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Qi Y, Schaap LA, Schalet BD, Hoogendijk EO, Deeg DJH, Visser M, Koivunen K, Huisman M, van Schoor NM. The development of intrinsic capacity measures for longitudinal research: The Longitudinal Aging Study Amsterdam. Exp Gerontol 2024; 197:112599. [PMID: 39366460 DOI: 10.1016/j.exger.2024.112599] [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: 08/02/2024] [Revised: 09/13/2024] [Accepted: 09/26/2024] [Indexed: 10/06/2024]
Abstract
BACKGROUND The World Health Organization has introduced the construct of intrinsic capacity (IC) as an important component of healthy ageing and overall well-being in older adults The present study aimed to develop domain-specific and composite IC scores and to validate these scores by examining their longitudinal relation with functioning. METHODS We used prospective data on participants aged 57 to over 90 years, with a 10-year follow-up, from the Longitudinal Aging Study Amsterdam, an ongoing cohort study of older Dutch men and women Using a formative, stepwise approach, we identified indicators across the different domains of IC, i.e. vitality, sensory, cognition, psychology, and locomotion, using a combination of unidimensional factor analyses and Partial Least Squares Structural Equation Modelling (PLS-SEM). Next, domain-specific and composite IC scores were generated, and the construct validity (score across age groups) and criterion validity (relationship with change in functional limitations) were assessed. RESULTS The multiple unidimensional factor analyses and PLS-SEM identified a total of 18 indicators, covering the five domains of IC. The mean composite IC score was 70.9 (SD = 0.9) in men and 69.7 (0.8) in women. The domain-specific and composite IC scores all showed good construct validity, with known-group validation results indicating age-related declines. A higher composite IC score was associated with less functional limitations over time (B = 0.20, 95%CI [0.19, 0.22]). CONCLUSION The developed domain-specific IC scores and the composite IC score effectively discriminated age-related declines in IC. Additionally, the composite IC score was longitudinally associated with functional limitations. By creating this comprehensive and reliable tool for tracking IC, we aim to provide valuable insights into the dynamics of ageing and support more effective strategies for promoting health and well-being throughout later life. These scores establish a foundation for future research to track longitudinal changes across various IC domains and relate these changes to key age-related outcomes.
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Affiliation(s)
- Yuwei Qi
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, the Netherlands.
| | - Laura A Schaap
- Aging and Later Life, Amsterdam Public Health Research Institute, the Netherlands; Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - Benjamin D Schalet
- Amsterdam University Medical Centers, Department of Epidemiology and Data Science, the Netherlands; Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Emiel O Hoogendijk
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, the Netherlands; Aging and Later Life, Amsterdam Public Health Research Institute, the Netherlands; Department of General Practice, Amsterdam UMC Location Vrije Universiteit Amsterdam, the Netherlands
| | - Dorly J H Deeg
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, the Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Kaisa Koivunen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Martijn Huisman
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, the Netherlands; Aging and Later Life, Amsterdam Public Health Research Institute, the Netherlands; Department of Sociology, Vrije Universiteit Amsterdam, the Netherlands
| | - Nastasja M van Schoor
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, the Netherlands; Aging and Later Life, Amsterdam Public Health Research Institute, the Netherlands
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Belachew A, Cherbuin N, Bagheri N, Burns R. Prevalence and Factors Associated With Healthy Aging in a Large Representative Community Sample of Older Ethiopians. J Aging Health 2024:8982643241273137. [PMID: 39165227 DOI: 10.1177/08982643241273137] [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: 08/22/2024]
Abstract
Objectives: To examine the prevalence and predictors of healthy aging among community-dwelling older adults living in Bahir Dar, Ethiopia. Methods: A community-based cross-sectional study included older adults aged 60 and above (n = 845; Mage = 71 years; 56.4% females). Poisson regression estimated the Relative Risk (RR) of factors associated with healthy aging status. Results: 36.7% of respondents were classified as healthy agers. Factors associated with an increased likelihood of healthy aging included reporting not being lonely, adequate nutrition, no multimorbidity, good self-rated health, financial independence, and engaging in at least 1 hour of moderate physical activity per week. Discussion: The proportion of healthy agers in this study was substantially lower compared to developed countries but comparable to the prevalence reported in similar developing nations. Enhancing physical activity, ensuring proper nutrition, interventions to foster social participation engagement, and networking, and managing chronic diseases were identified as promising strategies to promote healthy aging.
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Affiliation(s)
- Amare Belachew
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Health Economics, Wellbeing, and Society, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Nasser Bagheri
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Richard Burns
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Zhao Y, Summers R, Gathara D, English M. Conducting cross-cultural, multi-lingual or multi-country scale development and validation in health care research: A 10-step framework based on a scoping review. J Glob Health 2024; 14:04151. [PMID: 39024643 PMCID: PMC11257704 DOI: 10.7189/jogh.14.04151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background Valid, reliable and cross-cultural equivalent scales and measurement instruments that enable comparisons across diverse populations in different countries are important for global health research and practice. We developed a 10-step framework through a scoping review of the common strategies and techniques used for scale development and validation in a cross-cultural, multi-lingual, or multi-country setting, especially in health care research. Methods We searched MEDLINE, Embase, and PsycINFO for peer-reviewed studies that collected data from two or more countries or in two or more languages at any stages of scale development or validation and published between 2010-22. We categorised the techniques into three commonly used scale development and validation stages (item generation, scale development, and scale evaluation) as well as during the translation stage. We described the most commonly used techniques at each stage. Results We identified 141 studies that were included in the analysis. We summarised 14 common techniques and strategies, including focus groups or interviews with diverse target populations, and involvement of measurement experts and linguists for item content validity expert panel at the item generation stage; back-and-forth translation, collaborative team approach for the translation stage; cognitive interviews and different recruitment strategies and incentives in different settings for scale development stage; and three approaches for measurement invariance (multigroup confirmatory factor analysis, differential item functioning and multiple indicator multiple causes) for scale evaluation stage. Conclusions We provided a 10-step framework for cross-cultural, multi-lingual or multi-country scale development and validation based on these techniques and strategies. More research and synthesis are needed to make scale development more culturally competent and enable scale application to better meet local health and development needs.
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Affiliation(s)
- Yingxi Zhao
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, Oxford, UK
| | - Richard Summers
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Maternal, Adolescent, Reproductive, and Child Health (MARCH), London School of Hygiene and Tropical Medicine, London, UK
| | - Mike English
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, Oxford, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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Stepaniak U, Grosso G, Polak M, Gradowicz-Prajsnar B, Kozela M, Bobak M, Sanchez-Niubo A, Stefler D, Haro JM, Pająk A. Association between dietary (poly)phenol intake and the ATHLOS Healthy Ageing Scale in the Polish arm of the HAPIEE study. GeroScience 2024:10.1007/s11357-024-01275-0. [PMID: 38985401 DOI: 10.1007/s11357-024-01275-0] [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: 04/02/2024] [Accepted: 06/28/2024] [Indexed: 07/11/2024] Open
Abstract
Inverse association between (poly)phenol intake and age-related disorders has been demonstrated; however, little is known whether they affect comprehensively assessed healthy aging. The aim of this study was to evaluate the associations between the intake of (poly)phenol (including selected classes and subclasses) and healthy aging scores related to biopsychosocial aspects of health and functioning. A cross-sectional study was performed using data on 9774 randomly selected citizens of Krakow (Poland) who were 45-69 years of age. Dietary (poly)phenol intake was evaluated using a food frequency questionnaire and matching food consumption data with the Phenol-Explorer database. The healthy aging scores were estimated from the ATHLOS Healthy Ageing Scale (HAS) developed by the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) consortium. Beta coefficients were calculated using multivariable linear regression models. In multivariable adjusted models, there were significant positive associations between the ATHLOS HAS score and intake of total (poly)phenols (b per increase of 100 mg/day = 0.081; 95% CI, 0.050; 0.112) and among main classes of (poly)phenols with phenolic acids (b = 0.139; 95% CI, 0.098; 0.180). Intake of remaining classes of (poly)phenols (flavonoids, lignans, stilbenes, and others) was not related to the ATHLOS HAS score. Among individual classes studied, hydroxycinnamic acids, flavonols, flavones, and dihydrochalcones were associated with better healthy aging. The findings suggest the beneficial effect of total dietary (poly)phenol and some classes and subclasses of (poly)phenol intake in terms of healthy aging in Poland. These findings should be confirmed in other settings and with prospective data.
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Affiliation(s)
- Urszula Stepaniak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawinska Street 8, 31-066, Krakow, Poland.
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawinska Street 8, 31-066, Krakow, Poland
| | - Barbara Gradowicz-Prajsnar
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawinska Street 8, 31-066, Krakow, Poland
| | - Magdalena Kozela
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawinska Street 8, 31-066, Krakow, Poland
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Albert Sanchez-Niubo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawinska Street 8, 31-066, Krakow, Poland
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Sabariego C, Hodel J, Seijas V, Rodriguez-Laso A, Bickenbach J, Ehrmann C. Are healthy ageing trajectories suitable to identify rehabilitation needs of the ageing population? An exploratory study using ATHLOS cohort data. PLoS One 2024; 19:e0303865. [PMID: 38980879 PMCID: PMC11232974 DOI: 10.1371/journal.pone.0303865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 05/01/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND The ageing process is highly heterogeneous leading to diverse ageing trajectories. Such trajectories have been modelled to study trends and determinants of ageing and could potentially be used to inform the planning of rehabilitation services at population level. The objective of this paper was to explore whether healthy ageing trajectories are suitable to identify targets for rehabilitation interventions for the ageing population. METHODS Data from the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) harmonized cohort and the English Longitudinal Study of Ageing (ELSA), which is included in ATHLOS, were used. Growth mixture models were implemented to replicate healthy ageing trajectories modelled elsewhere as 'high stable', 'low stable', and 'rapid decline'. Regularized partial correlation networks were used to estimate expected-influence and bridge expected-influence centrality measures. RESULTS Healthy ageing trajectories modelled with ATHLOS (N = 131116) and ELSA (N = 14904) were consistent with previous work. At the first individual wave, prevalence of problems of respondents in the 'high stable' and 'rapid decline' trajectories were comparable; at the last individual wave, prevalence remained similar for the 'high stable' but increased substantially in all domains for the 'rapid decline' trajectory. Expected-influence centrality measures provided different results than prevalence estimates. For instance, in the first individual wave mobility and carrying, moving, and handling objects had highest impact on overall functioning for the 'rapid decline' and 'high stable' trajectories, while the most prevalent functioning problems concerned cognition, pain, as well as energy and drive functions. CONCLUSIONS Our study stressed the relevance of healthy ageing trajectories for identifying functioning domains and categories that need to be targeted by rehabilitation services in a heterogeneous ageing population. The use of such trajectories at country level has the potential to make a meaningful contribution to the planning and delivery of rehabilitation interventions through health systems and to informed policy making.
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Affiliation(s)
- Carla Sabariego
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
| | | | - Vanessa Seijas
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
| | - Angel Rodriguez-Laso
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
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Wang F, Gao C, Wang Y, Li Z, Zheng F, Luo Y. Relationship Between Physical Exercise and Cognitive Function Among Older Adults in China: Cross-Sectional Population-Based Study. JMIR Public Health Surveill 2024; 10:e49790. [PMID: 38815262 PMCID: PMC11176873 DOI: 10.2196/49790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/25/2023] [Accepted: 03/11/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The existing literature reveals several significant knowledge gaps that hinder health care providers in formulating exercise prescriptions for cognitive health. OBJECTIVE This study endeavors to elucidate the relationship between the level of physical activity and cognitive function in older adults in China. Moreover, it seeks to explore the associations between distinct exercise behaviors-such as exercise types, the purpose motivating engagement in exercise, the accessibility of exercise fields, and the inclination toward exercise-and cognitive function. METHODS Using data from the China Longitudinal Aging Social Survey (CLASS conducted in 2016, cognitive function was meticulously assessed through the modified Chinese version of the Mini-Mental State Examination, encompassing measures of orientation, memory, and calculation. Using self-report structured questionnaires, a myriad of information about physical activity during leisure time, exercise engagement, exercise intensity, primary exercise types, reasons for exercise participation, availability of sports facilities, and exercise willingness was diligently gathered. Robust ordinary least squares regression models were then used to compute coefficients along with 95% CIs. RESULTS A discernible inverted U-shaped trend in cognitive scores emerged as the level of physical activity surpassed the threshold of 500 metabolic equivalents of task (MET) minutes per week. Notably, individuals with a physical activity level between 500 and 999 MET minutes per week exhibited a coefficient of 0.31 (95% CI 0.09 to 0.54), those with a physical activity level between 1000 and 1499 MET minutes per week displayed a coefficient of 0.75 (95% CI 0.52 to 0.97), and those with a physical activity level above 1500 MET minutes per week demonstrated a coefficient of 0.45 (95% CI 0.23 to 0.68). Older individuals engaging in exercise at specific MET levels showcased superior cognitive function compared to their inactive counterparts. Furthermore, individuals driven by exercise motivations aimed at enhancing physical fitness and health, as well as those using sports facilities or public spaces for exercise, exhibited notably higher cognitive function scores. CONCLUSIONS The findings underscore the potential of exercise as a targeted intervention for the prevention and treatment of dementia or cognitive decline associated with aging in older individuals. Leveraging these insights to formulate informed exercise recommendations holds promise in addressing a significant public health challenge linked to aging populations.
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Affiliation(s)
- Fubaihui Wang
- Social Science of Sport Research Center, China Institute of Sport Science, Beijing, China
| | - Changqing Gao
- Mental Health Center, Kunming Medical University, Kunming, China
| | - Yantao Wang
- Institute for Crime Prevention, Ministry of Justice, Beijing, China
| | - Zhuo Li
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Feiran Zheng
- School of Ethnology and Sociology, Minzu University of China, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
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Cheng Y, Chen ZL, Wei Y, Gu N, Tang SL. Examining dynamic developmental trends: the interrelationship between age-friendly environments and healthy aging in the Chinese population-evidence from China Health and Retirement Longitudinal Study, 2011-2018. BMC Geriatr 2024; 24:429. [PMID: 38750429 PMCID: PMC11094897 DOI: 10.1186/s12877-024-05053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND The objective of this research is to investigate the dynamic developmental trends between Age-Friendly Environments (AFE) and healthy aging in the Chinese population. METHODS This study focused on a sample of 11,770 participants from the CHARLS and utilized the ATHLOS Healthy Aging Index to assess the level of healthy aging among the Chinese population. Linear mixed model (LMM) was used to explore the relationship between AFE and healthy aging. Furthermore, a cross-lagged panel model (CLPM) and a random-intercept cross-lagged panel model (RI-CLPM) were used to examine the dynamic developmental trends of healthy aging, taking into account both Between-Person effects and Within-Person effects. RESULTS The results from LMM showed a positive correlation between AFE and healthy aging (β = 0.087, p < 0.001). There was a positive interaction between the geographic distribution and AFE (central region * AFE: β = 0.031, p = 0.038; eastern region * AFE: β = 0.048, p = 0.003). In CLPM and RI-CLPM, the positive effect of healthy aging on AFE is a type of Between-Person effects (β ranges from 0.147 to 0.159, p < 0.001), while the positive effect of AFE on healthy aging is Within-Person effects (β ranges from 0.021 to 0.024, p = 0.004). CONCLUSION Firstly, individuals with high levels of healthy aging are more inclined to actively participate in the development of appropriate AFE compared to those with low levels of healthy aging. Furthermore, by encouraging and guiding individuals to engage in activities that contribute to building appropriate AFE, can elevate their AFE levels beyond the previous average level, thereby improving their future healthy aging levels. Lastly, addressing vulnerable groups by reducing disparities and meeting their health needs effectively is crucial for fostering healthy aging in these populations.
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Affiliation(s)
- Yan Cheng
- Nanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210000, People's Republic of China
| | - Zhi-Liang Chen
- Nanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210000, People's Republic of China
| | - Yue Wei
- Nanjing University of Chinese Medicine, Nanjing, 210023, People's Republic of China
| | - Ning Gu
- Nanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210000, People's Republic of China
| | - Shao-Liang Tang
- Nanjing University of Chinese Medicine, Nanjing, 210023, People's Republic of China.
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Wang X, Xie J, Shang M, Yin P, Gu J. Healthy aging trajectories and their predictors among Chinese older adults: Evidence from a 7-year nationwide prospective cohort study. Arch Gerontol Geriatr 2024; 120:105331. [PMID: 38377698 DOI: 10.1016/j.archger.2024.105331] [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: 10/12/2023] [Revised: 12/20/2023] [Accepted: 01/13/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES This study aimed to identify healthy aging trajectories of Chinese older adults, and explore the factors contributing to these trajectories. METHODS We used data from four waves (2011-2018) of China Health and Retirement Longitudinal Study. We developed a healthy aging metric based on the healthy aging framework of World Health Organization (WHO) and Bayesian multilevel item response theory (IRT) method. The healthy aging trajectories were identified using the latent class growth analysis. The predictors of trajectories were explored using multinomial logistic regression analysis. Additionally, we developed two alternative metrics for healthy aging based on the Chinese Healthy Ageing Index (CHAI) and Rowe and Kahn's model of successful aging, respectively. We compared these metrics to the one developed based on the WHO's healthy aging framework. RESULTS We identified three distinct healthy aging trajectories with varying scores and decline rates. Individuals who were female, had lower educational levels, resided in rural areas, experienced depression, had more chronic diseases, participated in fewer social activities, had fewer childhood friends, experienced more adverse childhood events, and had worse family financial status in childhood were more likely to experience a worse healthy aging trajectory compared to their counterparts. Supplementary analysis showed that healthy aging metric based on WHO definition and IRT method had the strongest association with health outcomes compared to the metrics based on CHAI, as well as Rowe and Kahn model. CONCLUSIONS Our findings provide a foundation for the development of tailored interventions to enhance and sustain healthy aging among Chinese older adults.
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Affiliation(s)
- Xu Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jinzhao Xie
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Menglin Shang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ping Yin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China; Key Laboratory of Health Informatics of Guangdong Province, Sun Yat-sen University, Guangzhou, China.
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Leonardi M, Martelletti P, Burstein R, Fornari A, Grazzi L, Guekht A, Lipton RB, Mitsikostas DD, Olesen J, Owolabi MO, Ruiz De la Torre E, Sacco S, Steiner TJ, Surya N, Takeshima T, Tassorelli C, Wang SJ, Wijeratne T, Yu S, Raggi A. The World Health Organization Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders and the headache revolution: from headache burden to a global action plan for headache disorders. J Headache Pain 2024; 25:4. [PMID: 38178049 PMCID: PMC10768290 DOI: 10.1186/s10194-023-01700-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024] Open
Abstract
The World Health Organization (WHO) Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders was developed by WHO to address the worldwide challenges and gaps in provision of care and services for people with epilepsy and other neurological disorders and to ensure a comprehensive, coordinated response across sectors to the burden of neurologic diseases and to promote brain health across life-course. Headache disorders constitute the second most burdensome of all neurological diseases after stroke, but the first if young and midlife adults are taken into account. Despite the availability of a range of treatments, disability associated with headache disorders, and with migraine, remains very high. In addition, there are inequalities between high-income and low and middle income countries in access to medical care. In line with several brain health initiatives following the WHOiGAP resolution, herein we tailor the main pillars of the action plan to headache disorders: (1) raising policy prioritization and strengthen governance; (2) providing effective, timely and responsive diagnosis, treatment and care; (3) implementing strategies for promotion and prevention; (4) fostering research and innovation and strengthen information systems. Specific targets for future policy actions are proposed. The Global Action Plan triggered a revolution in neurology, not only by increasing public awareness of brain disorders and brain health but also by boosting the number of neurologists in training, raising research funding and making neurology a public health priority for policy makers. Reducing the burden of headache disorders will not only improve the quality of life and wellbeing of people with headache but also reduce the burden of neurological disorders increasing global brain health and, thus, global population health.
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Affiliation(s)
- Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | | | - Rami Burstein
- John Hedley-Whyte Professor of Anesthesia and Neuroscience at the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Arianna Fornari
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Licia Grazzi
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Richard B Lipton
- Montefiore Headache Center and the Albert Einstein College of Medicine, New York, Bronx, USA
| | - Dimos Dimitrios Mitsikostas
- 1st Neurology Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mayowa Ojo Owolabi
- Faculty of Clinical Sciences, Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway
- Department of Neurology, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
- Division of Brain Sciences, Imperial College London, London, UK
| | | | - Takao Takeshima
- Department of Neurology, Headache Center, Tominaga Hospital, Osaka, Japan
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Shuu-Jiun Wang
- College of Medicine and Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tissa Wijeratne
- Department of Neurology, Sunshine Hospital, St Albans, VIC, Australia
- Australian Institute of Migraine, Pascoe Vale South, Victoria, Australia
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
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Lima RA, Condominas E, Sanchez-Niubo A, Olaya B, Koyanagi A, de Miquel C, Haro JM. Physical Activity Participation Decreases the Risk of Depression in Older Adults: The ATHLOS Population-Based Cohort Study. SPORTS MEDICINE - OPEN 2024; 10:1. [PMID: 38170286 PMCID: PMC10764659 DOI: 10.1186/s40798-023-00664-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND To which extent physical activity is associated with depression independent of older adults' physical and cognitive functioning is largely unknown. This cohort study using harmonised data by the EU Ageing Trajectories of Health: Longitudinal Opportunities and Synergies consortium, including over 20 countries, to evaluate the longitudinal association of physical activity (light-to-moderate or vigorous intensity) with depression in older adults (aged ≥ 50 years). RESULTS We evaluated 56,818 participants (light-to-moderate models; 52.7% females, age 50-102 years) and 62,656 participants (vigorous models; 52.7% females, age 50-105 years). Compared to never, light-to-moderate or vigorous physical activity was associated with a lower incidence rate ratio (IRR) of depression (light-to-moderate model: once/week: 0.632, 95% CI 0.602-0.663; twice or more/week: 0.488, 95% CI 0.468-0.510; vigorous model: once/week: 0.652, 95% CI 0.623-0.683; twice or more/week: 0.591, 95% CI 0.566-0.616). Physical activity remained associated with depression after adjustment for the healthy ageing scale, which is a scale that incorporated 41 items of physical and cognitive functioning (light-to-moderate model: once/week: 0.787, 95% CI 0.752-0.824; twice or more/week: 0.711, 95% CI 0.682-0.742; vigorous model: once/week: 0.828, 95% CI 0.792-0.866; twice or more/week: 0.820, 95% CI 0.786-0.856). CONCLUSIONS Physical activity, of any intensity and weekly frequency, was a strong protective factor against depression, independent of physical and mental functioning. Health policies could stimulate the incorporation of lower physical activity intensity to protect against depression, which might be more feasible at the population level.
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Affiliation(s)
- Rodrigo A Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Dr Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Elena Condominas
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Dr Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Sanchez-Niubo
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Dr Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Dr Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ai Koyanagi
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Dr Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Carlota de Miquel
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Dr Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Dr Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Silva N, Rajado AT, Esteves F, Brito D, Apolónio J, Roberto VP, Binnie A, Araújo I, Nóbrega C, Bragança J, Castelo-Branco P. Measuring healthy ageing: current and future tools. Biogerontology 2023; 24:845-866. [PMID: 37439885 PMCID: PMC10615962 DOI: 10.1007/s10522-023-10041-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/23/2023] [Indexed: 07/14/2023]
Abstract
Human ageing is a complex, multifactorial process characterised by physiological damage, increased risk of age-related diseases and inevitable functional deterioration. As the population of the world grows older, placing significant strain on social and healthcare resources, there is a growing need to identify reliable and easy-to-employ markers of healthy ageing for early detection of ageing trajectories and disease risk. Such markers would allow for the targeted implementation of strategies or treatments that can lessen suffering, disability, and dependence in old age. In this review, we summarise the healthy ageing scores reported in the literature, with a focus on the past 5 years, and compare and contrast the variables employed. The use of approaches to determine biological age, molecular biomarkers, ageing trajectories, and multi-omics ageing scores are reviewed. We conclude that the ideal healthy ageing score is multisystemic and able to encompass all of the potential alterations associated with ageing. It should also be longitudinal and able to accurately predict ageing complications at an early stage in order to maximize the chances of successful early intervention.
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Affiliation(s)
- Nádia Silva
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
| | - Ana Teresa Rajado
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
| | - Filipa Esteves
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
| | - David Brito
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
| | - Joana Apolónio
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
| | - Vânia Palma Roberto
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
- ABC Collaborative Laboratory, Association for Integrated Aging and Rejuvenation Solutions (ABC CoLAB), 8100-735, Loulé, Portugal
| | - Alexandra Binnie
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld. 2, 8005-139, Faro, Portugal
- Department of Critical Care, William Osler Health System, Etobicoke, ON, Canada
| | - Inês Araújo
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
- ABC Collaborative Laboratory, Association for Integrated Aging and Rejuvenation Solutions (ABC CoLAB), 8100-735, Loulé, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld. 2, 8005-139, Faro, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Clévio Nóbrega
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
- ABC Collaborative Laboratory, Association for Integrated Aging and Rejuvenation Solutions (ABC CoLAB), 8100-735, Loulé, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld. 2, 8005-139, Faro, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - José Bragança
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal
- ABC Collaborative Laboratory, Association for Integrated Aging and Rejuvenation Solutions (ABC CoLAB), 8100-735, Loulé, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld. 2, 8005-139, Faro, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Pedro Castelo-Branco
- Algarve Biomedical Center Research Institute (ABC-RI), Campus Gambelas, Bld.2, 8005-139, Faro, Portugal.
- ABC Collaborative Laboratory, Association for Integrated Aging and Rejuvenation Solutions (ABC CoLAB), 8100-735, Loulé, Portugal.
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld. 2, 8005-139, Faro, Portugal.
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal.
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Arroyo-Quiroz C, Brunauer R, Alavez S. Education and employment have a sex-dependent effect on healthy aging in Mexico. Geriatr Gerontol Int 2023; 23:980-981. [PMID: 37961039 DOI: 10.1111/ggi.14731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/28/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Carmen Arroyo-Quiroz
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Regina Brunauer
- Department of Veterinary Physiology and Pharmacology, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
- Bone Regeneration Group, LBG Ludwig Boltzmann Institute for Traumatology, Vienna, Austria
| | - Silvestre Alavez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
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Miķelsone M, Reine I, Tomsone S, Guðmundsson H, Ivanovs A, Guðmundsson HS. Construction of healthy aging index from two different datasets. Front Public Health 2023; 11:1231779. [PMID: 37744491 PMCID: PMC10513080 DOI: 10.3389/fpubh.2023.1231779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction The aging population presents both unique challenges and opportunities for societies around the world. To develop an effective healthy aging strategy, a tool for assessing aging process is needed. Numerous attempts to quantify the aging process have been made. However, there is still a challenge in developing and choosing a good enough score that is easy to apply, has a construct of variables that are available in most nationwide surveys for comparable results, and at the same time reflects the aging process of older individuals. The purpose of this study is to present our approach to construct a comparable Healthy Aging Index (HAI). Materials and methods In Latvia, data from Wave 8 of the Survey of Health, Aging and Retirement in Europe (SHARE), involving 420 respondents, were used. For comparative analysis, data from a HL20 study on the health and wellbeing of the older adults in Iceland, which included 1,033 respondents, were used. Results For Latvia, 13 items were selected, and for Iceland, nine items were selected. We constructed the HAI with four similar subscales for both countries-"Autonomy," "Health," "Wellbeing," and "Activities," and an additional subscale "Cognitive" for Latvia. We found matching items in all four subscales. For the Autonomy subscale, they were related to difficulties with everyday and daily tasks. In the Health subscale, the only matching item was self-rated physical health. One item related to loneliness was found for the Wellbeing subscale and one item related to social participation for the Activities subscale. Discussion In our study, we found evidence for the successful construction of a HAI in two different datasets. The strength of our construct lies in the use of data from one of the largest social science panel studies in Europe (SHARE). As we were able to apply the construct to the Icelandic study, we believe that items presented in our approach are available in other population-based studies as well, and, therefore, can be easily replicated by others. By examining the existing SHARE data, HAI could be used to analyze long-term changes and could provide a foundation for comparing and monitoring the evolution of aging over time as well as comparing the aging process across societies. This is required for the authorities to conduct further analyses, proposals, and action plans in support of healthy aging.
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Affiliation(s)
| | - Ieva Reine
- Statistics Unit, Riga Stradiņš University, Riga, Latvia
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Signe Tomsone
- Faculty of Rehabilitation, Riga Stradiņš University, Riga, Latvia
| | - Helgi Guðmundsson
- Social Science Research Institute, University of Iceland, Reykjavik, Iceland
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Ng TP, Gwee X, Chua DQL, Wee SL, Cheong CY, Yap PLK, Yap KB. The Healthy Ageing Questionnaire Index: Validation in the Singapore Longitudinal Ageing Study. Gerontology 2023; 69:1358-1367. [PMID: 37640015 DOI: 10.1159/000533635] [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: 10/07/2022] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Healthy ageing (HA) indices typically use full questionnaire, performance- or blood-based assessment of functional ability which are time-consuming and resource-intensive. We developed and validated a simple and brief Healthy Ageing Questionnaire (HAQ) index with comparable measurement accuracy. METHODS The 15-item HAQ (scored 0-100) was developed using data of 500 participants in the Singapore Study of Successful Ageing (SSOSA), a sub-cohort of the Singapore Longitudinal Ageing Study (SLAS-2). Its construct, concurrent, and predictive validity were evaluated in 2,161 participants in the SLAS-2 who were non-participants of the SSOSA. RESULTS The HAQ index (mean = 64.0, SD = 11.8) showed a coherent 3-factor structure (Cronbach's alpha = 0.735). HAQ scores were higher among participants who were female, highly educated, not living alone, non-smoking, non-alcohol drinkers, not at risk of malnutrition, were robust or pre-frail, not disabled, had no or <5 medical conditions, and no recent fall or hospitalization. It was positively correlated with Mini-Mental State Examination and life satisfaction, and negatively correlated with age, logMAR vision, 5 times sit-and-stand, and timed-up-and-go. The HAQ index was significantly correlated but showed modest concordance with the Rowe-Kahn SA index. Increasing HAQ index quintiles were associated with decreased mortality risks from 40.6 to 9.7 deaths per 1,000 person-years; covariate-adjusted hazard ratio for the highest Q5 levels (HAQ score >70) was 0.44 (95% CI = 0.28-0.67). Using receiver operating characteristics analysis of predictive accuracy for survival, the area under the curve of HAQ was 0.675, and Rowe-Kahn SA index was 0.660 (p = 0.361). CONCLUSION The HAQ is a brief and accurate HA index that is potentially useful across diverse settings and purposes in research, healthcare, and policy-making.
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Affiliation(s)
- Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Denise Q L Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shiou Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Chin Yee Cheong
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Philip Lin Kiat Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Keng Bee Yap
- Department of Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
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15
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Silva N, Rajado AT, Esteves F, Brito D, Apolónio J, Roberto VP, Binnie A, Araújo I, Nóbrega C, Bragança J, Castelo-Branco P, Andrade RP, Calado S, Faleiro ML, Matos C, Marques N, Marreiros A, Nzwalo H, Pais S, Palmeirim I, Simão S, Joaquim N, Miranda R, Pêgas A, Sardo A. Measuring healthy ageing: current and future tools. Biogerontology 2023. [DOI: https:/doi.org/10.1007/s10522-023-10041-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/23/2023] [Indexed: 09/01/2023]
Abstract
AbstractHuman ageing is a complex, multifactorial process characterised by physiological damage, increased risk of age-related diseases and inevitable functional deterioration. As the population of the world grows older, placing significant strain on social and healthcare resources, there is a growing need to identify reliable and easy-to-employ markers of healthy ageing for early detection of ageing trajectories and disease risk. Such markers would allow for the targeted implementation of strategies or treatments that can lessen suffering, disability, and dependence in old age. In this review, we summarise the healthy ageing scores reported in the literature, with a focus on the past 5 years, and compare and contrast the variables employed. The use of approaches to determine biological age, molecular biomarkers, ageing trajectories, and multi-omics ageing scores are reviewed. We conclude that the ideal healthy ageing score is multisystemic and able to encompass all of the potential alterations associated with ageing. It should also be longitudinal and able to accurately predict ageing complications at an early stage in order to maximize the chances of successful early intervention.
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Behr LC, Simm A, Kluttig A, Grosskopf Großkopf A. 60 years of healthy aging: On definitions, biomarkers, scores and challenges. Ageing Res Rev 2023; 88:101934. [PMID: 37059401 DOI: 10.1016/j.arr.2023.101934] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/26/2023] [Accepted: 04/12/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND AND OBJECTIVE As the proportion of aging people in our population increases steadily, global strategies accompanied by extensive research are necessary to tackle society and health service challenges. The World Health Organization recently published an action plan: "Decade of healthy aging 2020-2030", which calls for concerted collaboration to prevent poverty of older people to provide quality education, job opportunities, and an age-inclusive infrastructure. However, scientists worldwide still struggle to find definitions and appropriate measurements of aging per se and healthy aging in particular. This literature review aims to compile concepts of healthy aging and provide a condensed overview of the challenges in defining and measuring it, along with suggestions for further research. MATERIALS AND METHODS We conducted three independent systematic literature searches covering the main scopes addressed in this review: (1) concepts and definitions of healthy aging, (2) outcomes and measures in (healthy) aging studies and (3) scores and indices of healthy aging. For each scope, the retrieved literature body was screened and subsequently synthesized. RESULTS We provide a historical overview of the concepts of healthy aging over the past 60 years. Furthermore, we identifiy current difficulties in identifying healthy agers, including dichotomous measurements, illness-centered views, study populations & designs. Secondly, markers and measures of healthy aging are discussed, including points to consider, like plausibility, consistency, and robustness. Finally, we present healthy aging scores as measurements, which combine multiple aspects to avoid a dichotomous categorization and display the bio-psycho-social concept of healthy aging. DISCUSSION AND CONCLUSION When deducting research, scientists need to consider the diverse challenges in defining and measuring healthy aging. Considering that, we recommend scores that combine multiple aspects of healthy aging, such as the Healthy Ageing Index or the ATHLOS score, among others. Further efforts are to be made on a harmonized definition of healthy aging and validated measuring instruments that are modular, easy to apply and provide comparable results in different studies and cohorts to enhance the generalization of results.
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Affiliation(s)
- Luise Charlotte Behr
- University Clinic and Outpatient Clinic for Cardiac Surgery, Medical Faculty of the Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany; Institute of Medical Epidemiology, Biostatistics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Andreas Simm
- University Clinic and Outpatient Clinic for Cardiac Surgery, Medical Faculty of the Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anne Grosskopf Großkopf
- University Clinic and Outpatient Clinic for Cardiac Surgery, Medical Faculty of the Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany.
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Zhao IY, Ho MH, Tyrovolas S, Deng SY, Montayre J, Molassiotis A. Constructing the concept of healthy ageing and examining its association with loneliness in older adults. BMC Geriatr 2023; 23:325. [PMID: 37231364 DOI: 10.1186/s12877-023-04019-5] [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: 01/28/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND World Health Organization (WHO) has defined healthy ageing by highlighting five functional ability domains to (meet basic needs, make decisions, be mobile, build and maintain relationships, and contribute to society), which also emphasized the importance of addressing loneliness as priorities within United Nations Decade of Healthy Ageing initiative. However, the level and determinants of healthy ageing and its association with loneliness are rarely examined. This study aimed to construct a healthy ageing index to verify the WHO healthy ageing framework, measure five domains of functional ability of older adults and examine the relationship between functional ability domains and loneliness. METHODS A total of 10,746 older adults from the 2018 China Health and Retirement Longitudinal Study (CHARLS) were included. A healthy ageing index ranging from 0 to 17 was constructed using 17 components related to functional ability domains. Univariate and multivariate logistic regression analyses were utilized to determine the association between loneliness and healthy ageing. The STROBE guidelines with the RECORD statement for observational studies using routinely collected health data were observed. RESULTS The factor analysis verified the five functional ability domains for healthy ageing. After adjusting for confounders, being mobile, building and maintaining relationships, and learning, growing and making decisions were significantly associated with lesser loneliness among participants. CONCLUSIONS The healthy ageing index of this study can be utilized and further modified with respect to large-scale research with relevant healthy ageing topics. Our findings will support healthcare professionals to provide patient-centered care when identifying their comprehensive abilities and needs.
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Affiliation(s)
- Ivy Yan Zhao
- WHOCC Centre for Community Health Services, School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, P. R. China
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, P. R. China
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, P. R. China.
| | - Stefanos Tyrovolas
- WHOCC Centre for Community Health Services, School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, P. R. China
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, P. R. China
| | - Sasha Yuanjie Deng
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, P. R. China
| | - Jed Montayre
- WHOCC Centre for Community Health Services, School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, P. R. China
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, P. R. China
| | - Alex Molassiotis
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, P. R. China
- Office of the Vice-Chancellor, College of Arts, Humanities and Education, University of Derby, Derby, UK
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Malkowski OS, Kanabar R, Western MJ. Socio-economic status and trajectories of a novel multidimensional metric of Active and Healthy Ageing: the English Longitudinal Study of Ageing. Sci Rep 2023; 13:6107. [PMID: 37055521 PMCID: PMC10102137 DOI: 10.1038/s41598-023-33371-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/12/2023] [Indexed: 04/15/2023] Open
Abstract
Healthy ageing research largely has a unidimensional focus on physical health, negating the importance of psychosocial factors in the maintenance of a good quality-of-life. In this cohort study, we aimed to identify trajectories of a new multidimensional metric of Active and Healthy Ageing (AHA), including their associations with socio-economic variables. A latent AHA metric was created for 14,755 participants across eight waves of data (collected between 2004 and 2019) from the English Longitudinal Study of Ageing (ELSA), using Bayesian Multilevel Item Response Theory (MLIRT). Then, Growth Mixture Modelling (GMM) was employed to identify sub-groups of individuals with similar trajectories of AHA, and multinomial logistic regression examined associations of these trajectories with socio-economic variables: education, occupational class, and wealth. Three latent classes of AHA trajectories were suggested. Participants in higher quintiles of the wealth distribution had decreased odds of being in the groups with consistently moderate AHA scores (i.e., 'moderate-stable'), or the steepest deterioration (i.e., 'decliners'), compared to the 'high-stable' group. Education and occupational class were not consistently associated with AHA trajectories. Our findings reiterate the need for more holistic measures of AHA and prevention strategies targeted at limiting socio-economic disparities in older adults' quality-of-life.
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Affiliation(s)
- Olivia S Malkowski
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Ricky Kanabar
- Department of Social and Policy Sciences, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Max J Western
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
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Kozela M, Pająk A, Szafraniec K, Ayuso-Mateos JL, Bobak M, Lu W, Pikhart H, Polak M, Sanchez-Niubo A, Stepaniak U, Haro JM. ATHLOS Healthy Aging Scale score as the predictor of all-cause mortality in Poland and Czechia. Front Public Health 2023; 11:1114497. [PMID: 37006584 PMCID: PMC10061126 DOI: 10.3389/fpubh.2023.1114497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundThe ATHLOS consortium (Aging Trajectories of Health–Longitudinal Opportunities and Synergies) used data from several aging cohorts to develop a novel scale measuring healthy aging comprehensively and globally (ATHLOS Healthy Aging Scale). In the present study, we assessed the predictive performance of the ATHLOS Healthy Aging Scale for all-cause mortality in middle-aged and older adults.MethodsData from the Polish and Czech HAPIEE (Health Alcohol and Psychosocial factors In Eastern Europe) prospective cohorts were used. There were 10,728 Poles and 8,857 Czechs recruited. The ATHLOS Healthy Aging Scale score was calculated for all participants using data from the baseline examination carried out from 2002 to 2005. The follow-up for all-cause mortality was completed over 14 years. The associations between quintiles of the ATHLOS Healthy Aging Scale and all-cause mortality were estimated using Cox proportional hazards models.ResultsA total of 9,922 Polish and 8,518 Czech participants contributed ATHLOS Healthy Aging Scale and mortality data with 1,828 and 1,700 deaths, respectively. After controlling for age, the ATHLOS Healthy Aging Scale score was strongly associated with mortality in a graded fashion for both genders and countries (hazard ratios for lowest vs. highest quintile were 2.98 and 1.96 for Czech and Polish women and 2.83 and 2.66 for Czech and Polish men, respectively). The associations were only modestly attenuated by controlling for education, economic activity, and smoking, and there was further modest attenuation after additional adjustment for self-rated health.ConclusionThe novel ATHLOS Healthy Aging Scale is a good predictor of all-cause mortality in Central European urban populations, suggesting that this comprehensive measure is a useful tool for the assessment of the future health trajectories of older persons.
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Affiliation(s)
- Magdalena Kozela
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
- *Correspondence: Magdalena Kozela
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Krystyna Szafraniec
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - José Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czechia
| | - Wentian Lu
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czechia
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Albert Sanchez-Niubo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Urszula Stepaniak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
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20
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Torres JL, Vaz CT, Pinheiro LC, Braga LS, Moreira BS, Oliveira C, Lima-Costa MF. The relationship between loneliness and healthy aging indicators in Brazil (ELSI-Brazil) and England (ELSA): sex differences. Public Health 2023; 216:33-38. [PMID: 36791648 PMCID: PMC9992154 DOI: 10.1016/j.puhe.2023.01.005] [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: 09/05/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES This study aimed to estimate five harmonized healthy aging indicators covering functional ability and intrinsic capacity among older women and men from Brazil and England and evaluate their association with loneliness. STUDY DESIGN This was a cross-sectional study. METHODS We used two nationally representative samples of men and women aged ≥60 years from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) wave 2 (2019-2021; n = 6929) and the English Longitudinal Study of Aging wave 9 (2018-2019; n = 5902). Healthy aging included five separate indicators (getting dressed, taking medication, managing money, cognitive function, and handgrip strength). Loneliness was measured by the 3-item University of California Loneliness Scale. Logistic regression models stratified by sex and country were performed. RESULTS Overall, age-adjusted healthy aging indicators were worse in Brazil compared with England for both men and women. Considering functional ability, loneliness was negatively associated with all indicators (ranging from odds ratio [OR] = 0.26, [95% confidence interval (CI) 0.13-0.52] in English men regarding the ability to take medication to OR = 0.49 [95% CI 0.27-0.89] in Brazilian women regarding the ability to manage money). Considering intrinsic capacity, loneliness was negatively associated with a higher cognitive function (OR = 0.72; 95% CI 0.55-0.95 in English women) and a higher handgrip strength (OR = 0.61; 95% CI 0.45-0.83 in Brazilian women). Lonely women demonstrated lower odds of a higher number of healthy aging indicators than men in both countries. CONCLUSIONS Country-specific social environments should be targeted by public policies to decrease loneliness and promote healthy aging later in life.
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Affiliation(s)
- J L Torres
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - C T Vaz
- Campos Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, Minas Gerais, Brazil
| | - L C Pinheiro
- Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - L S Braga
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - B S Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Universidade Federal de Minas Gerais e Fundação Oswaldo Cruz - MG, Belo Horizonte, Minas Gerais, Brazil
| | - C Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - M F Lima-Costa
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil; Núcleo de Estudos em Saúde Pública e Envelhecimento, Universidade Federal de Minas Gerais e Fundação Oswaldo Cruz - MG, Belo Horizonte, Minas Gerais, Brazil
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21
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Langballe EM, Skirbekk V, Strand BH. Subjective age and the association with intrinsic capacity, functional ability, and health among older adults in Norway. Eur J Ageing 2023; 20:4. [PMID: 36853397 PMCID: PMC9975130 DOI: 10.1007/s10433-023-00753-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 03/01/2023] Open
Abstract
This study investigates the relationships between subjective age, intrinsic capacity, functional ability and health among Norwegians aged 60 years and older. The Norwegian Survey of Health and Ageing (NORSE) is a population-based, cross-sectional study of home-dwelling individuals aged 60-96 years in the former county of Oppland. Age- and sex-adjusted regression models were used to investigate the gap between subjective and chronological age and this gap's association with self-reported and objectively measured intrinsic capacity (covering all six sub domains defined by WHO), health, and functional ability among 817 NORSE participants. The results show most participants felt younger than their chronological age (86.5%), while relatively few felt the same as their chronological age (8.3%) or older (5.2%). The mean subjective age was 13.8 years lower than mean chronological age. Participants with urinal incontinence, poor vision, or poor hearing felt 3.1 [95% confidence interval (CI) (0.6, 5.5)], 2.9 [95% CI (0.2, 5.6)], and 2.9 [95% CI (0.3, 5.5)] years older, respectively, than participants without those conditions, whereas none of the following factors-anxiety, depression, chronic disease, Short Physical Performance Battery score, grip strength, cognition, or frailty-significantly had an impact on the gap. In line with prior research, this study finds that feeling considerably younger than one's chronological age is common at older ages. However, those with poor hearing, poor vision, and urinal incontinence felt less young compared to those not having these conditions. These relationships may exert undesirable effects on vitality and autonomy, which are considered key factors of intrinsic capacity and healthy ageing.
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Affiliation(s)
- Ellen Melbye Langballe
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. .,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
| | - Vegard Skirbekk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway ,Norwegian Institute of Public Health, Oslo, Norway
| | - Bjørn Heine Strand
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway ,Norwegian Institute of Public Health, Oslo, Norway
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22
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Yi H, Ng ST, Chang CM, Low CXE, Tan CS. Effects of neighborhood features on healthy aging in place: the composition and context of urban parks and traditional local coffeeshops in Singapore. BMC Geriatr 2022; 22:969. [PMID: 36522627 PMCID: PMC9753030 DOI: 10.1186/s12877-022-03679-z] [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: 04/03/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Healthy aging in place is affected by what the neighborhood provides for older adults. The mixed-methods ethnographic study explored the built environmental and contextual effects of urban parks and traditional local coffeeshops (kopitiam) on health practices among older adults in Singapore. METHODS A door-to-door survey with 497 older adults from 32 residential blocks in a public housing town assessed exercise and smoking. The walking distances from the residential blocks to the facilities were calculated. Regression analysis examined the associations between the distance and rates of exercise and smoking. Ethnographic assessment data contextualized the quantitative findings. RESULTS Older adults' exercise was associated with proximity to an urban park but not traditional local coffeeshops. High rates of smoking were clustered in the housing blocks close to the coffeeshops, which provided casual drinking places with smoking tables. The proximity to the coffeeshops was significantly associated with increased smoking and decreased exercise. A walking distance of 200 m to the park and coffeeshops was found to discriminate the outcomes. CONCLUSIONS The findings suggested that walking distances of a few blocks influenced health behaviors among older adults. Their smoking habits appeared to be maintained through environmental features and cultural norms attached to the coffeeshops. Policy of urban planning and redevelopment for the aging population needs to consider the socioecology of healthy aging in place.
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Affiliation(s)
- Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
| | - Shu Tian Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheng Mun Chang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheryl Xue Er Low
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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23
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Xu J, Xu J, Chen Y, Wang Y, Qin G, Gao J. Associations between trajectories of social participation and functional ability among older adults: Results from the China Health and Retirement Longitudinal Study. Front Public Health 2022; 10:1047105. [PMID: 36530681 PMCID: PMC9751478 DOI: 10.3389/fpubh.2022.1047105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Functional ability (FA) and social participation (SP) are important indicators of healthy aging, both their trajectories are heterogeneous. It is little known about how the SP trajectories affects FA trajectories. Methods FA was assessed by 20 items covering the ability of meeting basic needs and mobility. SP was assessed by frequency of participating in 10 social activities. Group-based trajectory modeling (GBTM) was used to identify the trajectories of FA and SP of the participants. Results Two FA trajectories were identified: low baseline-decline tendency (16.1%) and high baseline-stable tendency (83.9%) trajectories. Two SP trajectories were also identified: low baseline-stable tendency (58.5%) and high baseline-increase tendency (41.5%) trajectories. After controlling for the potential covariates, participants among the high baseline-increase tendency SP trajectory group also had significantly higher odds ratios to be belonged in high baseline-stable tendency FA trajectory group (ORs = 2.64, 95%CI = 1.98-3.05). Conclusions High-increasing social participation had a protective effect to maintain high baseline-stable tendency functional ability among older adults. These findings suggest social participation appears to have great benefits on promoting healthy aging in China.
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Affiliation(s)
- Jiaqin Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Yingwei Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Yujie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Guoyou Qin
- School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China
- Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases, Shanghai, China
- Core Unit of Shanghai Clinical Research Center for Geriatric Diseases, Shanghai, China
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24
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Marin IB, Fernández D, Ayuso-Mateos JL, Leonardi M, Tobiasz-Adamczyk B, Koskinen S, Sanchez-Niubo A, Cristóbal-Narváez P. Healthy aging and late-life depression in Europe: Does migration matter? Front Med (Lausanne) 2022; 9:866524. [PMID: 36425106 PMCID: PMC9680089 DOI: 10.3389/fmed.2022.866524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/22/2022] [Indexed: 11/03/2023] Open
Abstract
Background There is limited research examining the impact of risk and protective factors on late-life depression using large population-based datasets, particularly those examining differences among older migrants and non-migrants in Europe countries. Thus, the first aim was to analyze differences between migrants and non-migrants regarding socioeconomic status, depression, multimorbidity, healthy aging, and lifestyle behaviors. The second aim was to examine the impact of healthy aging on late-life depression in older migrants compared to their counterparts without a history of international migration in extensive and harmonized data from different population-based cohort studies. Materials and methods We analyzed cross-sectional, predominantly nationally representative, community-based data from European participants in the Aging Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) cohort. The descriptive analyses included sociodemographic variables, somatic comorbidities, multimorbidity, healthy aging, and lifestyle behaviors according to migration status. The effects of these variables on late-life depression were examined in a multivariate logistic regression model, including migration status and years since migration as predictors. Results Data of 122,571 individuals aged ≥ 50 years were analyzed, of which 11,799 (9.60%) were migrants. The descriptive analyses indicated that compared to non-migrants, migrants showed a higher prevalence of diabetes (25.6%), hypertension (38.0%), coronary artery disease (49.4%), stroke (4.9%), and depression (31.1%). Healthy aging was also better in non-migrants (51.7; SD = 9.7) than in migrants (39.6; SD = 18.2). The results of the logistic regression showed that migration status [OR = 1.231 (CIs: 0.914-1.547)] and increased number of years since migration in the host country [OR = 0.003 (CIs: 0.001-0.005)] were associated with greater levels of depressive symptoms. Concerning health variables, multimorbidity was associated with higher levels of depressive symptoms [OR = 0.244 (CIs: 0.211-0.278)], whereas better healthy aging was associated with fewer depressive symptoms [OR = -0.100 (CIs: -0.102 to -0.098)]. The interaction between migration and healthy aging status was also significant [OR. = -0.019 (CIs: -0.025 to -0.014)]. Conclusion Migrants reported higher risks for worse health outcomes compared to non-migrants. Significantly, worse healthy aging was associated with a greater risk of depressive symptoms in migrants than in non-migrants. Shedding light on migration and aging processes is essential for promoting a cross-cultural understanding of late-life depression in Europe.
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Affiliation(s)
- Ivet Bayes Marin
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut–Campus Clínic, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Fernández
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Serra Húnter fellow, Department of Statistics and Operations Research (DEIO), Universitat Politècnica de Catalunya BarcelonaTech, Barcelona, Spain
- Institute of Mathematics of UPC–BarcelonaTech, Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit–IRCCS Neurology Institute Besta, Milan, Italy
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Jagiellonian University Medical College, Kraków, Poland
| | - Seppo Koskinen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Albert Sanchez-Niubo
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Cristóbal-Narváez
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
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25
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Relationship between Dietary Macronutrients Intake and the ATHLOS Healthy Ageing Scale: Results from the Polish Arm of the HAPIEE Study. Nutrients 2022; 14:nu14122454. [PMID: 35745184 PMCID: PMC9229969 DOI: 10.3390/nu14122454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Despite extensive research, our knowledge on the relationship between nutrition and healthy ageing is limited. The aim of this study was to evaluate the associations between the intake of macronutrients and a single measure of healthy ageing (ATHLOS Healthy Ageing Scale). Methods: A cross-sectional analysis was performed using data from 9906 randomly selected citizens of Krakow (Poland) who were 45–69 years of age and participants of the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study. Macronutrient intake was evaluated using a food frequency questionnaire. ATHLOS Health Ageing Scale was estimated from 41 variables in pooled data from 16 cohorts. Standardized beta coefficients were estimated using multivariable linear regression models. Results: In multivariable adjusted models, there were significant positive associations between the ATHLOS Healthy Ageing Scale score and intake of protein (b = 0.030, 95% CI 0.001; 0.059 in men; b = 0.056, 95% CI 0.027; 0.085 in women), monounsaturated fatty acids (MUFA) (b = 0.042, 95% CI 0.013; 0.071 in men; b = 0.035, 95% CI 0.006; 0.064 in women), polyunsaturated fatty acids (PUFA) (b = 0.053, 95% CI 0.024; 0.082 in men; b = 0.063, 95% CI 0.034; 0.092 in women), and omega-3 PUFA (b = 0.031, 95% CI 0.002;0.060 in men; b = 0.054, 95% CI 0.026; 0.082 in women). Carbohydrate intake was inversely associated with the ATHLOS Healthy Ageing Scale in women. Total fat intake was positively associated with the ATHLOS Healthy Ageing Scale in men. Conclusions: A number of nutrients were associated with the healthy ageing score, suggesting that dietary habits may play an important role in healthy ageing. Further research in other settings and with a prospective design is strongly warranted.
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Chen J, Zeng Y, He W, Yang J, Xu D, Li H. How Healthy Aging and Contact With Children Are Associated With Satisfaction in Middle-Aged and Older Parents in China: A Mediation Analysis. Front Public Health 2022; 10:836558. [PMID: 35359770 PMCID: PMC8963940 DOI: 10.3389/fpubh.2022.836558] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/21/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives This study aims to examine the mediation role of satisfaction with children on the association between contact with children (CCT) and healthy aging among middle-aged and older parents in China. Methods Data from 9,575 parents over 45 years old were obtained from the 2018 China Health and Retirement Longitudinal Survey. A multinomial logistic regression model was applied to measure the association between contact, satisfaction, and healthy aging with potential confounders controlled. We used the Sobel-Goodman Mediation test to analyze the mediation role of satisfaction on the association between types of CCT and healthy aging. Results Parents with contact with adult children had higher satisfaction with children [for contact weekly (satisfied/unsatisfied): relative risk ratio (RRR) = 2.44, CI = 1.92-3.10] and higher healthy aging [for contact weekly (Q5/Q1): RRR = 1.41, CI = 1.13-1.77]. Satisfaction was strongly related to healthy aging [for satisfied (Q5/Q1): RRR = 3.44, CI = 2.14-5.51], and mediated 19.05% of healthy aging for weekly contact (Sobel test z = 4.338; indirect role = 0.014, CI = 0.011-0.018; direct role = 0.061, CI = 0.029-0.094). Subgroup analysis further revealed that satisfaction with contact played a partial mediating role between monthly contact and healthy aging in female and rural groups. Conclusions Monthly CCT is more appropriate for older parents. Satisfaction with children in older parents seems to act as a significant and partial mediator of the relationship between contact and healthy aging. The contribution of satisfaction to healthy aging could be important to be considered and promoted in women and rural older parents, independent of CCT.
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Affiliation(s)
- Jiangyun Chen
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China,ACACIA Labs of Southern Medical University Institute for Global Health (SIGHT) and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, China,Institute for Health Management, Southern Medical University, Guangzhou, China
| | - Yixin Zeng
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Wenjun He
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Jiao Yang
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Dong Xu
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China,ACACIA Labs of Southern Medical University Institute for Global Health (SIGHT) and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, China,Institute for Health Management, Southern Medical University, Guangzhou, China,Dong Xu
| | - Haomiao Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, China,*Correspondence: Haomiao Li
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27
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Gao J, Xu J, Chen Y, Wang Y, Ye B, Fu H. Development and Validation of a Multidimensional Population-Based Healthy Aging Scale: Results From the China Health and Retirement Longitudinal Study. Front Med (Lausanne) 2022; 9:853759. [PMID: 35237637 PMCID: PMC8882972 DOI: 10.3389/fmed.2022.853759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 01/24/2022] [Indexed: 11/21/2022] Open
Abstract
Background The World Health Organization proposed a multidimensional concept of healthy aging in 2015; there was limited evidence about how the concept was constructed and measured. The current study aims to develop a health aging scale (HAS) following the WHO framework and validate it using data from the China Health and Retirement Longitudinal Study (CHARLS). Methods A total of 13,233 adults aged ≥ 45 years old from the CHARLS included in current study. Based on the WHO framework, 37 self-reported indicators were used to determine healthy aging. Exploratory factor analysis and second-order and bi-factor modeling, as well as psychometric coefficients, were used to examine the structure of healthy aging. To assess concurrent validity of the HAS, regression analyses were used to examine the associations of HAS and its subscales with sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction in Wave 1. The predictive validity of HAS and subscales was assessed by their associations with mortality in Wave 2 follow-up using Cox regressions. Results The general HAS and its five subscales were generated according to bi-factor modeling [CFI = 0.949; TLI = 0.942; SRMSR = 0.030; and RMSEA = 0.033 (95% CI, 0.032–0.034)] and psychometric coefficients (ω = 0.903; ωH = 0.692; ECV = 0.459). The general HAS presented solid evidence of concurrent validity with various sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction; and predictive validity with mortality. Conclusions The population-based multidimensional healthy aging scale and its subscales can be used to monitor the trajectories of general healthy aging and its subdomains to support the development of healthy aging policies and interventions.
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Affiliation(s)
- Junling Gao
- School of Public Health, Fudan University, Shanghai, China
- Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases, Shanghai, China
- Core Unit of Shanghai Clinical Research Center for Geriatric Diseases, Shanghai, China
- *Correspondence: Junling Gao
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Yingwei Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Yujie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Bo Ye
- Huadong Hospital, Fudan University, Shanghai, China
| | - Hua Fu
- School of Public Health, Fudan University, Shanghai, China
- Hua Fu
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28
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Gabarrell-Pascuet A, Moneta MV, Ayuso-Mateos JL, Miret M, Lara E, Haro JM, Olaya B, Domènech-Abella J. The effect of loneliness and social support on the course of major depressive disorder among adults aged 50 years and older: A longitudinal study. Depress Anxiety 2022; 39:147-155. [PMID: 35029840 DOI: 10.1002/da.23236] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/28/2021] [Accepted: 12/17/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Previous research indicates that social support, loneliness, and major depressive disorder (MDD) are interrelated. Little is known about the potential pathways among these factors, in particular in the case of adults aged 50 years and older and suffering from MDD. The objective was to investigate whether loneliness mediates the association between low social support and recurrent episodes of MDD. METHODS We used data from a cohort of the Spanish general population interviewed at three time-points over a 7-year period. We included 404 individuals aged 50+ suffering from MDD in the baseline assessment. A 12-month major depressive episode was assessed with the Composite International Diagnostic Interview (CIDI) at each interview. The University of California, Los Angeles Loneliness Scale was used to measure loneliness, whereas social support was assessed through the Oslo Social Support Scale. We tested cross-lagged and autoregressive longitudinal associations using structural equation modeling. RESULTS We identified two significant longitudinal mediation patterns: lower social support predicted higher subsequent levels of loneliness (Coef. = -0.16; p < .05), which in turn predicted an increase in MDD recurrence (Coef. = 0.05; p < .05). CONCLUSIONS Interventions focused on promoting social support among older adults suffering from MDD may decrease feelings of loneliness and prevent recurrent episodes of MDD.
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Affiliation(s)
- Aina Gabarrell-Pascuet
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - María V Moneta
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - José L Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marta Miret
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Elvira Lara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Josep M Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Joan Domènech-Abella
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Sociology, Universitat de Barcelona, Barcelona, Spain
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Strand BH, Skirbekk V, Langballe EM, Bergh S, Landmark B, Wangensteen S, Selbæk G, Kirkevold Ø. Cohort profile: Norwegian survey of health and ageing (NORSE). BMC Public Health 2021; 21:2229. [PMID: 34876088 PMCID: PMC8653560 DOI: 10.1186/s12889-021-12294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The Norwegian Survey of Health and Ageing (NORSE) was set up to provide internationally comparable data on ageing in Norway, which includes measured intrinsic capacity and cognitive function. PARTICIPANTS NORSE is a population-based health examination study of seniors aged 60+ from the 1921-1958 birth cohorts in the former Norwegian county of Oppland, interviewed and examined during 2017-19 (N = 957, 16% response rate). NORSE is to some extent based on the SHARE-questionnaire ( share-project.org ), which includes work-related information, self-assessed and retrospective health, and expectations on longevity, quality of life, volunteering activities, consumption, and financial arrangements. In addition, several objective measures of intrinsic and cognitive capacity are included in NORSE. FINDINGS TO DATE A shorter preferred life expectancy (PLE) was found to be associated with the prospects of a life with dementia and chronic pain. Motivation for retirement was found to be related to work-life experience and health. Social media was mostly used in the younger age groups and there was a tendency towards more use in the higher educational groups. NORSE incorporates questions on religion, and older women tend to have a higher degree of religiosity (proxied as self-assessed religiosity) than men in their 80s, but more similar (and lower levels) among those in their 60s. FUTURE PLANS NORSE participants have allowed their data to be linked to National registry data and midlife health examination studies and thereby provide a longitudinal design as well as information on disability status, socioeconomic status, household and marital status, support to/from children and parents, and pension status.
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Affiliation(s)
- Bjørn Heine Strand
- Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213, Oslo, Norway.
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
| | - Vegard Skirbekk
- Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213, Oslo, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Ellen Melbye Langballe
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Brumunddal, Norway
| | | | - Sigrid Wangensteen
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, NTNU, Gjøvik, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, NTNU, Gjøvik, Norway
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Bayes-Marin I, Sanchez-Niubo A, Fernández D, Haro JM, Olaya B. Risk of all-cause mortality associated with chronic obstructive pulmonary disease and the role of healthy ageing trajectories: a population-based study of middle-aged and older adults. BMJ Open 2021; 11:e050947. [PMID: 34321308 PMCID: PMC8320253 DOI: 10.1136/bmjopen-2021-050947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aims were to study the risk of all-cause mortality associated with chronic obstructive pulmonary disease (COPD) and healthy ageing trajectories (HAT) in three birth cohorts and to determine the moderating role of HAT in the association between COPD and all-cause mortality. DESIGN Prospective cohort study. SETTING Data from waves 1 to 5 of The Survey of Health, Ageing and Retirement in Europe. PARTICIPANTS The total sample was 28 857 community-dwelling individuals aged 50+ years. MAIN OUTCOME All-cause mortality associated with COPD and HAT adjusting for covariates. We performed Aalen additive hazards models to explore these associations. Interactions between COPD and HAT were also explored. Analyses were conducted separately in three birth cohorts (>1945, 1936-1945 and ≤1935). Latent class growth analysis was used to classify participants into HAT. RESULTS Three parallel HAT were found in the three birth cohorts ('low', 'medium' and 'high' healthy ageing). Participants with COPD had an increased mortality risk, but this effect was no longer significant after adjusting for covariates. The 'low' HAT was associated with increased mortality risk in the three subsamples, although this effect was lower after adjustment. The interaction between COPD and HAT was significant only in the ≤1935 birth cohort, indicating that those with COPD and a 'low' trajectory had a greater risk of mortality. CONCLUSIONS The healthy ageing scale may be a suitable tool to identify patients at higher risk to mitigate disease burden and improve patients' quality of life.
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Affiliation(s)
- Ivet Bayes-Marin
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Catalunya, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Catalunya, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Sanchez-Niubo
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Catalunya, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Fernández
- Serra Húnter fellow, Department of Statistics and Operations Research, Polytechnic University of Catalonia, Barcelona, Catalunya, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Catalunya, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Catalunya, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Catalunya, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Goudsmit J, van den Biggelaar AHJ, Koudstaal W, Hofman A, Koff WC, Schenkelberg T, Alter G, Mina MJ, Wu JW. Immune age and biological age as determinants of vaccine responsiveness among elderly populations: the Human Immunomics Initiative research program. Eur J Epidemiol 2021; 36:753-762. [PMID: 34117979 PMCID: PMC8196271 DOI: 10.1007/s10654-021-00767-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 05/27/2021] [Indexed: 12/17/2022]
Abstract
The Human Immunomics Initiative (HII), a joint project between the Harvard T.H. Chan School of Public Health and the Human Vaccines Project (HVP), focuses on studying immunity and the predictability of immuneresponsiveness to vaccines in aging populations. This paper describes the hypotheses and methodological approaches of this new collaborative initiative. Central to our thinking is the idea that predictors of age-related non-communicable diseases are the same as predictors for infectious diseases like COVID-19 and influenza. Fundamental to our approach is to differentiate between chronological, biological and immune age, and to use existing large-scale population cohorts. The latter provide well-typed phenotypic data on individuals’ health status over time, readouts of routine clinical biochemical biomarkers to determine biological age, and bio-banked plasma samples to deep phenotype humoral immune responses as biomarkers of immune age. The first phase of the program involves 1. the exploration of biological age, humoral biomarkers of immune age, and genetics in a large multigenerational cohort, and 2. the subsequent development of models of immunity in relation to health status in a second, prospective cohort of an aging population. In the second phase, vaccine responses and efficacy of licensed COVID-19 vaccines in the presence and absence of influenza-, pneumococcal- and pertussis vaccines routinely offered to elderly, will be studied in older aged participants of prospective population-based cohorts in different geographical locations who will be selected for representing distinct biological and immune ages. The HII research program is aimed at relating vaccine responsiveness to biological and immune age, and identifying aging-related pathways crucial to enhance vaccine effectiveness in aging populations.
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Affiliation(s)
- Jaap Goudsmit
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Human Vaccines Project, New York, NY, USA
| | | | | | - Albert Hofman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wayne Chester Koff
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Human Vaccines Project, New York, NY, USA
| | - Theodore Schenkelberg
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Human Vaccines Project, New York, NY, USA
| | - Galit Alter
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Michael Joseph Mina
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Julia Wei Wu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Nguyen H, Moreno-Agostino D, Chua KC, Vitoratou S, Prina AM. Trajectories of healthy ageing among older adults with multimorbidity: A growth mixture model using harmonised data from eight ATHLOS cohorts. PLoS One 2021; 16:e0248844. [PMID: 33822803 PMCID: PMC8023455 DOI: 10.1371/journal.pone.0248844] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/07/2021] [Indexed: 02/07/2023] Open
Abstract
Objectives In this study we aimed to 1) describe healthy ageing trajectory patterns, 2) examine the association between multimorbidity and patterns of healthy ageing trajectories, and 3) evaluate how different groups of diseases might affect the projection of healthy ageing trajectories over time. Setting and participants Our study was based on 130880 individuals from the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) harmonised dataset, as well as 9171 individuals from Waves 2–7 of the English Longitudinal Study of Ageing (ELSA). Methods Using a healthy ageing index score, which comprised 41 items, covering various domains of health and ageing, as outcome, we employed the growth mixture model approach to identify the latent classes of individuals with different healthy ageing trajectories. A multinomial logistic regression was conducted to assess if and how multimorbidity status and multimorbidity patterns were associated with changes in healthy ageing, controlled for sociodemographic and lifestyle risk factors. Results Three similar patterns of healthy ageing trajectories were identified in the ATHLOS and ELSA datasets: 1) a ‘high stable’ group (76% in ATHLOS, 61% in ELSA), 2) a ‘low stable’ group (22% in ATHLOS, 36% in ELSA) and 3) a ‘rapid decline’ group (2% in ATHLOS, 3% in ELSA). Those with multimorbidity were 1.7 times (OR = 1.7, 95% CI: 1.4–2.1) more likely to be in the ‘rapid decline’ group and 11.7 times (OR = 11.7 95% CI: 10.9–12.6) more likely to be in the ‘low stable’ group, compared with people without multimorbidity. The cardiorespiratory/arthritis/cataracts group was associated with both the ‘rapid decline’ and the ‘low stable’ groups (OR = 2.1, 95% CI: 1.2–3.8 and OR = 9.8, 95% CI: 7.5–12.7 respectively). Conclusion Healthy ageing is heterogeneous. While multimorbidity was associated with higher odds of having poorer healthy ageing trajectories, the extent to which healthy ageing trajectories were projected to decline depended on the specific patterns of multimorbidity.
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Affiliation(s)
- Hai Nguyen
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Dario Moreno-Agostino
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Kia-Chong Chua
- Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Silia Vitoratou
- Biostatistics and Health Informatics Department, Psychometrics and Measurement Lab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - A Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Michel JP, Leonardi M, Martin M, Prina M. WHO's report for the decade of healthy ageing 2021–30 sets the stage for globally comparable data on healthy ageing. THE LANCET HEALTHY LONGEVITY 2021; 2:e121-e122. [DOI: 10.1016/s2666-7568(21)00002-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/06/2021] [Indexed: 11/27/2022]
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Critselis E, Panaretos D, Sánchez-Niubò A, Giné-Vázquez I, Ayuso-Mateos JL, Caballero FF, de la Fuente J, Haro JM, Panagiotakos D. Ageing trajectories of health-longitudinal opportunities and synergies (ATHLOS) Healthy Ageing Scale in adults from 16 international cohorts representing 38 countries worldwide. J Epidemiol Community Health 2020; 74:1043-1049. [PMID: 32801117 DOI: 10.1136/jech-2020-214496] [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: 05/07/2020] [Revised: 07/24/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Uniform international measurement tools for assessing healthy ageing are currently lacking. OBJECTIVES The study assessed the novel comprehensive global Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) Healthy Ageing Scale, using an Item Response Theory approach, for evaluating healthy ageing across populations. DESIGN Pooled analysis of 16 international longitudinal studies. SETTING 38 countries in five continents. SUBJECTS International cohort (n=355 314), including 44.4% (n=153 597) males, aged (mean±SD) 61.7±11.5 years old. METHODS The ATHLOS Healthy Ageing Scale (including 41 items related to intrinsic capacity and functional ability) was evaluated in a pooled international cohort (n=355 314 from 16 studies) according to gender, country of residence and age group. It was also assessed in a subset of eight cohorts with ≥3 waves of follow-up assessment. The independent samples t-test and Mann-Whitney test were applied for comparing normally and skewed continuous variables between groups, respectively. RESULTS The ATHLOS Scale (range: 12.49-68.84) had a mean (±SD) value of 50.2±10.0, with males and individuals >65 years old exhibiting higher and lower mean scores, respectively. Highest mean scores were detected in Switzerland, Japan and Denmark, while lowest in Ghana, India and Russia. When the ATHLOS Scale was evaluated in a subset of cohorts with ≥3 study waves, mean scores were significantly higher than those of the baseline cohort (mean scores in ≥3 study waves vs baseline: 51.6±9.4 vs 50.2±10.0; p<0.01). CONCLUSIONS The ATHLOS Healthy Ageing Scale may be adequately applied for assessing healthy ageing across populations.
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Affiliation(s)
- Elena Critselis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Proteomics Facility, Center for Systems Biology, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Dimitris Panaretos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Albert Sánchez-Niubò
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan De Deu, Sant Boi De Llobregat, Spain.,Centro De Investigación Biomédica En Red De Salud Mental (CIBERSAM), Instituto De Salud Carlos III, Madrid, Spain
| | - Iago Giné-Vázquez
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan De Deu, Sant Boi De Llobregat, Spain
| | - José Luis Ayuso-Mateos
- Centro De Investigación Biomédica En Red De Salud Mental (CIBERSAM), Instituto De Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Universidad Autonoma De Madrid, Madrid, Spain.,Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - Francisco Felix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Javier de la Fuente
- Department of Psychiatry, Universidad Autonoma De Madrid, Madrid, Spain.,Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - Josep Maria Haro
- Centro De Investigación Biomédica En Red De Salud Mental (CIBERSAM), Instituto De Salud Carlos III, Madrid, Spain
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece .,Faculty of Health, University of Canberra, Canberra, Australia
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