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Hirono T, Morita M, Michikawa T, Tobe R, Tobe T, Kato K, Kawabata S, Oya A, Kawano Y, Hayakawa K, Kaneko S, Matsumoto M, Nakamura M, Yamada S, Fujita N. Medication-based profiling of older orthopedic patients: a multicenter cross-sectional study. BMC Geriatr 2024; 24:672. [PMID: 39123123 PMCID: PMC11316294 DOI: 10.1186/s12877-024-05284-8] [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: 02/26/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Managing medication use in older orthopedic patients is imperative to extend their healthy life expectancy in an aging society. However, the actual situation regarding polypharmacy, the intake of potentially inappropriate medications (PIMs), and fall risk-increasing drugs (FRIDs) among older orthopedic patients is not well characterized. This study aimed to investigate the medication-based profiles of older orthopedic patients to highlight the critical points of concern. METHODS We retrospectively reviewed the clinical data of consecutive patients aged ≥ 65 years who underwent orthopedic surgery at two acute care hospitals between April 2020 and March 2021. The cutoff number of prescribed drugs for polypharmacy was set at 6. According to the specified guidelines, 19 categories of drugs were identified as PIMs, and 10 categories were classified as FRIDs. RESULTS A total of 995 older patients with orthopedic surgery were assessed, of which 57.4% were diagnosed with polypharmacy, 66.0% were receiving PIMs, and 41.7% were receiving FRIDs. The prevalence of FRID intake did not significantly differ among patients with degenerative spinal disease (n = 316), degenerative disease of extremities (n = 331), and fractures (n = 272). Compared with patients with degenerative disease of the extremities, the multivariable-adjusted prevalence ratios (PRs) of polypharmacy and PIM intake were significantly higher in patients with degenerative spinal disease (1.26 [confidence intervals (CI): 1.11-1.44] and 1.12 [CI: 1.00-1.25]), respectively. Use of antiemetic drugs (adjusted PR, 13.36; 95% CI: 3.14-56.81) and nonsteroidal anti-inflammatory drugs (adjusted PR, 1.37; 95% CI: 1.05-1.78) was significantly higher in patients with degenerative spinal disease. Among patients with degenerative spinal disease, the prevalence of antiemetic drug intake was 8.7% in lumbar spinal patients and 0% in cervical spinal patients. CONCLUSIONS More than half of the orthopedic patients in this study were affected by polypharmacy, and approximately two-thirds were prescribed some form of PIMs. Patients with degenerative spinal disease showed a significantly higher prevalence of polypharmacy and PIM use compared with other orthopedic diseases. Particular attention should be paid to the high frequency of antiemetic drugs and nonsteroidal anti-inflammatory drugs intake among patients with degenerative lumbar spine conditions.
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Affiliation(s)
- Takayuki Hirono
- Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Aichi, Japan
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuhiro Morita
- Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Aichi, Japan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan
| | - Risa Tobe
- Department of Clinical Pharmacy, School of Medicine, Fujita Health University, Aichi, Japan
| | - Takao Tobe
- Department of Clinical Pharmacy, School of Medicine, Fujita Health University, Aichi, Japan
| | - Koki Kato
- Department of Clinical Pharmacy, School of Medicine, Fujita Health University, Aichi, Japan
| | - Soya Kawabata
- Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Aichi, Japan
| | - Akihito Oya
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Kawano
- Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Aichi, Japan
| | - Kazue Hayakawa
- Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Aichi, Japan
| | - Shinjiro Kaneko
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Aichi, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shigeki Yamada
- Department of Clinical Pharmacy, School of Medicine, Fujita Health University, Aichi, Japan
| | - Nobuyuki Fujita
- Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Aichi, Japan.
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Kim CN, Jung YS, Kim YE, Ock M, Jin DL, Yoon SJ. Trends of Gaps Between Health-Adjusted Life Expectancy and Life Expectancy at the Regional Level in Korea Using a Group-Based Multi-Trajectory Modeling Approach (2008-2019). J Korean Med Sci 2024; 39:e145. [PMID: 38711316 DOI: 10.3346/jkms.2024.39.e145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/02/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Health-adjusted life expectancy (HALE) is an indicator of the average lifespan in good health. Through this study, we aimed to identify regional disparities in the gap between HALE and life expectancy, considering the trends that have changed over time in Korea. METHODS We employed a group-based multi-trajectory modeling approach to capture trends in the gap between HALE and life expectancy at the regional level from 2008 to 2019. HALE was calculated using incidence-based "years lived with disability." This methodology was also employed in the Korean National Burden of Disease Study. RESULTS Based on five different information criteria, the most fitted number of trajectory groups was seven, with at least 11 regions in each group. Among the seven groups, one had an exceptionally large gap between HALE and life expectancy compared to that of the others. This group was assigned to 17 regions, of which six were metropolitan cities. CONCLUSION Based on the results of this study, we identified regions in which health levels have deteriorated over time, particularly within specific areas of metropolitan cities. These findings can be used to design comprehensive policy interventions for community health promotion and urban regeneration projects in the future.
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Affiliation(s)
- Chung-Nyun Kim
- Department of Public Health, Graduate School of Korea University, Seoul, Korea
- Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, Korea
| | - Yoon-Sun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Dal-Lae Jin
- Department of Public Health, Graduate School of Korea University, Seoul, Korea
- Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Graduate School of Public Health, Korea University, Seoul, Korea
- Institute for Future Public Health, Korea University, Seoul, Korea.
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Crawford TK, Lafaver BN, Phillips CL. Extra-Skeletal Manifestations in Osteogenesis Imperfecta Mouse Models. Calcif Tissue Int 2024:10.1007/s00223-024-01213-4. [PMID: 38641703 DOI: 10.1007/s00223-024-01213-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/25/2024] [Indexed: 04/21/2024]
Abstract
Osteogenesis imperfecta (OI) is a rare heritable connective tissue disorder of skeletal fragility with an incidence of roughly 1:15,000. Approximately 85% of the pathogenic variants responsible for OI are in the type I collagen genes, COL1A1 and COL1A2, with the remaining pathogenic OI variants spanning at least 20 additional genetic loci that often involve type I collagen post-translational modification, folding, and intracellular transport as well as matrix incorporation and mineralization. In addition to being the most abundant collagen in the body, type I collagen is an important structural and extracellular matrix signaling molecule in multiple organ systems and tissues. Thus, OI disease-causing variants result not only in skeletal fragility, decreased bone mineral density (BMD), kyphoscoliosis, and short stature, but can also result in hearing loss, dentinogenesis imperfecta, blue gray sclera, cardiopulmonary abnormalities, and muscle weakness. The extensive genetic and clinical heterogeneity in OI has necessitated the generation of multiple mouse models, the growing awareness of non-skeletal organ and tissue involvement, and OI being more broadly recognized as a type I collagenopathy.This has driven the investigation of mutation-specific skeletal and extra-skeletal manifestations and broadened the search of potential mechanistic therapeutic strategies. The purpose of this review is to outline several of the extra-skeletal manifestations that have recently been characterized through the use of genetically and phenotypically heterogeneous mouse models of osteogenesis imperfecta, demonstrating the significant potential impact of OI disease-causing variants as a collagenopathy (affecting multiple organ systems and tissues), and its implications to overall health.
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Affiliation(s)
- Tara K Crawford
- Department of Biochemistry, University of Missouri-Columbia, Columbia, MO, USA
| | - Brittany N Lafaver
- Department of Biochemistry, University of Missouri-Columbia, Columbia, MO, USA
| | - Charlotte L Phillips
- Departments of Biochemistry and Child Health, University of Missouri-Columbia, 117 Schweitzer Hall, Columbia, MO, 65211, USA.
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Carvajal Rico J, Alaeddini A, Faruqui SHA, Fisher-Hoch SP, Mccormick JB. A Laplacian regularized graph neural network for predictive modeling of multiple chronic conditions. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 247:108058. [PMID: 38382304 DOI: 10.1016/j.cmpb.2024.108058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND GOALS One of the biggest difficulties facing healthcare systems today is the prevalence of multiple chronic diseases (MCC). Mortality and the development of new chronic illnesses are more likely in those with MCC. Pre-existing diseases and risk factors specific to the patient have an impact on the complex stochastic process that guides the evolution of MCC. This study's goal is to use a brand-new Graph Neural Network (GNN) model to examine the connections between specific chronic illnesses, patient-level risk factors, and pre-existing conditions. METHODS We propose a graph neural network model to analyze the relationship between five chronic conditions (diabetes, obesity, cognitive impairment, hyperlipidemia, and hypertension). The proposed model adds a graph Laplacian regularization term to the loss function, which aims to improve the parameter learning process and accuracy of the GNN based on the graph structure. For validation, we used historical data from the Cameron County Hispanic Cohort (CCHC). RESULTS Evaluating the Laplacian regularized GNN on data from 600 patients, we expanded our analysis from two chronic conditions to five chronic conditions. The proposed model consistently surpassed a baseline GNN model, achieving an average accuracy of ≥89% across all combinations. In contrast, the performance of the standard model declined more markedly with the addition of more chronic conditions. The Laplacian regularization provided consistent predictions for adjacent nodes, beneficial in cases with shared attributes among nodes. CONCLUSIONS The incorporation of Laplacian regularization in our GNN model is essential, resulting in enhanced node categorization and better predictive performance by harnessing the graph structure. This study underscores the significance of considering graph structure when designing neural networks for graph data. Future research might further explore and refine this regularization method for various tasks using graph-structured data.
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Affiliation(s)
- Julian Carvajal Rico
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, TX, 78249, United States of America
| | - Adel Alaeddini
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, TX, 78249, United States of America.
| | - Syed Hasib Akhter Faruqui
- Department of Engineering Technology, Sam Houston State University, Huntsville, Tx, 77341, United States of America
| | - Susan P Fisher-Hoch
- School of Public Health Brownsville, The University of Texas Health Science Center at Houston, Houston, TX, 78520, United States of America
| | - Joseph B Mccormick
- School of Public Health Brownsville, The University of Texas Health Science Center at Houston, Houston, TX, 78520, United States of America
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Feraldi A, Giudici C, Brouard N. Estimating the Sex Gap in Depression-Free Life Expectancy Among Widowed Americans Aged 50 and Older: An Application Using the Interpolated Markov Chain Approach. J Aging Health 2024:8982643241233029. [PMID: 38380998 DOI: 10.1177/08982643241233029] [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: 02/22/2024]
Abstract
OBJECTIVES Using Interpolated Markov Chain software, we compare the length of life with and without depression among married individuals and widowers, and the related sex differences. METHODS We applied a multi-state life table approach to estimate depression-free life expectancy among recent cohorts of older married and widowed women and men in the United States, using data from the Health and Retirement Study over a 7-year period (2012-2018). RESULTS The study revealed that the difference in life expectancy between sexes widens in the context of widowhood. At age 50, the sex gap in depression-free life expectancy is 0.8 years among married people, whereas the gap almost doubles to 1.7 years among widowed people. DISCUSSION By quantifying disparities in the duration of life affected by depression between married and widowed women and men, policymakers could properly allocate resources specifically to address the mental health needs of these groups.
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Affiliation(s)
- Alessandro Feraldi
- Research Group in Labor Demography, Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Statistica Science, Sapienza University of Rome, Rome, Italy
| | - Cristina Giudici
- Department of Statistica Science, Sapienza University of Rome, Rome, Italy
| | - Nicolas Brouard
- Department of Mortality Health and Epidemiology, French Institute for Demographic Studies, Paris, France
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Desai A, Pappuru RR, Tyagi M. Ten-year results of scleral-fixated intraocular lens implantation: outcomes of ab externo scleral fixation with 10-0 polypropylene suture. J Cataract Refract Surg 2024; 50:128-133. [PMID: 38259132 DOI: 10.1097/j.jcrs.0000000000001327] [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: 06/01/2023] [Accepted: 09/21/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE To describe long-term visual and anatomical outcomes of sutured scleral-fixated intraocular lens (SF IOL) implantation. SETTING Tertiary eyecare hospital in India. DESIGN Retrospective interventional noncomparative study. METHODS Postoperative change in corrected distance visual acuity (CDVA) and occurrence of complications were assessed from the patient medical records. Long-term SF IOL survival rates and factors affecting the occurrence of postoperative IOL-related complications were assessed. Patients with postoperative follow-up less than 10 years or incomplete medical records were excluded. RESULTS 64 eyes of 53 patients were included. Follow-up duration was 11.4 ± 1.2 years. Mean preoperative CDVA was 0.71 ± 0.43 logMAR (Snellen equivalent: 6/30), and mean CDVA at the final visit was 0.52 ± 0.49 logMAR (Snellen equivalent: 6/18) (P < .01). 48% cases had CDVA of 6/12 or better at the last follow-up. 58% cases had coexistent ocular pathology affecting the final visual outcome. IOL and suture-related complications were the commonest and included IOL decentration (17% cases), IOL drop (14%), and suture exposure (6%). The probability of IOL survival (postoperative period without IOL-related complications) was 90.6% at 8 years and 81.2% at 10 years (Kaplan-Meier analysis). Occurrence of postoperative IOL-related complications was unaffected by patient sex, age, indication for surgery (trauma or other), previous intraocular surgery, or technique of scleral fixation (2-point or 4-point) (multivariate regression analysis). CONCLUSIONS Although sutured SF IOL implantation is viable with favorable long-term visual outcomes, there is a risk of postoperative IOL-related complications. Occurrence of postoperative IOL-related complications is unaffected by patient and ocular factors.
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Affiliation(s)
- Arjun Desai
- From the Anant Bajaj Retina Institute, Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Hosokawa R, Ojima T, Myojin T, Aida J, Kondo K, Kondo N. Estimating Health Expectancy in Japanese Communities Using Mortality Rate and Disability Prevalence. JMA J 2024; 7:21-29. [PMID: 38314416 PMCID: PMC10834173 DOI: 10.31662/jmaj.2023-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/18/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Although mortality and disability are known to be associated with health expectancy (LE), few studies have assessed the extent to which a reduction in their prevalence can extend a person's LE. Moreover, differences in this relationship based on gender have not been established. Thus, in this study, we constructed a regression model using the rate of mortality and prevalence of disability to predict LE in older adults (≥65 years) and assess the relationships between LE, mortality rate, and disability prevalence based on gender. Methods Data were collected from Japan's population registry and long-term insurance records (N = 344). Multiple linear regression was used to analyze the relationship between LE, mortality rate, and disability prevalence, stratified by gender. Results Age-adjusted mortality rate and disability prevalence significantly predicted LE and were significantly correlated with the measured LE index for both genders. For every 1% annual decrease in age-adjusted mortality, LE increased by 1.54 years for men and 2.15 years for women. Similarly, a 1% annual decrease in age-adjusted disability prevalence increased LE by 0.22 years for men and 0.32 years for women. The regression model coefficients indicated that the strength of the association between LE, mortality rate, and disability prevalence differed between genders. Our model accurately predicted LE (men: adjusted R2 = 0.968, women: adjusted R2 = 0.994). Conclusions Health promotion policies that are geared toward increasing health expectancy can be evaluated using mortality rate and disability prevalence as prognostic indicators. The strength of the association between LE, mortality, and disability differed between genders, suggesting the need for gender-specific policy planning to increase LE for both genders.
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Affiliation(s)
- Rikuya Hosokawa
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tomoya Myojin
- Department of Public Health, Health Management and Policy, Nara Medical University, Nara, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Naoki Kondo
- Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
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Shen T, Payne CF. Disability and morbidity among US birth cohorts, 1998-2018: A multidimensional test of dynamic equilibrium theory. SSM Popul Health 2023; 24:101528. [PMID: 37927816 PMCID: PMC10625143 DOI: 10.1016/j.ssmph.2023.101528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/09/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
A substantial body of prior research has explored patterns of disability-free and morbidity-free life expectancy among older populations. However, these distinct facets of later-life health are almost always studied in isolation, even though they are very likely to be related. Using data from the US Health and Retirement Study and a multistate life table approach, this paper explores the interactions between disability, morbidity, and mortality by sex and education among four successive US birth cohorts, born from 1914 to 1923 to 1944-1953 and compared in the periods 1998-2008 and 2008-2018. We find little compression of disability but a marked expansion of morbidity across cohorts. However, disability-free life expectancy (DFLE) among those living with chronic morbidities has increased, even though at the population-level DFLE is largely unchanged. Broadly, these patterns suggest that successive cohorts of older populations in the US are experiencing a dynamic equilibrium, where the link between chronic morbidities and disability has weakened over successive cohorts. Investigating patterns by educational attainment, we find marked disparities where the least educated individuals not only live significantly fewer years free of disabilities or chronic morbidities but also have experienced an expansion in morbidity and disability. Our findings suggest that the future trajectory of disability-free life expectancy in the US is increasingly contingent on efforts to improve disease management and control the severe consequences of chronic morbidities.
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Affiliation(s)
- Tianyu Shen
- School of Demography, Australian National University, Canberra, Australia
| | - Collin F. Payne
- School of Demography, Australian National University, Canberra, Australia
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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Møgelmose S, Neels K, Beutels P, Hens N. Exploring the impact of population ageing on the spread of emerging respiratory infections and the associated burden of mortality. BMC Infect Dis 2023; 23:767. [PMID: 37936094 PMCID: PMC10629067 DOI: 10.1186/s12879-023-08657-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/28/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Increasing life expectancy and persistently low fertility levels have led to old population age structures in most high-income countries, and population ageing is expected to continue or even accelerate in the coming decades. While older adults on average have few interactions that potentially could lead to disease transmission, their morbidity and mortality due to infectious diseases, respiratory infections in particular, remain substantial. We aim to explore how population ageing affects the future transmission dynamics and mortality burden of emerging respiratory infections. METHODS Using longitudinal individual-level data from population registers, we model the Belgian population with evolving age and household structures, and explicitly consider long-term care facilities (LTCFs). Three scenarios are presented for the future proportion of older adults living in LTCFs. For each demographic scenario, we simulate outbreaks of SARS-CoV-2 and a novel influenza A virus in 2020, 2030, 2040 and 2050 and distinguish between household and community transmission. We estimate attack rates by age and household size/type, as well as disease-related deaths and the associated quality-adjusted life-years (QALYs) lost. RESULTS As the population is ageing, small households and LTCFs become more prevalent. Additionally, families with children become smaller (i.e. low fertility, single-parent families). The overall attack rate slightly decreases as the population is ageing, but to a larger degree for influenza than for SARS-CoV-2 due to differential age-specific attack rates. Nevertheless, the number of deaths and QALY losses per 1,000 people is increasing for both infections and at a speed influenced by the share living in LTCFs. CONCLUSION Population ageing is associated with smaller outbreaks of COVID-19 and influenza, but at the same time it is causing a substantially larger burden of mortality, even if the proportion of LTCF residents were to decrease. These relationships are influenced by age patterns in epidemiological parameters. Not only the shift in the age distribution, but also the induced changes in the household structures are important to consider when assessing the potential impact of population ageing on the transmission and burden of emerging respiratory infections.
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Affiliation(s)
- Signe Møgelmose
- Data Science Institute, Interuniversity Institute of Biostatistics and statistical Bioinformatics, Hasselt University, Hasselt, Belgium.
- Center for Population, Family and Health, University of Antwerp, Antwerp, Belgium.
| | - Karel Neels
- Center for Population, Family and Health, University of Antwerp, Antwerp, Belgium
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Niel Hens
- Data Science Institute, Interuniversity Institute of Biostatistics and statistical Bioinformatics, Hasselt University, Hasselt, Belgium
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Friedmann E, Gee NR, Simonsick EM, Kitner-Triolo MH, Resnick B, Adesanya I, Koodaly L, Gurlu M. Pet ownership and maintenance of cognitive function in community-residing older adults: evidence from the Baltimore Longitudinal Study of Aging (BLSA). Sci Rep 2023; 13:14738. [PMID: 37679499 PMCID: PMC10484936 DOI: 10.1038/s41598-023-41813-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023] Open
Abstract
Pet ownership has been associated with reduced deterioration in physical health as older adults age; little research focused on deterioration in cognitive function. We examine the relationship of pet, dog, cat ownership, and dog walking to changes in cognitive function among 637 generally healthy community-dwelling older adults (185 pet owners) aged 50-100 years (M = 68.3, SD = 9.6) within the BLSA. Cognitive assessments every 1-4 years over 1-13 years (M = 7.5, SD = 3.6) include the California Verbal Learning (Immediate, Short, Long Recall); Benton Visual Retention; Trail-Making (Trails A, B, B-A); Digit Span; Boston Naming (Naming); and Digit Symbol Substitution (Digit Symbol) Tests. In linear mixed models, deterioration in cognitive function with age was slower for pet owners than non-owners (Immediate, Short, Long Recall; Trails A,B,B-A; Naming; Digit Symbol); dog owners than non-owners (Immediate, Short Recall; Trails A,B; Naming; Digit Symbol); and cat owners than non-owners (Immediate, Short, Long Recall; Naming), controlling for age and comorbidities. Among dog owners (N = 73) walkers experienced slower deterioration than non-walkers (Trails B, B-A; Short Recall). All ps ≤ 0.05. We provide important longitudinal evidence that pet ownership and dog walking contribute to maintaining cognitive function with aging and the need to support pet ownership and dog walking in design of senior communities and services.
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Affiliation(s)
- Erika Friedmann
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA.
| | - Nancy R Gee
- Department of Psychiatry, Center for Human Animal Interaction, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Melissa H Kitner-Triolo
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Barbara Resnick
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA
| | - Ikmat Adesanya
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA
| | - Lincy Koodaly
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA
| | - Merve Gurlu
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Suite 402, Baltimore, MD, 21201, USA
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Huang G, Guo F, Cheng Z, Liu L, Zimmermann KF, Taksa L, Tani M, Franklin M. Nativity in the healthy migrant effect: Evidence from Australia. SSM Popul Health 2023; 23:101457. [PMID: 37456617 PMCID: PMC10338376 DOI: 10.1016/j.ssmph.2023.101457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
Migrant health constitutes an important public health issue; however, variations in the 'healthy migrant effect' among migrants of different nativity are not adequately understood. To fill this gap, this study examines the life expectancy (LE) and healthy life expectancy (HLE) of the Australian-born population and eight major migrant groups in Australia for 2006, 2011 and 2016. The results show that compared with the Australian-born population, the foreign-born population overall had a higher LE and HLE but a lower HLE/LE ratio. Considerable variations in migrant health status according to nativity were also observed. Specifically, migrants from South Africa, Britain and Germany exhibited a similar or higher LE, HLE and HLE/LE ratio, while those from China, India, Italy and Greece had a higher LE but a significantly lower HLE/LE ratio compared with the Australian-born population. Lebanese migrants were the only group who experienced an unchanging LE and a declining HLE from 2006 to 2016. These notable differences in migrants' health outcomes with respect to nativity may be explained by the sociocultural differences between the origin and host countries and the different extents of migration selectivity of different migrant groups. Targeted countermeasures such as improving the quality of life of migrants from culturally diverse backgrounds or with negative migration experiences are suggested.
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Affiliation(s)
- Guogui Huang
- Centre for Health Systems and Safety Research, Macquarie University, Australia
| | - Fei Guo
- Department of Management, Macquarie Business School, Macquarie University, Australia
| | - Zhiming Cheng
- Department of Management, Macquarie Business School, Macquarie University, Australia
- Social Policy Research Centre, University of New South Wales, Australia
| | - Lihua Liu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Klaus F. Zimmermann
- Global Labor Organization (GLO), Germany
- UNU-MERIT, Maastricht, The Netherlands
| | - Lucy Taksa
- Deakin University Business School, Deakin University, Australia
| | | | - Marika Franklin
- Deakin University Business School, Deakin University, Australia
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Choi PG, Park SH, Nirmala FS, Kim HS, Kim MJ, Hahm JH, Seo HD, Ahn J, Ha T, Jung CH. Geniposide-Rich Gardenia jasminoides Ellis Fruit Extract Increases Healthspan in Caenorhabditis elegans. J Gerontol A Biol Sci Med Sci 2023; 78:1108-1115. [PMID: 36821434 DOI: 10.1093/gerona/glad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Indexed: 02/24/2023] Open
Abstract
The human life span has been markedly extended since the 1900s, but it has not brought healthy aging to everyone. This increase in life expectancy without an increase in healthspan is a major global concern that imposes considerable health care budgets and degrades the quality of life of older adults. Dietary interventions are a promising strategy to increase healthspan. In this study, we evaluated whether a Gardenia jasminoides Ellis fruit ethanol extract (GFE) increases the life span of Caenorhabditis elegans (C. elegans). Treatment with 10 mg/mL GFE increased the life span by 27.1% when compared to the vehicle group. GFE (10 mg/mL) treatment improved healthspan-related markers (pharyngeal pumping, muscle quality, age-pigment, and reactive oxygen species accumulation) and exerted a protective effect against amyloid β 1-42 toxicity. These effects of GFE are related to the inhibition of insulin/IGF-1 signaling and activation of SKN-1/Nrf, thereby promoting the expression of stress resistance-related genes. In addition, treatment with 10 mM geniposide, the most abundant component of GFE, improved healthspan-related markers and increased life span by 18.55% when compared to the vehicle group. Collectively, these findings demonstrate that GFE and its component geniposide increase the life span along with healthspan in C. elegans.
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Affiliation(s)
- Pyeong Geun Choi
- Department of Food Biotechnology, University of Science and Technology, Daejeon, South Korea
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - So-Hyun Park
- Department of Food Biotechnology, University of Science and Technology, Daejeon, South Korea
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - Farida S Nirmala
- Department of Food Biotechnology, University of Science and Technology, Daejeon, South Korea
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - Hee Soo Kim
- Department of Food Biotechnology, University of Science and Technology, Daejeon, South Korea
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - Min Jung Kim
- Personalized Diet Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - Jeong-Hoon Hahm
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - Hyo-Deok Seo
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - Jiyun Ahn
- Department of Food Biotechnology, University of Science and Technology, Daejeon, South Korea
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - Taeyoul Ha
- Department of Food Biotechnology, University of Science and Technology, Daejeon, South Korea
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
| | - Chang Hwa Jung
- Department of Food Biotechnology, University of Science and Technology, Daejeon, South Korea
- Aging and Metabolism Research Group, Korea Food Research Institute, Jeollabuk-do, South Korea
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13
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Sempungu JK, Choi M, Lee EH, Lee YH. The Trend of Healthcare Needs among Elders and Its Association with Healthcare Access and Quality in Low-Income Countries: An Exploration of the Global Burden of Disease Study 2019. Healthcare (Basel) 2023; 11:healthcare11111631. [PMID: 37297769 DOI: 10.3390/healthcare11111631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/21/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
To investigate the trend of healthcare needs among elders in low-income countries (LICs) and how changes in healthcare access and quality (HAQ) have correlated with these changes from 1990 to 2019, this study used estimates from the global burden of disease (GBD) 2019 study, including prevalence, years of life lost (YLLs), years lived with disability (YLDs), life expectancy (LE), health-adjusted life expectancy (HALE) and the HAQ index for years 1990 and 2019. We found increases in numbers of YLLs, YLDs, and prevalent cases due to NCDs, and the rate of increase was higher for all indicators of non-communicable diseases (NCDs) when compared with communicable, maternal, neonatal and nutritional diseases among elders. We also observed increases in LE and HALE among all countries. However, this was also challenged by increases in unhealthy life years (ULYs) and their constant percentage of LE. The HAQ index of LICs was also found to be low, although it had increased during the period. A reduction in the burden of acute diseases explains the increase in LE, but increases in ULYs and the NCD burden were also observed. LICs need to improve their HAQ to counter the growing threat of longer but less healthy lives.
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Affiliation(s)
- Joshua Kirabo Sempungu
- Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Minjae Choi
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
- Institute for Future Public Health, Graduate School of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Eun Hae Lee
- Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Yo Han Lee
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
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14
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Lee SH, Kim J, Lim B, Lee HJ, Kim YH. Exercise with a wearable hip-assist robot improved physical function and walking efficiency in older adults. Sci Rep 2023; 13:7269. [PMID: 37142609 PMCID: PMC10160081 DOI: 10.1038/s41598-023-32335-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 03/26/2023] [Indexed: 05/06/2023] Open
Abstract
Wearable assistive robotics has emerged as a promising technology to supplement or replace motor functions and to retrain people recovering from an injury or living with reduced mobility. We developed delayed output feedback control for a wearable hip-assistive robot, the EX1, to provide gait assistance. Our purpose in this study was to investigate the effects of long-term exercise with EX1 on gait, physical function, and cardiopulmonary metabolic energy efficiency in elderly people. This study used parallel experimental (exercise with EX1) and control groups (exercise without EX1). A total of 60 community-dwelling elderly persons participated in 18 exercise intervention sessions during 6 weeks, and all participants were assessed at 5 time points: before exercise, after 9 exercise sessions, after 18 sessions, and 1 month and 3 months after the last session. The spatiotemporal gait parameters, kinematics, kinetics, and muscle strength of the trunk and lower extremities improved more after exercise with EX1 than in that without EX1. Furthermore, the effort of muscles over the trunk and lower extremities throughout the total gait cycle (100%) significantly decreased after exercise with EX1. The net metabolic energy costs during walking significantly improved, and functional assessment scores improved more in the experimental group than in the control group. Our findings provide evidence supporting the application of EX1 in physical activity and gait exercise is effective to improve age-related declines in gait, physical function, and cardiopulmonary metabolic efficiency among older adults.
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Affiliation(s)
- Su-Hyun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Jihye Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Bokman Lim
- WIRobotics, Yongin, 16942, Republic of Korea
| | - Hwang-Jae Lee
- Robot Business Team, Samsung Electronics, Suwon, 16677, Republic of Korea.
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea.
- Haeundae Sharing and Happiness Hospital, Pusan, 48101, Republic of Korea.
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15
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Ahmad NA, Ismail NW, Sidique SFA, Mazlan NS. Air pollution, governance quality, and health outcomes: evidence from developing countries. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:41060-41072. [PMID: 36630041 DOI: 10.1007/s11356-023-25183-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
While studies have demonstrated that air pollution can be catastrophic to the population's health, few empirical studies are found in the economic literature because a considerable proportion of the evidence comes from epidemiological studies. Because of the crucial role of governance in the health community, good governance has been a contentious issue in public sector management in recent years. Therefore, the aim of this study is to examine the effects of air pollution and the role of governance on health outcomes. This study employed the generalized method of moment (GMM) estimation techniques to analyse panel data for 72 developing countries from 2010 to 2017. The empirical results confirm that higher PM2.5 and CO2 levels have a detrimental influence on life expectancy and healthy life expectancy, whereas the role of governance has a positive impact on life expectancy and healthy life expectancy. Furthermore, the findings show governance quality plays a role in moderating the negative effect of PM2.5 on health outcomes. The ongoing rise in air pollution has had a significant impact on the health of developing countries. It appears that governance quality has improved health outcomes. The findings have important policy implications, such that strengthening governance can reduce air pollution emissions in developing countries. However, to reduce the health effects of air pollution, developing countries must implement effective environmental development policies and track the implementation and enforcement of such policies.
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Affiliation(s)
- Nor Asma Ahmad
- Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Kampus Kota, Pengkalan Chepa, 16100, Kota Bharu, Kelantan, Malaysia.
| | - Normaz Wana Ismail
- School of Business and Economics, Universiti Putra Malaysia UPM, 43400, Serdang, Selangor, Malaysia
| | - Shaufique Fahmi Ahmad Sidique
- Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia UPM, 43400, Serdang, Selangor, Malaysia
| | - Nur Syazwani Mazlan
- School of Business and Economics, Universiti Putra Malaysia UPM, 43400, Serdang, Selangor, Malaysia
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16
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Siddiqi A, Warren J, Anis HK, Barsoum WK, Bloomfield MR, Briskin I, Brooks PJ, Higuera CA, Kamath AF, Klika A, Krebs O, Krebs VE, Mesko NW, Molloy RM, Mont MA, Murray TG, Muschler GF, Patel P, Stearns KL, Strnad GJ, Suarez JC, Piuzzi NS. Do patient-reported outcome measures improve after aseptic revision total hip arthroplasty? Hip Int 2023; 33:267-279. [PMID: 34554849 DOI: 10.1177/11207000211036320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The purpose of this study was to determine patient-reported outcome measures (PROMs) changes in: (1) pain, function and global health; and (2) predictors of PROMs in patients undergoing aseptic revision total hip arthroplasty (rTHA) using a multilevel model with patients nested within surgeon. METHODS A prospective cohort of 216 patients with baseline and 1-year PROMs who underwent aseptic rTHA between January 2016 and December 2017 were analysed. The most common indication for rTHA was aseptic loosening, instability, and implant failure. The PROMs included in this study were HOOS Pain and HOOS Physical Function Short-form (PS), Veterans RAND-12 Physical Component Score (VR-12 PCS), and VR-12 Mental Component Score (MCS). Multivariable linear regression models were constructed for predicting 1-year PROMs. RESULTS Mean 1-year PROMs improvement for aseptic revisions were 30.4 points for HOOS Pain and 22.1 points for HOOS PS. Predictors of better pain relief were patients with higher baseline pain scores. Predictors of better 1-year function were patients with higher baseline function and patients with a posterolateral hip surgical approach during revision. Although VR-12 PCS scores had an overall improvement, nearly 50% of patients saw no improvement or had worse physical component scores. Only 30.7% of patients reported improvements in VR-12 MCS. CONCLUSIONS Overall, patients undergoing aseptic rTHA improved in pain and function PROMs at 1 year. Although global health assessment improved overall, nearly half of aseptic rTHA patients reported no change in physical/mental health status. The associations highlighted in this study can help guide the shared decision-making process by setting expectations before aseptic revision THA.
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Affiliation(s)
| | - Ahmed Siddiqi
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Jared Warren
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Hiba K Anis
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Wael K Barsoum
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Isaac Briskin
- Cleveland Clinic Department of Quantitative Health Sciences, Cleveland, OH, USA
| | - Peter J Brooks
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Carlos A Higuera
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Atul F Kamath
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Alison Klika
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Olivia Krebs
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Viktor E Krebs
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Nathan W Mesko
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Robert M Molloy
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Michael A Mont
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Trevor G Murray
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - George F Muschler
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Preetesh Patel
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Kim L Stearns
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Gregory J Strnad
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Nicolas S Piuzzi
- Orthopaedic Department, Cleveland Clinic Foundation, Cleveland, OH, USA
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17
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Maxfield M, Beagley L, Peckham A, Guest MA, Giasson HL, Byrd DR, Mun CJ, Yu F, Ng TK, Pohl JS, Koffer RE, Andel R, Coon DW. Mirabella at Arizona State University: A Case Example in Innovation at a University-Based Retirement Community. JOURNAL OF AGING AND ENVIRONMENT 2023. [DOI: 10.1080/26892618.2022.2158512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Molly Maxfield
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - Lindsey Beagley
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Mirabella at ASU, Arizona State University, Tempe, AZ, USA
| | - Allie Peckham
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - M. Aaron Guest
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - Hannah L. Giasson
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - DeAnnah R. Byrd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - Chung Jung Mun
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Phoenix, AZ, USA
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - Ted K.S Ng
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - Janet S. Pohl
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - Rachel E. Koffer
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - Ross Andel
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
| | - David W. Coon
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
- Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, AZ, USA
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18
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Hosokawa R, Ojima T, Myojin T, Kondo K, Kondo N. Geriatric symptoms associated with healthy life expectancy in older people in Japan. Environ Health Prev Med 2023; 28:44. [PMID: 37423739 DOI: 10.1265/ehpm.22-00300] [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: 07/11/2023] Open
Abstract
BACKGROUND We investigated the relationship between characteristic geriatric symptoms and healthy life expectancy in older adults in Japan. Additionally, we determined relationship predictors that would help formulate effective approaches toward promoting healthy life expectancy. METHODS The Kihon Checklist was used to identify older people at high risk of requiring nursing care in the near future. We evaluated the association of geriatric symptoms with healthy life expectancy while considering risk factors (frailty, poor motor function, poor nutrition, poor oral function, confinement, poor cognitive function, and depression). Data from the 2013 and 2019 Japan Gerontological Evaluation Studies were used. Healthy life expectancy was assessed using the multistate life table method. RESULTS Overall, 8,956 individuals were included. For both men and women, healthy life expectancy was shorter in the symptomatic group than in the asymptomatic group for several domains of the Kihon Checklist. For men, the difference between individuals with risk factors and those with no risk factors was the maximum for confinement (3.83 years) and the minimum for cognitive function (1.51 years). For women, the difference between individuals with risk factors and those with no risk factors was the maximum for frailty (4.21 years) and the minimum for cognitive function (1.67 years). Healthy life expectancy tended to be shorter when the number of risk factors was higher. Specifically, the difference between individuals with ≥3 risk factors and those with no risk factors was 4.46 years for men and 5.68 years for women. CONCLUSIONS Healthy life expectancy was negatively associated with characteristic geriatric symptoms, with strong associations with frailty, physical functional decline, and depression. Therefore, comprehensive assessment and prevention of geriatric symptoms may increase healthy life expectancy.
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Affiliation(s)
- Rikuya Hosokawa
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine
| | - Tomoya Myojin
- Department of Public Health, Health Management and Policy, Nara Medical University
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University
- Center for Well-being and Society, Nihon Fukushi University
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology
| | - Naoki Kondo
- School of Public Health and Graduate School of Medicine, Kyoto University
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19
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Friedmann E, Gee NR, Simonsick EM, Barr E, Resnick B, Werthman E, Adesanya I. Pet Ownership and Maintenance of Physical Function in Older Adults-Evidence From the Baltimore Longitudinal Study of Aging (BLSA). Innov Aging 2023; 7:igac080. [PMID: 36915903 PMCID: PMC10006577 DOI: 10.1093/geroni/igac080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives Pet ownership or human-animal interaction has been associated with better health outcomes in individuals with disease or disability. We hypothesized that pet ownership, as well as dog ownership and cat ownership separately, are associated with maintaining physical function, and leisure time physical activity and that among dog owners, dog walking is associated with maintaining these outcomes for generally healthy community-dwelling older adults participating in the Baltimore Longitudinal Study of Aging. Research Design and Methods A total of 637 men (44.1%) and women aged 50-100 years (M = 68.3, standard deviation [SD] = 9.6) completed a comprehensive pet ownership questionnaire that ascertained pet ownership history 10-13 years and had serial assessments of physical function every 1-4 years prior. Linear or generalized linear mixed models with time varying pet ownership were used to examine change in physical function over a mean of 7.5 years (range 1-13, SD = 3.6) according to pet ownership. Results Pet owners (n = 185) were significantly younger (p < .001) and had fewer comorbidities (p = .03) than nonowners; thus, age and comorbidities were included as covariates in the longitudinal analyses. Physical function and leisure time physical activity declined with aging across all outcomes (p < .001); the decline was slower among pet owners in overall physical performance (p < .001), rapid gait speed (p = .03), usual gait speed (p = .032), cardiorespiratory fitness (p < .001), and physical well-being (p = .002) controlling for age and comorbidities. Changes in leisure time physical activities with aging did not differ between pet owners and nonowners. Dog walking was not independently related to the maintenance of physical function or leisure time physical activity with aging. Discussion and Implications This study provides the first longitudinal evidence that pet ownership is associated with maintained physical function among community-dwelling generally healthy older adults.
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Affiliation(s)
- Erika Friedmann
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Nancy R Gee
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Erik Barr
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Emily Werthman
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Ikmat Adesanya
- University of Maryland School of Nursing, Baltimore, Maryland, USA
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20
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Molina-Martínez MÁ, Marsillas S, Sánchez-Román M, del Barrio E. Friendly Residential Environments and Subjective Well-Being in Older People with and without Help Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15832. [PMID: 36497900 PMCID: PMC9741280 DOI: 10.3390/ijerph192315832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
Previous studies have shown that friendly environments are associated with well-being and higher quality of life in older people. This study aimed to investigate the relationship between friendly environments and subjective well-being by segmenting the population according to the need for help in performing activities of daily living (ADLs) in a representative sample of people over 55 years of age in the Basque Country (Spain) (n = 2760). To determine the predictive power of friendliness on subjective well-being, two separate linear regression models were obtained according to the need for help in ADLs. The results obtained show a greater explanatory power of the model in the case of people who required help. However, in the case of people who do not need help, subjective health had a greater weight in the predictions. This paper's findings support the greater importance of the characteristics of the physical and social environment, as people's functional status worsens, with friendliness being an explanatory factor for people's well-being as they age and their dependency increases.
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Affiliation(s)
- María Ángeles Molina-Martínez
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
- ENCAGEn-CM R&D Programme, Faculty of Education and Psychology, Francisco de Vitoria University, 28223 Madrid, Spain
| | | | - María Sánchez-Román
- ENCAGEn-CM R&D Programme, Research Group on Ageing (GIE-CSIC), Institute of Economics, Geography and Demography (IEGD-CSIC), Spanish National Research Council (CSIC), 28037 Madrid, Spain
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21
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Milholland B, Vijg J. Why Gilgamesh failed: the mechanistic basis of the limits to human lifespan. NATURE AGING 2022; 2:878-884. [PMID: 37118288 DOI: 10.1038/s43587-022-00291-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/05/2022] [Indexed: 04/30/2023]
Abstract
The purpose of this Perspective is to clarify for an interdisciplinary audience the fundamental concepts of human longevity and provide evidence for a limit to human lifespan. This observed limit is placed into a broader framework by showing how it has arisen through the process of evolution and by enumerating the molecular mechanisms that may enforce it. Finally, we look toward potential future developments and the prospects for possibly circumventing the current limit.
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Affiliation(s)
| | - Jan Vijg
- Department of Genetics, Albert Einstein College of Medicine, New York City, NY, USA.
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22
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Impacto do tratamento oncológico na qualidade de vida de idosas com câncer de mama atendidas pelo Sistema Único de Saúde. PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2022. [DOI: 10.15448/2357-9641.2022.1.43014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objetivos: avaliar a qualidade de vida (QV), as interações medicamentosas e a adesão ao tratamento em pacientes idosas com câncer de mama que realizaram tratamento oncológico pelo Sistema Único de Saúde (SUS).Métodos: coorte prospectiva, com seis meses de seguimento, que incluiu pacientes idosas com câncer de mama atendidas em Hospital Universitário de Porto Alegre e atendidas pelo SUS. Foram selecionadas mulheres com idade ≥ 60 anos, divididas em dois grupos (60-69 anos e ≥ 70 anos).Resultados: 38 pacientes foram incluídas nas análises sobre QV e adesão ao tratamento. Dentro da classificação molecular, os subtipos mais diagnosticados foram, Luminal B/Her2- (34,2%), Luminal A (26,3%), Luminal B/HER2+ (21,1%). Os sintomas físicos mais relacionados à doença, no momento do diagnóstico, foram insônia, rigidez musculoesquelética, preocupação com os outros e com o futuro. Em contrapartida, seis meses depois os resultados menos favoráveis foram fadiga, náusea e vômito, dispneia, dor, inapetência, constipação, diarreia, problemas financeiros, efeitos adversos da terapia sistêmica, sintomas nas mamas e braços e alopecia. Baixos níveis de adesão ao tratamento foram identificados em 67,6% das pacientes. A polifarmácia foi evidenciada em 60,6%, e foi observada ao menos uma interação medicamentosa potencial em 78,8% da amostra. A média de medicamentos utilizados foi de 7,24 (DP= 3,77).Conclusões: este estudo demonstrou a importância do acompanhamento da população idosa com câncer de mama que faz uso de tratamento quimioterápico, a fim de compreender as implicações da senescência, bem como melhorar as taxas de adesão à terapia e a qualidade de vida desta população.
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Are Measures of Health Status for the Total Population Good Proxies for the Health of the Older Population in International Comparison Studies? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137559. [PMID: 35805218 PMCID: PMC9265627 DOI: 10.3390/ijerph19137559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
In the face of population aging, the health of older people is becoming especially important, impacting various areas of life, societies and countries’ economies. To provide the basis for effective decisions to achieve better health, comparative analyses can be used to find best practices to follow. The aim of the research was to check whether drawing conclusions about the older population’s health based on the health status of the total population is justified in international comparison analyses. An analysis was conducted for six population health indicators for European countries from 2010–2019. Rankings were created for the total population and the older subpopulation, and then ranks for these two populations were compared using statistical methods. The statistical analyses indicate that there is a strong, statistically significant relationship between the ranks for the total and the older population. However, looking at the descriptive analysis and visual presentation of data, differences in international rankings of indicator values for these two populations can be observed. As older people comprise a specific group of the population that is growing ever bigger and increasingly significant, it would be advisable to present the results of international comparisons not only for the total, but separately for the older population as well.
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Govier DJ, Cohen-Cline H, Marsi K, Roth SE. Differences in access to virtual and in-person primary care by race/ethnicity and community social vulnerability among adults diagnosed with COVID-19 in a large, multi-state health system. BMC Health Serv Res 2022; 22:511. [PMID: 35428257 PMCID: PMC9012053 DOI: 10.1186/s12913-022-07858-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/29/2022] [Indexed: 02/08/2023] Open
Abstract
Background Research exploring telehealth expansion during the COVID-19 pandemic has demonstrated that groups disproportionately impacted by COVID-19 also experience worse access to telehealth. However, this research has been cross-sectional or short in duration; geographically limited; has not accounted for pre-existing access disparities; and has not examined COVID-19 patients. We examined virtual primary care use by race/ethnicity and community social vulnerability among adults diagnosed with COVID-19 in a large, multi-state health system. We also assessed use of in-person primary care to understand whether disparities in virtual access may have been offset by improved in-person access. Methods Using a cohort design, electronic health records, and Centers for Disease Control and Prevention Social Vulnerability Index, we compared changes in virtual and in-person primary care use by race/ethnicity and community social vulnerability in the year before and after COVID-19 diagnosis. Our study population included 11,326 adult patients diagnosed with COVID-19 between March and July 2020. We estimated logistic regression models to examine likelihood of primary care use. In all regression models we computed robust standard errors; in adjusted models we controlled for demographic and health characteristics of patients. Results In a patient population of primarily Hispanic/Latino and non-Hispanic White individuals, and in which over half lived in socially vulnerable areas, likelihood of virtual primary care use increased from the year before to the year after COVID-19 diagnosis (3.6 to 10.3%); while in-person use remained stable (21.0 to 20.7%). In unadjusted and adjusted regression models, compared with White patients, Hispanic/Latino and other race/ethnicity patients were significantly less likely to use virtual care before and after COVID-19 diagnosis; Hispanic/Latino, Native Hawaiian/Pacific Islander, and other race/ethnicity patients, and patients living in socially vulnerable areas were also significantly less likely to use in-person care during these time periods. Conclusions Newly expanded virtual primary care has not equitably benefited individuals from racialized groups diagnosed with COVID-19, and virtual access disparities have not been offset by improved in-person access. Health systems should employ evidence-based strategies to equitably provide care, including representative provider networks; targeted, empowering outreach; co-developed culturally and linguistically appropriate tools and technologies; and provision of enabling resources and services.
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Analysis of Spatial Distribution of CVD and Multiple Environmental Factors in Urban Residents. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:9799054. [PMID: 35341172 PMCID: PMC8942627 DOI: 10.1155/2022/9799054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/20/2022] [Indexed: 11/17/2022]
Abstract
Cardiovascular disease (CVD) poses a serious threat to urban health with the development of urbanization. There are multifaceted and comprehensive influencing factors for CVD, so clarifying the spatial distribution characteristics of CVD and multiple environmental influencing factors is conducive to improving the active health intervention of urban environment and promoting the sustainable development of cities The spatial distribution characteristics of CVD deaths in a certain district, Bengbu City, Huaihe River Basin, China, in 2019 were explored, and the correlation between multiple environmental factors and CVD mortality was investigated in this study, to reveal the action mechanism of multiple environmental factors affecting the risk of mortality. Relevant studies have shown that (1) CVD deaths are characterized as follows: male deaths are more than females; the mortality is higher in those of higher age; most of them are unemployed; cardiocerebral infarction is the main cause of death; and the deaths are mainly distributed in the central city and near the old urban area. (2) The increased CVD mortality can be attributed to the increased density of restaurants and cigarette and wine shops around the residential area, the increased traffic volume, the dense residential and spatial forms, the low green space coverage, and the distance from rivers. Therefore, appropriate urban planning and policies can improve the active health interventions in cities and reduce CVD mortality.
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Global, regional, and national burden of diseases and injuries for adults 70 years and older: systematic analysis for the Global Burden of Disease 2019 Study. BMJ 2022; 376:e068208. [PMID: 35273014 PMCID: PMC9316948 DOI: 10.1136/bmj-2021-068208] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors. DESIGN Systematic analysis. SETTING Participants were aged ≥70 from 204 countries and territories, 1990-2019. MAIN OUTCOMES MEASURES Years of life lost, years lived with disability, disability adjusted life years, life expectancy at age 70 (LE-70), healthy life expectancy at age 70 (HALE-70), proportion of years in ill health at age 70 (PYIH-70), risk factors, and data coverage index were estimated based on standardised GBD methods. RESULTS Globally the population of older adults has increased since 1990 and all cause death rates have decreased for men and women. However, mortality rates due to falls increased between 1990 and 2019. The probability of death among people aged 70-90 decreased, mainly because of reductions in non-communicable diseases. Globally disability burden was largely driven by functional decline, vision and hearing loss, and symptoms of pain. LE-70 and HALE-70 showed continuous increases since 1990 globally, with certain regional disparities. Globally higher LE-70 resulted in higher HALE-70 and slightly increased PYIH-70. Sociodemographic and healthcare access and quality indices were positively correlated with HALE-70 and LE-70. For high exposure risk factors, data coverage was moderate, while limited data were available for various dietary, environmental or occupational, and metabolic risks. CONCLUSIONS Life expectancy at age 70 has continued to rise globally, mostly because of decreases in chronic diseases. Adults aged ≥70 living in high income countries and regions with better healthcare access and quality were found to experience the highest life expectancy and healthy life expectancy. Disability burden, however, remained constant, suggesting the need to enhance public health and intervention programmes to improve wellbeing among older adults.
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27
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Gendered Racism on the Body: An Intersectional Approach to Maternal Mortality in the United States. POPULATION RESEARCH AND POLICY REVIEW 2022. [DOI: 10.1007/s11113-021-09691-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences. Microorganisms 2022; 10:microorganisms10020229. [PMID: 35208684 PMCID: PMC8879770 DOI: 10.3390/microorganisms10020229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 12/01/2022] Open
Abstract
Adverse childhood experiences (ACEs), which can include child trafficking, are known to program children for disrupted biological cycles, premature aging, microbiome dysbiosis, immune-inflammatory misregulation, and chronic disease multimorbidity. To date, the microbiome has not been a major focus of deprogramming efforts despite its emerging role in every aspect of ACE-related dysbiosis and dysfunction. This article examines: (1) the utility of incorporating microorganism-based, anti-aging approaches to combat ACE-programmed chronic diseases (also known as noncommunicable diseases and conditions, NCDs) and (2) microbiome regulation of core systems biology cycles that affect NCD comorbid risk. In this review, microbiota influence over three key cyclic rhythms (circadian cycles, the sleep cycle, and the lifespan/longevity cycle) as well as tissue inflammation and oxidative stress are discussed as an opportunity to deprogram ACE-driven chronic disorders. Microbiota, particularly those in the gut, have been shown to affect host–microbe interactions regulating the circadian clock, sleep quality, as well as immune function/senescence, and regulation of tissue inflammation. The microimmunosome is one of several systems biology targets of gut microbiota regulation. Furthermore, correcting misregulated inflammation and increased oxidative stress is key to protecting telomere length and lifespan/longevity and extending what has become known as the healthspan. This review article concludes that to reverse the tragedy of ACE-programmed NCDs and premature aging, managing the human holobiont microbiome should become a routine part of healthcare and preventative medicine across the life course.
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Haupt S, Niedrist T, Sourij H, Schwarzinger S, Moser O. The Impact of Exercise on Telomere Length, DNA Methylation and Metabolic Footprints. Cells 2022; 11:153. [PMID: 35011715 PMCID: PMC8750279 DOI: 10.3390/cells11010153] [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: 11/30/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023] Open
Abstract
Aging as a major risk factor influences the probability of developing cancer, cardiovascular disease and diabetes, amongst others. The underlying mechanisms of disease are still not fully understood, but research suggests that delaying the aging process could ameliorate these pathologies. A key biological process in aging is cellular senescence which is associated with several stressors such as telomere shortening or enhanced DNA methylation. Telomere length as well as DNA methylation levels can be used as biological age predictors which are able to detect excessive acceleration or deceleration of aging. Analytical methods examining aging are often not suitable, expensive, time-consuming or require a high level of technical expertise. Therefore, research focusses on combining analytical methods which have the potential to simultaneously analyse epigenetic, genomic as well as metabolic changes.
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Affiliation(s)
- Sandra Haupt
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany;
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8010 Graz, Austria;
| | - Harald Sourij
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria;
| | - Stephan Schwarzinger
- NBNC—North Bavarian NMR-Centre, University of Bayreuth, 95440 Bayreuth, Germany;
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany;
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria;
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Brown R, Sillence E, Coventry L, Simpson E, Gibbs J, Tariq S, C. Durrant A, Lloyd K. Understanding the attitudes and experiences of people living with potentially stigmatised long-term health conditions with respect to collecting and sharing health and lifestyle data. Digit Health 2022; 8:20552076221089798. [PMID: 35463624 PMCID: PMC9019355 DOI: 10.1177/20552076221089798] [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: 12/24/2020] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background The emerging landscape of patient-generated data (PGData) provides an opportunity to collect large quantities of information that can be used to develop our understanding of different health conditions and potentially improve the quality of life for those living with long-term health condition (LTHCs). If the potential benefits of PGData are to be realised, we need a better understanding of the psychological barriers and facilitators to the collection and beneficial sharing of health and lifestyle data. Due to the understudied role that stigma plays in sharing PGData, we explore the attitudes and experiences of those living with potentially stigmatised LTHCs with respect to collecting and sharing health and lifestyle data. Methods This study used semi-structured interviews and a card sorting task to explore the attitudes and experiences of people living with potentially stigmatised LTHCs. Fourteen adult participants who reported having a range of conditions were recruited in England. Template analysis was used to analyse interview transcripts and descriptive statistics were used for the card sorting task. Results The findings present four overarching themes: Preferences for collecting health and lifestyle data, Importance of anonymity, Expected use of data, and Sources of emotional support. Participants illustrated a general willingness to share health and lifestyle data; however, there were some notable differences in sharing experiences, varying both by information type and recipient group. Overall, participants did not identify health-related stigma as a barrier to collecting or sharing their personal health and lifestyle data. Conclusions We outline a number of preferences that participants feel would encourage them to collect and share data more readily, which may be considered when developing data sharing tools for the future.
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Affiliation(s)
- Richard Brown
- Department of Psychology, Northumbria University, Newcastle, UK
| | | | - Lynne Coventry
- Department of Psychology, Northumbria University, Newcastle, UK
| | - Emma Simpson
- The NHS Business Services Authority, Newcastle, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
| | | | - Karen Lloyd
- Institute for Global Health, University College London, London, UK
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Alves AM, Rodrigues A, Sa-Couto P, Simões JL. Effect of an Educational Nursing Intervention on the Mental Adjustment of Patients with Chronic Arterial Hypertension: An Interventional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:170. [PMID: 35010430 PMCID: PMC8750213 DOI: 10.3390/ijerph19010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
The objective of this analytical and interventional prospective quantitative study was to assess the effect of an educational intervention performed by nurses for mental adjustment to chronic disease in patients with hypertension. A convenience sample was studied, composed of 329 participants with chronic hypertension, followed in a primary healthcare unit in the Central Region of Portugal. Data collection was carried out by applying the Mental Adjustment to Disease Scale (MADS) before and 1 month after the educational nursing intervention between September 2017 and February 2018. Prior to the application of the educational intervention, 43.5% of the participants were classified as "unadjusted" in at least one of the subscales of MADS. After the educational intervention, 21.3% of the participants classified as "unadjusted" became "adjusted" in all MADS subscales. The success rate of the intervention varied from 26.9% (in the fatalism subscale) to 44.6% (for the anxious concern subscale). Participants were more likely to be mentally "unadjusted" to hypertension if they lived with other family members, had an active professional situation before the diagnosis of hypertension, still had an active professional situation now, were under 65 years old, had a shorter time to diagnosis (1-2 years), and measured blood pressure less regularly. The educational intervention performed by nurses is relevant for the mental adjustment of hypertensive patients, contributing to increased knowledge, as well as improvement in preventive and self-care practices, facilitating the experience of the health/disease transition process.
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Affiliation(s)
- Ana Margarida Alves
- Inpatient Service of Surgical Specialties, Centro Hospitalar do Baixo Vouga E.P.E., 3810-164 Aveiro, Portugal;
| | - Alexandre Rodrigues
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Center for Health Studies and Research, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Pedro Sa-Couto
- Centre for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, 3810-193 Aveiro, Portugal;
| | - João Lindo Simões
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
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Finch T, Jonas MC, Rubenstein K, Watson E, Basra S, Martinez J, Horberg M. Life Expectancy Trends Among Integrated Health Care System Enrollees, 2014-2017. Perm J 2021; 25:20.286. [PMID: 35348069 PMCID: PMC8784056 DOI: 10.7812/tpp/20.286] [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: 10/22/2020] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Centers for Disease Control and Prevention (CDC) has reported downward trends in life expectancy and racial/ethnic differences between 2014 and 2017. OBJECTIVE To determine the life expectancy of the Kaiser Permanente Mid-Atlantic States (KPMAS) insured population as compared to the CDC National Vital Statistics data from 2014 to 2017. We also aimed to highlight the utilization of membership data to inform population statistical estimates such as life expectancy. We examine whether national trends in life expectancy are reflected in an insured population with relatively uniform access to care. METHODS This retrospective, data only study examined life expectancy between 2014 and 2017. Data from electronic medical records and the National Death Index were combined to construct complete life tables by race and sex for the KPMAS population, which was compared to the CDC National Vital Statistics data. RESULTS From 2014 to 2017, the overall KPMAS population life expectancy at birth varied between 84.6 and 85.2 years compared to the CDC reported national average of 78.6-78.9 years (p < 0.001). While the CDC dataset reported a 3.5- to 3.7-year life expectancy gap between non-Hispanic White and non-Hispanic Black populations, in the KPMAS population, this gap was significantly smaller (0.0-0.9 years). The gap in life expectancy between males and females was consistent across KPMAS and the CDC data; however, overall KPMAS male and female patient life expectancy was extended in comparison. CONCLUSION Among members who disclosed their race/ethnicity, KPMAS Hispanic, non-Hispanic Black, and non-Hispanic White members had significantly higher life expectancies than the CDC dataset in all years reported.
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Affiliation(s)
- Tori Finch
- Mid-Atlantic Permanente Medical Group, Rockville, MD
| | - M Cabell Jonas
- Mid-Atlantic Permanente Medical Group, Rockville, MD
- Mid-Atlantic Permanente Research Institute, Rockville, MD
| | - Kevin Rubenstein
- Mid-Atlantic Permanente Medical Group, Rockville, MD
- Mid-Atlantic Permanente Research Institute, Rockville, MD
| | - Eric Watson
- Mid-Atlantic Permanente Medical Group, Rockville, MD
- Mid-Atlantic Permanente Research Institute, Rockville, MD
| | - Sundeep Basra
- Mid-Atlantic Permanente Medical Group, Rockville, MD
- Mid-Atlantic Permanente Research Institute, Rockville, MD
| | - Jose Martinez
- Mid-Atlantic Permanente Medical Group, Rockville, MD
| | - Michael Horberg
- Mid-Atlantic Permanente Medical Group, Rockville, MD
- Mid-Atlantic Permanente Research Institute, Rockville, MD
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Baban B, Khodadadi H, Salles ÉL, Costigliola V, Morgan JC, Hess DC, Vaibhav K, Dhandapani KM, Yu JC. Inflammaging and Cannabinoids. Ageing Res Rev 2021; 72:101487. [PMID: 34662745 PMCID: PMC8662707 DOI: 10.1016/j.arr.2021.101487] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/02/2021] [Accepted: 10/12/2021] [Indexed: 01/07/2023]
Abstract
Aging is a complex phenomenon associated with a wide spectrum of physical and physiological changes affecting every part of all metazoans, if they escape death prior to reaching maturity. Critical to survival, the immune system evolved as the principal component of response to injury and defense against pathogen invasions. Because how significantly immune system affects and is affected by aging, several neologisms now appear to encapsulate these reciprocal relationships, such as Immunosenescence. The central part of Immunosenescence is Inflammaging -a sustained, low-grade, sterile inflammation occurring after reaching reproductive prime. Once initiated, the impact of Inflammaging and its adverse effects determine the direction and magnitudes of further Inflammaging. In this article, we review the nature of this vicious cycle, we will propose that phytocannabinoids as immune regulators may possess the potential as effective adjunctive therapies to slow and, in certain cases, reverse the pathologic senescence to permit a more healthy aging.
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Affiliation(s)
- Babak Baban
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, DCG Center for Excellence in Research, Scholarship and Innovation (CERSI), Augusta University, Augusta, GA, USA; Center for Excellence in Research, Scholarship and Innovation, Dental College of Georgia, Augusta, Augusta University, Augusta, GA, USA; Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA; Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| | - Hesam Khodadadi
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, DCG Center for Excellence in Research, Scholarship and Innovation (CERSI), Augusta University, Augusta, GA, USA; Center for Excellence in Research, Scholarship and Innovation, Dental College of Georgia, Augusta, Augusta University, Augusta, GA, USA
| | - Évila Lopes Salles
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, DCG Center for Excellence in Research, Scholarship and Innovation (CERSI), Augusta University, Augusta, GA, USA; Center for Excellence in Research, Scholarship and Innovation, Dental College of Georgia, Augusta, Augusta University, Augusta, GA, USA
| | | | - John C Morgan
- Parkinson's Foundation Center of Excellence, Movement Disorders, Program, Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - David C Hess
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Kumar Vaibhav
- Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Krishnan M Dhandapani
- Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Jack C Yu
- Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Mental health, substance use, and suicidal ideation among unpaid caregivers of adults in the United States during the COVID-19 pandemic: Relationships to age, race/ethnicity, employment, and caregiver intensity. J Affect Disord 2021; 295:1259-1268. [PMID: 34706440 PMCID: PMC8413485 DOI: 10.1016/j.jad.2021.08.130] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/30/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unpaid caregivers of adults play critical roles in health care systems by providing care to older adults and those with chronic conditions. The COVID-19 pandemic has heightened caregiving needs, forcing some into caregiving roles and disrupting others. We sought to estimate the prevalence of and identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation amongst unpaid caregivers of adults versus non-caregivers. METHODS During June 24-30, 2020, surveys were administered to U.S. adults. Quota sampling and survey weighting were implemented to improve sample representativeness of age, gender, and race/ethnicity. RESULTS Of 9,896 eligible invited adults, 5,412 (54.7%) completed surveys and 5,011 (92.6%) met screening criteria and were analyzed, including 1,362 (27.2%) caregivers. Caregivers had higher adverse mental health symptom prevalences than non-caregivers, including suicidal ideation (33.4% vs 3.7%, p < 0.0001). Symptoms were more common among caregivers who were young vs older adults (e.g., aged 18-24 vs ≥65 years, aPR 2.75, 95% CI 1.95-3.88, p < 0.0001) and with moderate and high vs low Caregiver Intensity Index scores (2.31, 1.65-3.23; 2.81, 2.00-3.94; both p < 0.0001). LIMITATIONS Self-report data may be subject to recall, response, and social desirability biases; unpaid caregivers were self-identified; child caregiving roles were not assessed; and internet-based survey samples might not fully represent the U.S. CONCLUSIONS Caregivers experienced disproportionately high levels of adverse mental health symptoms. Younger caregivers and those with higher caregiving intensity were disproportionately affected. Increased visibility of and access to mental health care resources are urgently needed to address mental health challenges of caregiving.
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Reply to Permanyer et al.: The uncertainty surrounding healthy life expectancy indicators. Proc Natl Acad Sci U S A 2021; 118:2115544118. [PMID: 34772817 PMCID: PMC8609540 DOI: 10.1073/pnas.2115544118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 11/22/2022] Open
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Boissonneault M, Rios P. Changes in healthy and unhealthy working-life expectancy over the period 2002–17: a population-based study in people aged 51–65 years in 14 OECD countries. THE LANCET HEALTHY LONGEVITY 2021; 2:e629-e638. [DOI: 10.1016/s2666-7568(21)00202-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
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Elmaleh DR, Downey MA, Kundakovic L, Wilkinson JE, Neeman Z, Segal E. New Approaches to Profile the Microbiome for Treatment of Neurodegenerative Disease. J Alzheimers Dis 2021; 82:1373-1401. [PMID: 34219718 DOI: 10.3233/jad-210198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Progressive neurodegenerative diseases represent some of the largest growing treatment challenges for public health in modern society. These diseases mainly progress due to aging and are driven by microglial surveillance and activation in response to changes occurring in the aging brain. The lack of efficacious treatment options for Alzheimer's disease (AD), as the focus of this review, and other neurodegenerative disorders has encouraged new approaches to address neuroinflammation for potential treatments. Here we will focus on the increasing evidence that dysbiosis of the gut microbiome is characterized by inflammation that may carry over to the central nervous system and into the brain. Neuroinflammation is the common thread associated with neurodegenerative diseases, but it is yet unknown at what point and how innate immune function turns pathogenic for an individual. This review will address extensive efforts to identify constituents of the gut microbiome and their neuroactive metabolites as a peripheral path to treatment. This approach is still in its infancy in substantive clinical trials and requires thorough human studies to elucidate the metabolic microbiome profile to design appropriate treatment strategies for early stages of neurodegenerative disease. We view that in order to address neurodegenerative mechanisms of the gut, microbiome and metabolite profiles must be determined to pre-screen AD subjects prior to the design of specific, chronic titrations of gut microbiota with low-dose antibiotics. This represents an exciting treatment strategy designed to balance inflammatory microglial involvement in disease progression with an individual's manifestation of AD as influenced by a coercive inflammatory gut.
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Affiliation(s)
- David R Elmaleh
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,AZTherapies, Inc., Boston, MA, USA
| | | | | | - Jeremy E Wilkinson
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ziv Neeman
- Department of Radiology, Emek Medical Center, Afula, Israel.,Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Eran Segal
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel.,Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
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Accurate characterization of β-amyloid (Aβ40, Aβ42) standards using species-specific isotope dilution by means of HPLC-ICP-MS/MS. Anal Bioanal Chem 2021; 414:639-648. [PMID: 34355254 PMCID: PMC8748378 DOI: 10.1007/s00216-021-03571-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 11/10/2022]
Abstract
The amyloid β peptide, as one of the main components in senile plaque, represents a defining pathological feature for Alzheimer’s disease, and is therefore commonly used as a biomarker for this disease in clinical analysis. However, the selection of suitable standards is limited here, since only a few are commercially available, and these suffer from varying purity. Hence, the accurate characterization of these standards is of great importance. In this study, we developed a method for the traceable quantification of the peptide content using species-specific isotope dilution and ICP-MS/MS detection. It is based on the separation of the sulfur-containing amino acids methionine and cysteine after oxidation and hydrolysis of the peptide. Using a strong anion exchange column, both amino acids could be separated from each other, as well as from their oxidized forms and sulfate. The sulfur content was determined via ICP-MS/MS using oxygen as reaction gas. Species-specific isotope dilution was enabled by using a 34S-labeled yeast hydrolysate, containing methionine sulfone and cysteic acid with different isotopic composition. The peptide contents of Aβ standards (Aβ40,42), as well as myoglobin and lysozyme with different degrees of purity, were determined. For validation purposes, the standard reference material NIST 2389a, which contains the amino acids in a similar concentration, was subjected to the developed sample preparation and analysis method. In addition to accounting for errors during sample preparation, high levels of accuracy and precision could be obtained using this method, making it fit-for-purpose for the characterization of peptide standards.
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Nielsen CR, Ahrenfeldt LJ, Jeune B, Christensen K, Lindahl-Jacobsen R. Healthy life expectancy by frailty state in Europe from 2004 to 2015: findings from SHARE. Eur J Public Health 2021; 31:554-560. [PMID: 33615329 PMCID: PMC8485734 DOI: 10.1093/eurpub/ckab012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As populations age, the possible consequences of increased frailty are a major concern for the health sector. Here, we investigate how life expectancy with and without frailty has changed during a 10-11-year-period across Europe. METHODS The Sullivan method was used to investigate changes in life expectancy with and without frailty in 10 European countries. Frailty status (non-frail, pre-frail and frail) was determined by use of the Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI). Data on frailty prevalence was obtained from 21 698 individuals in wave 1 (2004-05) and 38 859 individuals in wave 6 (2015) of the SHARE. Information on mortality was obtained from the Eurostat Database. RESULTS In 2015, women aged 70 spent 25.0% (95% CI: 24.0-26.1) of their remaining life expectancy in a frail state, and the number for men was 11.5% (95% CI: 10.7-12.3). Southern Europeans spent 24.2% (95% CI: 22.9-25.4) of their remaining life expectancy in a frail state and the numbers for Central Europeans and Northern Europeans were 17.0% (95% CI: 16.0-17.9) and 12.2% (95% CI: 10.9-13.5), respectively. From 2004-05 to 2015, life expectancy increased by 1.1 years (from 15.3 to 16.4 years) for 70-year-old Europeans. Similarly, non-frail life expectancy increased by 1.1 years (95% CI: 0.8-1.4), whereas no significant changes in life expectancy in frail states were observed. CONCLUSIONS This study suggests that Europeans today spend more years in a non-frail state than Europeans did 10-11 years ago. Our findings reflect a considerable inequality by gender and region.
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Affiliation(s)
- Camilla Riis Nielsen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Interdisiciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Linda Juel Ahrenfeldt
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Bernard Jeune
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kaare Christensen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Public Health, Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Rune Lindahl-Jacobsen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Interdisiciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark
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Pérès K, Zamudio-Rodriguez A, Dartigues JF, Amieva H, Lafitte S. Prospective pragmatic quasi-experimental study to assess the impact and effectiveness of an innovative large-scale public health intervention to foster healthy ageing in place: the SoBeezy program protocol. BMJ Open 2021; 11:e043082. [PMID: 33926977 PMCID: PMC8094369 DOI: 10.1136/bmjopen-2020-043082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION With the accelerating pace of ageing, healthy ageing has become a major challenge for all societies worldwide. Based on that Healthy Ageing concept proposed by the WHO, the SoBeezy intervention has been designed through an older person-centred and integrated approach. The programme creates the environments that maximise functional ability to enable people to be and do what they value and to stay at home in best possible conditions. METHODS AND ANALYSIS Five levers are targeted: tackling loneliness, restoring feeling of usefulness, finding solutions to face material daily life difficulties, promoting social participation and combating digital divide. Concretely, the SoBeezy programme relies on: (1) a digital intelligent platform available on smartphone, tablet and computer, but also on a voice assistant specifically developed for people with digital divide; (2) a large solidarity network which potentially relies on everyone's engagement through a participatory intergenerational approach, where the older persons themselves are not only service receivers but also potential contributors; (3) an engagement of local partners and stakeholders (citizens, associations, artisans and professionals). Organised as a hub, the system connects all the resources of a territory and provides to the older person the best solution to meet his demand. Through a mixed, qualitative and quantitative (before/after analyses and compared to controls) approach, the research programme will assess the impact and effectiveness on healthy ageing, the technical usage, the mechanisms of the intervention and conditions of transferability and scalability. ETHICS AND DISSEMINATION Inserm Ethics Committee and the Comité Éthique et Scientifique pour les Recherches, les Études et les Évaluations dans le domaine de la Santé approved this research and collected data will be deposited with a suitable data archive.
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Affiliation(s)
- Karine Pérès
- Univ. Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | | | | | - Hélène Amieva
- Univ. Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | - Stephane Lafitte
- University Hospital Centre Bordeaux Cardiology Hospital Anaesthesiology and Reanimation, Pessac, Nouvelle-Aquitaine, France
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Hakim AM. A Proposed Hypothesis on Dementia: Inflammation, Small Vessel Disease, and Hypoperfusion Is the Sequence That Links All Harmful Lifestyles to Cognitive Impairment. Front Aging Neurosci 2021; 13:679837. [PMID: 33994998 PMCID: PMC8116506 DOI: 10.3389/fnagi.2021.679837] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/17/2022] Open
Abstract
There is growing consensus that certain lifestyles can contribute to cognitive impairment and dementia, but the physiological steps that link a harmful lifestyle to its negative impact are not always evident. It is also unclear whether all lifestyles that contribute to dementia do so through the same intermediary steps. This article will focus on three lifestyles known to be risk factors for dementia, namely obesity, sedentary behavior, and insufficient sleep, and offer a unifying hypothesis proposing that lifestyles that negatively impact cognition do so through the same sequence of events: inflammation, small vessel disease, decline in cerebral perfusion, and brain atrophy. The hypothesis will then be tested in a recently identified risk factor for dementia, namely hearing deficit. If further studies confirm this sequence of events leading to dementia, a significant change in our approach to this debilitating and costly condition may be necessary, possible, and beneficial.
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Affiliation(s)
- Antoine M. Hakim
- Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
- Division of Neurology, University of Ottawa, Ottawa, ON, Canada
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West JS, Lynch SM. Demographic and Socioeconomic Disparities in Life Expectancy With Hearing Impairment in the United States. J Gerontol B Psychol Sci Soc Sci 2021; 76:944-955. [PMID: 32944746 PMCID: PMC8063680 DOI: 10.1093/geronb/gbaa166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Hearing impairment is one of the most common disabilities among older people, and its prevalence will increase as the U.S. population ages. However, little is known about social disparities in onset or transitions into and out of hearing impairment, nor how these transitions impact years of life to be spent impaired. METHOD We investigate the number of years an "average" person can expect to live with and without hearing impairment after age 50; sex, race, educational, and regional differences in these expectancies; and the implication of hearing impairment for remaining life expectancy. Bayesian multistate life table methods are applied to 9 waves of data from the Health and Retirement Study (1998-2014) to investigate social disparities in life expectancy with hearing impairment (n = 20,200) for the general population, people hearing impaired at age 50, and people hearing unimpaired at age 50. RESULTS Men, Hispanics, persons with less educational attainment, and those born in the south can expect to live a larger proportion of their remaining lives hearing impaired. Although transitions from hearing impaired to unimpaired occur, those with some hearing impairment at age 50 can expect to live more years with hearing impairment, and hearing impairment does not shorten remaining life expectancy. DISCUSSION Significant sociodemographic disparities in hearing impaired life expectancy exist. In contrast to past research, we find that hearing impairment does not affect total life expectancy. Future research should consider the consequences of hearing impairment for years to be lived with other age-related and potentially downstream health outcomes.
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Affiliation(s)
- Jessica S West
- Department of Sociology, Duke University, Durham, North Carolina
| | - Scott M Lynch
- Department of Sociology, Duke University, Durham, North Carolina
- Duke University Population Research Institute, Duke University, Durham, North Carolina
- Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina
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ElTanbouly MA, Noelle RJ. Rethinking peripheral T cell tolerance: checkpoints across a T cell's journey. Nat Rev Immunol 2021; 21:257-267. [PMID: 33077935 DOI: 10.1038/s41577-020-00454-2] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 01/10/2023]
Abstract
Following their exit from the thymus, T cells are endowed with potent effector functions but must spare host tissue from harm. The fate of these cells is dictated by a series of checkpoints that regulate the quality and magnitude of T cell-mediated immunity, known as tolerance checkpoints. In this Perspective, we discuss the mediators and networks that control the six main peripheral tolerance checkpoints throughout the life of a T cell: quiescence, ignorance, anergy, exhaustion, senescence and death. At the naive T cell stage, two intrinsic checkpoints that actively maintain tolerance are quiescence and ignorance. In the presence of co-stimulation-deficient T cell activation, anergy is a dominant hallmark that mandates T cell unresponsiveness. When T cells are successfully stimulated and reach the effector stage, exhaustion and senescence can limit excessive inflammation and prevent immunopathology. At every stage of the T cell's journey, cell death exists as a checkpoint to limit clonal expansion and to terminate unrestrained responses. Here, we compare and contrast the T cell tolerance checkpoints and discuss their specific roles, with the aim of providing an integrated view of T cell peripheral tolerance and fate regulation.
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Affiliation(s)
- Mohamed A ElTanbouly
- Department of Microbiology and Immunology, Geisel School of Medicine, Norris Cotton Cancer Center, Dartmouth College, Hanover, NH, USA
| | - Randolph J Noelle
- Department of Microbiology and Immunology, Geisel School of Medicine, Norris Cotton Cancer Center, Dartmouth College, Hanover, NH, USA.
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Kim HJ, Lee JY, Lee ES, Jung HJ, Ahn HJ, Jung HI, Kim BI. Simple oral exercise with chewing gum for improving oral function in older adults. Aging Clin Exp Res 2021; 33:1023-1031. [PMID: 32476089 DOI: 10.1007/s40520-020-01606-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/18/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND As general and oral health are closely interrelated, promoting oral health may extend a healthy life expectancy. AIMS To evaluate the long-term effects of simple oral exercise (SOE) and chewing gum exercise on mastication, salivation, and swallowing function in adults aged ≥ 65 years. METHODS Ninety-six participants were assigned to control, SOE, and GOE (chewing gum exercise with SOE) groups. The SOE comprised exercises to improve mastication, salivation, and swallowing function. Control group participants performed no exercises. The intervention period was 8 weeks, followed by a 3-week maintenance period. The Mixing Ability Index (MAI), occlusal force, unstimulated saliva, and repetitive saliva swallowing test were evaluated at baseline and 2, 5, 8, and 11 weeks later. Self-reported discomfort was re-evaluated after 8 weeks. RESULTS After 8 weeks, mean MAI differences from baseline significantly increased in both groups; the increase in the GOE group was largest and four times higher than in the control group. Mean differences of occlusal force from baseline increased by 56 N (SOE group) and 60 N (GOE group). The increase of salivation was greater in the SOE (3.6-fold) and GOE (2.2-fold) groups than in the control group. Furthermore, 27% and 18% of SOE and GOE group participants, respectively, were re-categorized as having good swallowing function. Participants reported less discomfort as oral functions improved. DISCUSSION These findings may facilitate the development of clinical practice guidelines for optimal oral care in older adults. CONCLUSION While both SOE and GOE may improve oral function in older adults, GOE is recommended for those with impaired mastication. TRIAL REGISTRATION KCT0003305, retrospectively registered 31/10/2018.
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Sreedharan J, Nair SC, Muttappallymyalil J, Gopakumar A, Eapen NT, Satish KP, Manda V. Case fatality rates of COVID-19 across the globe: are the current draconian measures justified? JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:2575-2583. [PMID: 33777655 PMCID: PMC7988255 DOI: 10.1007/s10389-021-01491-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 02/16/2021] [Indexed: 12/13/2022]
Abstract
Aim The current study assessed the case fatality rate (CFR) across different income level countries of the world, and the virulence pattern of COVID-19, against the backdrop of panic and uncertainty faced by many governments, who are trying to impose draconian containment measures to control the outbreak. Subjects and Methods: Data on confirmed cases and number of deaths due to coronavirus infection were retrieved from the WHO as on 30 March 2020, and examined for the various income level countries, per the World Bank criteria. The CFR was calculated country-wise and estimated for the various groups such as low, lower-middle, upper-middle, and high-income, and the data was analyzed. Results The overall CFR for the high income countries was 5.0%, compared with a CFR of 2.8% for low-income countries. The upper-middle-income countries showed a CFR of 4.3%, while the lower-middle-income countries stood at 3.7%. The results from our study predict that the maximum CFR in high-income countries will be contained at approximately 5% (95% CI). The CFR for the low, lower-middle, and upper-middle-income countries will range between 2.8 and 4.3% (95% CI). Conclusion COVID-19, irrespective of its transmissibility, produces a lower CFR compared with that of SARS-Cov and MERS-Cov, although COVID-19 has infected eight times more countries than MERS-Cov and SARS-Cov, and caused a higher number of deaths. The nation-wide lockdown measures to prevent the spread of the virus may be reconsidered, given the hardships for the population and their impact on the economic system.
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Affiliation(s)
| | - Satish Chandrasekhar Nair
- Tawam Hospital Johns Hopkins Medicine Affiliate and College of Medicine, UAE University, Al Ain, UAE
| | | | - Aji Gopakumar
- Institutional Research Unit, Gulf Medical University, P O Box 4184, Ajman, UAE
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Ross E, Wright H, Villani A. Lower body extremity function is associated with health-related quality of life: a cross-sectional analysis of overweight and obese older adults with and without type 2 diabetes mellitus. Qual Life Res 2021; 30:2265-2273. [PMID: 33745064 DOI: 10.1007/s11136-021-02821-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE We aimed to explore the relationship between characteristics of the sarcopenic phenotype and health-related quality of life (HRQoL) in community-dwelling overweight and obese older adults with and without type 2 diabetes mellitus (T2DM). METHODS Appendicular lean mass (ALM), corrected for height (ALM/m2) was assessed by dual-energy X-ray absorptiometry. Muscle strength was assessed using handgrip strength (HGS), and lower extremity physical function was assessed using the Short Performance Physical Battery (SPPB) and gait speed. HRQoL was determined using the short-form 36 (SF-36) survey. Multiple regression analysis was used to examine the association between characteristics of the sarcopenic phenotype and domains of HRQoL. RESULTS A total of n = 152 community-dwelling older adults were included (T2DM cohort: n = 87, 71.2 ± 8.2 years, BMI: 29.5 ± 5.9 kg/m2; Obese cohort: n = 65, 68.7 ± 5.6 years, BMI: 33.7 ± 4.9 kg/m2). After adjusting for potential confounders, gait speed and SPPB were positively associated with the physical function subscale of HRQoL (Gait speed: ß = 0.658; P < 0.001; SPPB: ß = 0.478; P < 0.001). This relationship was also maintained for gait speed when assessed independently by cohort (T2DM cohort: ß = 0.637; P < 0.001; Obese cohort: ß = 0.507; P = 0.003). CONCLUSIONS Our results further contribute to the literature suggesting that lower body extremity function is associated with the physical function subscale of HRQoL. However, larger longitudinal data are required to assess whether lower body extremity function is independently associated with HRQoL, which includes the potential impact of nutrition and physical activity status.
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Affiliation(s)
- Emily Ross
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4558, Australia
| | - Hattie Wright
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4558, Australia
| | - Anthony Villani
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4558, Australia.
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Wu J, Lai T, Han H, Liu J, Wang S, Lyu J. Global, regional and national disability-adjusted life years due to HIV from 1990 to 2019: findings from the Global Burden of Disease Study 2019. Trop Med Int Health 2021; 26:610-620. [PMID: 33639020 DOI: 10.1111/tmi.13565] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Increasing life expectancy and decreasing mortality in patients with HIV infection are well documented. However, details of how many of the years of healthy life are damaged by HIV infection vs. good health have not been understood. We conducted this study to provide a comprehensive assessment of the levels and trends of the global burden, as measured by disability-adjusted life years (DALYs), of HIV infection. METHODS Data on HIV-related DALY were obtained from the Global Burden of Disease Study 2019. The absolute numbers and age-standardised rates of DALYs due to HIV were reported between 1990 and 2019. Estimated annual percentage changes in age-standardised rates by sex, region and nation were calculated to quantify the temporal trends in HIV burden. RESULTS Global HIV infection caused 47.63 million DALYs in 2019, presenting a 1.28-fold increase from 1990 to 2019. In 2019, years of life lost contributed to most of the total DALYs, but the increases in HIV-related years lived with disability have outpaced increases in years of life lost. The age-standardised rates of HIV-related DALYs in 2019 decreased as the sociodemographic indexes increased. The highest age-standardised rates were observed in sub-Saharan Africa, and the greatest increments over time were detected in Oceania. CONCLUSIONS Globally, HIV continues to cause enormous healthy life loss. The first and foremost strategy for controlling the HIV burden is still the reduction of premature deaths, and much effort needs to be exerted to mitigate the harm of comorbidities.
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Affiliation(s)
- Jiayuan Wu
- Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Tianwen Lai
- Department of Pulmonary and Critical Care Medicine, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Huanqin Han
- Department of Infectious Disease, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jie Liu
- Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.,School of Public Health, Guangdong Medical University, Zhanjiang, China
| | - Shuangmiao Wang
- Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jun Lyu
- Department of Clinical Research, the Affiliated Hospital of Ji'nan University, Guangzhou, China
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Vaupel JW, Villavicencio F, Bergeron-Boucher MP. Demographic perspectives on the rise of longevity. Proc Natl Acad Sci U S A 2021; 118:e2019536118. [PMID: 33571137 PMCID: PMC7936303 DOI: 10.1073/pnas.2019536118] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This article reviews some key strands of demographic research on past trends in human longevity and explores possible future trends in life expectancy at birth. Demographic data on age-specific mortality are used to estimate life expectancy, and validated data on exceptional life spans are used to study the maximum length of life. In the countries doing best each year, life expectancy started to increase around 1840 at a pace of almost 2.5 y per decade. This trend has continued until the present. Contrary to classical evolutionary theories of senescence and contrary to the predictions of many experts, the frontier of survival is advancing to higher ages. Furthermore, individual life spans are becoming more equal, reducing inequalities, with octogenarians and nonagenarians accounting for most deaths in countries with the highest life expectancy. If the current pace of progress in life expectancy continues, most children born this millennium will celebrate their 100th birthday. Considerable uncertainty, however, clouds forecasts: Life expectancy and maximum life span might increase very little if at all, or longevity might rise much faster than in the past. Substantial progress has been made over the past three decades in deepening understanding of how long humans have lived and how long they might live. The social, economic, health, cultural, and political consequences of further increases in longevity are so significant that the development of more powerful methods of forecasting is a priority.
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Affiliation(s)
- James W Vaupel
- Danish Centre for Demographic Research, University of Southern Denmark, 5230 Odense, Denmark;
- Interdisciplinary Center on Population Dynamics, University of Southern Denmark, 5230 Odense, Denmark
| | - Francisco Villavicencio
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205
| | - Marie-Pier Bergeron-Boucher
- Danish Centre for Demographic Research, University of Southern Denmark, 5230 Odense, Denmark
- Interdisciplinary Center on Population Dynamics, University of Southern Denmark, 5230 Odense, Denmark
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Barak Y, Leitch S, Glue P. The Great Escape. Centenarians' exceptional health. Aging Clin Exp Res 2021; 33:513-520. [PMID: 32488471 DOI: 10.1007/s40520-020-01552-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Centenarians escapers are those who reached 100 years of age without the diagnosis of any of the common age-related diseases and exploring their characteristics will inform about successful ageing. No previous study has examined centenarians free of common chronic diseases amongst New Zealand centenarians. METHODS Retrospective observational cross-sectional review of a national dataset determining the prevalence of depression, dementia, diabetes and hypertension, smoking, physical activity and social relationships among older adults (aged 60-99 years) and centenarians. Participants were all older New Zealanders living independently in the community who completed the international Residential Assessment Instrument-Home Care (interRAI-HC) assessment during the study's 5-year period (July 2013-June 2018). RESULTS The assessments of 292 centenarians (mean age 101.03, SD 1.27 years) and 103,377 elderly (mean age 81.7, SD 5.7 years) were analysed. Compared to the elderly, centenarians were more likely to be female (74.7%, compared with 59.3% elderly, p < 0.001). Centenarians free of common chronic diseases did not differ from other centenarians on any of the analysed variables. Reduction in smoking rates and steady high rates of social engagement were associated with reaching a centenarian status free of common chronic diseases compared with older adults. CONCLUSIONS Not smoking and being socially engaged throughout older age were associated with being a centenarian free of common chronic diseases. This study adds to our understanding the complexities of attaining exceptional longevity.
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Klar MK, Geyer S, Safieddine B, Tetzlaff F, Tetzlaff J, Sperlich S. Trends in healthy life expectancy between 2002 and 2018 in Germany - Compression or expansion of health-related quality of life (HRQOL)? SSM Popul Health 2021; 13:100758. [PMID: 33732863 PMCID: PMC7937823 DOI: 10.1016/j.ssmph.2021.100758] [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: 11/06/2020] [Revised: 01/29/2021] [Accepted: 02/13/2021] [Indexed: 12/29/2022] Open
Abstract
The question of whether rising life expectancy has led to additional life years spent in good health or poor health is of major public health relevance. We tested the theories of compression or expansion of morbidity for Germany with respect to the mental and physical component summary scales (MCS/PCS) of the health-related quality of life (HRQOL) questionnaire (SF-12). Data of 90,758 women and 81,400 men were obtained from the German Socio-Economic Panel between 2002 and 2018. Linear and logistic regression analyses were applied to estimate temporal changes in MCS and PCS in different life stages. The development of healthy life expectancy (H-LE) expressed by life years without severe functional limitations was calculated by applying the Sullivan method. Overall, a significant increase of MCS and PCS was found in both genders. The rise was mainly due to declining proportions of severe limitations (norm values < 40 points) while the proportions of norm values > 60 points did not change substantially. Improvements were most apparent for the 'young seniors' (65-79 years) and at 'old age' (80 years +). In contrast, no improvements in PCS were found for 'later working life' (50-64 years) and decreasing levels were observed for persons of 'middle working age' (30-49 years). During the study period, H-LE at age 50 increased in women/men by 2.93/2.90 years (MCS) and 1.92/2.53 years (PCS), respectively. Our results support the hypothesis of absolute compression of morbidity. However, since consistent improvements were not found for ages below 65 years, it remains open to debate whether the positive health trend will also persist in the future. Our findings suggest that health promotion efforts should be strengthened for people of middle and later working age to support healthy aging.
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Affiliation(s)
| | - Siegfried Geyer
- Hannover Medical School, Medical Sociology, Hannover, Germany
| | | | - Fabian Tetzlaff
- Hannover Medical School, Medical Sociology, Hannover, Germany
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