic peers (odds ratio [OR]: 3.83, 95% confidence interval [CI]: 1.10-13.31, P = .035). Examining changes in frailty stage over time, we found that anosmics were more likely to transition from prefrail to frail over 5 years (OR: 3.25, 95% CI: 1.31-8.08, P = .011). Interestingly, hyposmics did not show a similar trajectory toward frailty (P > .05). In contrast, olfactory dysfunction was not associated with frailty in cross-section (OR: 0.90, 95% CI: 0.43-1.89, P = .787, hyposmia; OR: 0.72, 95% CI: 0.15-3.35, P = .673, anosmia). CONCLUSION Older US adults with anosmia face higher odds of becoming frail over 5 years, especially those in the prefrail stage. Olfactory dysfunction may serve as a surrogate marker for early-stage neurodegenerative diseases, which are strong contributors to frailty.
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Affiliation(s)
- Esther Wang
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
| | - Martha K McClintock
- Department of Psychology, The Institute for Mind and Biology, The University of Chicago, Chicago, Illinois, USA
| | - Leah J Witt
- Divisions of Geriatrics and Pulmonary, Critical Care, Allergy and Sleep Medicine, The University of California, San Francisco, San Francisco, California, USA
| | - Jayant M Pinto
- Department of Surgery, Section of Otolaryngology, The University of Chicago Medicine, Chicago, Illinois, USA
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2
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Wang AZ, Wroblewski KE, Hawkley L, Pinto JM. Types of sensory disability are differentially associated with mental health in older US adults over time. J Am Geriatr Soc 2024. [PMID: 38944677 DOI: 10.1111/jgs.19056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/28/2024] [Accepted: 06/10/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and olfaction disability on mental health outcomes in older US adults. METHODS We studied respondents from the first three rounds (2005/6, 2010/11, and 2015/16) of the National Social Life, Health and Aging Project, a nationally representative, longitudinal study of older US adults. Sensory function was assessed by structured interviewer ratings (hearing and vision) and objective assessment (olfaction). Cox proportional hazards models and one degree of freedom tests for trend were utilized to analyze the relationships between sensory disability and self-rated mental health, frequent depressive symptoms, frequent perceived stress, frequent anxiety symptoms, and frequent loneliness symptoms over time, adjusting for demographics, health behaviors, comorbidities, and cognitive function. RESULTS We analyzed data from 3940 respondents over 10 years of follow-up. A greater number of sensory disabilities was associated with greater hazard of low self-rated mental health, frequent depressive symptoms, frequent perceived stress, and frequent loneliness symptoms over time (p ≤ 0.003, all). After adjusting for covariates, older adults with a greater number of sensory disabilities had greater hazard of low self-rated mental health (HR = 1.22, CI = [1.08, 1.38], p = 0.002) and loneliness symptoms (HR = 1.13, CI = [1.05, 1.22], p = 0.003) over time in our tests for trend. In our Cox proportional hazards model, older adults with vision disability had greater hazard of low self-rated mental health (HR = 1.34, 95% CI = [1.05, 1.72], p = 0.02) and loneliness symptoms (HR = 1.21, CI = [1.04, 1.41], p = 0.01). CONCLUSIONS Older US adults with greater numbers of sensory disabilities face worse subsequent mental health. Future longitudinal studies dissecting the relationship of all five classical senses will be helpful in further understanding how improving sensory function might improve mental health in older adults.
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Affiliation(s)
- Alexander Z Wang
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
| | | | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, Illinois, USA
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3
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Lebuf E, Van Dyck D, Van de Velde L, Beeckman M, Van Cauwenberg J, Compernolle S. Sedentary patterns and health outcomes in the oldest-old: a latent profile analysis. PeerJ 2024; 12:e17505. [PMID: 38938606 PMCID: PMC11210487 DOI: 10.7717/peerj.17505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/13/2024] [Indexed: 06/29/2024] Open
Abstract
Background Sedentary behavior is most prevalent among those aged 80 years and above, referred to as the oldest-old. Current literature emphasizes the significance of sedentary behavior patterns, but further evidence is required to understand how these patterns relate to specific health outcomes and to identify at-risk profiles for tailored interventions in the oldest-old. Therefore, the aim of this study was to identify profiles of adults aged 80+ years based on their sedentary patterns and health outcomes, and to examine associations between profiles and socio-demographics. Methods A cross-sectional study was conducted in Flanders (Belgium) from February 2021 to December 2022 recruiting 90 older adults (80+) through convenience sampling, employing word of mouth, social media and local service centers. Latent profile analysis identified device-based sedentary patterns and assessed their associations with physical and cognitive functioning, mental health-related quality of life (QoL), and social isolation. Associations of these profiles with socio-demographic factors were analyzed. Results Three distinct profiles were identified: (1) the 'cognitively and physically frail' profile, (2) the 'healthy' profile and (3) the 'lower mental health-related QoL' profile. Those in the 'cognitively and physically frail' profile exhibited the least favorable sedentary pattern, and had a higher likelihood of residing in a nursing home. No significant differences were found for the other socio-demographic variables, being age, sex, educational degree and family situation. Conclusions Three distinct profiles in the oldest-old population, based on cognitive and physical functioning, mental health-related QoL, and sedentary behavior patterns, were identified. Lower physical and cognitive functioning was associated with unhealthy sedentary patterns. Further research with larger samples is crucial to uncover potential links between socio-demographics and at-risk subgroups, enhancing our understanding of sedentary behavior and geriatric health outcomes in this population.
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Affiliation(s)
- Elien Lebuf
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Laura Van de Velde
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Melanie Beeckman
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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Wang E, Wroblewski KE, McClintock MK, Pinto JM, Witt LJ. Olfactory decline develops in parallel with frailty in older US adults with obstructive lung diseases. Int Forum Allergy Rhinol 2024; 14:819-827. [PMID: 37747949 PMCID: PMC10961252 DOI: 10.1002/alr.23273] [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: 07/22/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Frailty is prevalent among older adults with asthma or chronic obstructive pulmonary disease (obstructive lung diseases [OLDs]). Frailty and OLD's co-occurrence is associated with increased hospitalization/mortality. Chemosensory dysfunction is closely connected to both OLD and frailty. We evaluated the utility of olfactory decline as a biomarker of frailty in the setting of OLD. METHODS We performed a prospective, longitudinal, nationally representative study of community-dwelling older US adults in the National Social Life, Health and Aging Project, an omnibus in-home survey. Respondents reported a physician's diagnosis of OLD. Decline in odor identification and sensitivity over 5 years and frailty (adapted fried frailty phenotype criteria) were measured using standard tools. Multivariate logistic regressions evaluated the association between OLD status, olfactory decline, and frailty. RESULTS We compared individuals with OLD (n = 98; mean age 71.2 years, 59.2% women) and those without OLD (n = 1036; mean age 69.5 years, 58.9% women). Olfactory identification decline was associated with developing frailty over the 5-year follow-up period in individuals with OLD (odds ratio [OR] = 9.1, 95% confidence interval [CI] = 2.1-38.6, p = 0.003). Olfactory decline predicted incidence of frailty in individuals with OLD (identification: OR = 4.8, 95% CI = 1.3-17.5, P = 0.018; sensitivity: OR = 6.1, 95%CI = 1.2-31.0, p = 0.030) but not in those without OLD adjusting for demographics, heavy alcohol use, current smoking, and comorbidity. Results were robust to different thresholds for olfactory decline and frailty development. CONCLUSIONS Older adults with OLD who experience olfactory decline face higher odds of developing frailty. Use of olfactory decline as a biomarker to identify frailty could allow earlier intervention and decrease adverse outcomes for high-risk older adults with OLD.
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Affiliation(s)
- Esther Wang
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
| | - Martha K McClintock
- Department of Psychology and The Institute for Mind and Biology, The University of Chicago, Chicago, Illinois, USA
| | - Jayant M Pinto
- Department of Surgery, Section of Otolaryngology, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Leah J Witt
- Divisions of Geriatrics and Pulmonary, Critical Care, Allergy and Sleep Medicine, The University of California, San Francisco, San Francisco, California, USA
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Pinton A, Wroblewski K, Schumm LP, Hawkley LC, Huisingh-Scheetz M. Relating depression, anxiety, stress and loneliness to 5-year decline in physical function and frailty. Arch Gerontol Geriatr 2023; 115:105199. [PMID: 37776753 PMCID: PMC10615850 DOI: 10.1016/j.archger.2023.105199] [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: 01/19/2023] [Revised: 08/28/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES While depression has been associated with physical function decline and worsening frailty in older adults, the impact of other mental health symptoms on physical function and frailty is unknown. The study objective was to determine whether depression, perceived stress, loneliness, and anxiety symptoms affect 5-year physical function and frailty trajectories of older adults. METHODS The National Social Life, Health, and Aging Project (NSHAP) is a nationally-representative study of adults born between 1920 and 1947. The analysis included data collected in 2010-11 and 2015-16. Mental health symptoms were quantified using NSHAP's measures of anxiety (range:0-21), perceived stress (0-8), depression (0-22), and loneliness (0-6); higher scores indicated worse symptoms. We regressed 2015-16 3 m usual walk time, five-repeated chair stand time or an adapted frailty phenotype scale (0-4) separately on each 2010-11 mental health scale, adjusting for baseline physical function or frailty, demographics, and comorbidities. RESULTS In separate models, every one-point increase on the depression or perceived stress scales was associated with, respectively, a 0.06 s slower (95 % CI: 0.03, 0.10) or 0.09 s slower (95 % CI: 0.01, 0.16) 5-year walk time. Every one-point increase on the depression or perceived stress scales was associated with a 0.15 s slower (95 % CI: 0.06, 0.23) or 0.16 s slower (95 % CI: 0.02, 0.29) 5-year chair stand time. Every one-point increase on the depression scale predicted 0.06 higher log odds of having a worse frailty score 5 years later. Only depression's association with 3 m walk time and chair stands remained significant in models including all four mental health scales. DISCUSSION Older adults with more depression and to a lesser extent stress symptoms may experience faster physical function decline and worsening frailty. Future work exploring and addressing the mechanisms underlying these relationships are warranted.
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Affiliation(s)
- Anabella Pinton
- University of Chicago, Biological Sciences Collegiate Division, Chicago, IL, USA
| | - Kristen Wroblewski
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - L Philip Schumm
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | | | - Megan Huisingh-Scheetz
- Section of Geriatrics and Palliative Medicine, Department of Medicine, University of Chicago, 5841 South Maryland Ave. MC 6098, Chicago, IL 60637, USA.
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Picchiello MC, Carpenter BD. Heterogeneity in Measures and Rates of Reported Dementia and Subjective Memory Complaints Across U.S. National Surveys. J Gerontol B Psychol Sci Soc Sci 2023; 78:1854-1859. [PMID: 37584229 PMCID: PMC10645309 DOI: 10.1093/geronb/gbad111] [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: 01/09/2023] [Indexed: 08/17/2023] Open
Abstract
OBJECTIVES Several U.S. health surveillance surveys contain items related to self- and proxy reports of dementia and subjective memory complaints (SMC). Despite their similar content, these items differ in terminology, item specificity, and time frame. The goal of this study was to analyze whether item features might influence endorsement rates for dementia and SMC. METHODS We calculated design-appropriate estimates for the endorsement of dementia and SMC across U.S.-based national surveys and employed pairwise comparisons to evaluate endorsement rates across surveys. We also examined item characteristics to explore possible effects on endorsement rates. RESULTS Endorsement rates were wide-ranging for dementia (ranging from 2.7% to 9.9%) and SMC (5.6% to 46.6%). Pairwise comparisons revealed statistically significant differences on most dementia-related items (76%), and all SMC comparisons (100%). Items varied substantially in the terminology used to assess dementia and SMC (e.g., "dementia" vs "Alzheimer's disease") and used different time frames (e.g., "past month" vs "5 years"). DISCUSSION National survey data on reported dementia and SMC can have important research, training, and policy implications, yet endorsement rates vary widely across surveys. That variability could emerge from subtle but influential item characteristics, and our findings highlight the need for item harmonization, in even their most basic characteristics. Standardizing items across national surveillance surveys facilitates comparison across surveys so that we can better understand the true burden of these conditions to inform public health initiatives.
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Affiliation(s)
- Matthew C Picchiello
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Brian D Carpenter
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
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Choi KW, Waite LJ, Finch LE, Kotwal AA. Social Isolation and Worsening Health Behaviors Among Older Adults During the COVID-19 Pandemic. J Gerontol B Psychol Sci Soc Sci 2023; 78:1903-1916. [PMID: 37591797 PMCID: PMC10645306 DOI: 10.1093/geronb/gbad122] [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: 09/15/2022] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVES We examine the relationship between social isolation, poor health behaviors, and the perceived worsening of older adults' health behaviors following the coronavirus outbreak. We assess the extent to which psychological pathways mediate the relationship between social isolation and worsening health behaviors. METHODS Drawing on data from the National Social Life Health and Aging Project Round 3 (2015) and its coronavirus immune disease 2019 (COVID-19) substudy (2020; N = 2,549), we use generalized linear models to explore how indicators of social isolation during the COVID-19 pandemic-infrequent in-person contact with friends and family in 2020 and decreased in-person contact with friends and family since COVID-19 started-are associated with (1) poor health behaviors (low physical activity, drinks per week, smoking, and poor sleep) in 2020 and (2) perceived worsening of health behaviors (reports of decreased physical activity, increased drinking and smoking, and feeling less rested) since the pandemic started. RESULTS Infrequent in-person contact was not associated with poor health behaviors. Decreases in in-person contact, on the other hand, were associated with worsening health behaviors. Older adults who reported decreases in in-person contact were more likely to perceive a decrease in physical activity, an increase in drinking, and feeling less rested. Emotional well-being, particularly loneliness compared to anxiety or depressive feelings, partially mediated the relationship between perceived worsening of health behaviors and a decrease in in-person contact with friends, and to a lesser extent, with family. DISCUSSION Our study suggests that in-person contact may play a distinct role in shaping older adults' well-being during the pandemic.
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Affiliation(s)
- Kyung Won Choi
- Department of Sociology, University of Chicago, Chicago, Illinois, USA
| | - Linda J Waite
- Department of Sociology, University of Chicago, Chicago, Illinois, USA
- Academic Research Centers, NORC at the University of Chicago, Chicago, Illinois, USA
| | - Laura E Finch
- Academic Research Centers, NORC at the University of Chicago, Chicago, Illinois, USA
| | - Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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8
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Kuang K, Huisingh-Scheetz M, Miller MJ, Waite L, Kotwal AA. The association of gait speed and self-reported difficulty walking with social isolation: A nationally-representative study. J Am Geriatr Soc 2023; 71:2549-2556. [PMID: 37000466 PMCID: PMC10524495 DOI: 10.1111/jgs.18348] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/21/2023] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Mobility assessments are commonly used among older adults as risk stratification for falls, preoperative function, frailty, and mortality. We determined if gait speed and self-reported difficulty walking are similarly associated with social isolation and loneliness, which are key markers of social well-being and linked to health outcomes. METHODS We used 2015-2016 data from the National Social life Health and Aging Project (NSHAP), an in-person nationally-representative survey of 2640 community-dwelling adults ≥65 years old. We measured gait speed (timed 3-m walk: unable to walk, ≥5.7 s, and <5.7 s), and self-reported difficulty walking one block or across the room (unable, "much," "some," or "no" difficulty). Social measures included loneliness (3-item UCLA scale), social isolation (12-item scale), and individual social activities (frequency socializing, religious participation, community participation, and volunteering). We used logistic regression to determine the adjusted probability of each social measure by gait speed and difficulty walking, adjusting for sociodemographic and health characteristics, and tested for interaction terms with age. RESULTS Participants were on average 75 years old (SD = 7.1), 54% female, 9% Black/African American, and 6% Hispanic. Difficulty walking one block was associated with (p < 0.05): social isolation (much difficulty: 26% vs no difficulty: 18%), low socializing (33% vs 19%), low volunteering (67% vs 53%), low community participation (54% vs 43%), low religious participation (51% vs 46%), and loneliness (25% vs 14%). Difficulty walking across the room was similarly strongly associated with social isolation and individual activities. The association between self-reported difficulty walking and social isolation was stronger at older ages (p-value of interaction <0.001). CONCLUSIONS Self-reported mobility difficulty is a widely used clinical assessment that is strongly associated with loneliness and social isolation, particularly at older ages. Among persons with limited mobility, clinicians should consider a careful social history to identify social needs and interventions addressing mobility to enhance social connections.
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Affiliation(s)
- Kathy Kuang
- University of Arizona College of Medicine – Tucson, Tucson, AZ
| | - Megan Huisingh-Scheetz
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, IL
| | - Matthew J. Miller
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA
| | - Linda Waite
- Department of Sociology, University of Chicago, Chicago, IL
| | - Ashwin A. Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center
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Qu T. Chronic Illness and Social Network Bridging in Later Life. SOCIAL NETWORKS 2023; 74:1-12. [PMID: 37982028 PMCID: PMC10655771 DOI: 10.1016/j.socnet.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Chronic disease has profound impacts on the structural features of individuals' interpersonal connections such as bridging - ties to people who are otherwise poorly connected to each other. Prior research has documented competing arguments regarding the benefits of network bridging, but less is known about how chronic illness influences bridging and its underlying mechanisms. Using data on 1,555 older adults from the National Social Life, Health, and Aging Project (NSHAP), I find that older adults diagnosed with chronic illness tend to have lower bridging potential in their networks, particularly between kin and non-kin members. They also report more frequent interactions with close ties but fewer neighbors, friends, and colleagues in their networks, which mediates the association between chronic illness and social network bridging. These findings illuminate both direct and indirect pathways through which chronic illness affects network bridging and highlight the context-specific implications for social networks in later life.
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Affiliation(s)
- Tianyao Qu
- Department of Sociology, Cornell University, Ithaca, USA
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10
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Yu Z, Chen Y, Xia Q, Qu Q, Dai T. Identification of status quo and association rules for chronic comorbidity among Chinese middle-aged and older adults rural residents. Front Public Health 2023; 11:1186248. [PMID: 37325337 PMCID: PMC10267321 DOI: 10.3389/fpubh.2023.1186248] [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: 03/14/2023] [Accepted: 05/11/2023] [Indexed: 06/17/2023] Open
Abstract
Background Chronic comorbidity has become a major challenge in chronic disease prevention and control. This issue is particularly pronounced in rural areas of developing countries, where the prevalence of chronic disease comorbidity is high, especially among middle-aged and older adults populations. However, the health status of middle-aged and older adults individuals in rural areas of China has received inadequate attention. Therefore, it is crucial to investigate the correlation among chronic diseases to establish a reference basis for adjusting health policies aimed at promoting the prevention and management of chronic diseases among middle-aged and older adults individuals. Methods This study selected 2,262 middle-aged and older adults residents aged 50 years or older in Shangang Village, Jiangsu Province, China, as the study population. To analyze the chronic comorbidity of middle-aged and older adults residents with different characteristics, we used the χ2 test with SPSS statistical software. Data analysis was conducted using the Apriori algorithm of Python software, set to mine the strong association rules of positive correlation between chronic disease comorbidities of middle-aged and older adults residents. Results The prevalence of chronic comorbidity was 56.6%. The chronic disease comorbidity group with the highest prevalence rate was the lumbar osteopenia + hypertension group. There were significant differences in the prevalence of chronic disease comorbidity among middle-aged and older adults residents in terms of gender, BMI, and chronic disease management. The Apriori algorithm was used to screen 15 association rules for the whole population, 11 for genders, and 15 for age groups. According to the order of support, the most common association rules of comorbidity of three chronic diseases were: {lumbar osteopenia} → {hypertension} (support: 29.22%, confidence: 58.44%), {dyslipidemia} → {hypertension} (support: 19.14%, confidence: 65.91%) and {fatty liver} → {hypertension} (support: 17.82%, confidence: 64.17%). Conclusion The prevalence of chronic comorbidity among middle-aged and older adults rural residents in China is relatively high. We identified many association rules among chronic diseases, dyslipidemia is mostly the antecedent, and hypertension is primarily the result. In particular, the majority of comorbidity aggregation patterns consisted of hypertension and dyslipidemia. By implementing scientifically-proven prevention and control strategies, the development of healthy aging can be promoted.
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Affiliation(s)
- Zijing Yu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Qianhang Xia
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Qingru Qu
- PBC School of Finance, Tsinghua University, Beijing, China
| | - Tao Dai
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
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11
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Shen S, Liu H. Cognitive Impairment Leads to Increased Feelings of Sexual Obligation Among a National Longitudinal Sample of Sexually Active Adults Aged 62 and Older. THE GERONTOLOGIST 2023; 63:297-307. [PMID: 35675363 PMCID: PMC9960026 DOI: 10.1093/geront/gnac078] [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: 01/27/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We work from a gendered life-course perspective to examine the relationship between cognitive impairment and feelings of sexual obligation among U.S. older adults. RESEARCH DESIGN AND METHODS Data are drawn from 2 rounds of the National Social Life, Health, and Aging Project (2010/2011 and 2015/2016). The analytic sample includes 575 sexually active respondents aged 62-86 at baseline. Cognitive impairment is measured using a survey-adapted version of the Montreal Cognitive Assessment, with categories of normal, mild cognitive impairment, and dementia. We estimate cross-lagged models to test the potential reciprocal relationships between cognitive impairment and feelings of sexual obligation. RESULTS Older adults with dementia at baseline had significantly higher odds of sexual obligation 5 years later than their peers with normal cognition at baseline, after adjusting for gender, race/ethnicity, education, income, age, marital status, self-rated health, depression, comorbidities, and sexual obligation at baseline. We find no evidence of a reciprocal relationship, as sexual obligation at baseline did not predict later cognitive status. DISCUSSION AND IMPLICATIONS Older adults with dementia often remain sexually active after their 60s, and many of them feel obligated to have sex with their partner. Our study highlights the importance of understanding the context of their sexual lives. The quality of their sexual relationship, such as whether they feel a duty to maintain their earlier sexual activity or please their partner, and the health implications of sexual obligation should be considered alongside the increase of older adults with dementia.
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Affiliation(s)
- Shannon Shen
- Department of Sociology, Texas A&M University-San Antonio, San Antonio, Texas, USA
| | - Hui Liu
- Department of Sociology, Michigan State University, East Lansing, Michigan, USA
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12
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Joo WT. Educational gradient in social network changes at disease diagnosis. Soc Sci Med 2023; 317:115626. [PMID: 36586184 PMCID: PMC10039803 DOI: 10.1016/j.socscimed.2022.115626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
This study examines the educational gradient in social network changes following the diagnosis of new chronic diseases. Using a representative sample of the US older population, the author shows that the network size and amount of health-related discussion with social network members increased only for older adults with a bachelor's degree. Tie-level analyses reveal that such increase is from the activation of health discussion with the existing social network members, but not from the changes in discussion partners. These results suggest that heterogeneous temporal dynamics in social networks may be one mechanism that shapes diverging health trajectories in later life.
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Affiliation(s)
- Won-Tak Joo
- Department of Demography, University of California, Berkeley, 328 Social Sciences Building, Berkeley, CA, 94720, USA.
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Marini CM, Zhaoyang R, Martire LM, Buxton OM. The Social Context of Partnered Older Adults' Insomnia Symptoms. Int J Aging Hum Dev 2022; 97:18-34. [PMID: 36172628 PMCID: PMC10043039 DOI: 10.1177/00914150221128973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study included an examination of social factors that mitigate or exacerbate insomnia symptoms among older adults who are married or living with a partner. We first examined the unique effects of spousal support and strain on insomnia symptoms and then evaluated the degree to which extramarital social factors (e.g., friend support) moderated spousal influences. Data came from Waves 2 and 3 of the National Social Life, Health, and Aging Project. Our sample consisted of 495 participants who were either married or cohabitating with a partner (M age in years = 69.84, SD = 8.08). Spousal strain-but not support-predicted higher insomnia symptoms 5 years later. Spousal influences on sleep, however, were moderated by extramarital factors in nuanced ways. Findings highlight the importance of taking into account older adults' wider social context when examining the ways in which sleep is sensitive to positive and negative aspects of marital quality.
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Affiliation(s)
- Christina M Marini
- Gordon F. Derner School of Psychology, 3479Adelphi University, Garden City, NY, USA
| | - Ruixue Zhaoyang
- The Center for Healthy Aging, 311285The Pennsylvania State University, University Park, PA, USA
| | - Lynn M Martire
- The Center for Healthy Aging, 311285The Pennsylvania State University, University Park, PA, USA.,Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
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14
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Exploring Shared Effects of Multisensory Impairment, Physical Dysfunction, and Cognitive Impairment on Physical Activity: An Observational Study in a National Sample. J Aging Phys Act 2022; 30:572-580. [PMID: 34611055 PMCID: PMC9843725 DOI: 10.1123/japa.2021-0065] [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: 02/25/2021] [Revised: 08/14/2021] [Accepted: 08/23/2021] [Indexed: 01/19/2023]
Abstract
Multisensory, physical, and cognitive dysfunction share age-related physiologic disturbances and may have common health effects. We determined whether the effect of multisensory impairment on physical activity (PA) is explained by physical (timed up and go) or cognitive (Short Portable Mental Status Questionnaire) dysfunction. A National Social Life, Health, and Aging Project participant subset (n = 507) underwent objective sensory testing in 2005-2006 and wrist accelerometry in 2010-2011. We related multisensory impairment to PA using multivariate mixed-effects linear regression and compared the effect magnitude after adjusting for physical then cognitive dysfunction. Worse multisensory impairment predicted lower PA across three scales (Global Sensory Impairment: β = -0.04, 95% confidence interval [-0.07, -0.02]; Total Sensory Burden: β = -0.01, 95% confidence interval [-0.03, -0.003]; and Number of Impaired Senses: β = -0.02, 95% confidence interval [-0.04, -0.004]). Effects were similar after accounting for physical and cognitive dysfunction. Findings suggest that sensory, physical, and cognitive dysfunction have unique mechanisms underlying their PA effects.
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15
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Shi C, Babiker N, Urbanek JK, Grossman RL, Huisingh-Scheetz M, Rzhetsky A. Free-living wrist and hip accelerometry forecast cognitive decline among older adults without dementia over 1- or 5-years in two distinct observational cohorts. NPJ AGING 2022; 8:7. [PMID: 35927250 PMCID: PMC9170733 DOI: 10.1038/s41514-022-00087-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/28/2022] [Indexed: 11/09/2022]
Abstract
The prevalence of major neurocognitive disorders is expected to rise over the next 3 decades as the number of adults ≥65 years old increases. Noninvasive screening capable of flagging individuals most at risk of subsequent cognitive decline could trigger closer monitoring and preventive strategies. In this study, we used free-living accelerometry data to forecast cognitive decline within 1- or 5-years in older adults without dementia using two cohorts. The first cohort, recruited in the south side of Chicago, wore hip accelerometers for 7 continuous days. The second cohort, nationally recruited, wore wrist accelerometers continuously for 72 h. Separate classifier models forecasted 1-year cognitive decline with over 85% accuracy using hip data and forecasted 5-year cognitive decline with nearly 70% accuracy using wrist data, significant improvements compared to demographics and comorbidities alone. The proposed models are readily translatable to clinical practices serving ageing populations.
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Affiliation(s)
- Chengjian Shi
- grid.170205.10000 0004 1936 7822Pritzker School for Molecular Engineering, University of Chicago, Chicago, IL 60637 USA ,grid.170205.10000 0004 1936 7822Department of Medicine, University of Chicago, Chicago, IL 60637 USA
| | - Niser Babiker
- grid.170205.10000 0004 1936 7822Department of Medicine, University of Chicago, Chicago, IL 60637 USA
| | - Jacek K. Urbanek
- grid.21107.350000 0001 2171 9311Department of Medicine, Johns Hopkins University, Baltimore, MD 21287 USA
| | - Robert L. Grossman
- grid.170205.10000 0004 1936 7822Department of Medicine, University of Chicago, Chicago, IL 60637 USA ,grid.170205.10000 0004 1936 7822Department of Computer Science, University of Chicago, Chicago, IL 60637 USA
| | | | - Andrey Rzhetsky
- Department of Medicine, University of Chicago, Chicago, IL, 60637, USA. .,Department of Human Genetics, University of Chicago, Chicago, IL, 60637, USA.
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16
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Witt LJ, Wroblewski KE, Pinto JM, Wang E, McClintock MK, Dale W, White SR, Press VG, Huisingh-Scheetz M. Beyond the Lung: Geriatric Conditions Afflict Community-Dwelling Older Adults With Self-Reported Chronic Obstructive Pulmonary Disease. Front Med (Lausanne) 2022; 9:814606. [PMID: 35237627 PMCID: PMC8884078 DOI: 10.3389/fmed.2022.814606] [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] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/14/2022] [Indexed: 12/27/2022] Open
Abstract
Rationale Chronic obstructive pulmonary disease (COPD) predominantly affects older adults. However, the co-morbid occurrence of geriatric conditions has been understudied. Objective Characterize the prevalence of geriatric conditions among community-dwelling U.S. older adults with self-reported COPD. Methods We conducted a nationally representative, cross-sectional study of 3,005 U.S. community-dwelling older adults (ages 57–85 years) from the National Social Life, Health, and Aging Project (NSHAP). We evaluated the prevalence of select geriatric conditions (multimorbidity, functional disability, impaired physical function, low physical activity, modified frailty assessment, falls, polypharmacy, and urinary incontinence) and psychosocial measures (frequency of socializing, sexual activity in the last year, loneliness, cognitive impairment, and depressive symptoms) among individuals with self-reported COPD as compared to those without. Using multivariate logistic and linear regressions, we investigated the relationships between COPD and these geriatric physical and psychosocial conditions. Main Results Self-reported COPD prevalence was 10.7%, similar to previous epidemiological studies. Individuals with COPD had more multimorbidity [modified Charlson score 2.6 (SD 1.9) vs. 1.6 (SD 1.6)], more functional disability (58.1 vs. 29.6%; adjusted OR 3.1, 95% CI 2.3, 4.3), falls in the last year (28.4 vs. 20.8%; adjusted OR 1.4, 95% CI 1.01, 2.0), impaired physical function (75.8 vs. 56.6%; adjusted OR 2.1, 95% CI 1.1, 3.7), more frequently reported extreme low physical activity (18.7 vs. 8.1%; adjusted OR 2.3, 95% CI 1.5, 3.5) and higher frailty prevalence (16.0 vs. 2.7%; adjusted OR 6.3, 95% CI 3.0,13.0) than those without COPD. They experienced more severe polypharmacy (≥10 medications, 37.5 vs. 16.1%; adjusted OR 2.9, 95% CI 2.0, 4.2). They more frequently reported extreme social disengagement and were lonelier, but the association with social measures was eliminated when relationship status was accounted for, as those with COPD were less frequently partnered. They more frequently endorsed depressive symptoms (32.0 vs. 18.9%, adjusted OR 1.9, 95% CI 1.4, 2.7). There was no noted difference in cognitive impairment between the two populations. Conclusions Geriatric conditions are common among community-dwelling older adults with self-reported COPD. A “beyond the lung” approach to COPD care should center on active management of geriatric conditions, potentially leading to improved COPD management, and quality of life.
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Affiliation(s)
- Leah J Witt
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, United States
| | - Jayant M Pinto
- Department of Surgery, The University of Chicago Medicine, Chicago, IL, United States
| | - Esther Wang
- Pritzker School of Medicine, The University of Chicago, Chicago, IL, United States
| | - Martha K McClintock
- Department of Comparative Human Development, The Institute for Mind and Biology, University of Chicago, Chicago, IL, United States
| | - William Dale
- Department of Supportive Care Medicine, City of Hope, Duarte, CA, United States
| | - Steven R White
- Department of Medicine, The University of Chicago, Chicago, IL, United States
| | - Valerie G Press
- Department of Medicine, The University of Chicago, Chicago, IL, United States
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17
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Adaralegbe AA, Egbuchiem H, Adeoti O, Abbasi K, Ezeani E, Adaralegbe NJF, Babarinde AO, Boms M, Nzeako C, Ayeni O. Do Personality Traits Influence the Association Between Depression and Dementia in Old Age? Gerontol Geriatr Med 2022; 8:23337214211068257. [PMID: 35071694 PMCID: PMC8772013 DOI: 10.1177/23337214211068257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Depression and personality traits are independent predictors of dementia or cognitive impairment. Despite the well-established relationship between these two psychosocial factors and dementia, no research has been documented on how personality traits can influence dementia in older adults exhibiting depressive symptoms. This study explores the influence of personality traits on the association between change in depression and dementia in old age. A population-based longitudinal cohort study involving two waves of data collected 5 years apart, containing 2210 American older adults, from the National Social Life, Health, and Aging Project to explore if personality traits influence how change in depression predicts the development of dementia. We assessed these relationships while adjusting for sociodemographic characteristics. Change in depression increased the likelihood of dementia at T2 by 4.2% (AOR = 1.04, p = 0.019) in the co-variate adjusted model. Personality traits, overall, did not influence how depression predicts the development of dementia. However, agreeableness individually nullified the effect of depression on the development of dementia, whereas extraversion was the only personality trait that significantly predicted dementia. Prosocial behaviors should be promoted in old age as these appear to be protective. In addition, early life education and a strong social support can keep the depression–dementia spectrum at bay in old age.
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Affiliation(s)
| | | | | | - Khuzeman Abbasi
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Esther Ezeani
- Department of Pulmonary Medicine, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | | | | | - Maureen Boms
- School of Public Health Tuscaloosa, The University of Alabama System, Tuscaloosa, AL, USA
| | | | - Olumide Ayeni
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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18
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Fassihi SC, Mathur A, Best MJ, Chen AZ, Gu A, Quan T, Wang KY, Wei C, Campbell JC, Thakkar SC. Neural network prediction of 30-day mortality following primary total hip arthroplasty. J Orthop 2021; 28:91-95. [PMID: 34898926 DOI: 10.1016/j.jor.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/21/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose is to utilize an artificial neural network (ANN) model to determine the most important variables in predicting mortality following total hip arthroplasty (THA). Methods Patients that underwent primary THA were included from a national database. Demographic, preoperative, and intraoperative variables were analyzed based on their contribution to 30-day mortality with the use of an ANN model. Results The five most important factors in predicting mortality following THA were preoperative international normalized ratio, age, body mass index, operative time, and preoperative hematocrit. Conclusion ANN modeling represents a novel approach to determining perioperative factors that predict mortality following THA.
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Affiliation(s)
- Safa C Fassihi
- Department of Orthopedic Surgery, George Washington Hospital, 2300 M St NW, Washington, DC, 20037, USA
| | - Abhay Mathur
- Department of Orthopedic Surgery, George Washington Hospital, 2300 M St NW, Washington, DC, 20037, USA
| | - Matthew J Best
- Johns Hopkins Department of Orthopaedic Surgery, Adult Reconstruction Division, 10700 Charter Drive, Suite 205, Columbia, MD, 21044, USA
| | - Aaron Z Chen
- Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10021, USA
| | - Alex Gu
- Department of Orthopedic Surgery, George Washington Hospital, 2300 M St NW, Washington, DC, 20037, USA
| | - Theodore Quan
- Department of Orthopedic Surgery, George Washington Hospital, 2300 M St NW, Washington, DC, 20037, USA
| | - Kevin Y Wang
- Johns Hopkins Department of Orthopaedic Surgery, Adult Reconstruction Division, 10700 Charter Drive, Suite 205, Columbia, MD, 21044, USA
| | - Chapman Wei
- Department of Orthopedic Surgery, George Washington Hospital, 2300 M St NW, Washington, DC, 20037, USA
| | - Joshua C Campbell
- Department of Orthopedic Surgery, George Washington Hospital, 2300 M St NW, Washington, DC, 20037, USA
| | - Savyasachi C Thakkar
- Johns Hopkins Department of Orthopaedic Surgery, Adult Reconstruction Division, 10700 Charter Drive, Suite 205, Columbia, MD, 21044, USA
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Zhang XM, Tao YH, Zhou XL, Shang XL, Gong XB, Liu YC, Huang YY, Chen G, Yu ZY, Wang JT, Du ZG, Wu GF, Zhang Y, Guo JC, Zhou HG. The role of carbonic anhydrase III and autophagy in type 2 diabetes with cardio-cerebrovascular disease. Metab Brain Dis 2021; 36:2329-2341. [PMID: 34665375 PMCID: PMC8580918 DOI: 10.1007/s11011-021-00839-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/06/2021] [Indexed: 01/10/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases among the elderly people. The T2DM increases the risk of cardio-cerebrovascular disease (CCD), and the main pathological change of the CCD is atherosclerosis (AS). Meanwhile, the carbonic anhydrases (CAs) are involved in the formation and progression of plaques in AS. However, the exact physiological mechanism of carbonic anhydrase III (CAIII) has not been clear yet, and there are also no correlation study between CAIII protein and T2DM with CCD. The 8-week old diabetic mice (db/db-/- mice) and wild-type mice (wt mice) were feed by a normal diet till 32 weeks, and detected the carotid artery vascular opening angle using the method of biomechanics; The changes of cerebral cortex and myocardium were watched by the ultrastructure, and the autophagy were observed by electron microscope; The tissue structure, inflammation and cell injury were observed by Hematoxylin and eosin (HE) staining; The apoptosis of cells were observed by TUNEL staining; The protein levels of CAIII, IL-17, p53 were detected by immunohistochemical and Western Blot, and the Beclin-1, LC3, NF-κB were detected by Western Blot. All statistical analysis is performed using PRISM software. Compared with wt mice, db/db-/- mice' carotid artery open angle increased significantly. Electron microscope results indicated that autophagy in db/db-/- mice cerebral cortex and heart tissue decreased and intracellular organelle ultrastructure were damaged. HE staining indicated that, db/db-/- mice' cerebral cortex and heart tissue stained lighter, inflammatory cells infiltration, cell edema were obvious, myocardial fibers were disorder, and myocardial cells showed different degrees of degeneration. Compared with wt mice, TUNEL staining showed that there was obviously increase in db/db-/- mice cortex and heart tissue cell apoptosis. The results of immunohistochemistry and Western Blot indicated that CAIII, Beclin-1 and LC3II/I expression levels conspicuously decreased in cortex and heart tissue of db/db-/- mice, and the expression level of IL-17, NF-κB and p53 obviously increased. The carotid artery' vascular stiffness was increased and which was probably related with formation of AS in diabetic mice. And the autophagy participated in the occurrence and development of diabetic CCD. CAIII protein might somehow be involved in the regulation of autophagy probably through affecting cell apoptosis and inflammation, but the underlying mechanism remains to be further studied.
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Affiliation(s)
- Xiao-Ming Zhang
- Geriatrics Department and National Clinical Research Center for Aging and Medicine, Huashan Hospital, and Institutes of Brain Science, Fudan University, Shanghai, 200040, China
| | - Ying-Hong Tao
- Department of Medical Examination Center, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xiu-Ling Zhou
- Department of Ultrasonics, Huashan Hospital, Fudan Univesity, Shanghai, 200040, China
| | - Xi-Liang Shang
- Department of Sport Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xiao-Bo Gong
- Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Ying-Chao Liu
- Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China
| | - Yan-Yan Huang
- Geriatrics Department and National Clinical Research Center for Aging and Medicine, Huashan Hospital, and Institutes of Brain Science, Fudan University, Shanghai, 200040, China
| | - Gang Chen
- Geriatrics Department and National Clinical Research Center for Aging and Medicine, Huashan Hospital, and Institutes of Brain Science, Fudan University, Shanghai, 200040, China
| | - Zhong-Yu Yu
- Geriatrics Department and National Clinical Research Center for Aging and Medicine, Huashan Hospital, and Institutes of Brain Science, Fudan University, Shanghai, 200040, China
| | - Jian-Tao Wang
- Geriatrics Department and National Clinical Research Center for Aging and Medicine, Huashan Hospital, and Institutes of Brain Science, Fudan University, Shanghai, 200040, China
| | - Zun-Guo Du
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Guo-Feng Wu
- Department of Emergency Neurology, Guiyang Medical University, Guiyang, 550004, China
| | - Yu Zhang
- Geriatrics Department and National Clinical Research Center for Aging and Medicine, Huashan Hospital, and Institutes of Brain Science, Fudan University, Shanghai, 200040, China.
| | - Jing-Chun Guo
- Geriatrics Department and National Clinical Research Center for Aging and Medicine, Huashan Hospital, and Institutes of Brain Science, Fudan University, Shanghai, 200040, China.
| | - Hou-Guang Zhou
- Geriatrics Department and National Clinical Research Center for Aging and Medicine, Huashan Hospital, and Institutes of Brain Science, Fudan University, Shanghai, 200040, China.
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20
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Todinova S, Krumova S, Bogdanova D, Danailova A, Zlatareva E, Kalaydzhiev N, Langari A, Milanov I, Taneva SG. Red Blood Cells' Thermodynamic Behavior in Neurodegenerative Pathologies and Aging. Biomolecules 2021; 11:biom11101500. [PMID: 34680133 PMCID: PMC8534019 DOI: 10.3390/biom11101500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/17/2021] [Accepted: 10/08/2021] [Indexed: 02/07/2023] Open
Abstract
The main trend of current research in neurodegenerative diseases (NDDs) is directed towards the discovery of novel biomarkers for disease diagnostics and progression. The pathological features of NDDs suggest that diagnostic markers can be found in peripheral fluids and cells. Herein, we investigated the thermodynamic behavior of the peripheral red blood cells (RBCs) derived from patients diagnosed with three common NDDs—Parkinson’s disease (PD), Alzheimer’s disease (AD), and amyotrophic lateral sclerosis (ALS) and compared it with that of healthy individuals, evaluating both fresh and aged RBCs. We established that NDDs can be differentiated from the normal healthy state on the basis of the variation in the thermodynamic parameters of the unfolding of major RBCs proteins—the cytoplasmic hemoglobin (Hb) and the membrane Band 3 (B3) protein. A common feature of NDDs is the higher thermal stability of both Hb and B3 proteins along the RBCs aging, while the calorimetric enthalpy can distinguish PD from ALS and AD. Our data provide insights into the RBCs thermodynamic behavior in two complex and tightly related phenomena—neurodegenerative pathologies and aging, and it suggests that the determined thermodynamic parameters are fingerprints of the altered conformation of Hb and B3 protein and modified RBCs’ aging in the studied NDDs.
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Affiliation(s)
- Svetla Todinova
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev, 1113 Sofia, Bulgaria; (S.T.); (S.K.); (A.D.); (A.L.)
| | - Sashka Krumova
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev, 1113 Sofia, Bulgaria; (S.T.); (S.K.); (A.D.); (A.L.)
| | - Desislava Bogdanova
- Department of Neurology, University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sv. Naum, 1113 Sofia, Bulgaria; (D.B.); (E.Z.); (N.K.); (I.M.)
| | - Avgustina Danailova
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev, 1113 Sofia, Bulgaria; (S.T.); (S.K.); (A.D.); (A.L.)
| | - Elena Zlatareva
- Department of Neurology, University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sv. Naum, 1113 Sofia, Bulgaria; (D.B.); (E.Z.); (N.K.); (I.M.)
| | - Nikolay Kalaydzhiev
- Department of Neurology, University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sv. Naum, 1113 Sofia, Bulgaria; (D.B.); (E.Z.); (N.K.); (I.M.)
| | - Ariana Langari
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev, 1113 Sofia, Bulgaria; (S.T.); (S.K.); (A.D.); (A.L.)
| | - Ivan Milanov
- Department of Neurology, University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sv. Naum, 1113 Sofia, Bulgaria; (D.B.); (E.Z.); (N.K.); (I.M.)
| | - Stefka G. Taneva
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev, 1113 Sofia, Bulgaria; (S.T.); (S.K.); (A.D.); (A.L.)
- Correspondence:
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21
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Wong CK, Mak RY, Kwok TS, Tsang JS, Leung MY, Funabashi M, Macedo LG, Dennett L, Wong AY. Prevalence, Incidence, and Factors Associated With Non-Specific Chronic Low Back Pain in Community-Dwelling Older Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2021; 23:509-534. [PMID: 34450274 DOI: 10.1016/j.jpain.2021.07.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/10/2021] [Accepted: 07/27/2021] [Indexed: 12/21/2022]
Abstract
Chronic low back pain (CLBP) is common among older adults. This systematic review aimed to summarize: (1) the prevalence and incidence of CLBP in older adults, and (2) demographic, psychological, and clinical factors positively/negatively associated with prevalence/incidence of CLBP among older adults. Four databases were searched to identify relevant publications. Ten studies (31,080 older adults) were included after being screened by 5 independent reviewers using predetermined criteria. The methodological quality of these studies was evaluated by standardized tools. The quality of evidence for all factors were appraised by modified GRADE for cohort studies. Twenty-eight and 1 factors were associated with a higher prevalence and a lower 5-year cumulative incidence of CLBP, respectively. No prognostic factor was identified. There was very limited to limited evidence that females, obesity, anxiety, depression, mental disorders, self-expectation of recovery, self-perceived health status, lifestyle (smoking, daily fluoride consumption), previous falls or lower body injury, retirement/disability due to ill health, family history of body pain, comorbidity (knee osteoarthritis, or chronic obstructive pulmonary disease with/without hypertension), weak abdominal muscles, leg pain, leg pain intensity, widespread pain, pain interference on functioning, use of pain medication, occupational exposure (driving for >20 years, or jobs involving bending/twisting for >10 years), disc space narrowing and severe facet osteoarthritis were significantly related to a higher prevalence of CLBP in older adults. However, very limited evidence suggested that intermediate level of leisure-time physical activity was associated with a lower prevalence of CLBP in older adults. Given the aging population and limited information regarding risk factors for CLBP in older adults, future high-quality prospective studies should identify relevant risk factors to help develop proper preventive and treatment strategies. PERSPECTIVE: Despite the high prevalence of non-specific chronic low back pain among older adults, there is only very limited to limited evidence regarding factors associated with a higher prevalence of chronic low back pain in this population. Given the aging population, high-quality prospective studies are warranted to address this gap.
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Affiliation(s)
- Charles Kw Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Rebecca Yw Mak
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Terence Sy Kwok
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Joshua Sh Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Marco Yc Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Martha Funabashi
- Division of Research and Innovation, Canadian Memorial of Chiropractic College, Toronto, Ontario, Canada; Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Luciana G Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Liz Dennett
- Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
| | - Arnold Yl Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
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22
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Huisingh-Scheetz M, Wroblewski K, Waite L, Huang ES, Schumm LP, Hedeker D. Variability in Hourly Activity Levels: Statistical Noise or Insight Into Older Adult Frailty? J Gerontol A Biol Sci Med Sci 2021; 76:1608-1618. [PMID: 33049032 DOI: 10.1093/gerona/glaa262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Frailty is associated with lower mean activity; however, hourly activity is highly variable among older individuals. We aimed to relate frailty to hourly activity variance beyond frailty's association with mean activity. METHOD Using the 2010-2011 National Social Life, Health and Aging Project wrist accelerometry data (n = 647), we employed a mixed-effects location scale model to simultaneously determine whether an adapted phenotypic frailty scale (0-4) was associated with the log10-mean hourly counts per minute (cpm) and between-and within-subject hourly activity variability, adjusting for demographics, health characteristics, season, day-of-week, and time-of-day. We tested the significance of a Frailty × Time-of-day interaction and whether adjusting for sleep time altered relationships. RESULTS Each additional frailty point was associated with a 7.6% (10-0.0343, β = -0.0343; 95% CI: -0.05, -0.02) lower mean hourly cpm in the morning, mid-day, and late afternoon but not evening. Each frailty point was also associated with a 24.5% (e0.219, β = 0.219; 95% CI: 0.09, 0.34) greater between-subject hourly activity variance across the day; a 7% (e0.07, β = 0.07; 95% CI: 0.01¸ 0.13), 6% (e0.06, β = 0.06; 95% CI: 0, 0.12), and 10% (e0.091, β = 0.091; 95% CI: 0.03, 0.15) greater within-subject hourly activity variance in the morning, mid-day, and late afternoon, respectively; and a 6% (e-0.06, β = -0.06; 95% CI: -0.12, -0.003) lower within-subject hourly activity variance in the evening. Adjusting for sleep time did not alter results. CONCLUSIONS Frail adults have more variable hourly activity levels than robust adults, a potential novel marker of vulnerability. These findings suggest a need for more precise activity assessment in older adults.
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Affiliation(s)
| | | | - Linda Waite
- Department of Sociology and NORC, University of Chicago, Illinois
| | - Elbert S Huang
- Section of General Internal Medicine, University of Chicago, Illinois
| | - L Philip Schumm
- Department of Public Health Sciences, University of Chicago, Illinois
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Illinois
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Educational level as a protective factor against the influence of depressive symptoms on cognition in older adults: implications for functional independence during a 10-year follow-up. Int Psychogeriatr 2021; 33:813-825. [PMID: 33762060 DOI: 10.1017/s1041610221000272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To examine whether the educational level moderates the relationship between baseline depressive symptoms and cognitive functioning at 5- and 10-year follow-ups in older adults, considering the association between cognitive functioning and difficulty with activities of daily living (ADL). DESIGN Using a prospective design, a path analysis was performed. SETTING In-home, face-to-face interviews and self-administered questionnaires, within the National Social Life, Health, and Aging Project. PARTICIPANTS In total, 1,461 participants (mean age = 66.62) were followed up from Wave 1 (baseline) to Wave 2 (at 5 years) and Wave 3 (at 10 years). MEASUREMENTS Depressive symptoms were assessed at baseline. Cognitive functioning and difficulty with ADL were assessed at baseline and at 5 and 10 years. RESULTS Educational level moderates the relationship between depressive symptoms and cognitive functioning at 5 years (β = 0.07, SE = 0.03, p = 0.04, Cohen's f2 = 0.02), being depressive symptoms related to poor cognitive functioning only at low educational levels. Cognitive functioning predicts difficulty with ADL at 5 and 10 years (β = -0.08, SE = 0.03, p = 0.008, Cohen's f2 = 0.01; β = -0.09, SE = 0.03, p = 0.006, Cohen's f2 = 0.02). The proposed model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, 90% CI 0.0001-0.03, SRMR = 0.004, and χ2(8) = 7.16, p = 0.52). CONCLUSIONS Cognitive reserve may act as a protective factor against the effect of depressive symptoms on cognition in older adults, which, in turn, is relevant to their functional independence.
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Siegel JK, Yuan X, Wroblewski KE, McClintock MK, Pinto JM. Sleep-Disordered Breathing Is Associated With Impaired Odor Identification in Older U.S. Adults. J Gerontol A Biol Sci Med Sci 2021; 76:528-533. [PMID: 33313784 DOI: 10.1093/gerona/glaa276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sleep-disordered breathing (SDB) is a common, underdiagnosed condition in older adults with major health consequences, including disrupted central nervous system functioning. Whether SDB may affect sensory function is unclear. We sought to address this question by comparing 2 forms of olfactory testing which measure peripheral and central olfactory processing. METHODS We assessed SDB (survey-reported snoring frequency, nighttime apneic events, or diagnosis of sleep apnea) in the National Social Life, Health, and Aging Project, a nationally representative sample of older U.S. adults. Odor sensitivity (peripheral) and odor identification (central) were assessed with validated instruments. Logistic regression was used to test the relationship between SDB and olfaction, accounting for relevant covariates, including demographics, cognition, and comorbidity. RESULTS Twenty-nine percent of older U.S. adults reported symptoms of SDB (apneic events or nightly snoring). Of these, only 32% had been diagnosed with sleep apnea. Older adults with SDB (those who reported symptoms or have been diagnosed with sleep apnea) were significantly more likely to have impaired odor identification (odds ratio 2.13, 95% confidence interval 1.19-3.83, p = .012) in analyses that accounted for age, gender, race/ethnicity, education, cognition, comorbidities (including depression), and body mass index. Presence of SDB was not associated with impaired odor sensitivity (odds ratio 1.03, 95% confidence interval 0.75-1.43, p = .84). CONCLUSION SDB is highly prevalent but underdiagnosed in older U.S. adults and is associated with impaired odor identification but not odor sensitivity. These data support the concept that SDB affects pathways in the central nervous system which involve chemosensory processing.
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Affiliation(s)
- Jesse K Siegel
- Pritzker School of Medicine, The University of Chicago, Illinois
| | - Xiandao Yuan
- Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, China
| | | | - Martha K McClintock
- Department of Psychology and The Institute for Mind and Biology, The University of Chicago, Illinois
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine, Illinois
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González Silva Y, Abad Manteca L, Fernández Gómez MJ, Martín Vallejo J, De la Red Gallego H, Pérez Castrillón JL. Utilidad del índice de comorbilidad de Charlson en personas ancianas. Concordancia con otros índices de comorbilidad. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2021. [DOI: 10.55783/rcmf.140205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objetivo. El objetivo principal de nuestro estudio fue evaluar la utilidad actual del índice de comorbilidad de Charlson (CCI) para predecir la mortalidad en personas mayores y la concordancia entre varios índices.
Diseño. Estudio observacional, cohorte concurrente.
Emplazamiento. Servicio de Medicina Interna de un hospital terciario, pacientes ambulatorios de un centro de salud y residentes de cuatro hogares de ancianos.
Participantes. 375 individuos ≥ 65 años, con supervivencia esperada ≥ 6 meses, sin deterioro cognitivo.
Mediciones principales. Se realizaron tres índices: CCI, el índice geriátrico de comorbilidad (GIC) y el índice de Kaplan-Feinstein (KF). A los 12 meses, se registró mortalidad. Los datos se analizaron con IBM SPSS Statistics® versión 23.0.
Resultados. Edad media: 81,4 años. El CCI mostró comorbilidad baja-media en el grupo ambulatorio de 65-75 años (43 [75,4%]); moderada-alta más común en hospitalizados (19 [61,3%]) y en hogares de ancianos (5 [62,5%]). Al año fallecieron 59 (16,1%) individuos: con CCI: 10 (6,4%) comorbilidad baja-media y 49 (23,3%) moderada-alta, odds ratio (OR) 3,63 (intervalo de confianza [IC] 95% 1,76-7,51); con KF: 27 (13,3%) baja-media y 32 (19,5%) moderada-alta, OR 1,38 (IC 95% 0,78-2,44), y con GIC: 45 (14,1%) baja-media y 14 (29,2%) moderada-alta, OR 2,47 (IC 95% 1,21-5,06). La concordancia entre CCI-KF fue: 65-75 años: K = 0,62, 76-85 años: K = 0,396, y ≥ 86 años: K = 0,255. La concordancia entre CCI-GIC: 65-75 años: K = 0,202, 76-85 años: K = 0,069, y ≥ 86 años: K = 0,118.
Conclusión. El CCI es el mejor predictor de mortalidad después de 1 año de seguimiento. Concordancia considerable entre CCI y KF en los individuos de 65-75 años, en el resto de las franjas etarias la correlación con GIC fue insignificante.
Palabras clave: comorbilidad, mortalidad, anciano frágil.
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Affiliation(s)
| | - Laura Abad Manteca
- Servicio de Medicina Interna. Hospital Universitario Río Hortega. Valladolid (España)
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Yang EZ, Kotwal AA, Lisha NE, Wong JS, Huang AJ. Formal and informal social participation and elder mistreatment in a national sample of older adults. J Am Geriatr Soc 2021; 69:2579-2590. [PMID: 34105769 DOI: 10.1111/jgs.17282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES Older adults' susceptibility to mistreatment may be affected by their participation in social activities, but little is known about relationships between social participation and elder mistreatment. DESIGN Cross-sectional analysis. SETTING/PARTICIPANTS National probability sample of older community-dwelling U.S. adults interviewed in 2015-2016, including 1268 women and 973 men (mean age 75 years and 76 years, respectively; 82% non-Hispanic white). MEASUREMENTS Frequency of participation in formal activities (organized meetings, religious services, and volunteering) and informal social activities (visiting friends and family) was assessed by questionnaire. Elder mistreatment included emotional (four items), physical (two items), and financial mistreatment (two items) since age 60. Multivariable logistic regression examined associations between each type of social participation and elder mistreatment among men and women, adjusting for age, race/ethnicity, education, and comorbidity. RESULTS Forty percent of women and 22% of men reported at least one form of mistreatment (emotional, physical, or financial). Women reporting at least monthly engagement in formal social activities were more likely to report emotional mistreatment (adjusted odds ratio (AOR) 1.59, 95% confidence interval (CI) 1.09-2.33). Among men, monthly organized meeting attendance was associated with increased odds of emotional mistreatment (AOR 1.34, 95% CI 1.01-1.93). Weekly informal socializing was inversely associated with emotional mistreatment (AOR 0.59, 95% CI 0.44-0.78) and financial mistreatment (AOR 0.59, 95% CI 0.42-0.85) among women. CONCLUSION In this national cohort, older adults who were frequently engaged in formal social activities reported similar or higher levels of mistreatment than those with less frequent organized social participation. Older women with regular informal contact with family or friends were less likely to report some kinds of mistreatment. Strategies for detecting and mitigating elder mistreatment should consider differences in patterns of formal and informal social participation and their potential contribution to mistreatment risk.
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Affiliation(s)
- Emmy Z Yang
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Nadra E Lisha
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jaclyn S Wong
- Department of Sociology, University of South Carolina, Columbia, South Carolina, USA
| | - Alison J Huang
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Xu L, Liu J, Wroblewski KE, McClintock MK, Pinto JM. Odor Sensitivity Versus Odor Identification in Older US Adults: Associations With Cognition, Age, Gender, and Race. Chem Senses 2021; 45:321-330. [PMID: 32406505 DOI: 10.1093/chemse/bjaa018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The ability to identify odors predicts morbidity, mortality, and quality of life. It varies by age, gender, and race and is used in the vast majority of survey and clinical literature. However, odor identification relies heavily on cognition. Other facets of olfaction, such as odor sensitivity, have a smaller cognitive component. Whether odor sensitivity also varies by these factors has not been definitively answered. We analyzed data from the National Social Life, Health, and Aging Project, a nationally representative study of older US adults (n = 2081). Odor identification was measured using 5 validated odors presented with Sniffin' Stick pens as was odor sensitivity in a 6-dilution n-butanol constant stimuli detection test. Multivariate ordinal logistic regression modeled relationships between olfaction and age, gender, race, cognition, education, socioeconomic status, social network characteristics, and physical and mental health. Odor sensitivity was worse in older adults (P < 0.01), without gender (P = 0.56) or race (P = 0.79) differences. Odor identification was also worse in older adults, particularly men (both P ≤ 0.01), without differences by race. Decreased cognitive function was associated with worse odor identification (P ≤ 0.01) but this relationship was weaker for odor sensitivity (P = 0.02) in analyses that adjusted for other covariates. Odor sensitivity was less strongly correlated with cognitive ability than odor identification, confirming that it may be a more specific measure of peripheral olfactory processing. Investigators interested in associations between olfaction and health should consider both odor sensitivity and identification when attempting to understand underlying neurosensory mechanisms.
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Affiliation(s)
- Lucy Xu
- Pritzker School of Medicine, The University of Chicago, Chicago, USA
| | - Jia Liu
- Beijing An Zhen Hospital, Capital Medical University, An Zhen Hospital, Beijing, China
| | | | - Martha K McClintock
- Department of Comparative Human Development, The University of Chicago, Chicago, USA.,Center on Demography and Aging, The University of Chicago, Chicago, USA.,Institute for Mind and Biology, The University of Chicago, Institute for Mind and Biology, Chicago, USA
| | - Jayant M Pinto
- Section of Otolaryngology, Head and Neck Surgery, The University of Chicago, Chicago, USA.,Institute for Population and Precision Health, The University of Chicago, Chicago, USA
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Leung V, Wroblewski K, Schumm LP, Huisingh-Scheetz M, Huang ES. Re-examining the Classification of Older Adults with Diabetes by Comorbidities and Relationship with Frailty, Disability, and 5-year Mortality. J Gerontol A Biol Sci Med Sci 2021; 76:2071-2079. [PMID: 34003280 DOI: 10.1093/gerona/glab141] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Limited research has been conducted to risk stratify older adults with diabetes. Our objective was to re-examine the 2005-06 classification systems in participants who are now five years older. METHODS We examined a subsample of 884 community-residing older adults with the diagnosis of diabetes from the National Social Life, Health, and Aging Project (NSHAP). The primary objective was to utilize a latent class analysis (LCA) to fit a model to 11 comorbidities, comparing the 2010-11 LCA model to that of 2005-6. The secondary objective was to evaluate the association of the identified classes with frailty, disability, and five-year mortality. RESULTS Both 2005-6 LCA and the 2010-11 LCA model fit three similar comorbidity profiles: Class 1 with the lowest rates of nearly all comorbidities, Class 2 had highest rates of obesity, hypertension, arthritis, and incontinence, and Class 3 had the higher rates of myocardial infarctions, congestive heart failure, and stroke. When compared to the healthier Class 1 (class probability=0.67), participants with a comorbidity profile with more prevalent cardiovascular conditions (Class 3; 0.09) were at higher risk of frailty and mortality, but not disability; whereas participants with a comorbidity profile with more prevalent geriatric syndrome conditions (Class 2; 0.24) were at higher risk of frailty and disability, but not mortality. CONCLUSIONS We reconfirmed three latent-classes with distinct comorbidity profiles among older adults with diabetes. However, the complex relationships between comorbidity classes with frailty, disability, and mortality will likely require revision of the current rationale for stratified goal setting and treatment selection.
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Affiliation(s)
- Vania Leung
- Department of Academic Internal Medicine and Geriatrics, University of Illinois at Chicago
| | | | | | | | - Elbert S Huang
- Section of General Internal Medicine, University of Chicago
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Hsieh N, Liu H, Lai WH. Elevated Risk of Cognitive Impairment Among Older Sexual Minorities: Do Health Conditions, Health Behaviors, and Social Connections Matter? THE GERONTOLOGIST 2021; 61:352-362. [PMID: 32951038 PMCID: PMC8023357 DOI: 10.1093/geront/gnaa136] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Little research has examined cognitive health disparities between sexual minority and heterosexual populations. Further, most extant studies rely on subjective measures of cognitive functioning and non-probability samples. This study uses a performance-based cognitive screening tool and a nationally representative sample of older Americans to examine the disparity in cognitive impairment by sexual orientation and the potential mechanisms producing this disparity. RESEARCH DESIGN AND METHODS Using data from the 2015-2016 National Social Life, Health, and Aging Project (N = 3,567), we analyzed respondents' scores on the survey-adapted Montreal Cognitive Assessment. We estimated ordinal logit regressions to examine the relationship between sexual orientation and cognitive impairment and used the Karlson-Holm-Breen method to assess how mental and physical conditions, health behaviors, and social connections mediate this relationship. RESULTS The prevalence of cognitive impairment is significantly higher among sexual minority older adults than among heterosexual older adults when sociodemographic factors are adjusted for. Depressive symptoms explain some of this prevalence gap. Although anxiety symptoms, physical comorbidity, health behaviors, and social connections may contribute to cognitive impairment, they do not explain the cognitive disparity by sexual orientation. DISCUSSION AND IMPLICATIONS The findings indicate that depressive symptoms are an important link between minority sexual orientation and cognitive impairment and highlight the importance of studying other potential mechanisms that we could not explore in this study. Future research should further investigate how minority stress processes may unfold to accelerate cognitive decline among sexual minorities over the life course.
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Affiliation(s)
- Ning Hsieh
- Department of Sociology, Michigan State
University, East Lansing
| | - Hui Liu
- Department of Sociology, Michigan State
University, East Lansing
| | - Wen-Hua Lai
- Department of Sociology, Michigan State
University, East Lansing
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30
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Coppa D, Winchester SB, McAlvin E, Roberts MB, Maestri X. Use of social determinants of health codes in home-based primary care. J Am Assoc Nurse Pract 2021; 34:42-49. [PMID: 33731551 DOI: 10.1097/jxx.0000000000000586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 01/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Affordable Care Act created funding for nurse practitioner education programs to transform the primary health care workforce through student awareness of how social, political, economic, and environmental factors influence individual and population health. Funding established Academic Clinical Partnerships (ACPs) that created value-based health care models, which improved patient outcomes and decreased hospital and emergency department admissions and health care costs. The ACP established a home-based primary health care (HBPC) program to deliver primary care and collect patient data. PURPOSE The purposes were to describe the incidence of chronic conditions for HBPC patients and determine associations between chronic conditions and presence of social determinants of health (SDoH). METHODOLOGY Nurse practitioner students were assigned to HBPC clinical placements. A convenience sample of 102 high-risk, homebound patients was identified. Nurse practitioners and students recorded deidentified patient data, including ICD-10-CM codes into a Health Insurance Portability and Accountability Act compliant platform. Secondary analysis of patient records assessed for SDoH through Z codes. RESULTS Patients had high incidences of hypertension, diabetes, pulmonary disease, heart disease, chronic pain, mood, and substance abuse disorders. Secondary analysis revealed that 92% of patients had indications for the use of Z codes, but these were not recorded. CONCLUSIONS Common Z codes were personal risk factors, housing/economic circumstances, care provider dependency, lifestyle, and family support. IMPLICATIONS FOR PRACTICE By coding for SDoH, providers and agencies can realize higher reimbursement rates in HBPC settings. Nurse practitioners can use this information to provide better treatment recommendations, more accurate diagnoses, and referrals to enhance primary care services to a patient population negatively affected by SDoH.
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Affiliation(s)
- Denise Coppa
- College of Nursing, University of Rhode Island, Providence, Rhode Island
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31
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Olfaction Is Associated With Sexual Motivation and Satisfaction in Older Men and Women. J Sex Med 2021; 18:295-302. [DOI: 10.1016/j.jsxm.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/10/2020] [Accepted: 12/02/2020] [Indexed: 01/17/2023]
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Factors predicting the severity of acute pancreatitis in elderly patients. Aging Clin Exp Res 2021; 33:183-192. [PMID: 32185694 DOI: 10.1007/s40520-020-01523-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 02/26/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) are associated with organ failure (OF), which can be lethal. AIMS This study determined the factors that predict the severity of AP at admission in elderly patients. METHODS In this retrospective study, the data from elderly patients (> 60 years of age) admitted within 72 h of onset of symptoms without OF were collected. These data at admission were analyzed and correlated with the severity of AP. To identify the factors associated with more serious AP (i.e. MSAP and SAP), patients were divided into mild acute pancreatitis (MAP) and MSAP + SAP groups. RESULTS A total of 198 patients [MAP group (n = 135) and MSAP + SAP group (n = 63)] were included. Biliary disease was the most common etiology. Respiratory failure was the most common OF. Logistic regression analyses indicated that idiopathic etiology (odds ratio [OR]: 3.029, 95% confidence interval [CI]: 1.017-9.022, p = 0.047), pre-existing pulmonary disease (OR: 7.104, CI 1.750-28.84, p = 0.006), increased hematocrit level (OR: 3.717, 95%CI 1.372-10.070, p = 0.010), serum calcium (OR: 0.023, 95%CI 0.001-0.371, p = 0.008), serum glucose (OR: 1.157, 95%CI 1.031-1.299, p = 0.013), arterial partial pressure of oxygen (PaO2) (OR: 0.914, 95%CI 0.874-0.956, p < 0.001), and pleural effusion (OR: 4.979, 95%CI 1.863-13.303, p = 0.001) were independent predictors of more serious AP. CONCLUSION This study found that idiopathic etiology, pre-existing pulmonary diseases, increased hematocrit level or pleural effusion, higher serum glucose, and lower serum calcium or PaO2 at the time of admission independently correlated with more serious AP in the elderly patients.
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Guida JL, Holt CL, Dallal CM, He X, Gold R, Liu H. Social Relationships and Functional Impairment in Aging Cancer Survivors: A Longitudinal Social Network Study. THE GERONTOLOGIST 2020; 60:607-616. [PMID: 31050729 DOI: 10.1093/geront/gnz051] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 04/09/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The intersection of cancer, treatment, and aging accelerates functional decline. Social networks, through the provision of social support and resources, may slow the progression of functional deterioration. Socioemotional selectivity theory posits that aging and major life events, like cancer, cause an intentional social network pruning to procure and maintain emotionally fulfilling bonds, while shedding weaker, less supportive relationships. However, it is relatively unknown if such network changes impact functional impairment in cancer survivors. This study examined the relationships between changes in the egocentric social network and functional impairment in older adult cancer survivors and a similarly aged group without cancer (older adults). RESEARCH DESIGN AND METHODS Data were analyzed from 1,481 community dwelling older adults (n = 201 cancer survivors) aged 57-85 years, from Waves 1 and 2 (2005-2006 and 2010-2011) of the National Social Life, Health and Aging Project. Associations were analyzed with multiple logistic regression. RESULTS Cancer survivors and older adults reported similar levels of functional impairment and social network change. Adding 2 new relationships exhibited protective effects against functional impairment, irrespective of cancer status (odds ratio [OR]: 0.64, 95% confidence interval [CI]: 0.41-0.99). Declines in frequent contact were associated with higher odds of functional impairment among cancer survivors (OR: 1.92, 95% CI: 1.15-3.20). Social network components were not significantly associated with functional impairment in older adults. DISCUSSION AND IMPLICATIONS Adding new relationships may reduce disability in older adults and increasing network contact may help cancer survivors remain independent. Social network interventions may improve quality of life for older adults.
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Affiliation(s)
- Jennifer L Guida
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Populations Sciences, National Cancer Institute, Bethesda, Maryland
| | - Cheryl L Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park
| | - Cher M Dallal
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park
| | - Xin He
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park
| | - Robert Gold
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park
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Pagano G, Pallardó FV, Lyakhovich A, Tiano L, Fittipaldi MR, Toscanesi M, Trifuoggi M. Aging-Related Disorders and Mitochondrial Dysfunction: A Critical Review for Prospect Mitoprotective Strategies Based on Mitochondrial Nutrient Mixtures. Int J Mol Sci 2020; 21:ijms21197060. [PMID: 32992778 PMCID: PMC7582285 DOI: 10.3390/ijms21197060] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/20/2020] [Accepted: 09/22/2020] [Indexed: 12/16/2022] Open
Abstract
A number of aging-related disorders (ARD) have been related to oxidative stress (OS) and mitochondrial dysfunction (MDF) in a well-established body of literature. Most studies focused on cardiovascular disorders (CVD), type 2 diabetes (T2D), and neurodegenerative disorders. Counteracting OS and MDF has been envisaged to improve the clinical management of ARD, and major roles have been assigned to three mitochondrial cofactors, also termed mitochondrial nutrients (MNs), i.e., α-lipoic acid (ALA), Coenzyme Q10 (CoQ10), and carnitine (CARN). These cofactors exert essential–and distinct—roles in mitochondrial machineries, along with strong antioxidant properties. Clinical trials have mostly relied on the use of only one MN to ARD-affected patients as, e.g., in the case of CoQ10 in CVD, or of ALA in T2D, possibly with the addition of other antioxidants. Only a few clinical and pre-clinical studies reported on the administration of two MNs, with beneficial outcomes, while no available studies reported on the combined administration of three MNs. Based on the literature also from pre-clinical studies, the present review is to recommend the design of clinical trials based on combinations of the three MNs.
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Affiliation(s)
- Giovanni Pagano
- Department of Chemical Sciences, Federico II Naples University, I-80126 Naples, Italy; (M.T.); (M.T.)
- Correspondence:
| | - Federico V. Pallardó
- Department of Physiology, Faculty of Medicine and Dentistry, University of Valencia-INCLIVA, CIBERER, E-46010 Valencia, Spain;
| | - Alex Lyakhovich
- Vall d’Hebron Institut de Recerca, E-08035 Barcelona, Catalunya, Spain;
- Institute of Molecular Biology and Biophysics of the “Federal Research Center of Fundamental and Translational Medicine”, Novosibirsk 630117, Russia
| | - Luca Tiano
- Department of Life and Environmental Sciences, Polytechnical University of Marche, I-60100 Ancona, Italy;
| | - Maria Rosa Fittipaldi
- Internal Medicine Unit, San Francesco d’Assisi Hospital, I-84020 Oliveto Citra (SA), Italy;
| | - Maria Toscanesi
- Department of Chemical Sciences, Federico II Naples University, I-80126 Naples, Italy; (M.T.); (M.T.)
| | - Marco Trifuoggi
- Department of Chemical Sciences, Federico II Naples University, I-80126 Naples, Italy; (M.T.); (M.T.)
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Cohen AB, Costello DM, OʼLeary JR, Fried TR. Older Adults without Desired Surrogates in a Nationally Representative Sample. J Am Geriatr Soc 2020; 69:114-121. [PMID: 32898285 DOI: 10.1111/jgs.16813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES Little is known about older adults who have intact capacity but do not have a desired surrogate to make decisions if their capacity becomes impaired. DESIGN Cross-sectional study of a nationally representative sample. SETTING National Social Life, Health, and Aging Project (NSHAP), 2005-2006. PARTICIPANTS Community-dwelling older adults without known cognitive impairment, aged 57 to 85, interviewed as part of NSHAP (n = 2,767). MEASUREMENTS We examined demographic, medical, and social connectedness characteristics associated with answering "no" to this question: "Do you have someone who you would like to make medical decisions for you if you were unable, as for example if you were seriously injured or very sick?" Because many states permit nuclear family to make decisions for persons with no legally appointed health care agent, we used logistic regression to identify factors associated with individuals who were ill suited to this paradigm in the sense that they had nuclear family but did not have a desired surrogate. RESULTS Among NSHAP respondents, 7.5% (95% confidence interval = 6.4-8.7) did not have a desired surrogate. Nearly 90% of respondents without desired surrogates had nuclear family. Compared with respondents with desired surrogates, those without desired surrogates had lower indicators of social connectedness. On average, however, they had four confidants, approximately 70% socialized at least monthly, and more than 90% could discuss their health with a confidant. Among respondents who had nuclear family, few characteristics distinguished those with and without desired surrogates. CONCLUSION Nearly 8% of older adults did not have a desired surrogate. Most had nuclear family and were not socially disconnected. Older adults should be asked explicitly about a desired surrogate, and strategies are needed to identify surrogates for those who do not have family or would not choose family to make decisions for them.
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Affiliation(s)
- Andrew B Cohen
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Health System, West Haven, Connecticut, USA
| | - Darcé M Costello
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - John R OʼLeary
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Terri R Fried
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Health System, West Haven, Connecticut, USA
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Patel T, Ivo J, Faisal S, McDougall A, Carducci J, Pritchard S, Chang F. A Prospective Study of Usability and Workload of Electronic Medication Adherence Products by Older Adults, Caregivers, and Health Care Providers. J Med Internet Res 2020; 22:e18073. [PMID: 32348292 PMCID: PMC7298635 DOI: 10.2196/18073] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 12/23/2022] Open
Abstract
Background A decreased capacity to self-manage medications results in nonadherence, medication errors, and drug-related problems in older adults. Previous research identified 80 electronic medication adherence products available to assist patients with self-management of medications. Unfortunately, the usability and workload of these products are unknown. Objective This study aimed to examine the usability and workload of a sample of electronic medication adherence products. Methods In a prospective, mixed methods study, a sample of older adults, health care professionals, and caregivers tested the usability and workload of 21 electronic medication adherence products. Each participant tested 5 products, one at a time, after which they completed the system usability scale (SUS) and NASA-task load index (NASA-TLX), instruments that measure the usability and workload involved in using a product. Higher SUS scores indicate more user-friendliness, whereas lower NASA-TLX raw scores indicate less workload when using a product. Results Electronic medication adherence products required a mean of 12.7 steps (range 5-20) for the appropriate use and took, on average, 15.19 min to complete the setup tasks (range 1-56). Participants were able to complete all steps without assistance 55.3% of the time (103 out of the 186 tests were completed by 39 participants; range 0%-100%). The mean SUS and NASA-TLX raw scores were 52.8 (SD 28.7; range 0-100) and 50.0 (SD 25.7; range 4.2-99.2), respectively, revealing significant variability among the electronic medication adherence products. The most user-friendly products were found to be TimerCap travel size (mean 78.67, SD 15.57; P=.03) and eNNOVEA Weekly Planner with Advanced Auto Reminder (mean 78.13, SD 14.13; P=.049) as compared with MedReady 1700 automated medication dispenser (mean 28.63, SD 21.24). Similarly, MedReady (72.92, SD 18.69) was found to be significantly more work intensive when compared with TimerCap (29.35, SD 20.35; P=.03), e-pill MedGlider home medication management system (28.43, SD 20.80; P=.02), and eNNOVEA (28.65, SD 14.97; P=.03). The e-pill MedTime Station automatic pill dispenser with tipper (71.77, SD 21.98) had significantly more workload than TimerCap (P=.04), MedGlider (P=.03), and eNNOVEA (P=.04). Conclusions This study demonstrated that variability exists in the usability and workload of different electronic medication adherence products among older adults, caregivers, and clinicians. With few studies having investigated the usability and workload of electronic medication adherence products, no benchmarks exist to compare the usability and workload of these products. However, our study highlights the need to assess the usability and workload of different products marketed to assist with medication taking and provides guidance to clinicians regarding electronic medication adherence product recommendations for their patients. Future development of electronic medication adherence products should ensure that the target populations of patients are able to use these products adequately to improve medication management.
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Affiliation(s)
- Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada.,Centre for Family Medicine Family Health Team, Kitchener, ON, Canada.,Department of Family Medicine, DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.,Schlegel-University of Waterloo Research Institute of Aging, University of Waterloo, Waterloo, ON, Canada
| | - Jessica Ivo
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
| | - Sadaf Faisal
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
| | - Aidan McDougall
- Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
| | - Jillian Carducci
- Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
| | - Sarah Pritchard
- Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
| | - Feng Chang
- School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
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Darnell EP, Wroblewski KE, Pagel KL, Kern DW, McClintock MK, Pinto JM. IL-1Rahigh-IL-4low-IL-13low: A Novel Plasma Cytokine Signature Associated with Olfactory Dysfunction in Older US Adults. Chem Senses 2020; 45:407-414. [PMID: 32369568 PMCID: PMC7320218 DOI: 10.1093/chemse/bjaa029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inflammation has been implicated in physical frailty, but its role in sensory impairment is unclear. Given that olfactory impairment predicts dementia and mortality, determining the role of the immune system in olfactory dysfunction would provide insights mechanisms of neurosensory decline. We analyzed data from the National Social Life, Health and Aging Project, a representative sample of home-dwelling older US adults. Plasma levels of 18 cytokines were measured using standard protocols (Luminex xMAP). Olfactory function was assessed with validated tools (n-butanol sensitivity and odor identification, each via Sniffin' Sticks). We tested the association between cytokine profiles and olfactory function using multivariate ordinal logistic regression, adjusting for age, gender, race/ethnicity, education level, cognitive function, smoking status, and comorbidity. Older adults with the IL-1Rahigh-IL-4low-IL-13low cytokine profile had worse n-butanol odor sensitivity (odds ratio [OR] = 1.61, 95% confidence interval [CI] 1.19-2.17) and worse odor identification (OR = 1.42, 95% CI 1.11-1.80). Proinflammatory, Th1, or Th2 cytokine profiles were not associated with olfactory function. Moreover, accounting for physical frailty did not alter the main findings. In conclusion, we identified a plasma cytokine signature-IL-1Rahigh-IL-4low-IL-13low-that is associated with olfactory dysfunction in older US adults. These data implicate systemic inflammation in age-related olfactory dysfunction and support a role for immune mechanisms in this process, a concept that warrants additional scrutiny.
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Affiliation(s)
- Eli P Darnell
- Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Kristina L Pagel
- Department of Comparative Human Development, The University of Chicago, Chicago, IL, USA
- Center on Demography and Aging, The University of Chicago, Chicago, IL, USA
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, USA
| | - David W Kern
- Department of Comparative Human Development, The University of Chicago, Chicago, IL, USA
| | - Martha K McClintock
- Department of Comparative Human Development, The University of Chicago, Chicago, IL, USA
- Center on Demography and Aging, The University of Chicago, Chicago, IL, USA
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, USA
| | - Jayant M Pinto
- Center on Demography and Aging, The University of Chicago, Chicago, IL, USA
- Section of Otolaryngology—Head and Neck Surgery, Department of Surgery, The University of Chicago, Chicago, IL, USA
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38
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Koll TT, Semin JN, Brodsky R, Keehn D, Fisher AL, High R, Beadle JN. Health-related and sociodemographic factors associated with physical frailty among older cancer survivors. J Geriatr Oncol 2020; 12:96-101. [PMID: 32451313 DOI: 10.1016/j.jgo.2020.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 03/17/2020] [Accepted: 04/26/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The purpose of this study was to examine factors associated with frailty in older cancer survivors. MATERIALS AND METHODS This is a cross-sectional study using data from the National Social Health and Aging Project (NSHAP) Wave 2, and includes an in-home, nationally representative sample of community-dwelling adults ≥50 years and older from the United States. Frailty score was computed for each individual using a modified 4-point scale based on the phenotypic frailty. Ordinal logistic regression was used to characterize the association between health-related, sociodemographic factors and frailty. RESULTS Among the 3377 participants, 461 were cancer survivors (answered "yes" to "ever have cancer other than skin cancer"). A final sample of 394 cancer survivors were included: 59 participants (16.1%) were frail, 219 participants were pre-frail (59.8%), and 88 participants were non-frail (24.0%). The univariate analyses showed increasing age (OR 1.48; CI 1.29-1.72; p-value <.001), comorbidities (OR 1.43; CI 1.25-1.64; p-value <.001), depression (OR 1.27; CI 1.19-1.35; p-value <.001) and low mobility (OR 1.55; CI 1.37-1.78; p-value <.001) were associated with frailty. Participants with high self-rated (good/very good/ excellent) physical health (OR 0.18; CI 0.11-0.30; p < .001) and mental health (OR 0.27; CI 0.15-0.50; p < .001) were less likely to be frail. In a multivariate model, frailty was associated with age, self-rated physical health, depression, ability to perform activities of daily living, and mobility (p < .05). CONCLUSION The findings highlight the importance of incorporating geriatric assessment into cancer survivorship to prevent and delay the progression of frailty.
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Affiliation(s)
- Thuy T Koll
- Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America.
| | - Jessica N Semin
- Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Rachel Brodsky
- Department of Gerontology, University of Nebraska Omaha, Omaha, NE, United States of America
| | - Daina Keehn
- Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Alfred L Fisher
- Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Robin High
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Janelle N Beadle
- Department of Gerontology, University of Nebraska Omaha, Omaha, NE, United States of America
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Goichot B, Raverot V, Klein M, Vija Racaru L, Abeillon-Du Payrat J, Lairez O, Leroy R, Cailleux A, Wolff P, Groussin L, Kaltenbach G, Caron P. Management of thyroid dysfunctions in the elderly. French Endocrine Society consensus statement 2019. Long version. ANNALES D'ENDOCRINOLOGIE 2020; 81:89-100. [PMID: 32416938 DOI: 10.1016/j.ando.2020.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Bernard Goichot
- Service de médecine interne, endocrinologie et nutrition, hôpital de Hautepierre, hôpitaux universitaires, 67098 Strasbourg cedex, France.
| | - Véronique Raverot
- Hospices civils de Lyon, groupement hospitalier Est, LBMMS, laboratoire d'hormonologie, 69677 Bron cedex, France.
| | - Marc Klein
- Service EDN, CHU de Nancy, 54500 Vandœuvre-Lès-Nancy, France.
| | - Lavinia Vija Racaru
- Service de médecine nucléaire, institut universitaire de cancérologie de Toulouse Oncopole, 31059 Toulouse, France.
| | | | - Olivier Lairez
- Fédération des services de cardiologie, centre d'imagerie cardiaque, CHU Rangueil, CHU de Toulouse, Toulouse, France.
| | - Rémy Leroy
- Cabinet d'endocrinologie et diabétologie, 71, rue de La Louvière, 59000 Lille, France.
| | - Anne Cailleux
- Clinique Mathilde, 7, boulevard de l'Europe, 76100 Rouen, France.
| | - Pierre Wolff
- Espace santé, 8, rue de Lattre de Tassigny, 69350 La Mulatière, France.
| | - Lionel Groussin
- Université de Paris, Inserm U1016, CNRS UMR8104, institut Cochin, service d'endocrinologie, AP-HP, hôpital Cochin, 75014 Paris, France.
| | - Georges Kaltenbach
- Pôle de gériatrie, hôpital de la Robertsau, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France.
| | - Philippe Caron
- Service d'endocrinologie et maladies métaboliques, CHU Larrey, 31059 Toulouse, France.
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Iveniuk J, Donnelly P, Hawkley L. The Death of Confidants and Changes in Older Adults' Social Lives. Res Aging 2020; 42:236-246. [PMID: 32274965 DOI: 10.1177/0164027520917061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examines the consequences of confidant death for the social lives of older adults, testing hypotheses from socio-emotional selectivity theory and the hierarchical compensatory model. We draw upon longitudinal data from the National Social Life Health and Aging Project-a nationally representative survey of older adults (N = 2,261). We employ ordinary least squares (OLS) and ordinal logistic regressions in the context of multiple imputation with chained equations, checking our findings with doubly robust estimation. We find that the death of a spouse, but not the death of a family member or friend, was associated with increased support from friends and family, spending more time with family, and more frequent participation in religious services, but not volunteering. Death of other confidants also had little impact on older adults' social lives, suggesting the robustness of their networks to nonspousal loss.
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41
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Hawkley L, Zheng B, Hedberg EC, Huisingh-Scheetz M, Waite L. Cognitive limitations in older adults receiving care reduces well-being among spouse caregivers. Psychol Aging 2020; 35:28-40. [PMID: 31985247 PMCID: PMC6989024 DOI: 10.1037/pag0000406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A large number of older adults have physical and/or cognitive challenges and require help to manage everyday activities. Many older adults receive care from a spouse. Over the long term, this has adverse consequences for caregiver health and well-being. Less is known about the outcomes associated with the early transition to becoming a spousal caregiver. Nor is it clear how mild-cognitive decline worsens caregiver outcomes. The present study uses dyadic data from 588 couples in the National Social Life, Health, and Aging Project to compare mental and social well-being in marital partners who became a spousal caregiver versus those who remained noncaregivers or became caregivers for someone other than a spouse between 2010 and 2015. Cognitive ability was assessed using a validated version of the Montreal Cognitive Assessment. Moderated Actor-Partner Independence Models revealed that becoming a caregiver was associated with an increase in perceived stress in both men and women, and an increase in anxiety among men. Partners' cognitive limitations moderated, in a dose-dependent fashion, the association between becoming a caregiver and changes in well-being. Specifically, becoming a caregiver was associated with increased support from friends for wives at lower levels of husband's cognitive ability, and with increased anxiety for husbands at lower levels of wife's cognitive ability. Associations were independent of demographic characteristics and physical limitations. We discuss the value of using population-based samples to study the transition to caregiving and implications for interventions during the early transition to a caregiving role for even modestly cognitively impaired partners. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Louise Hawkley
- Academic Research Centers, National Opinion Research Center (NORC) at the University of Chicago
| | - Boyan Zheng
- Academic Research Centers, National Opinion Research Center (NORC) at the University of Chicago
| | - E C Hedberg
- Academic Research Centers, National Opinion Research Center (NORC) at the University of Chicago
| | - Megan Huisingh-Scheetz
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago
| | - Linda Waite
- Department of Sociology, University of Chicago
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Abstract
Objectives: We examine whether police-reported crime is associated with adiposity and examine to what extent the association between crime and adiposity is explained by perceived neighborhood danger with a particular focus on gender differences. Method: Data are drawn from the wave of 2010-2011 National Social Life, Health, and Aging Project merged with information on neighborhood social environment and Federal Bureau of Investigation (FBI) crime report. We use burglary as a main predictor. Waist circumference (WC) and body mass index (BMI) are used to assess adiposity. Results: Living in neighborhoods with higher levels of burglary is associated with a larger WC, a higher BMI, and greater adiposity risk for women, but not for men. These associations are partially explained by perceived danger among women. Discussion: Our findings identify neighborhood burglary rates as a contextual risk in later-life adiposity and highlight that perceived neighborhood safety contributes to gender differences in health outcomes.
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Affiliation(s)
- Haena Lee
- 1 University of Michigan, Ann Arbor, USA
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43
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Cognitive Function and its Risk Factors Among Older US Adults Living at Home. Alzheimer Dis Assoc Disord 2019; 32:207-213. [PMID: 29334499 DOI: 10.1097/wad.0000000000000241] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Montreal Cognitive Assessment (MoCA) has not been administered to a representative national sample, precluding comparison of patient scores to the general population and for risk factor identification. METHODS A validated survey-based adaptation of the MoCA (MoCA-SA) was administered to a probability sample of home-dwelling US adults aged 62 to 90, using the National Social Life, Health, and Aging Project (n=3129), yielding estimates of prevalence in the United States. The association between MoCA-SA scores and sociodemographic and health-related risk factors were determined. RESULTS MoCA-SA scores decreased with age, and there were substantial differences among sex, education, and race/ethnicity groups. Poor physical health, functional status, and depression were also associated with lower cognitive performance; current health behaviors were not. Using the recommended MoCA cut-point score for Mild Cognitive Impairment (MoCA score <26; MoCA-SA score <17), 72% (95% confidence interval, 69% to 74%) of older US adults would be classified as having some degree of cognitive impairment. CONCLUSIONS Our results provide an important national estimate for interpreting MoCA scores from individual patients, and establish wide variability in cognition among older home-dwelling US adults. Care should be taken in applying previously-established MoCA cut-points to the general population, especially when evaluating individuals from educationally and ethnically diverse groups.
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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: 47] [Impact Index Per Article: 9.4] [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.
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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
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Kotwal AA, Walter LC, Lee SJ, Dale W. Are We Choosing Wisely? Older Adults' Cancer Screening Intentions and Recalled Discussions with Physicians About Stopping. J Gen Intern Med 2019; 34:1538-1545. [PMID: 31147981 PMCID: PMC6667516 DOI: 10.1007/s11606-019-05064-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/11/2019] [Accepted: 04/11/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND National guidelines recommend against cancer screening for older individuals with less than a 10-year life expectancy, but it is unknown if this population desires ongoing screening. OBJECTIVE To determine (1) if older individuals with < 10-year life expectancy have future intentions for cancer screening, (2) if they recall a doctor previously suggesting that screening is no longer needed, and (3) individual characteristics associated with intentions to seek screening. DESIGN National Social life Health and Aging Project (2015-2016), a nationally representative, cross-sectional survey. PARTICIPANTS Community-dwelling adults 55-97 years old (n = 3816). MAIN MEASURES Self-reported: (1) mammography and PSA testing within the last 2 years, (2) future intentions to be screened, and (3) discussion with a doctor that screening is no longer needed. Ten-year life expectancy was estimated using the Lee prognostic index. Multivariate logistic regression analysis examined intentions to pursue future screening, adjusting for sociodemographic and health covariates. KEY RESULTS Among women 75-84 with < 10-year life expectancy, 59% intend on future mammography and 81% recall no conversation with a doctor that mammography may no longer be necessary. Among men 75-84 with < 10-year life expectancy, 54% intend on future PSA screening and 77% recall no discussions that PSA screening may be unnecessary. In adjusted analyses, those reporting recent cancer screening or no recollection that screening may not be necessary were more likely to want future mammography or PSA screening (p < 0.001). CONCLUSION Over 75% of older individuals with limited life expectancy intend to continue cancer screening, and less than 25% recall discussing with physicians the need for these tests. In addition to public health and education efforts, these results suggest that older adults' recollection of being told by physicians that screening is not necessary may be a modifiable risk factor for reducing overscreening in older adults with limited life expectancy.
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Affiliation(s)
- Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
| | - Louise C Walter
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Sei J Lee
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, USA
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Cavallini G, Scroppo F. Relationships between biological aging and male reproductive monitors. Asian J Androl 2019; 22:330-332. [PMID: 31274474 PMCID: PMC7275790 DOI: 10.4103/aja.aja_27_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Fabrizio Scroppo
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Viale L. Borri 57, Varese 21100, Italy
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47
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McSorley VE, Bin YS, Lauderdale DS. Associations of Sleep Characteristics With Cognitive Function and Decline Among Older Adults. Am J Epidemiol 2019; 188:1066-1075. [PMID: 30759177 DOI: 10.1093/aje/kwz037] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 12/22/2022] Open
Abstract
Sleep laboratory studies find that restricted sleep duration leads to worse short-term cognition, especially memory. Observational studies find associations between self-reported sleep duration or quality and cognitive function. However self-reported sleep characteristics might not be highly accurate, and misreporting could relate to cognition. In the Sleep Study of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative cohort of older US adults (2010-2015), we examined whether self-reported and actigraph-measured sleep are associated with cross-sectional cognitive function and 5-year cognitive decline. Cognition was measured with the survey adaptation of the multidimensional Montreal Cognitive Assessment (MoCA-SA). At baseline (n = 759), average MoCA-SA score was 14.1 (standard deviation, 3.6) points of a possible 20. In cross-sectional models, actigraphic sleep-disruption measures (wake after sleep onset, fragmentation, percentage sleep, and wake bouts) were associated with worse cognition. Sleep disruption measures were standardized, and estimates of association were similar (range, -0.37 to -0.59 MoCA-SA point per standard deviation of disruption). Actigraphic sleep-disruption measures were also associated with odds of 5-year cognitive decline (4 or more points), with wake after sleep onset having the strongest association (odds ratio = 1.43, 95% confidence interval: 1.04, 1.98). Longitudinal associations were generally stronger for men than for women. Self-reported sleep showed little association with cognitive function.
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Affiliation(s)
- V Eloesa McSorley
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Yu Sun Bin
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Australia
| | - Diane S Lauderdale
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
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Barcelos Winchester S. Social Determinants of Health Assessment Tool: Implications for Healthcare Practice. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:395-408. [PMID: 31088227 DOI: 10.1080/19371918.2019.1614507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Underserved populations are at risk for chronic health conditions due to social determinants. There is a gap in instrument availability in identifying individuals at risk of, or experiencing, cumulative social, environmental, economic, and cultural factors impacting health. The Social Determinants of Health Assessment Tool is a brief, cost-effective semistructured interview allowing healthcare professionals to engage in appropriate service prioritization. Phase I of this instrument development reported adequate face validity by Delphi panel consensus with experts in social work, nursing, public health, and psychology. This instrument identifies individuals at risk of social determinants to improve healthcare and social service delivery.
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Shen S. Chronic Disease Burden, Sexual Frequency, and Sexual Dysfunction in Partnered Older Adults. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:706-720. [PMID: 31018802 DOI: 10.1080/0092623x.2019.1610127] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This research evaluates the relationship between chronic disease burden and partnered sexuality of older adults by using data from the National Social Life, Health, and Aging Project. Ordinary least squares and logistic regressions identify how chronic disease burden is associated with sexual frequency and sexual dysfunction for men (N = 893) and women (N = 641). Results indicate that an increasing chronic disease burden is negatively associated with men's sexual frequency, while a greater burden of chronic disease is related to a greater risk of lubrication problems for women and orgasm problems for men. The findings reveal gender differences in how disease is linked to older adults' sexual lives.
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Affiliation(s)
- Shannon Shen
- Social Sciences, Texas A&M University - San Antonio , San Antonio , TX , USA
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50
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Huisingh-Scheetz M, Wroblewski K, Kocherginsky M, Huang E, Dale W, Waite L, Schumm LP. The Relationship Between Physical Activity and Frailty Among U.S. Older Adults Based on Hourly Accelerometry Data. J Gerontol A Biol Sci Med Sci 2019; 73:622-629. [PMID: 29106478 DOI: 10.1093/gerona/glx208] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/20/2017] [Indexed: 11/14/2022] Open
Abstract
Background/Objectives Accelerometry measures older adult (in)activity with high resolution. Most studies summarize activity over the entire wear time. We extend prior work by analyzing hourly activity data to determine how frailty and other characteristics relate to activity among older adults. Methods Using wrist accelerometry data collected from the National Social Life, Health and Aging Project (n = 651), a nationally-representative probability sample of older adults, we used mixed effects linear regression to model the logarithm of hourly counts per minute as a function of an adapted phenotypic frailty score, adjusting for demographic and health characteristics, season, day of week and time of day. Results Higher frailty scores were associated with modestly lower activity; each frailty point (0-4) corresponded to a 7% lower mean hourly counts per minute. Older age, more comorbidities, male gender, and higher BMI were also associated with lower activity, though the latter was not evident among frail respondents. After adjusting for differences associated with frailty and other covariates, a substantial amount of between-individual variability in activity remained, as well as within-individual variability across days. Conclusion Our findings indicate that frail elders, men, those who are older, overweight or have multiple comorbidities are most likely to have low activity. However, residual differences between individuals remain larger than the differences associated with frailty and other covariates. We suggest defining individual-specific activity goals and further research to identify the sources of between-individual variability to better understand how activity reflects health status and to permit the development of more effective interventions.
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Affiliation(s)
| | | | - Masha Kocherginsky
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Elbert Huang
- Department of Medicine, Section of General Medicine, University of Chicago Medicine, Illinois
| | - William Dale
- Department of Medicine, Section of Geriatrics and Palliative Medicine, Illinois
| | - Linda Waite
- Department of Sociology, University of Chicago, Illinois.,NORC at the University of Chicago, Illinois
| | - L Philip Schumm
- Department of Public Health Sciences, University of Chicago, Illinois
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