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Narayanan ML, Holck P, Lin AL, Schraer CD. Living well with diabetes in Alaska. Int J Circumpolar Health 2024; 83:2341988. [PMID: 38718274 PMCID: PMC11080664 DOI: 10.1080/22423982.2024.2341988] [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: 12/11/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
Many people with diabetes mellitus experience minimal or no complications. Our objective was to determine the proportion of Alaska Native people who experienced four major complications or mortality and to identify factors that may be associated with these outcomes. We used records in a diabetes registry and clinical and demographic variables in our analyses. We used logistic regression and Cox Proportional Hazards models to evaluate associations of these parameters with death and complications that occurred prior to 2013. The study included 591 Alaska Native people with non-type 1 diabetes mellitus, diagnosed between 1986 and 1992. Over 60% of people in this study remained free of four major diabetes-related complications for the remainder of life or throughout the approximately 20-year study period. Lower BMI, higher age at diagnosis of diabetes, and use of at least one diabetes medication were associated with death and a composite of four complications. A majority of Alaska Native people with DM had none of four major complications over a 20-year period. Lower BMI and use of diabetes medications were associated with higher hazard for some deleterious outcomes. This suggests that goals in care of elders should be carefully individualised. In addition, we discuss several programme factors that we believe contributed to favourable outcomes.
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Affiliation(s)
- Meera L. Narayanan
- Diabetes Program, Alaska Native Tribal Health Consortium Diabetes Program, Anchorage, AK, USA
| | - Peter Holck
- Research Services, Alaska Native Tribal Health Consortium Research Services, Anchorage, AK, USA
| | - Ai-Ling Lin
- Diabetes Program, Alaska Native Tribal Health Consortium Diabetes Program, Anchorage, AK, USA
| | - Cynthia D. Schraer
- Diabetes Program, Alaska Native Tribal Health Consortium Diabetes Program, Anchorage, AK, USA
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Pes GM, Errigo A, Dore MP. Association between Mild Overweight and Survival: A Study of an Exceptionally Long-Lived Population in the Sardinian Blue Zone. J Clin Med 2024; 13:5322. [PMID: 39274535 PMCID: PMC11396680 DOI: 10.3390/jcm13175322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 08/29/2024] [Accepted: 09/04/2024] [Indexed: 09/16/2024] Open
Abstract
Background/Objectives: Overweight and obesity are generally considered risk factors for premature mortality. However, scientific evidence suggests that among older populations, mild conditions of overweight might be associated with reduced comorbidity and longer survival. This study investigates the potential association between anthropometric parameters and survival among a cohort of nonagenarians in Sardinia, Italy. Methods: This study included 200 subjects (50% females) aged 89 and older, enrolled in 2018 in the Sardinian Blue Zone-a population known for longevity-and followed for up to six years. Anthropometric variables such as body height, weight, age, sex, comorbidity, disability, and food group intake were collected using validated questionnaires and analyzed through multivariable analysis. Results: Out of 200 participants at baseline, 28 (14%) were still alive after six years of follow-up (females 10%, males 18%). Mean survival was 3.36 years (range 0.1-6.9 years) for males and 3.03 years (range 0.2-6.6 years) for females. Participants with a Body Mass Index (BMI) in the range of 25.0-27.0 kg/m2 among males and 25.0-27.2 kg/m2 among females had longer survival compared to those who were underweight (p = 0.002) or obese (p < 0.0001). The Cox proportional hazards regression model, adjusted for age, sex, and comorbidity, revealed a statistically significant association between the BMI and survival, demonstrating an inverted-U relationship. This indicates that mild overweight was associated with a survival advantage compared to both normal weight and obesity. Conclusions: Our study indicates that mild, but not severe, overweight in nonagenarians is associated with extended lifespan. Therefore, primary care physicians and geriatricians should exercise caution before recommending calorie-restricted diets for mildly overweight elderly patients.
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Affiliation(s)
- Giovanni Mario Pes
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Clinica Medica, Viale San Pietro 8, 07100 Sassari, Italy
- Sardinia Blue Zone Longevity Observatory, 08040 Santa Maria Navarrese, Italy
| | - Alessandra Errigo
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Clinica Medica, Viale San Pietro 8, 07100 Sassari, Italy
| | - Maria Pina Dore
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Clinica Medica, Viale San Pietro 8, 07100 Sassari, Italy
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
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Wang Y, Shen S, Han P, Zheng K, Chen C, Wu Y, Huang C, Guo J, Qi Y, Chen X, Zheng Y, Xia X, Peng S, Guo Q. The association between visceral fat obesity and prefrailty in Chinese older adults: a cross-sectional study. BMC Endocr Disord 2024; 24:136. [PMID: 39090692 PMCID: PMC11295587 DOI: 10.1186/s12902-024-01625-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/14/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The prevalence of obesity is escalating. Previous research has concentrated on the link between frailty and obesity; however, the association between prefrailty and obesity has been less studied. Prefrailty screening and intervention may prevent or postpone frailty in older persons. OBJECTIVE The study was to investigate into the relationship between prefrailty and several obesity indicators in Chinese community-dwelling older individuals. METHODS This research employed the Frailty Screening Index to investigate the frailty phenotype of people living in Shanghai. Bioelectrical impedance analysis was used for evaluating body composition. RESULTS There were 510 participants (39.0%) with high visceral adipose areas. Participants with a high visceral adipose area showed a higher risk of prefrailty (adjusted OR, 1.53; 95% CI, 1.19-1.96), according to multivariate models. When body mass index (BMI) and visceral fat area (VFA) were combined, it was discovered that having an overweight BMI with normal VFA was a protective factor for prefrailty (corrected OR, 0.62; 95% CI, 0.43-0.90), but having a normal weight but excess VFA increased the risk of prefrailty (corrected OR, 1.87; 95% CI, 1.15-3.03). CONCLUSION Visceral fat obesity is an independent risk factor for prefrailty in Chinese older adults. Implementing targeted interventions, such as dietary modifications, increased physical activity, and other lifestyle changes, could play a crucial role in reducing the risk of prefrailty and improving overall health outcomes in this population.
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Affiliation(s)
- Yue Wang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 200135, China
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Suxing Shen
- Rehabilitation Medicine Department, Tianjin Fifth Central Hospital, Tianjin, 300457, China
| | - Peipei Han
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Kai Zheng
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 200135, China
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Cheng Chen
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
- School of Health, Fujian Medical University, Fuzhou, 350122, Fujian, China
| | - Yahui Wu
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 200135, China
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Chuanjun Huang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 200135, China
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Jiangling Guo
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yiqiong Qi
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200438, China
| | - Xiaoyu Chen
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Yuxuan Zheng
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Xinwei Xia
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Siyan Peng
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Qi Guo
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China.
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200438, China.
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences affiliated Zhoupu Hospital, 279 Zhouzhu Highway, Pudong New Area, Shanghai, 201318, China.
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Guo J, Dove A, Shang Y, Marseglia A, Johnell K, Rizzuto D, Xu W. Associations Between Mid- to Late-Life Body Mass Index and Chronic Disease-Free Survival: A Nationwide Twin Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad111. [PMID: 37096341 PMCID: PMC10733179 DOI: 10.1093/gerona/glad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Some studies have linked late-life overweight to a reduced mortality risk compared to normal body mass index (BMI). However, the impact of late-life overweight and its combination with mid-life BMI status on healthy survival remains unclear. We aimed to investigate whether and to what extent mid- and/or late-life overweight are associated with chronic disease-free survival. METHODS Within the Swedish Twin Registry, 11 597 chronic disease-free twins aged 60-79 years at baseline were followed up for 18 years. BMI (kg/m2) was recorded at baseline and 25-35 years before baseline (ie, midlife) and divided as underweight (<20), normal (≥20-25), overweight (≥25-30), and obese (≥30). Incident chronic diseases (cardiovascular diseases, type 2 diabetes, and cancer) and deaths were ascertained via registries. Chronic disease-free survival was defined as years lived until the occurrence of any chronic diseases or death. Data were analyzed using multistate survival analysis. RESULTS Of all participants, 5 640 (48.6%) were overweight/obese at baseline. During the follow-up, 8 772 (75.6%) participants developed at least 1 chronic disease or died. Compared to normal BMI, late-life overweight and obesity were associated with 1.1 (95% CI, 0.3, 2.0) and 2.6 (1.6, 3.5) years shorter chronic disease-free survival. Compared to normal BMI through mid- to late life, consistent overweight/obesity and overweight/obesity only in mid-life led to 2.2 (1.0, 3.4) and 2.6 (0.7, 4.4) years shorter disease-free survival, respectively. CONCLUSIONS Late-life overweight and obesity may shorten disease-free survival. Further research is needed to determine whether preventing overweight/obesity from mid- to late life might favor longer and healthier survival.
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Affiliation(s)
- Jie Guo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Abigail Dove
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Ying Shang
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Anna Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Kolberg M, Paur I, Sun YQ, Gjøra L, Skjellegrind HK, Thingstad P, Strand BH, Selbæk G, Fagerhaug TN, Thoresen L. Prevalence of malnutrition among older adults in a population-based study - the HUNT Study. Clin Nutr ESPEN 2023; 57:711-717. [PMID: 37739727 DOI: 10.1016/j.clnesp.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Malnutrition is common in older adults and is associated with increased morbidity and mortality rates. AIM The aim of the study is to describe the prevalence of malnutrition based on low BMI, involuntary weight loss, and reduced food intake, in a Norwegian population of community-dwelling older adults and older adults living in nursing homes. METHODS This population-based study is part of the fourth wave of the Trøndelag Health Study (HUNT4) and includes participants ≥70 years from the HUNT4 70+ cohort. The HUNT4 70+ cohort consist of 9930 (response rate 51.2%) participants. In the current study 8127 older people had complete dataset for inclusion in the analyses. Participants completed a self-report questionnaire and standardised interviews and clinical assessments at field stations, in participants' homes or at nursing homes. Malnutrition was defined using the following criteria: low BMI, involuntary weight loss and severely reduced food intake. The standardised prevalence of malnutrition was estimated using inverse probability weighting (IPW) with weights for sex, age and education of the total population in the catchment area of HUNT. RESULTS Of the 8127 included participants, 7671 (94.4%) met at field stations, 356 (4.4%) were examined in their home, and 100 (1.2%) in nursing homes. In total, 14.3% of the population were malnourished based on either low BMI, weight loss, or reduced food intake, of which low BMI was the most frequently fulfilled criterion. The prevalence of malnutrition was less common among men than among women (10.1 vs 18.0%, p < 0.001), also after adjustment for age (OR 0.53, 95% confidence interval (CI) 0.46-0.61). The prevalence increased gradually with increasing age and the regression analysis adjusted for sex showed that for each year increase in age the prevalence of malnutrition increased with 4.0% (OR 1.04, 95% CI 1.03-1.05). The prevalence was higher both among older adults examined in their homes (26.4%) and residents in nursing home (23.6%), as compared to community-dwelling older adults who met at field stations (13.5%). CONCLUSION The prevalence of malnutrition is high in the older population. Special attention on prevention and treatment of malnutrition should be given to older women, the oldest age groups, and care-dependent community-dwelling older adults and nursing home residents.
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Affiliation(s)
- Marit Kolberg
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
| | - Ingvild Paur
- Norwegian Advisory Unit on Disease-related Undernutrition, Oslo, Norway; Section for Clinical Nutrition, Department of Clinical Services, Division of Cancer Medicine, Oslo University Hospital, Norway; Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Yi-Qian Sun
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Linda Gjøra
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Håvard Kjesbu Skjellegrind
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Health and Welfare, Trondheim Municipality, Trondheim, Norway
| | - Bjørn Heine Strand
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Geir Selbæk
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tone Natland Fagerhaug
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lene Thoresen
- Oncology Clinic, Trondheim University Hospital, Trondheim, Norway
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Dramé M, Godaert L. The Obesity Paradox and Mortality in Older Adults: A Systematic Review. Nutrients 2023; 15:nu15071780. [PMID: 37049633 PMCID: PMC10096985 DOI: 10.3390/nu15071780] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
“Obesity paradox” describes the counterintuitive finding that aged overweight and obese people with a particular disease may have better outcomes than their normal weight or underweight counterparts. This systematic review was performed to summarize the publications related to the obesity paradox in older adults, to gain an in-depth understanding of this phenomenon. PubMed©, Embase©, and Scopus© were used to perform literature search for all publications up to 20 March 2022. Studies were included if they reported data from older adults on the relation between BMI and mortality. The following article types were excluded from the study: reviews, editorials, correspondence, and case reports and case series. Publication year, study setting, medical condition, study design, sample size, age, and outcome(s) were extracted. This review has been registered with PROSPERO (no. CRD42021289015). Overall, 2226 studies were identified, of which 58 were included in this systematic review. In all, 20 of the 58 studies included in this review did not find any evidence of an obesity paradox. Of these 20 studies, 16 involved patients with no specific medical condition, 1 involved patients with chronic diseases, and 2 involved patients with type 2 diabetes mellitus. Seven out of the nine studies that looked at short-term mortality found evidence of the obesity paradox. Of the 28 studies that examined longer-term mortality, 15 found evidence of the obesity paradox. In the studies that were conducted in people with a particular medical condition (n = 24), the obesity paradox appeared in 18 cases. Our work supports the existence of an obesity paradox, especially when comorbidities or acute medical problems are present. These findings should help guide strategies for nutritional counselling in older populations.
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Affiliation(s)
- Moustapha Dramé
- EpiCliV Research Unit, Faculty of Medicine, University of the French West Indies, 97261 Fort-de-France, France
- Department of Clinical Research and Innovation, University Hospitals of Martinique, 97261 Fort-de-France, France
| | - Lidvine Godaert
- EpiCliV Research Unit, Faculty of Medicine, University of the French West Indies, 97261 Fort-de-France, France
- Department of Geriatrics, General Hospital of Valenciennes, 59300 Valenciennes, France
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GDLAM and SPPB batteries for screening sarcopenia in community-dwelling Spanish older adults: Healthy-age network study. Exp Gerontol 2023; 172:112044. [PMID: 36509296 DOI: 10.1016/j.exger.2022.112044] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To determine the diagnostic ability of GDLAM and SPPB batteries to classify people with sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP19). STUDY DESIGN This cross-sectional study recruited 584 participants (240 men, 65.33 ± 8.68 years old). The diagnostic criteria of the EWGSOP19 for probable, confirmed and severe sarcopenia were used as the standard. Then, the Latin American Group for Maturity battery-GDLAM- and the short physical performance battery-SPPB- were measured. The ability as screening methods of these two batteries were determined by specific indicators including sensitivity, specificity, receiver operating characteristic (ROC) curve, and area under the ROC curves (AUC). MAIN OUTCOME MEASURES Anthropometric variables (Body mass, height, triceps, thigh and calf skinfolds and relaxed arm, middle-thigh and calf girths), handgrip strength (HG), chair stand, 4 m walk, and timed-up-and-go-tests (TUG) as well as the Latin American Group for Maturity battery (GDLAM) and the short physical performance battery (SPPB) were performed. RESULTS The GDLAM battery shows a sensitivity from moderate to high (60.1-72.2 %), and specificity from moderate (57.6 %) to very high (90.7 %) to identify sarcopenia categories (probable, confirmed and severe). However, the SPPB battery shows a lack of classification ability for probable sarcopenia (AUC = 0.436; p = 0.123), confirmed sarcopenia (AUC = 0.499; p = 0.959) and severe sarcopenia (AUC = 0.484; p = 0.532). Those participants classified as probable sarcopenia or confirmed sarcopenia measured by GDLAM battery according to the cut-off points obtained in the ROC curve showed a higher probability to be in the probable sarcopenia (OR = 2.8; p = 0.001) or confirmed sarcopenia categories (OR = 10; p = 0.002), respectively, based on EWGSOP19 criteria. CONCLUSIONS The GDLAM screening battery showed improved properties in terms of distinguishing individuals at risk for sarcopenia from those who were not.
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Physical activity and body mass index were interactively related to health-related quality of life among older adults. Arch Gerontol Geriatr 2023; 104:104833. [PMID: 36240587 DOI: 10.1016/j.archger.2022.104833] [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: 06/14/2022] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE The purpose of this study was to examine how meeting physical activity (PA) guidelines (i.e., moderate-to-vigorous aerobic activity, muscle strengthening activity) and weight status were interactively related to health-related quality of life (HRQoL) among older adults. METHODS A cross-sectional analysis was conducted using data from 87,495 older adults aged 65+ years who participated in the U.S. 2019 Behavioral Risk Factor Surveillance System. PA, weight status, and HRQoL were assessed by validated questionnaires via phone interviews. Binomial logistic regression models were used to examine the interactive effects of meeting PA guidelines and weight status on the odds of having poor HRQoL after controlling for key confounders. RESULTS Compared to participants meeting both PA guidelines and with normal weight, both underweight and obese older adults had significantly higher odds of having poor general health (OR= 1.55-6.16) regardless of meeting PA guideline status, and those meeting muscle strengthening activities only or meeting neither PA guideline reported higher odds of poor physical health (OR= 1.83-6.22) regardless of weight status. Similarly, those meeting neither PA guideline had significantly higher odds of having poor mental health (OR= 1.69-2.78) regardless of weight status, and those meeting muscle strengthening activities only or meeting neither PA guideline reported higher odds of having frequent activity limitation days (OR= 2.18-7.05). CONCLUSIONS The positive associations between moderate-to-vigorous aerobic PA and HRQoL indicate the need to promote aerobic PA in older adults. Both sex and weight status should be considered when designing PA interventions to improve HRQoL among older adults.
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Boriani G, Vitolo M, Malavasi VL, Proietti M, Fantecchi E, Diemberger I, Fauchier L, Marin F, Nabauer M, Potpara TS, Dan GA, Kalarus Z, Tavazzi L, Maggioni AP, Lane DA, Lip GYH. Impact of anthropometric factors on outcomes in atrial fibrillation patients: analysis on 10 220 patients from the European Society of Cardiology (ESC)-European Heart Rhythm Association (EHRA) EurObservational Research Programme on Atrial Fibrillation (EORP-AF) general long-term registry. Eur J Prev Cardiol 2022; 29:1967-1981. [PMID: 35671129 DOI: 10.1093/eurjpc/zwac115] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/07/2022] [Accepted: 05/31/2022] [Indexed: 09/07/2023]
Abstract
AIM To investigate the association of anthropometric parameters [height, weight, body mass index (BMI), body surface area (BSA), and lean body mass (LBM)] with outcomes in atrial fibrillation (AF). METHODS AND RESULTS Ten-thousand two-hundred twenty patients were enrolled [40.3% females, median age 70 (62-77) years, followed for 728 (interquartile range 653-745) days]. Sex-specific tertiles were considered for the five anthropometric variables. At the end of follow-up, survival free from all-cause death was worse in the lowest tertiles for all the anthropometric variables analyzed. On multivariable Cox regression analysis, an independent association with all-cause death was found for the lowest vs. middle tertile when body weight (hazard ratio [HR] 1.66, 95%CI 1.23-2.23), BMI (HR 1.65, 95%CI 1.23-2.21), and BSA (HR 1.49, 95%CI 1.11-2.01) were analysed in female sex, as well as for body weight in male patients (HR 1.61, 95%CI 1.25-2.07). Conversely, the risk of MACE was lower for the highest tertile (vs. middle tertile) of BSA and LBM in males and for the highest tertile of weight and BSA in female patients. A higher occurrence of haemorrhagic events was found for female patients in the lowest tertile of height [odds ratio (OR) 1.90, 95%CI 1.23-2.94] and LBM (OR 2.13, 95%CI 1.40-3.26). CONCLUSIONS In AF patients height, weight, BMI, BSA, and LBM were associated with clinical outcomes, with all-cause death being higher for patients presenting lower values of these variables, i.e. in the lowest tertiles of distribution. The anthropometric variables independently associated with other outcomes were also different between male and female subjects.
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Affiliation(s)
- Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Vincenzo L Malavasi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Elisa Fantecchi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Igor Diemberger
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain
| | - Michael Nabauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Intensive Arrhythmia Care, Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- 'Carol Davila' University of Medicine, Colentina University Hospital, Bucharest, Romania
| | - Zbigniew Kalarus
- Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | | | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Lopuszanska-Dawid M, Kupis P, Lipowicz A, Kołodziej H, Szklarska A. How Stress Is Related to Age, Education, Physical Activity, Body Mass Index, and Body Fat Percentage in Adult Polish Men? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912149. [PMID: 36231449 PMCID: PMC9566620 DOI: 10.3390/ijerph191912149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/18/2022] [Accepted: 09/22/2022] [Indexed: 05/17/2023]
Abstract
Stressful events and chronic tension are considered a burden and a threat to physical, mental, and social health. The aim of the study was to demonstrate the associations of variation in stress exposure with social factors, physical activity, basic components of physical fitness, body mass index (BMI) and percentage of body fat (BFP). An additional objective was to identify the main BFP modifiers among those analyzed. The material consisted of data of ethnically homogeneous group 355 men (32-87 yrs), invited to the study as part of the Wroclaw Male Study research project. The analyzed features included socioeconomic status (age, educational level), elements of lifestyle (physical activity), major and most important stressful life events-Social Readjustment Rating Scale (SRRS) and basic parameters of the somatic structure of the body (BMI, BFP). Statistical analyses included: chi-square test, Mann-Whitney U test and backward stepwise regression (significance level α = 0.05). Stress exposure showed significant socioeconomic variation among the adult Poles studied. Higher levels of education were associated with higher levels of stress. Significant correlations between SRRS and physical activity were found, especially in men older than 60 years and with higher levels of education. A positive relationship was shown between SRRS and BFP, especially in men under 60 years of age. BFP appeared to depend mainly on age and stress. The main determinants of SRRS were age and education level, while BFP turned out to be more sensitive to stress than BMI. The modifying force of physical activity for SRRS appears to be age dependent.
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Affiliation(s)
- Monika Lopuszanska-Dawid
- Department of Human Biology, Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-834-04-31
| | - Przemysław Kupis
- Department of Human Biology, Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland
| | - Anna Lipowicz
- Department of Anthropology, Faculty of Biology and Animal Science, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - Halina Kołodziej
- Department of Anthropology, Faculty of Biology and Animal Science, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - Alicja Szklarska
- Polish Academy of Sciences, Poland, Palace of Culture and Science, Defilad Square 1, 00-901 Warsaw, Poland
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Marcos-Pardo PJ, Abelleira-Lamela T, Vaquero-Cristobal R, González-Gálvez N. Changes in life satisfaction, depression, general health and sleep quality of Spanish older women during COVID-19 lockdown and their relationship with lifestyle: an observational follow-up study. BMJ Open 2022; 12:e061993. [PMID: 36002204 PMCID: PMC9412044 DOI: 10.1136/bmjopen-2022-061993] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/02/2022] [Indexed: 11/24/2022] Open
Abstract
OBJETIVES To analyse the effects of COVID-19 lockdown on mental well-being variables of older women, and to determine the influence of lifestyle and age on such effects. The hypothesis of the study was that all parameters related to mental well-being would worsen in older women during the COVID-19 lockdown. DESIGN Observational follow-up study. Pre lockdown measurements were taken before the lockdown. Post lockdown measurements were taken as soon as began the de-escalation. SETTING Senior centres in the Region of Murcia (Spain). PARTICIPANTS The sample was composed of 40 older women volunteers, over 54 years of age (mean age=62.35±8.15 years). PRIMARY AND SECONDARY OUTCOME MEASURES Pre lockdown and post lockdown evaluations were carried out face to face. The following questionnaires were completed: Satisfaction with Life Scale, The Center for Epidemiologic Studies Depression Scale, The Short Form 36 Health Survey, The Pittsburgh Sleep Quality Index, the Global Physical Activity Questionnaire and Prevention with Mediterranean Diet. RESULTS Post lockdown, a worsening was found in the variables of life satisfaction (p=0.001); depression (p<0.001), quality of life in physical role (p=0.006), pain (p=0.004), emotional role (p<0.001) and mental health (p<0.001); and sleep quality (p=0.018), sleep latency (p=0.004), sleep disturbances (p=0.002) and global sleep quality score (p=0.002). It was found how age influenced the variables of pain (p=0.003) and social role (p=0.047), as well as the influence of a healthy lifestyle on the variables analysed (F=6.214; p=0.017). Adherence to the Mediterranean diet was shown to be a protective factor against increased depression (p=0.03). Spending time sitting was shown to be a risk factor for physical role health (p=0.002), as was advanced age on health due to worsening pain (p=0.005), or an unhealthy lifestyle on increased consumption of sleeping aids (p=0.017). CONCLUSION The lockdown had a great negative impact on Spanish older women on mental well-being variables. TRIAL REGISTRATION NUMBER NCT04958499.
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Affiliation(s)
- Pablo Jorge Marcos-Pardo
- SPORT Research Group (CTS-1024), CERNEP Research Center, Universidad de Almeria, Almeria, Andalucía, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes, Madrid, Spain
| | - Tomás Abelleira-Lamela
- Injury prevention in sport Research Group (PRELEDE), Faculty of Sport, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Raquel Vaquero-Cristobal
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes, Madrid, Spain
- Injury prevention in sport Research Group (PRELEDE), Faculty of Sport, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Noelia González-Gálvez
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes, Madrid, Spain
- Injury prevention in sport Research Group (PRELEDE), Faculty of Sport, Universidad Católica San Antonio de Murcia, Murcia, Spain
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12
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An observational study on body mass index during rehabilitation and follow-up in people with spinal cord injury in Denmark. Spinal Cord 2022; 60:157-162. [PMID: 34975155 DOI: 10.1038/s41393-021-00730-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Observational study OBJECTIVE: To describe body mass index (BMI) during rehabilitation in people with a newly sustained spinal cord injury (SCI). SETTING Inpatient SCI rehabilitation in Denmark. PARTICIPANTS Inpatients, >18 years, having sustained a SCI within the last 12 months at admission to primary rehabilitation, inclusive of various SCI etiology, neurological level, completeness of the lesion or mobility status. METHODS Measures of BMI were obtained at admission and discharge as part of standard care. At one SCI center measures of BMI were sampled at follow up 9.5 months after discharge as well. BMI was described by mean and standard deviation (SD). Paired t-test was used to test difference in BMI between admission and discharge. Repeated measures Analysis of Variance (ANOVA) was used for analyzing BMI deriving from three time points. RESULTS Overall BMI was stable with no change (25.4 kg/m2 at admission and 25.6 kg/m2 at discharge) during rehabilitation at the two national centers. In participants with an American Spinal Injury Association (ASIA) Impairment Scale (AIS) D classification, BMI was higher during rehabilitation compared to the other groups and increased significantly (p = 0.008) from discharge to follow up. CONCLUSIONS Overall BMI was stable but higher than recommended in people with SCI undergoing rehabilitation at the two national centers in Denmark. Participants with an AIS D SCI were obese according to SCI adjusted BMI and the World Health Organization (WHO) recommendations during rehabilitation and at follow up.
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Cho Y, Cho Y, Choi HJ, Lee H, Lim TH, Kang H, Ko BS, Oh J. The effect of BMI on COVID-19 outcomes among older patients in South Korea: a nationwide retrospective cohort study. Ann Med 2021; 53:1292-1301. [PMID: 34382503 PMCID: PMC8366651 DOI: 10.1080/07853890.2021.1946587] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/17/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has caused deaths and shortages in medical resources worldwide, making the prediction of patient prognosis and the identification of risk factors very important. Increasing age is already known as one of the main risk factors for poor outcomes, but the effect of body mass index (BMI) on COVID-19 outcomes in older patients has not yet been investigated. Aim: We aimed to determine the effect of BMI on the severity and mortality of COVID-19 among older patients in South Korea. Methods: Data from 1272 COVID-19 patients (≥60 years old) were collected by the Korea Centers for Disease Control and Prevention. The odds ratios (ORs) of severe infection and death in the BMI groups were analyzed by logistic regression adjusted for covariates.Results: The underweight group (BMI<18.5 kg/m2) had a higher OR for death (adjusted OR = 2.23, 95% confidence interval [95% CI] = 1.06-4.52) than the normal weight group (BMI, 18.5-22.9 kg/m2). Overweight (BMI, 23.0-24.9 kg/m2) was associated with lower risks of both severe infection (adjusted OR = 0.55, 95% CI = 0.31-0.94) and death (adjusted OR = 0.50, 95% CI = 0.27-0.91). Conclusions: Underweight was associated with an increased risk of death, and overweight was related to lower risks of severe infection and death in older COVID-19 patients in Korea. However, this study was limited by the lack of availability of some information, including smoking status.KEY MESSAGESUnderweight is an independent risk factor of death in older COVID-19 patients.Overweight patients have a lower risk of death and severe infection than normal-weight patients.
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Affiliation(s)
- Yongtak Cho
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Yongil Cho
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyuk Joong Choi
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Heekyung Lee
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Tae Ho Lim
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyunggoo Kang
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Byuk Sung Ko
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jaehoon Oh
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
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14
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Padilla CJ, Ferreyro FA, Arnold WD. Anthropometry as a readily accessible health assessment of older adults. Exp Gerontol 2021; 153:111464. [PMID: 34256113 DOI: 10.1016/j.exger.2021.111464] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 12/30/2022]
Abstract
Anthropometry (derived from the Greek Anthropos: human, and metron: measure) refers to the systematic collection, and measurement of the physical characteristics of the human body, primarily body weight, body size, and shape. Anthropometric values are closely related to genetic factors, environmental characteristics, social, and cultural conditions, lifestyle, functional status, and health. Anthropometric measurements can be used to assess risk of malnutrition, obesity, muscle wasting, increased fat mass, and maldistribution of adipose tissue. Potential modifiable factors include circumferences, skinfolds, and body weight. While are height, and the bone diameters are non-modifiable. Kinanthropometry is the study of size, shape, proportionality, composition, biological maturation, and body function, in order to understand the process of growth, exercise, sports performance, and nutrition. Aging of the population, which is associated with increased risk of chronic disease, and disability, is one of the most important demographic changes facing many countries. Anthropometric indicators are simple, portable, non-invasive, inexpensive, and easily applied measurements that can be readily applied in geriatric populations to guide preventative measures, and medical interventions in older adults.
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Affiliation(s)
- Carlos J Padilla
- Division of Neuromuscular Diseases, Department of Neurology, The Ohio State Wexner Medical Center, Columbus, OH, USA.
| | - Fernando A Ferreyro
- Division of Nutritional Science, Department of Health Science, Universidad de las Americas Puebla, Puebla, Mexico.
| | - W David Arnold
- Division of Neuromuscular Diseases, Department of Neurology, The Ohio State Wexner Medical Center, Columbus, OH, USA; Department of PM&R, The Ohio State Wexner Medical Center, Columbus, OH, USA; Department of Neuroscience, The Ohio State Wexner Medical Center, Columbus, OH, USA; Department of Physiology and Cell Biology, The Ohio State Wexner Medical Center, Columbus, OH, USA.
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15
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Fancy T, Huang AT, Kass JI, Lamarre ED, Tassone P, Mantravadi AV, Alwani MM, Subbarayan RS, Bur AM, Worley ML, Graboyes EM, McMullen CP, Azoulay O, Wax MK, Cave TB, Al-Khudari S, Abello EH, Higgins KM, Ryan JT, Orzell SC, Goldman RA, Vimawala S, Fernandes RP, Abdelmalik M, Rajasekaran K, L'Esperance HE, Kallogjeri D, Rich JT. Complications, Mortality, and Functional Decline in Patients 80 Years or Older Undergoing Major Head and Neck Ablation and Reconstruction. JAMA Otolaryngol Head Neck Surg 2021; 145:1150-1157. [PMID: 31600390 DOI: 10.1001/jamaoto.2019.2768] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance Data regarding outcomes after major head and neck ablation and reconstruction in the growing geriatric population (specifically ≥80 years of age) are limited. Such information would be extremely valuable in preoperative discussions with elderly patients about their surgical risks and expected functional outcomes. Objectives To identify patient and surgical factors associated with 30-day postoperative complications, 90-day mortality, and 90-day functional decline; to explore whether an association exists between the type of reconstructive procedure and outcome; and to create a preoperative risk stratification system for these outcomes. Design, Setting, and Participants This retrospective, multi-institutional cohort study included patients 80 years or older undergoing pedicle or free-flap reconstruction after an ablative head and neck surgery from January 1, 2015, to December 31, 2017, at 17 academic centers. Data were analyzed from February 1 through April 20, 2019. Main Outcomes and Measures Thirty-day serious complication rate, 90-day mortality, and 90-day decline in functional status. Preoperative comorbidity and frailty were assessed using the American Society of Anesthesiologists classification, Adult Comorbidity Evaluation-27 score, and Modified Frailty Index. Multivariable clustered logistic regressions were performed. Conjunctive consolidation was used to create a risk stratification system. Results Among 376 patients included in the analysis (253 [67.3%] men), 281 (74.7%) underwent free-flap reconstruction. The median age was 83 years (range, 80-98 years). A total of 193 patients (51.3%) had 30-day serious complications, 30 (8.0%) died within 90 days, and 36 of those not dependent at baseline declined to dependent status (11.0%). Type of flap (free vs pedicle, bone vs no bone) was not associated with these outcomes. Variables associated with worse outcomes were age of at least 85 years (odds ratio [OR] for 90-day mortality, 1.19 [95% CI 1.14-1.26]), moderate or severe comorbidities (OR for 30-day complications, 1.80 [95% CI, 1.34-2.41]; OR for 90-day mortality, 3.33 [95% CI, 1.29-8.60]), body mass index (BMI) of less than 25 (OR for 30-day complications, 0.95 [95% CI, 0.91-0.99]), high frailty (OR for 30-day complications, 1.72 [95% CI, 1.10-2.67]), duration of surgery (OR for 90-day functional decline, 2.94 [95% CI, 1.81-4.79]), flap failure (OR for 90-day mortality, 3.56 [95% CI, 1.47-8.62]), additional operations (OR for 30-day complications, 5.40 [95% CI, 3.09-9.43]; OR for 90-day functional decline, 2.94 [95% CI, 1.81-4.79]), and surgery of the maxilla, oral cavity, or oropharynx (OR for 90-day functional decline, 2.51 [95% CI, 1.30-4.85]). Age, BMI, comorbidity, and frailty were consolidated into a novel 3-tier risk classification system. Conclusions and Relevance Important demographic, clinical, and surgical characteristics were found to be associated with postoperative complications, mortality, and functional decline in patients 80 years or older undergoing major head and neck surgery. Free flap and bony reconstruction were not independently associated with worse outcomes. A novel risk stratification system is presented.
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Affiliation(s)
- Tanya Fancy
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown
| | - Andrew T Huang
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas
| | - Jason I Kass
- Department of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Eric D Lamarre
- Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Patrick Tassone
- Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Avinash V Mantravadi
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - Mohamedkazim M Alwani
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - Rahul S Subbarayan
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City
| | - Andrés M Bur
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City
| | - Mitchell L Worley
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | | | - Ofer Azoulay
- Department of Otolaryngology-Head and Neck Surgery, New York University Health, New York, New York
| | - Mark K Wax
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland
| | - Taylor B Cave
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland
| | - Samer Al-Khudari
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Eric H Abello
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Kevin M Higgins
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jesse T Ryan
- Department of Otolaryngology-Head and Neck Surgery, Upstate Medical University, State University of New York, Syracuse
| | - Susannah C Orzell
- Department of Otolaryngology-Head and Neck Surgery, Upstate Medical University, State University of New York, Syracuse
| | - Richard A Goldman
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Swar Vimawala
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rui P Fernandes
- Department of Otolaryngology-Head and Neck Surgery, University of Florida College of Medicine, Jacksonville
| | - Michael Abdelmalik
- Department of Otolaryngology-Head and Neck Surgery, University of Florida College of Medicine, Jacksonville
| | - Karthik Rajasekaran
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia
| | - Heidi E L'Esperance
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jason T Rich
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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Xiong J, Qian Y, Yu S, Ji H, Teliewubai J, Chi C, Lu Y, Zhou Y, Fan X, Li J, Blacher J, Zhang Y, Xu Y. Somatotype and Its Impact on Asymptomatic Target Organ Damage in the Elderly Chinese: The Northern Shanghai Study. Clin Interv Aging 2021; 16:887-895. [PMID: 34054294 PMCID: PMC8153068 DOI: 10.2147/cia.s302468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/13/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the relationship between asymptomatic target organ damage (TOD) and different somatotypes in a population of elderly from Chinese community-dwelling. Methods A total of 2098 Chinese senior residents from northern Shanghai older than 65 years were recruited in the research. The following somatotype parameters were recorded and analyzed: body mass index, waist circumference, hip circumference, and waist-hip ratio were recorded and calculated. Asymptomatic TOD, including urine albumin/creatinine ratio, estimated glomerular filtration rate (eGFR), intima-media thickness (IMT), left ventricular mass index (LVMI), left ventricular diastolic function, and carotid-femoral pulse wave velocity (PWV) was recorded using the MyLab30 Gold CV system and SphygmoCor. Results Of all 2098 residents, 817 (38.9%) were overweight and 289 (13.8%) were obese. All somatotype measures were significantly correlated with TOD parameters (p<0.05). After adjustment for age and male gender, in total population, LVMI (p<0.001), cardiac diastolic function (E/Ea, p<0.001), PWV (p<0.001), eGFR (p=0.03), and urine albumin/creatinine ratio (p<0.001) changed gradually and significantly correlated with increasing BMI values. Obesity and overweight were independently related to the incidence of LVH, LVDD, artery stiffness, carotid arterial plaque, and microalbuminuria. Conclusion The incidence of asymptomatic TOD was significantly correlated with overweight and obesity, especially in women, whereas the underweight may favor in the prevention of TOD.
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Affiliation(s)
- Jing Xiong
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yunyun Qian
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - HongWei Ji
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jiadela Teliewubai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - YuYan Lu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - YiWu Zhou
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - XiMin Fan
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jue Li
- The Research Institute of Clinical Epidemiology, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jacques Blacher
- Paris Descartes University, AP-HP, Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - YaWei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
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17
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Farsijani S, Xue L, Boudreau RM, Santanasto AJ, Kritchevsky SB, Newman AB. Body composition by computed tomography vs. dual energy x-ray absorptiometry: Long-term prediction of all-cause mortality in the Health ABC cohort. J Gerontol A Biol Sci Med Sci 2021; 76:2256-2264. [PMID: 33835154 DOI: 10.1093/gerona/glab105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Body composition assessment by computed tomography (CT) predicts health outcomes in diverse populations. However, its performance in predicting mortality has not been directly compared to dual-energy-X-ray-absorptiometry (DXA). Additionally, the association between different body compartments and mortality, acknowledging the compositional nature of human body, is not well-studied. Compositional Data Analysis, that is applied to multivariate proportion-type dataset, may help to account for the inter-relationships of body compartments by constructing log-ratios of components. Here, we determined the associations of baseline CT-based measures of mid-thigh cross-sectional areas vs. DXA measures of body composition with all-cause mortality in Health ABC cohort, using both traditional (individual body compartments) and Compositional Data Analysis (using ratios of body compartments) approaches. METHODS The Health ABC study assessed body composition in 2911 older adults in 1996-97. We investigated the individual and ratios of (by Compositional Analysis) body compartments assessed by DXA (lean, fat, and bone-mass) and CT (muscle, subcutaneous fat area, intermuscular fat (IMF), and bone) on mortality, using Cox proportional hazard models. RESULTS Lower baseline muscle area by CT (HRmen=0.56 [95%CI: 0.48-0.67], HRwomen=0.60 [0.48-0.74]), fat-mass by DXA (HRmen=0.48 [0.24-0.95]) were predictors of mortality in traditional Cox-regression analysis. Consistently, Compositional Data Analysis revealed that lower muscle area vs. IMF, muscle area vs. bone area, and lower fat-mass vs. lean-mass were associated with higher mortality in both sexes. CONCLUSION Both CT measure of muscle area and DXA fat-mass (either individually or relative to other body compartments) were strong predictors of mortality in both sexes in a community research setting.
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Affiliation(s)
- Samaneh Farsijani
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.,Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA
| | - Lingshu Xue
- Health Policy and Management; Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pittsburgh, PA
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.,Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA
| | - Adam J Santanasto
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.,Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.,Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA
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18
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Borda MG, Venegas-Sanabria LC, Garcia-Cifuentes E, Gomez RC, Cano-Gutierrez CA, Tovar-Rios DA, Aarsland V, Khalifa K, Jaramillo-Jimenez A, Aarsland D, Soennesyn H. Body mass index, performance on activities of daily living and cognition: analysis in two different populations. BMC Geriatr 2021; 21:177. [PMID: 33711937 PMCID: PMC7953600 DOI: 10.1186/s12877-021-02127-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/25/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND With this study, we aim to determine the associations of the different categories of the body mass index (BMI) with activities of daily living (ADL) and cognitive performance in two different populations living in the community; Colombian and South Korean older adults. METHODS We performed a cross-sectional analysis of two surveys separately; The Survey on Health, Well-Being, and Aging in Colombia (SABE) (n = 23,343) and the Korean Longitudinal Study of aging (KLoSA) (n = 4556). Participants older than 50 years were selected from rural and urban areas achieving a representative sample. Here we investigated the association between BMI categories with function using zero-inflated negative binomial regressions, and with cognition using logistic regression models. RESULTS After adjustment, in Colombia, underweight was associated with an impaired score on the Mini-mental State Examination (MMSE) and worse performance in the instrumental activities of daily living (IADL). Also, being overweight was associated with a better score on the MMSE and the IADL. For both outcomes education level significantly influenced the predictions. In South Korea, there were no significant associations for cognition, IADL, or basic activities of daily living (BADL). CONCLUSIONS In the Colombian population, underweight, was associated with reduced cognitive performance and daily functioning. Additionally, being overweight but not obese was associated with better cognition and daily functioning. In South Korea, there were no significant associations between BMI and cognition, IADL, or BADL.
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Affiliation(s)
- Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, PB 8100, N-4068, Stavanger, Norway.
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Luis Carlos Venegas-Sanabria
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
- Grupo de Neurociencias de Antioquia, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Elkin Garcia-Cifuentes
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ronald Camilo Gomez
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
- Grupo de Neurociencias de Antioquia, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Carlos Alberto Cano-Gutierrez
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
- Grupo de Neurociencias de Antioquia, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Diego Alejandro Tovar-Rios
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, PB 8100, N-4068, Stavanger, Norway
- Unidad Geriatría Hospital Universitario San Ignacio, Bogotá, Colombia
- Universidad Del Valle, School of Statistics, Faculty of engineering, Santiago De Cali, Valle Del Cauca, Colombia
| | - Vera Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, PB 8100, N-4068, Stavanger, Norway
| | - Khadija Khalifa
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, PB 8100, N-4068, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Alberto Jaramillo-Jimenez
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, PB 8100, N-4068, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of mathematics and statistics, Universidad Autónoma de Occidente, Faculty of Basic Sciences, Santiago de Cali, Colombia
- Grupo Neuropsicología y Conducta, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, PB 8100, N-4068, Stavanger, Norway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Hogne Soennesyn
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, PB 8100, N-4068, Stavanger, Norway
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Edwards MA, Mazzei M, Agarwal S, Rhodes L, Bruff A. Exploring perioperative outcomes in metabolic and bariatric surgery amongst the elderly: an analysis of the 2015-2017 MBSAQIP database. Surg Obes Relat Dis 2021; 17:1096-1106. [PMID: 33785272 DOI: 10.1016/j.soard.2021.02.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/24/2020] [Accepted: 02/16/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) is increasingly performed in patients >65 years. Studies of perioperative outcomes have shown equivocal results. OBJECTIVES Our study objective was to explore perioperative outcomes in elderly MBS patients compared with those <65 years. SETTING Academic Hospital. METHODS Primary sleeve (SG) and gastric bypass (RYGB) cases were identified from the 2015-2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Selected cases were stratified by age (≥65 yr versus <65 yr). Univariate and multivariate logistic regression analyses were performed comparing outcomes in the elderly with the general MBS cohort. RESULTS 26,557 (5.6%) of MBS cases were performed in elderly patients, who were more likely to be white, male, have a lower mean body mass index (BMI), receive a gastric bypass, and robotic-assisted surgery. Elderly patients had a significantly higher disease burden, and most outcome measures were significantly higher in elderly patients, including mortality and morbidity. On multivariate regression analyses, elderly patients undergoing SG have significantly less risk of mortality and morbidity compared with RYGB. In general, co-morbidities were in most cases more strongly predictive of complications than age alone. The number needed to harm (NNH) for overall and related morbidity were 59 and 232, respectively. CONCLUSION Elderly MBS patients have higher disease burden and higher adverse outcomes following MBS; however, complications in this cohort remain overall rare. When performing bariatric surgery on elderly patients, procedure consideration should favor SG as RYGB is independently associated with worse outcomes.
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Affiliation(s)
| | - Michael Mazzei
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| | - Shilpa Agarwal
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| | - Lori Rhodes
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| | - Allison Bruff
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania
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Lin YK, Wang CC, Yen YF, Chen LJ, Ku PW, Chen CC, Lai YJ. Association of body mass index with all-cause mortality in the elderly population of Taiwan: A prospective cohort study. Nutr Metab Cardiovasc Dis 2021; 31:110-118. [PMID: 33097409 DOI: 10.1016/j.numecd.2020.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/27/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS The nutritional status of the elderly is different from that of young people. Body composition changes as people age, for example, fat mass increases, muscle mass decreases, and body fat distribution is changed. We aimed to investigate the association of body mass index (BMI) with cause-specific mortality in the elderly population. METHODS AND RESULTS The data of annual health examination for the older citizens (≥65 years old) from 2006 to 2011 in Taipei City Hospital were used. Information on baseline demographics, lifestyle behaviors, medical, and drug usage were collected by a self-administered questionnaire. Cause-specific mortality was ascertained from the National Registration of Death. Individuals were followed up until death or December 31, 2012, whichever was earlier. Univariable and multivariable Cox proportional hazard analyses were applied to investigate the association between BMI and all-cause mortality. Among 81,221 older people included in the analysis, 42,602 (52.45%) were men. The mean age was 73.85 ± 6.32 years. Among the 81,221 participants, 3398 (4.18%) were underweight, 36,476 (44.91%) were normal weight, 25,708 (31.65%) were overweight, and 15,639 (19.25%) were obese. Those in the BMI category 27 ≤ BMI<28 kg/m2 had the lowest all-cause mortality risk. The BMI of lowest cause-specific mortality was between 27 kg/m2 and 28 kg/m2 in infection mortality, between 28 kg/m2 and 29 kg/m2 in circulation mortality, between 29 kg/m2 and 30 kg/m2 in respiratory mortality, and between 31 kg/m2 and 32 kg/m2 in cancer mortality. CONCLUSIONS The current study found a J-shaped relation between BMI and cause-specific mortality in the elderly population of Taiwan.
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Affiliation(s)
- Yu-Kai Lin
- Department of Health and Welfare, College of City Management, University of Taipei, Taipei, Taiwan
| | - Chun-Chieh Wang
- Division of Chest Medicine, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan; Central Taiwan University of Science and Technology Department of Eldercare, Taichung, Taiwan
| | - Yung-Feng Yen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - Po-Wen Ku
- Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yun-Ju Lai
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan.
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21
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Marcos-Pardo PJ, González-Gálvez N, López-Vivancos A, Espeso-García A, Martínez-Aranda LM, Gea-García GM, Orquín-Castrillón FJ, Carbonell-Baeza A, Jiménez-García JD, Velázquez-Díaz D, Cadenas-Sanchez C, Isidori E, Fossati C, Pigozzi F, Rum L, Norton C, Tierney A, Äbelkalns I, Klempere-Sipjagina A, Porozovs J, Hannola H, Niemisalo N, Hokka L, Jiménez-Pavón D, Vaquero-Cristóbal R. Sarcopenia, Diet, Physical Activity and Obesity in European Middle-Aged and Older Adults: The LifeAge Study. Nutrients 2020; 13:E8. [PMID: 33375058 PMCID: PMC7822002 DOI: 10.3390/nu13010008] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 02/07/2023] Open
Abstract
The revised European consensus defined sarcopenia as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality. The aim of this study was to determine the prevalence of sarcopenia and analyse the influence of diet, physical activity (PA) and obesity index as risk factors of each criteria of sarcopenia. A total of 629 European middle-aged and older adults were enrolled in this cross-sectional study. Anthropometrics were assessed. Self-reported PA and adherence to the Mediterranean diet were evaluated with the Global Physical Activity Questionnaire (GPAQ) and Prevention with Mediterranean Diet questionnaire (PREDIMED), respectively. The functional assessment included handgrip strength, lower body muscle strength, gait speed and agility/dynamic balance. Of the participants, 4.84% to 7.33% showed probable sarcopenia. Sarcopenia was confirmed in 1.16% to 2.93% of participants. Severe sarcopenia was shown by 0.86% to 1.49% of participants. Male; age group ≤65 years; lower body mass index (BMI); high levels of vigorous PA; and the consumption of more than one portion per day of red meat, hamburgers, sausages or cold cuts and/or preferential consumption of rabbit, chicken or turkey instead of beef, pork, hamburgers or sausages (OR = 0.126-0.454; all p < 0.013) resulted as protective factors, and more time of sedentary time (OR = 1.608-2.368; p = 0.032-0.041) resulted as a risk factor for some criteria of sarcopenia. In conclusion, age, diet, PA, and obesity can affect the risk of having low muscle strength, low muscle mass or low functional performance, factors connected with sarcopenia.
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Affiliation(s)
- Pablo Jorge Marcos-Pardo
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Noelia González-Gálvez
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Abraham López-Vivancos
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Alejandro Espeso-García
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
| | - Luis Manuel Martínez-Aranda
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
| | - Gemma María Gea-García
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Francisco Javier Orquín-Castrillón
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Ana Carbonell-Baeza
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - José Daniel Jiménez-García
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - Daniel Velázquez-Díaz
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - Cristina Cadenas-Sanchez
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - Emanuele Isidori
- Department of Movement, Human and Health Sciences University of Rome “Foro Itálico”, 00135 Roma, Italy; (E.I.); (L.R.)
| | - Chiara Fossati
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
- Department of Movement, Human and Health Sciences University of Rome “Foro Itálico”, 00135 Roma, Italy; (E.I.); (L.R.)
| | - Fabio Pigozzi
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
- Department of Movement, Human and Health Sciences University of Rome “Foro Itálico”, 00135 Roma, Italy; (E.I.); (L.R.)
| | - Lorenzo Rum
- Department of Movement, Human and Health Sciences University of Rome “Foro Itálico”, 00135 Roma, Italy; (E.I.); (L.R.)
| | - Catherine Norton
- Health Research Institute (HRI), University of Limerick, V94 T9PX Limerick, Ireland; (C.N.); (A.T.)
| | - Audrey Tierney
- Health Research Institute (HRI), University of Limerick, V94 T9PX Limerick, Ireland; (C.N.); (A.T.)
| | - Ilvis Äbelkalns
- Faculty of Pedagogy, Psychology and Art, University of Latvia, 1586 Riga, Latvia; (I.Ä.); (A.K.-S.); (J.P.)
| | - Agita Klempere-Sipjagina
- Faculty of Pedagogy, Psychology and Art, University of Latvia, 1586 Riga, Latvia; (I.Ä.); (A.K.-S.); (J.P.)
| | - Juris Porozovs
- Faculty of Pedagogy, Psychology and Art, University of Latvia, 1586 Riga, Latvia; (I.Ä.); (A.K.-S.); (J.P.)
| | - Heikki Hannola
- Business and Services Department, Sport and Leisure, Lapland University of Applied Sciences, 96300 Rovaniemi, Finland; (H.H.); (N.N.); (L.H.)
| | - Niko Niemisalo
- Business and Services Department, Sport and Leisure, Lapland University of Applied Sciences, 96300 Rovaniemi, Finland; (H.H.); (N.N.); (L.H.)
| | - Leo Hokka
- Business and Services Department, Sport and Leisure, Lapland University of Applied Sciences, 96300 Rovaniemi, Finland; (H.H.); (N.N.); (L.H.)
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - Raquel Vaquero-Cristóbal
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
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Ihama F, Pandyan A, Roffe C. Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study. Eur Geriatr Med 2020; 12:79-89. [PMID: 33108636 PMCID: PMC7900088 DOI: 10.1007/s41999-020-00383-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 08/08/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Fragility fractures are common in care home residents but established tools have not been tested in this population. AIM To identify the most practicable tool for use. METHODS DESIGN: Multicentre prospective observational cohort pilot study. SETTING 18 care homes in Boston, UK. ASSESSMENTS fragility risk score at baseline with FRAX, QFractureScore, Garvan nomogram, body mass index and TUGT for each participant. OUTCOMES falls, fractures, combined falls & fractures. Follow-up; 12 months. RESULTS 217/618 (35%) residents in the 18 care homes were enrolled. 147 (68%) had mental capacity,70 (32%) did not. There were 325 falls and 10 fractures in participants during the study. At the same time there were 1671 falls and 103 fractures in residents not participating in the study. Multiple regression analyses showed that only age had a statistically significant association with falls (χ2(1) = 5.7775, p = 0.0162), fractures (χ2(1) = 4.7269, p = 0.0297) and combined falls & fractures (χ2(1) = 4.7269, p = 0.0297). C-statistics were: falls; FRAX 0.544, BMI 0.610, QFractureScore 0.554, Garvan nomogram 0.579, TUGT 0.656, fractures; FRAX 0.655, BMI 0.708, QFractureScore 0.736, Garvan nomogram 0.712, TUGT 0.590, combined falls and fractures, c-statistics were same as for fractures. Fifty-four participants (25%) died during follow-up. Charlson comorbidity index predicted mortality, R2 = 0.021 (p = 0.034). CONCLUSIONS QFractureScore, BMI and Garvan nomogram were good predictors of fractures and combined falls and fractures Only age had statistically significant association with the outcomes. No tool was good predictor of falls.
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Affiliation(s)
- F Ihama
- Department of Medicine/Elderly Care, Pilgrim Hospital Boston, Sibsey Road, Boston, PE21 9QS, UK.
| | - A Pandyan
- School of Allied Health Professions, Mackay Building, Keele University, Keele, ST5 5BG, UK
| | - C Roffe
- Guy Hilton Research Centre, 1 Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK
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Ying DG, Ko SH, Li YC, Chen CX. Association between intensive glycemic control and mortality in elderly diabetic patients in the primary care: A retrospective cohort study. Prim Care Diabetes 2020; 14:476-481. [PMID: 32291184 DOI: 10.1016/j.pcd.2020.02.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/23/2020] [Accepted: 02/29/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine the association between the most recent HbA1c values and the mortality of elderly Type 2 Diabetic (T2DM) patients managed in the public primary care setting and to explore the associating risk factors. DESIGN Retrospective cohort study. SUBJECTS All T2DM patients aged 65 or above, who attended a public primary care clinic for regular follow up from 01/01/2012 to 31/12/2012 were included. Their follow up status till 31/12/2017 was reviewed. Those who were deceased on or before 31/12/2017 were matched randomly with controls that were alive in the same cohort for comparison. MAIN OUTCOME MEASURES Patients' demographics, smoking status, duration of T2DM, biochemical parameters including the most recent HbA1c, lipid profile, renal function test, drug profile, co-morbidities and all-cause mortality were retrieved from Hospital Authority's CDARS and CMS systems. RESULTS Both high (>8.0%) and low (<6.5%) HbA1c values were associated with increased odd ratio of all-cause mortality among T2DM elderly patients treated in the primary care. There was a 3-fold increase in odd ratio when the HbA1c reading was very low (<6.0%). Associated risk factors for all-cause mortality in elderly T2DM patients included smoker status, lower BMIs, and higher LDL levels and use of sulphonylureas. CONCLUSIONS Glycemic target for elderly T2DM patients should be approached cautiously. Over-aggressive treatment may lead to increased mortality among elderly T2DM patients.
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Affiliation(s)
- Derek Gc Ying
- Dept of Family Medicine and General Out-patient Clinics, Kowloon Central Cluster, Hong Kong SAR.
| | - S H Ko
- Dept of Family Medicine and General Out-patient Clinics, Kowloon Central Cluster, Hong Kong SAR
| | - Y C Li
- Dept of Family Medicine and General Out-patient Clinics, Kowloon Central Cluster, Hong Kong SAR
| | - Catherine Xr Chen
- Dept of Family Medicine and General Out-patient Clinics, Kowloon Central Cluster, Hong Kong SAR
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Oyedeji CI, Hall K, Luciano A, Morey MC, Strouse JJ. Geriatric assessment for older adults with sickle cell disease: protocol for a prospective cohort pilot study. Pilot Feasibility Stud 2020; 6:131. [PMID: 32974042 PMCID: PMC7495855 DOI: 10.1186/s40814-020-00673-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/01/2020] [Indexed: 11/20/2022] Open
Abstract
Background The life expectancy for people with sickle cell disease (SCD) has improved tremendously over the last 50 years. This population experiences hemolysis and vaso-occlusion in multiple organs that lead to complications such as cardiopulmonary disease, strokes, and avascular necrosis. These complications can limit mobility and aerobic endurance, similar to limitations that often occur in geriatric populations. These sickle-cell and age-related events lead to frequent hospitalization, which further increases the risk of functional decline. We have few tools to measure functional decline in people with SCD. The purpose of this paper is to describe a protocol to evaluate the feasibility of sickle cell disease geriatric assessment (SCD-GA). Methods/design We will enroll 40 adults with SCD (20 age 18–49.99 years and 20 age ≥ 50 years) in a prospective cohort study to assess the feasibility of SCD-GA. The SCD-GA includes validated measures from the oncology geriatric assessment enriched with additional physical and cognitive measures. The SCD-GA will be performed at the first study visit, at 10 to 20 days after hospitalization, and at 12 months (exit visit). With input from a multidisciplinary team of sickle cell specialists, geriatricians, and experts in physical function and physical activity, we selected assessments across 7 domains: functional status (11 measures), comorbid medical conditions (1 measure), psychological state (1 measure), social support (2 measures), weight status (2 measures), cognition (3 measures), and medications (1 measure). We will measure the proportion completing the assessment with feasibility as the primary outcome. Secondary outcomes include the proportion consenting and completing all study visits, duration of the assessment, acceptability, and adverse events. Discussion We present the protocol and rationale for selection of the measures included in SCD-GA. We also outline the methods to determine feasibility and subsequently to optimize the SCD-GA in preparation for a larger multicenter validation study of the SCD-GA.
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Affiliation(s)
- Charity I Oyedeji
- Department of Medicine, Division of Hematology, Duke University School of Medicine, 315 Trent Dr. Suite 261, DUMC Box 3939, Durham, NC 27710 USA.,Duke Claude D. Pepper Older Americans Independence Center, Durham, NC USA
| | - Katherine Hall
- Duke Claude D. Pepper Older Americans Independence Center, Durham, NC USA.,Department of Medicine, Division of Geriatrics, Duke University, Durham, NC USA.,Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, NC USA
| | - Alison Luciano
- Duke Claude D. Pepper Older Americans Independence Center, Durham, NC USA
| | - Miriam C Morey
- Duke Claude D. Pepper Older Americans Independence Center, Durham, NC USA.,Department of Medicine, Division of Geriatrics, Duke University, Durham, NC USA.,Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, NC USA
| | - John J Strouse
- Department of Medicine, Division of Hematology, Duke University School of Medicine, 315 Trent Dr. Suite 261, DUMC Box 3939, Durham, NC 27710 USA.,Duke Claude D. Pepper Older Americans Independence Center, Durham, NC USA.,Department of Medicine, and Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, Durham, NC USA.,Division of Pediatric Hematology-Oncology, Duke University, Durham, NC USA
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25
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Marcos-Pardo PJ, González-Gálvez N, Espeso-García A, Abelleira-Lamela T, López-Vivancos A, Vaquero-Cristóbal R. Association among Adherence to the Mediterranean Diet, Cardiorespiratory Fitness, Cardiovascular, Obesity, and Anthropometric Variables of Overweight and Obese Middle-Aged and Older Adults. Nutrients 2020; 12:nu12092750. [PMID: 32927609 PMCID: PMC7551167 DOI: 10.3390/nu12092750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to evaluate the independent and combined associations between adherence to the Mediterranean diet (AMedDiet), cardiorespiratory fitness (CRF), and different parameters of overweight and obese middle-aged and older adults. Sixty-two participants were enrolled in this cross-sectional study. Fat mass was measured with Dual energy X-ray absorptiometry. AMedDiet and physical activity (PA) were assessed with the PREDIMED and Global PA Questionnaire (GPAQ). Maximal aerobic power was assessed using the 6-min walk test. Systolic (SBP) and diastolic (DBP) blood pressure (BP) were measured with Omron M6, and double product (DP) and mean BP (MBP) were calculated. Kinanthropometry proportionality variables related to obesity were also calculated. Participants with a low CRF as an independent factor or together with a low AMedDiet obtained significantly higher BP, total and trunk fat mass, and proportionality variables (all p ˂ 0.0001). According to the multiple nonlinear regression analysis, Vo2max, AMedDiet, and sex explained 53.4% of SBP, with this formula: 238.611 − (3.63*Vo2max) + (0.044*Vo2max2) − (13.051*AMedDiet) + (0.68*AMedDiet2) + (12.887*sex). SBP and p rediction SBP with the new formula showed a correlation of 0.731 (p ˂ 0.0001); showing a difference between the values of −0.278 (p = 0.883). In conclusion, CRF as an independent factor and combined with AMedDiet can be associated with BP, body composition, and proportionality in overweight and obese middle-aged and older adults.
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Affiliation(s)
- Pablo J. Marcos-Pardo
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
| | - Noelia González-Gálvez
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
- Correspondence: ; Tel.: +34-968-278-824
| | - Alejandro Espeso-García
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
| | - Tomás Abelleira-Lamela
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
| | - Abraham López-Vivancos
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
| | - Raquel Vaquero-Cristóbal
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
- Sports Injury Prevention Research Group, Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain
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26
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Spadaccini D, Perna S, Peroni G, D’Antona G, Iannello G, Faragli A, Infantino V, Riva A, Petrangolini G, Negro M, Gasparri C, Rondanelli M. DXA-Derived Visceral Adipose Tissue (VAT) in Elderly: Percentiles of Reference for Gender and Association with Metabolic Outcomes. Life (Basel) 2020; 10:E163. [PMID: 32846931 PMCID: PMC7554982 DOI: 10.3390/life10090163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/19/2020] [Accepted: 08/22/2020] [Indexed: 12/23/2022] Open
Abstract
This study aimed to establish the Dual-Energy X-ray Absorptiometry (DXA)-derived Visceral adipose tissue (VAT) reference values for gender and assess the metabolic outcomes associated to the VAT in a cohort of elderly patients. The sample included 795 elderly patients (226/569: men/women) aged 65-100 years (mean age 80.9 ± 7.5ys). Body composition measures and VAT were assessed by DXA and Core-Scan software. Biochemical analysis and a multidimensional comprehensive geriatric assessment were performed. VAT percentiles at the level of 5, 25, 50, 75, 95 were found in males at the following levels: 246, 832, 1251, 1769, 3048 cm3 and for females at 99, 476, 775, 1178, 2277 cm3. Moreover, this study showed that DXA-VAT was associated to a worsening of lipid, glycemic, hematocrit and kidney profile. Further studies will be needed in order to implement these findings in order to define the (DXA)-derived VAT levels associated to the frailty related risk factors in elderly.
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Affiliation(s)
- Daniele Spadaccini
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Via Emilia 12, 27100 Pavia, Italy; (G.P.); (C.G.)
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Zallaq 32038, Bahrain;
| | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Via Emilia 12, 27100 Pavia, Italy; (G.P.); (C.G.)
| | - Giuseppe D’Antona
- CRIAMS-Sport Medicine Centre, University of Pavia, 27058 Voghera, Italy; (G.D.); (M.N.)
| | - Giancarlo Iannello
- General Management, Azienda di Servizi alla Persona di Pavia, 27100 Pavia, Italy;
| | - Alessandro Faragli
- Department of Internal Medicine and Cardiology, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany;
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, 13353 Berlin, Germany
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany
| | - Vittoria Infantino
- Department of Public Health, Experimental and Forensic Medicine, Unit of Human and Clinical Nutrition, University of Pavia, 27100 Pavia, Italy; (V.I.); (M.R.)
| | - Antonella Riva
- Research and Development Unit, Indena, 20139 Milan, Italy; (A.R.); (G.P.)
| | | | - Massimo Negro
- CRIAMS-Sport Medicine Centre, University of Pavia, 27058 Voghera, Italy; (G.D.); (M.N.)
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Via Emilia 12, 27100 Pavia, Italy; (G.P.); (C.G.)
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, Unit of Human and Clinical Nutrition, University of Pavia, 27100 Pavia, Italy; (V.I.); (M.R.)
- IRCCS Mondino Foundation, 27100 Pavia, Italy
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27
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Health economic benefits from optimized meal services to older adults-a literature-based synthesis. Eur J Clin Nutr 2020; 75:26-37. [PMID: 32801305 DOI: 10.1038/s41430-020-00700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 06/19/2020] [Accepted: 08/04/2020] [Indexed: 11/08/2022]
Abstract
Malnutrition among older adults causes health problems and economic costs. Prevention of malnutrition through meal service can reduce such costs. This study estimates potential health economic benefits to be generated through meal service to home-dwelling older adults. The study contains three components: (1) systems analysis describing the relationship between meal service, nutritional status, health risk, and health-related costs, focusing on older adults, (2) a series of literature reviews to quantify the identified elements in each stage-subject combination: (i) meal service impact on nutrition status of older adults, (ii) associations between nutrition status and health risks, (iii) health care resource needs associated with these health risks, and (3) a model synthesis of literature findings to estimate the expected economic benefit of improved health status derived from meal service enrollment, using Denmark as an example. Expected economic benefits in terms of saved direct and indirect health care costs and improved quality-of-life was estimated at an amount of €307 per year per individual enrolled, of which direct health care cost savings constituted €75, while value of improved quality-of-life and reduced mortality constituted the rest. The average health economic benefit from enrolling older adults into meal service is likely to decrease with the number of subscribers. Findings like these are important to take into consideration, when making policy decisions regarding size of the meal service capacity, although it should be noted that the presented estimates are based on a number of assumptions of which some are subject to uncertainty.
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28
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Nutritional Status Plays More Important Role in Determining Functional State in Older People Living in the Community than in Nursing Home Residents. Nutrients 2020; 12:nu12072042. [PMID: 32660012 PMCID: PMC7400166 DOI: 10.3390/nu12072042] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to verify whether the relationship between nutritional and functional status differs between seniors in the community and those in long-term care institutions. One hundred nursing home (NH) residents aged 60 years and above and 100 sex- and age-matched community-dwelling (CD) older adults were examined. Functional status was assessed using the Comprehensive Geriatric Assessment (CGA) and nutritional status using anthropometric measures, the Mini Nutritional Assessment questionnaire (MNA) and bioimpedance analysis (BIA). Significant environmental interactions were observed with resting metabolic rate (RMR), extracellular water (ECW) and intracellular water (ICW) ratio, skeletal muscle mass (SMM), skeletal muscle index (SMI) and impedance (Z) and resistance (R) to the results of the Timed Up and Go (TUG) test. The two groups demonstrated different relationships between Z and R and handgrip strength and between Geriatric Depression Scale (GDS) score and fat free mass (FFM), body density, total body water (TBW) and phase angle (PhA). Nutritional status seems to be more important for functional state in CD older people than in NH residents. Therefore, to ensure the functional independence of seniors living in the community, it is crucial to maintain the correct nutritional parameters. Further studies are necessary to account for the fact that this relationship is less significant among NH residents and to identify other factors that may contribute to these discrepancies between community and institutional environments.
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29
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Changes in Body Mass Index, Energy Intake, and Fluid Intake over 60 Months Premortem as Prognostic Factors in Frail Elderly: A Post-Death Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061823. [PMID: 32168925 PMCID: PMC7142819 DOI: 10.3390/ijerph17061823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/07/2020] [Accepted: 03/09/2020] [Indexed: 12/11/2022]
Abstract
Survival prediction is considered difficult in elderly individuals with cognitive frailty or dementia that leads to death. The aim of this study was to verify temporal changes in body mass index (BMI), energy intake, and fluid intake measured continuously in frail elderly people as prognostic factors for death. We assessed 106 frail elderly individuals who received >2-year care at an elderly care facility and died at the facility. We analyzed temporal changes in BMI, energy intake, and fluid intake from a maximum of 60 months premortem to death and determined the relationship between these parameters. BMI was significantly below the reference values from 9 months prior to death, but energy intake remained constant from 2 months prior to death to death (p < 0.001). However, the mean fluid intake decreased suddenly immediately prior to death. We compared the changes in each parameter during the year prior to death and during the preceding year and found significant differences in all parameters (p < 0.001). From 60 months prior to death to death, BMI, energy intake, and fluid intake decreased in the same order over time. Therefore, these parameters can be used as prognostic factors for death in frail elderly people.
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30
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Jacobsen BK, Melhus M, Kvaløy K, Siri SRA, Michalsen VL, Broderstad AR. A descriptive study of ten-year longitudinal changes in weight and waist circumference in the multi-ethnic rural Northern Norway. The SAMINOR Study, 2003-2014. PLoS One 2020; 15:e0229234. [PMID: 32074126 PMCID: PMC7029861 DOI: 10.1371/journal.pone.0229234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 02/01/2020] [Indexed: 01/22/2023] Open
Abstract
The obesity epidemic is dynamic with varying secular trends and differences between countries and ethnic groups. The objective of this study was to describe the age- and sex-specific longitudinal changes in weight and waist circumference in a rural Norwegian population with a high proportion of the indigenous Sami population. Based on two population-based surveys, SAMINOR 1 (2003-2004) and SAMINOR 2 (2012-2014), we present longitudinal changes in weight and waist circumference according to age at baseline in the SAMINOR 1 Survey and sex during the 10-year period. The analyses included 1538 men and 1958 women aged 36 to 69 at baseline (birth year 1934 to 1967). Forty-one percent of the population were Sami. Both weight and waist circumference were measured. The mean weight increased 0.8 kg (95% confidence interval: 0.5, 1.1) in men and 0.3 kg (95% confidence interval: 0, 0.5) in women. In both men and women, younger individuals gained significantly more weight during the 10-year follow-up than older participants (p < 0.001). The mean weight showed a statistically significant increase in men aged 36-54 and women aged 36-49 at baseline and was statistically significantly reduced in men and women aged 60-69. The mean waist circumference increased by 6.3 cm (95% confidence interval: 6.0, 6.6) in men and 8.4 cm (95% confidence interval 8.1, 8.8) in women. The mean waist circumference increased statistically significantly from SAMINOR 1 to SAMINOR 2 in all age groups, and there was an inverse relationship between age at baseline and change in waist circumference (p < 0.001). Waist circumference increased more than can be explained by changes in weight and age during the 10-year period. The inverse relationships between age at baseline in SAMINOR 1 and the 10-year change in weight and waist circumference were found in both Sami and non-Sami participants. The findings underline the need for prevention of obesity, particularly in younger people, as it is difficult to achieve permanent weight loss.
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Affiliation(s)
- Bjarne K. Jacobsen
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kirsti Kvaløy
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU–Norwegian University of Science and Technology, Trondheim, Norway
| | - Susanna R. A. Siri
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vilde Lehne Michalsen
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, Department of Medicine, The University Hospital of North Norway, Harstad, Norway
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31
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Cortellini A, Bozzetti F, Palumbo P, Brocco D, Di Marino P, Tinari N, De Tursi M, Agostinelli V, Patruno L, Valdesi C, Mereu M, Verna L, Lanfiuti Baldi P, Venditti O, Cannita K, Masciocchi C, Barile A, McQuade JL, Ficorella C, Porzio G. Weighing the role of skeletal muscle mass and muscle density in cancer patients receiving PD-1/PD-L1 checkpoint inhibitors: a multicenter real-life study. Sci Rep 2020; 10:1456. [PMID: 31996766 PMCID: PMC6989679 DOI: 10.1038/s41598-020-58498-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/13/2020] [Indexed: 01/10/2023] Open
Abstract
Sarcopenia represents one of the hallmarks of all chronic diseases, including cancer, and was already investigated as a prognostic marker in the pre-immunotherapy era. Sarcopenia can be evaluated using cross-sectional image analysis of CT-scans, at the level of the third lumbar vertebra (L3), to estimate the skeletal muscle index (SMI), a surrogate of skeletal muscle mass, and to evaluate the skeletal muscle density (SMD). We performed a retrospective analysis of consecutive advanced cancer patient treated with PD-1/PD-L1 checkpoint inhibitors. Baseline SMI and SMD were evaluated and optimal cut-offs for survival, according to sex and BMI (+/−25) were computed. The evaluated clinical outcomes were: objective response rate (ORR), immune-related adverse events (irAEs), progression free survival (PFS) and overall survival (OS). From April 2015 to April 2019, 100 consecutive advanced cancer patients were evaluated. 50 (50%) patients had a baseline low SMI, while 51 (51%) had a baseline low SMD according to the established cut offs. We found a significant association between SMI and ECOG-PS (p = 0.0324), while no correlations were found regarding SMD and baseline clinical factors. The median follow-up was 20.3 months. Patients with low SMI had a significantly shorter PFS (HR = 1.66 [95% CI: 1.05–2.61]; p = 0.0291) at univariate analysis, but not at the multivariate analysis. They also had a significantly shorter OS (HR = 2.19 [95% CI: 1.31–3.64]; p = 0.0026). The multivariate analysis confirmed baseline SMI as an independent predictor for OS (HR = 2.19 [1.31–3.67]; p = 0.0027). We did not find significant relationships between baseline SMD and clinical outcomes, nor between ORR, irAEs and baseline SMI (data not shown). Low SMI is associated with shortened survival in advanced cancer patients treated with PD1/PDL1 checkpoint inhibitors. However, the lack of an association between SMI and clinical response suggests that sarcopenia may be generally prognostic in this setting rather than specifically predictive of response to immunotherapy.
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Affiliation(s)
- Alessio Cortellini
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy. .,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.,Radiology Department, St. Salvatore Hospital, L'Aquila, Italy
| | - Davide Brocco
- Clinical Oncology Unit, S.S. Annunziata Hospital, Chieti, Italy
| | | | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti, Italy
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti, Italy
| | - Veronica Agostinelli
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Leonardo Patruno
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Cristina Valdesi
- Department of neuroscience, Imaging and clinical Science, University G.D'Annunzio, Chieti, Italy
| | - Manuela Mereu
- Section of Integrated Imaging and Radiological Therapies, Department of Neuroscience, University of Chieti, Chieti, Italy
| | - Lucilla Verna
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Paola Lanfiuti Baldi
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Olga Venditti
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Katia Cannita
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.,Radiology Department, St. Salvatore Hospital, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.,Radiology Department, St. Salvatore Hospital, L'Aquila, Italy
| | - Jennifer Leigh McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Corrado Ficorella
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giampiero Porzio
- Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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32
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Dose–response relationship between body mass index and risks of all-cause mortality and disability among the elderly: A systematic review and meta-analysis. Clin Nutr 2019; 38:1511-1523. [DOI: 10.1016/j.clnu.2018.07.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/18/2018] [Indexed: 01/01/2023]
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33
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Lees MJ, Wilson OJ, Hind K, Ispoglou T. Muscle quality as a complementary prognostic tool in conjunction with sarcopenia assessment in younger and older individuals. Eur J Appl Physiol 2019; 119:1171-1181. [PMID: 30806780 PMCID: PMC6469623 DOI: 10.1007/s00421-019-04107-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/20/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE This pilot study investigated differences in lean tissue mass, muscle strength, muscle quality (strength per unit of muscle mass; MQ), and functional performance in healthy younger and older individuals. The most robust predictors of appendicular lean mass (ALM) were then determined in each group. METHODS Fifty younger (18-45 years) and 50 older (60-80 years) participants completed tests of upper and lower body strength alongside body composition by dual-energy X-ray absorptiometry from which upper- and lower-body MQ were estimated. Available cut-points for older people were used to determine low upper-body MQ in both groups. Low lower-body MQ was determined as at least two standard deviations below the mean of the younger group. Functional performance was assessed by gait speed. Sarcopenia was identified using two established definitions. RESULTS Upper and lower body strength, ALM, lower-body MQ and gait speed were significantly higher in the younger group (all p < 0.002). Sarcopenia was identified in 2-4% of the older group. Low upper-body MQ was evident in 32% and 42% of the younger and older group, respectively. Low lower-body MQ was observed in 4% of younger participants, and 50% of older participants. In both groups, the most robust predictors of ALM were upper and lower body strength (young R2 = 0.74, 0.82; older R2 = 0.68, 0.72). CONCLUSIONS Low MQ despite low prevalence rates of sarcopenia in both groups suggests a need for age-specific MQ cut-points. Muscle quality assessments might be useful complementary prognostic tools alongside existing sarcopenia definitions.
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Affiliation(s)
- Matthew J Lees
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK.
| | - Oliver J Wilson
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK
| | - Karen Hind
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Theocharis Ispoglou
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK
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Barbera M, Mangialasche F, Jongstra S, Guillemont J, Ngandu T, Beishuizen C, Coley N, Brayne C, Andrieu S, Richard E, Soininen H, Kivipelto M. Designing an Internet-Based Multidomain Intervention for the Prevention of Cardiovascular Disease and Cognitive Impairment in Older Adults: The HATICE Trial. J Alzheimers Dis 2019; 62:649-663. [PMID: 29480185 DOI: 10.3233/jad-170858] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Many dementia and cardiovascular disease (CVD) cases in older adults are attributable to modifiable vascular and lifestyle-related risk factors, providing opportunities for prevention. In the Healthy Aging Through Internet Counselling in the Elderly (HATICE) randomized controlled trial, an internet-based multidomain intervention is being tested to improve the cardiovascular risk (CVR) profile of older adults. OBJECTIVE To design a multidomain intervention to improve CVR, based on the guidelines for CVR management, and administered through a coach-supported, interactive, platform to over 2500 community-dwellers aged 65+ in three European countries. METHODS A comparative analysis of national and European guidelines for primary and secondary CVD prevention was performed. Results were used to define the content of the intervention. RESULTS The intervention design focused on promoting awareness and self-management of hypertension, dyslipidemia, diabetes mellitus, and overweight, and supporting smoking cessation, physical activity, and healthy diet. Overall, available guidelines lacked specific recommendations for CVR management in older adults. The comparative analysis of the guidelines showed general consistency for lifestyle-related recommendations. Key differences, identified mostly in methods used to assess the overall CVR, did not hamper the intervention design. Minor country-specific adaptations were implemented to maximize the intervention feasibility in each country. CONCLUSION Despite differences in CVR management within the countries considered, it was possible to design and implement the HATICE multidomain intervention. The study can help define preventative strategies for dementia and CVD that are applicable internationally.
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Affiliation(s)
- Mariagnese Barbera
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Francesca Mangialasche
- Department of Neurobiology, Aging Research Center, Health Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Susan Jongstra
- Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands
| | | | - Tiia Ngandu
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Cathrien Beishuizen
- Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Nicola Coley
- INSERM, University of Toulouse UMR 1027, Toulouse, France.,Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | | | - Sandrine Andrieu
- INSERM, University of Toulouse UMR 1027, Toulouse, France.,Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Edo Richard
- Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hilkka Soininen
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Miia Kivipelto
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Neurobiology, Division of Clinical Geriatrics, Care Sciences and Society, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.,Stockholms Sjukhem, R&D unit, Stockholm Sweden
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Al Kibria GM. Prevalence and factors affecting underweight, overweight and obesity using Asian and World Health Organization cutoffs among adults in Nepal: Analysis of the Demographic and Health Survey 2016. Obes Res Clin Pract 2019; 13:129-136. [PMID: 30718074 DOI: 10.1016/j.orcp.2019.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/22/2018] [Accepted: 01/14/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE There is a little published data on prevalence and determinants of underweight, overweight and obesity among adults in Nepal. This study analysed the cross-sectional Nepal Demographic and Health Survey (NDHS) 2016 to obtain these using the World Health Organization (WHO) and Asian-specific cutoffs of body mass index (BMI). METHODS The 2016 NDHS used a multistage cluster-sampling design to obtain data on major health indicators in Nepal. The BMI cutoffs for underweight was <18.5kg/m2. The BMI cutoffs for overweight/obesity as per the Asian and WHO classifications were ≥23, and ≥25kg/m2, respectively. After reporting the prevalence according to sex and background characteristics, multilevel logistic regression was conducted to estimate odds ratios. SUBJECTS This analysis included 12,652 adults (5283 males and 7369 females) with a median age of 40 years (interquartile range [IQR]: 28-54). RESULTS The overall median BMI was 21.5kg/m2 (IQR:19.3-24.3). The overall prevalence of underweight was 16.7% (15.1% among males and 17.1% among females). The Asian-specific BMI cutoffs found the prevalence of overweight and obesity as 26.4% (27.4% among males and 25.6% among females) and 11.0% (7.7% among males and 13.3% among females), respectively. The WHO-recommended BMI cutoffs found 18.2% people overweight (16.7% among males and 19.3% among females) and 4.3% (2.5% among males and 5.6% among females) people obese. The prevalence and odds of extreme body weight categories (i.e., underweight, overweight and obesity) varied according to age, sex, education level, household wealth status, place, ecological zone and provinces of residence as per both recommended cutoffs. Overall, higher education level and wealth status were positively associated with overweight/obesity and inversely associated with underweight as per both cutoffs. CONCLUSION A large proportion Nepalese adults have either underweight, overweight or obesity, and could be at a greater risk of mortality and morbidity due to these extreme body weight categories. It is essential to address the factors or characteristics that are associated with the higher prevalence and likelihood of these extreme body weight categories to reduce the overall burden of underweight and overweight/obesity in Nepal.
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Affiliation(s)
- Gulam Muhammed Al Kibria
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland Baltimore, Baltimore, MD 21201, USA.
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36
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Martinez-Nicolas A, Madrid JA, García FJ, Campos M, Moreno-Casbas MT, Almaida-Pagán PF, Lucas-Sánchez A, Rol MA. Circadian monitoring as an aging predictor. Sci Rep 2018; 8:15027. [PMID: 30301951 PMCID: PMC6177481 DOI: 10.1038/s41598-018-33195-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 09/25/2018] [Indexed: 12/14/2022] Open
Abstract
The ageing process is associated with sleep and circadian rhythm (SCR) frailty, as well as greater sensitivity to chronodisruption. This is essentially due to reduced day/night contrast, decreased sensitivity to light, napping and a more sedentary lifestyle. Thus, the aim of this study is to develop an algorithm to identify a SCR phenotype as belonging to young or aged subjects. To do this, 44 young and 44 aged subjects were recruited, and their distal skin temperature (DST), activity, body position, light, environmental temperature and the integrated variable TAP rhythms were recorded under free-living conditions for five consecutive workdays. Each variable yielded an individual decision tree to differentiate between young and elderly subjects (DST, activity, position, light, environmental temperature and TAP), with agreement rates of between 76.1% (light) and 92% (TAP). These decision trees were combined into a unique decision tree that reached an agreement rate of 95.3% (4 errors out of 88, all of them around the cut-off point). Age-related SCR changes were very significant, thus allowing to discriminate accurately between young and aged people when implemented in decision trees. This is useful to identify chronodisrupted populations that could benefit from chronoenhancement strategies.
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Affiliation(s)
- A Martinez-Nicolas
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - J A Madrid
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - F J García
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Geriatrics Section, Hospital Virgen del Valle, Toledo, Spain
| | - M Campos
- Department of Computer Science and Systems, University of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - M T Moreno-Casbas
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain
| | - P F Almaida-Pagán
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - A Lucas-Sánchez
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - M A Rol
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain.
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.
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Nam GE, Park HS. Perspective on Diagnostic Criteria for Obesity and Abdominal Obesity in Korean Adults. J Obes Metab Syndr 2018; 27:134-142. [PMID: 31089555 PMCID: PMC6504202 DOI: 10.7570/jomes.2018.27.3.134] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/10/2018] [Accepted: 08/19/2018] [Indexed: 01/02/2023] Open
Abstract
Excessive body weight is associated with increased health risks in humans. In general, the risk of mortality increases with greater obesity. The 2018 guideline for the management of obesity by the Korean Society for the Study of Obesity proposed the body mass index (BMI) cut-off levels of 25 kg/m2 and 23 kg/m2 as diagnostic criteria for obesity and overweight (pre-obese) in Korean adults, respectively. Abdominal obesity has been defined as waist circumference (WC) ≥90 cm in men and WC ≥85 cm in women. In this review, the validity of these criteria for Korean adults was examined based on the evidence regarding the associations of obesity index with mortality and morbidity. The American Association of Clinical Endocrinologists/American College of Endocrinology algorithm and American Diabetes Association guideline for the medical care of obese and overweight patients support a BMI of 25 kg/m2 and 23 kg/m2, respectively, as the cut-off levels for Asians (and some ethnicities) corresponding to the BMI values of 30 kg/m2 and 25 kg/m2, respectively, for Caucasians. In the future, the optimal cut-off levels for obesity and abdominal obesity may require adjustment as the demographic characteristics of the Korean population change. In addition, development of more valid indicators that better reflect health risks of obesity is needed.
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Affiliation(s)
- Ga Eun Nam
- Department of Family Medicine, Sahmyook Medical Center, Seoul,
Korea
| | - Hye Soon Park
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
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Nowicki GJ, Ślusarska B, Bartoszek A, Kocka K, Deluga A, Kachaniuk H, Łuczyk M. Moderation and Mediation Analysis of the Relationship between Total Protein Concentration and the Risk of Depressive Disorders in Older Adults with Function Dependence in Home Care. Nutrients 2018; 10:nu10101374. [PMID: 30261582 PMCID: PMC6213179 DOI: 10.3390/nu10101374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/17/2018] [Accepted: 09/21/2018] [Indexed: 12/29/2022] Open
Abstract
Due to its devastating consequences, late-life depression is an important public health problem. The aim of the study was an analysis of variables which may potentially influence the risk of depression (GDS-SF). Furthermore, the aim was to study possible mediating effects of given variables on the relationship between the total protein concentration and the risk of depression in older adults with chronic diseases, and physical function impairment. The research sample included 132 older adults with chronic conditions and physical function impairments, residing in a long-term care in residential environment. In the studied group of sensory organs, diseases proved to be a significant moderator of the relationship between GDS-SF and total serum protein concentration. A stronger relationship was observed in subjects suffering from diseases of sensory organs (b = −6.42, 95% CI= −11.27; −1.58). The Barthel index and 25(OH)D vitamin were the most significant mediators of the examined relationship. Cohort research is suggested to confirm the hypothesis.
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Affiliation(s)
- Grzegorz Józef Nowicki
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Staszica 6, 20-081 Lublin, Poland.
| | - Barbara Ślusarska
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Staszica 6, 20-081 Lublin, Poland.
| | - Agnieszka Bartoszek
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Staszica 6, 20-081 Lublin, Poland.
| | - Katarzyna Kocka
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Staszica 6, 20-081 Lublin, Poland.
| | - Alina Deluga
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Staszica 6, 20-081 Lublin, Poland.
| | - Hanna Kachaniuk
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Staszica 6, 20-081 Lublin, Poland.
| | - Marta Łuczyk
- Department of Oncology, Medical University of Lublin, Staszica 6, 20-081 Lublin, Poland.
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Wang L, Crawford JD, Reppermund S, Trollor J, Campbell L, Baune BT, Sachdev P, Brodaty H, Samaras K, Smith E. Body mass index and waist circumference predict health-related quality of life, but not satisfaction with life, in the elderly. Qual Life Res 2018; 27:2653-2665. [PMID: 29881897 DOI: 10.1007/s11136-018-1904-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVES While obesity has been linked with lower quality of life in the general adult population, the prospective effects of present obesity on future quality of life amongst the elderly is unclear. This article investigates the cross-sectional and longitudinal relationships between obesity and aspects of quality of life in community-dwelling older Australians. METHOD A 2-year longitudinal sample of community dwellers aged 70-90 years at baseline, derived from the Sydney Memory and Ageing Study (MAS), was chosen for the study. Of the 1037 participants in the original MAS sample, a baseline (Wave 1) sample of 926 and a 2-year follow-up (Wave 2) sample of 751 subjects were retained for these analyses. Adiposity was measured using body mass index (BMI) and waist circumference (WC). Quality of life was measured using the Assessment of Quality of Life (6 dimensions) questionnaire (AQoL-6D) as well as the Satisfaction with Life Scale (SWLS). Linear regression and analysis of covariance (ANCOVA) were used to examine linear and non-linear relationships between BMI and WC and measures of health-related quality of life (HRQoL) and satisfaction with life, adjusting for age, sex, education, asthma, osteoporosis, depression, hearing and visual impairment, mild cognitive impairment, physical activity, and general health. Where a non-linear relationship was found, established BMI or WC categories were used in ANCOVA. RESULTS Greater adiposity was associated with lower HRQoL but not life satisfaction. Regression modelling in cross-sectional analyses showed that higher BMI and greater WC were associated with lower scores for independent living, relationships, and pain (i.e. worse pain) on the AQoL-6D. In planned contrasts within a series of univariate analyses, obese participants scored lower in independent living and relationships, compared to normal weight and overweight participants. Longitudinal analyses found that higher baseline BMI and WC were associated with lower independent living scores at Wave 2. CONCLUSIONS Obesity is associated with and predicts lower quality of life in elderly adults aged 70-90 years, and the areas most affected are independent living, social relationships, and the experience of pain.
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Affiliation(s)
- Lucy Wang
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Australia, Sydney, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia
| | - Simone Reppermund
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Australia, Sydney, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Australia, Sydney, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia
| | - Lesley Campbell
- Diabetes Program, Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia
- Department of Endocrinology, St Vincent's Hospital, Darlinghurst, NSW, 2010, Australia
| | - Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia
- Dementia Collaborative Research Centre, School of Psychiatry, UNSW Australia, Sydney, Australia
| | - Katherine Samaras
- Diabetes Program, Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia
- Department of Endocrinology, St Vincent's Hospital, Darlinghurst, NSW, 2010, Australia
| | - Evelyn Smith
- Clinical and Health Psychology Research Initiative, School of Social Sciences and Psychology, Western Sydney University, Bankstown Campus, Sydney, Australia.
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia.
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Podell R, Shriqui VK, Sagy YW, Manor O, Ben-Yehuda A. The quality of primary care provided to the elderly in Israel. Isr J Health Policy Res 2018; 7:21. [PMID: 29860940 PMCID: PMC5985580 DOI: 10.1186/s13584-018-0214-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In view of increasing global and local trends in population ageing and the high healthcare utilization rates among the elderly, this study assesses the quality of primary care provided to the elderly population in Israel. It examines changes in quality over time, how quality varies across sub-groups of the elderly, and how quality in Israel compares with other countries. Data originate from the National Program for Quality Indicators in Community Healthcare (QICH), which operates in full collaboration with Israel's four HMOs. METHODS The study population included all elderly Israeli residents aged 65 years or older during 2002-2015 (N = 879,671 residents in 2015). Seven elderly-specific quality indicators from within the QICH framework were included: influenza and pneumococcal vaccinations, benzodiazepine overuse, long-acting benzodiazepine use, body weight documentation, weight loss and underweight. In addition, two non-age specific quality indicators relating to diabetes mellitus were included: the rate of HbA1C documentation and uncontrolled diabetes. Data were collected from patient electronic medical records (EMR) in accordance with each HMO, and aggregated by three variables: gender, age, and socio-economic position (SEP). RESULTS During the measurement period, vaccination rates significantly increased (Influenza: from 42.0% in 2002 to 63.2% in 2015; and pneumococcal vaccination: from 25.8% in 2005 to 77.0% in 2015). Body weight documentation (in 65-74 year old persons) increased from only 16.3% in 2003 to 80.9% in 2015. The rate of underweight (BMI < 23 kg/m2) and significant weight-loss (10% or more of their body weight) was only measured in 2015. The overall rate of benzodiazepine overuse remained steady from 2011 to 2015 at around 5%, while the rate of long-acting benzodiazepine use decreased from 3.8% in 2011 to 2.4% in 2015. The rate of HbA1c documentation for elderly diabetics was higher than for non-elderly diabetics in 2015 (92.2% vs 87.9%). The rate of uncontrolled diabetes was lower for the elderly than the non-elderly population in 2015 (6.9% vs. 15.7%). Gender disparities were observed across all measures, after age stratification, with worse indicator rates among females compared to males. SEP-disparities were not consistent across measures. In all indicators except benzodiazepine overuse, Israel showed a higher quality of care for the elderly in comparison with the international healthcare community. CONCLUSIONS Overall, the quality of care received by elderly Israelis has improved substantially since measurements first began; yet, females receive lower quality care than males. Monitoring results of primary care quality indicators can contribute to population's successful aging; both chronic conditions at earlier ages (e.g. diabetes), and short-term hazardous conditions such as the use of potentially harmful medications and weight loss should be evaluated.
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Affiliation(s)
- Rachel Podell
- Program team of the National Program for Quality Indicators in Community Healthcare in Israel, Hebrew University, POB 12272, 92210 Jerusalem, Israel
- Braun School of Public Health, Hebrew University, POB 12272, 92210 Jerusalem, Israel
| | - Vered Kaufman Shriqui
- Department of Nutritional Sciences, School of Health Sciences, Ariel University, Ariel, Israel
| | - Yael Wolff Sagy
- Program directorate of the National Program for Quality Indicators in Community Healthcare in Israel, Hebrew University, POB 12272, 92210 Jerusalem, Israel
- Braun School of Public Health, Hebrew University, POB 12272, 92210 Jerusalem, Israel
| | - Orly Manor
- Program directorate of the National Program for Quality Indicators in Community Healthcare in Israel, Hebrew University, POB 12272, 92210 Jerusalem, Israel
- Braun School of Public Health, Hebrew University, POB 12272, 92210 Jerusalem, Israel
| | - Arie Ben-Yehuda
- Program directorate of the National Program for Quality Indicators in Community Healthcare in Israel, Hadassah Medical Center, POB 12000, 92210 Jerusalem, Israel
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Zhou X, Perez-Cueto FJA, Santos QD, Monteleone E, Giboreau A, Appleton KM, Bjørner T, Bredie WLP, Hartwell H. A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People. Nutrients 2018; 10:E128. [PMID: 29373529 PMCID: PMC5852704 DOI: 10.3390/nu10020128] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 12/21/2022] Open
Abstract
Because eating habits are inseparably linked with people's physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases-PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies' duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people's dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account.
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Affiliation(s)
- Xiao Zhou
- Department of Food Science, University of Copenhagen, 1958 Frederiksberg C, Denmark.
| | | | - Quenia Dos Santos
- Department of Food Science, University of Copenhagen, 1958 Frederiksberg C, Denmark.
| | - Erminio Monteleone
- Department of Management of Agricultural, Food and Forestry Systems, University of Florence, 50144 Florence, Italy.
| | - Agnès Giboreau
- Centre for Food and Hospitality Research, Institute Paul Bocuse, 69130 Ecully, France.
| | - Katherine M Appleton
- Research Centre for Behaviour Change, Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole BH12 5BB, UK.
| | - Thomas Bjørner
- Department of Architecture, Design and Media Technology, Aalborg University, 9000 Aalborg, Denmark.
| | - Wender L P Bredie
- Department of Food Science, University of Copenhagen, 1958 Frederiksberg C, Denmark.
| | - Heather Hartwell
- Faculty of Management, Bournemouth University, Poole BH12 5BB, UK.
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Perceived quality of life and acceptance of illness in people with type 2 diabetes mellitus. MENOPAUSE REVIEW 2017; 16:79-85. [PMID: 29507573 PMCID: PMC5834920 DOI: 10.5114/pm.2017.70583] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/08/2017] [Indexed: 12/02/2022]
Abstract
Objectives Type 2 diabetes exerts a significant impact on the patient’s quality of life. Its chronic nature, incurability and complications weaken the motivation of patients to fight the disease and its acceptance. The aim of research was to determine whether and to what extent diabetes modulates the quality of life of patients and in particular which domain of the patient’s life is most limited. In addition, we looked at whether the quality of life perceived by patients is determined by gender and whether and to what extent they accept their illness. Material and methods A study on 100 patients with type 2 diabetes from the Wielkopolska region in Poland was carried out at the end of 2013/beginning of 2014 using a diagnostic survey, and the research techniques were a standardized questionnaire – ADDQoL19 (Audit of Diabetes-Dependent Quality of Life 19) and the AIS questionnaire (Acceptance of Illness Scale) developed by Felton and modified by Juczyński. Results The results suggest that the quality of life of the patients was “neither good nor bad”, whereby women perceive it as being lower than men. While analysing the impact of diabetes on the different domains of the lives of men and women, it should be stressed that most affected were diet, satisfying appetite, independence, financial position, feelings about the future, sex life, and freedom in the consumption of drinks. More than half of men and women did not accept their illness; however, younger persons unlike older accepted diabetes to a much greater degree. Conclusions Type 2 diabetes negatively affects the quality of life of patients and its impact is felt more by women. In both sexes, the most affected domain of quality of life is the lack of nutritional freedom. The acceptance of illness is dependent upon age.
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Chang YK, Huang LF, Shin SJ, Lin KD, Chong K, Yen FS, Chang HY, Chuang SY, Hsieh TJ, Hsiung CA, Hsu CC. A Point-based Mortality Prediction System for Older Adults with Diabetes. Sci Rep 2017; 7:12652. [PMID: 28978911 PMCID: PMC5627261 DOI: 10.1038/s41598-017-12751-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 09/15/2017] [Indexed: 02/07/2023] Open
Abstract
The mortality prediction models for the general diabetic population have been well established, but the corresponding elderly-specific model is still lacking. This study aims to develop a mortality prediction model for the elderly with diabetes. The data used for model establishment were derived from the nationwide adult health screening program in Taiwan in 2007-2010, from which we applied a 10-fold cross-validation method for model construction and internal validation. The external validation was tested on the MJ health screening database collected in 2004-2007. Multivariable Cox proportional hazards models were used to predict five-year mortality for diabetic patients ≥65 years. A total of 220,832 older subjects with diabetes were selected for model construction, of whom 23,241 (10.5%) died by the end of follow-up (December 31, 2011). The significant predictors retained in the final model included age, gender, smoking status, body mass index (BMI), fasting glucose, systolic and diastolic blood pressure, leukocyte count, liver and renal function, total cholesterol, hemoglobin, albumin, and uric acid. The Harrell's C in the development, internal-, and external-validation datasets were 0.737, 0.746, and 0.685, respectively. We established an easy-to-use point-based model that could accurately predict five-year mortality risk in older adults with diabetes.
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Affiliation(s)
- Y K Chang
- Department of Medical Research, Tung's Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - L F Huang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - S J Shin
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Ditvision of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - K D Lin
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Ditvision of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - K Chong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
| | - F S Yen
- Dr. Yen's Clinic, Taoyuan, Taiwan
| | - H Y Chang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - S Y Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - T J Hsieh
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - C A Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - C C Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
- Department of Health Services Administration, China Medical University, Taichung, Taiwan.
- Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan.
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Lorem GF, Schirmer H, Emaus N. What is the impact of underweight on self-reported health trajectories and mortality rates: a cohort study. Health Qual Life Outcomes 2017; 15:191. [PMID: 28969649 PMCID: PMC5625617 DOI: 10.1186/s12955-017-0766-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 09/25/2017] [Indexed: 12/15/2022] Open
Abstract
Background Utilizing a cohort study design combining a survey approach with repeated physical examinations, we examined the independent effects of BMI on mortality and self-reported health (SRH) and whether these independent effects change as people grow older. Methods The Tromsø Study consists of six surveys conducted in the municipality of Tromsø, Norway, with large representative samples of a general population. In total, 31,985 subjects participated in at least one of the four surveys administered between 1986 and 2008. Outcomes of interest were SRH and all-cause mortality. Results Overweight and underweight subjects reported significantly lower levels of SRH, but age affected the thinnest subjects more than all others. The SRH trajectory of underweight subjects at age 25 was slightly above the other categories (0.08), but it fell to −.30 below the reference category at age 90. For obese subjects, the difference was −0.15 below the reference category at age 25 and −0.18 below at age 90. This implies that even though a low BMI was slightly beneficial at a young age, it represented an increasing risk with age that crossed the reference curve at age 38 and even crossed the obese trajectory at age 67 in the full fitted model. The proportional hazard ratio for those who were underweight was 1.69 (95% CI: 1.38-2.06) for all-cause death as compared to 1.12 (95% CI: 1.02-1.23) for obese subjects. Conclusion BMI affected SRH and all-cause mortality independently from comorbidity, mental health, health-related behaviors and other biological risk factors. Being underweight was associated with excess mortality as compared to all others, and age affected the thinnest subjects more than all others. Weight increase was beneficial for mortality but not for SRH among the underweight. The rapid decline of SRH with increasing age suggests that particular attention should be paid to underweight after 38 years of age. Electronic supplementary material The online version of this article (10.1186/s12955-017-0766-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Geir Fagerjord Lorem
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Henrik Schirmer
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Nina Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Poljsak B. NAMPT-Mediated NAD Biosynthesis as the Internal Timing Mechanism: In NAD+ World, Time Is Running in Its Own Way. Rejuvenation Res 2017; 21:210-224. [PMID: 28756747 DOI: 10.1089/rej.2017.1975] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The biological age of organisms differs from the chronological age and is determined by internal aging clock(s). How cells estimate time on a scale of 24 hours is relatively well studied; however, how biological time is measured by cells, tissues, organs, or organisms in longer time periods (years and decades) is largely unknown. What is clear and widely agreed upon is that the link to age and age-related diseases is not chronological, as it does not depend on a fixed passage of time. Rather, this link depends on the biological age of an individual cell, tissue, organ, or organism and not on time in a strictly chronological sense. Biological evolution does not invent new methods as often as improving upon already existing ones. It should be easier to evolve and remodel the existing (circadian) time clock mechanism to use it for measurement or regulation of longer time periods than to invent a new time mechanism/clock. Specifically, it will be demonstrated that the circadian clock can also be used to regulate circannual or even longer time periods. Nicotinamide phosphoribosyltransferase (NAMPT)-mediated nicotinamide adenine dinucleotide (NAD+) levels, being regulated by the circadian clock, might be the missing link between aging, cell cycle control, DNA damage repair, cellular metabolism and the aging clock, which is responsible for the biological age of an organism. The hypothesis that NAMPT/NAD+/SIRT1 might represent the time regulator that determines the organismal biological age will be presented. The biological age of tissues and organs might be regulated and synchronized through eNAMPT blood secretion. The "NAD World 2.0" concept will be upgraded with detailed insights into mechanisms that regulate NAD+-mediated aging clock ticking, the duration and amplitude of which are responsible for the aging rate of humans.
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Affiliation(s)
- Borut Poljsak
- Laboratory of Oxidative Stress Research, Faculty of Health Sciences, University of Ljubljana , Ljubljana, Slovenia
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46
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Gallego González E, Ortiz Alonso FJ, Vidán Astiz MT, Soria Felix S, García Cárdenas V, Omonte Guzmán J, Abizanda P, Valadés Malagón MI, Oreja Sevilla S, Serra Rexach JA. Development and validation of a prognostic index for 6- and 12-month mortality in hospitalized older adults. Arch Gerontol Geriatr 2017; 73:269-278. [PMID: 28869885 DOI: 10.1016/j.archger.2017.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/16/2017] [Accepted: 07/17/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND/AIM Estimation of mortality in elderly patients is difficult yet very important when planning care. Previous tools are complicated or do no take into account some major determinants of mortality (i.e., frailty). We designed a simple, accurate, and non-disease-specific tool to predict individual mortality risk after hospital discharge in older adults. METHODS Patients admitted to the Acute Geriatric Unit were assessed at adission and at discharge and contacted 6 and 12 months later. Determinants of mortality were obtained. Using multivariable analysis, beta coeffcicients were calculated to build 2 scores able to predict mortality at 6 and 12 months after discharge. The scores were tested on a sample comprising 75% of the patients, who were randomly selected; they were validated using the remaining 25%. Discrimination was assessed using ROC curves. Scores were calculated for each patient and divided into tertiles. Survival analysis was performed. RESULTS Determinants of mortality at 6 months were dependent ambulation at baseline, full dependence at discharge, length of stay, pluripatology, pressure ulcers, low grip strength, malignacy, and male gender. At 12 months the determinants were: dependent amblation at baseline, full dependence at discharge, pluripatology, low BMI, low grip strength, heart failure, malignacy, and male gender. Discrimination and calibration were excellent. Survival analysis demonstrated different survival trajectories (p<0.001) for each tertile in both scores. CONCLUSIONS Our incices provide accurate prognostic information in elderly patients after discharge. They can be calculated easily, quickly and do not require technical or laboratory support, thus endorsing their value in dalily clinical practice.
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Affiliation(s)
- Eva Gallego González
- Hospital Universitario de Canarias, Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERFES, Madrid, Spain.
| | - Francisco Javier Ortiz Alonso
- Instituto de Investigación Sanitaria Gregorio Marañón, CIBERFES, Madrid, Spain; Geriatrics Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Maria Teresa Vidán Astiz
- Instituto de Investigación Sanitaria Gregorio Marañón, CIBERFES, Madrid, Spain; Geriatrics Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, CIBERFES, Spain.
| | - Selene Soria Felix
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | | | - John Omonte Guzmán
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Pedro Abizanda
- Geriatrics Department, Complejo Hospitalario Universitario de Albacete, CIBERFES, Albacete, Spain.
| | | | - Silvia Oreja Sevilla
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - José Antonio Serra Rexach
- Instituto de Investigación Sanitaria Gregorio Marañón, CIBERFES, Madrid, Spain; Geriatrics Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, CIBERFES, Spain.
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47
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Butler R, McClinchy J, Morreale-Parker C, Marsh W, Rennie KL. BMI calculation in older people: The effect of using direct and surrogate measures of height in a community-based setting. Clin Nutr ESPEN 2017; 22:112-115. [PMID: 29415827 DOI: 10.1016/j.clnesp.2017.07.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 07/15/2017] [Accepted: 07/31/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS There is currently no consensus on which measure of height should be used in older people's body mass index (BMI) calculation. Most estimates of nutritional status include a measurement of body weight and height which should be reliable and accurate, however at present several different methods are used interchangeably. BMI, a key marker in malnutrition assessment, does not reflect age-related changes in height or changes in body composition such as loss of muscle mass or presence of oedema. The aim of this pilot study was to assess how the use of direct and surrogate measures of height impacts on BMI calculation in people aged ≥75 years. METHODS A cross-sectional study of 64 free-living older people (75-96 yrs) quantified height by two direct measurements, current height (HC), and self-report (HR) and surrogate equations using knee height (HK) and ulna length (HU). BMI calculated from current height measurement (BMIC) was compared with BMI calculated using self-reported height (BMIR) and height estimated from surrogate equations for knee height (BMIK) and ulna length (BMIU). RESULTS Median difference of BMIC-BMIR was 2.31 kg/m2. BMIK gave the closest correlation to BMIC. The percentage of study participants identified at increased risk of under-nutrition (BMI < 20 kg/m2) varied depending on which measure of height was used to calculate BMI; from 5% (BMIC), 7.8% (BMIK), 12.5% (BMIU), to 14% (BMIR) respectively. CONCLUSIONS The results of this pilot study in a relatively healthy sample of older people suggest that interchangeable use of current and reported height in people ≥75 years can introduce substantial significant systematic error. This discrepancy could impact nutritional assessment of older people in poor health and lead to misclassification during nutritional screening if other visual and clinical clues are not taken into account. This could result in long-term clinical and cost implications if individuals who need nutrition support are not correctly identified. A consensus is required on which method should be used to quantify height in older people to improve accuracy of nutritional assessment and clinical care.
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Affiliation(s)
- Rose Butler
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts AL10 9AB, UK.
| | - Jane McClinchy
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts AL10 9AB, UK
| | - Claudia Morreale-Parker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts AL10 9AB, UK
| | - Wendy Marsh
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts AL10 9AB, UK
| | - Kirsten L Rennie
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts AL10 9AB, UK
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Lee G, Park J, Oh SW, Joh HK, Hwang SS, Kim J, Park D. Association between Body Mass Index and Quality of Life in Elderly People over 60 Years of Age. Korean J Fam Med 2017; 38:181-191. [PMID: 28775807 PMCID: PMC5541165 DOI: 10.4082/kjfm.2017.38.4.181] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/05/2016] [Accepted: 10/05/2016] [Indexed: 11/19/2022] Open
Abstract
Background The Korean population is aging rapidly and the number of health threats is increasing. The elderly obese population is also increasing and this study aimed to evaluate the association between body mass index (BMI) and health-related quality of life in the elderly Korean population. Methods The Korean version Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was administered to elderly subjects (≥60 years) selected from welfare and health centers, and university hospitals. Sociodemographic information and subjects' height and weight were also recorded. Results The study population's mean age was 74.2±7.1 years, and the average BMI was 24.5±3.2 kg/m2. The 542 participants were segregated based on BMI quartiles. The SF-36 scores were compared among the sex-stratified quartile groups after adjusting for age, education level, income, smoking, alcohol, and arthritis diagnosis. The SF-36 scores were compared for four BMI quartiles stratified by sex, after adjusting for age, education level, income, smoking, alcohol consumption, and arthritis diagnosis. Men in the Q3 and Q4 groups had higher mental health scores than men in Q2 group. Additionally, men in the Q3 group had higher social function scores than those in the Q2 and Q4 groups. No differences were observed for the remaining six domains; no significant score differences were observed in any of the survey domains for the female subjects. Conclusion There was no significant association between a high BMI and a low quality of life in the elderly Korean population selected from hospitals and welfare centers, as assessed using the SF-36 scores.
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Affiliation(s)
- Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jiyoung Park
- Department of Family Medicine, Kwangdong Oriental Hospital, Seoul, Korea
| | - Seung-Won Oh
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Hee-Kyung Joh
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Family Medicine, Seoul National University Health Service Center, Seoul, Korea
| | - Seung-Sik Hwang
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jeehyun Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Danbee Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
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Ferriolli E, Pessanha FPADS, Moreira VG, Dias RC, Neri AL, Lourenço RA. Body composition and frailty profiles in Brazilian older people: Frailty in Brazilian Older People Study-FIBRA-BR. Arch Gerontol Geriatr 2017; 71:99-104. [PMID: 28395196 DOI: 10.1016/j.archger.2017.03.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 01/25/2017] [Accepted: 03/25/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the association between body composition and frailty in older Brazilian subjects. MATERIAL AND METHODS This is a Cross-sectional study called FIBRA-BR and developed in community Brazilian aged ≥65 (n=5638). Frailty was assessed according to Fried et al. definition and body composition was determined by BMI, waist circumference and waist-hip ratio. RESULTS The lowest prevalence of frailty was observed in subjects with BMI between 25.0 and 29.9kg/m2. Subjects with a BMI <18.5 and those with elevated WC presented a higher risk of frailty compared to eutrophic subjects (odds ratio (OR)=3.10; 95% CI: 2.06-4.67) and (OR=1.15; 95% CI: 1.03-1.27), respectively. Being overweight was protective for pre-frailty (OR=0.48; 95% CI: 0.4-0.58) and frailty (OR=0.77; 95% CI: 0.67-0.9). Obese older people presented a higher risk of pre-frailty only (OR=1.29; 95% CI: 1.09-1.51). Older people with high WC showed a greater proportion of frailty regardless of the BMI range. CONCLUSION Undernutrition is associated with pre-frailty and frailty in Brazilian elderly subjects, whereas obesity is associated only with pre-frailty. Overweight seems to have a protective effect against the syndrome. The excess of abdominal fat is associated with both profiles independent of the BMI.
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Affiliation(s)
- Eduardo Ferriolli
- Division of General Internal and Geriatric Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | | | - Virgílio Garcia Moreira
- GeronLab, Internal Medicine Department, Health Science School, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.
| | - Rosângela Corrêa Dias
- Division of Physiotherapy, School of Physiotherapy, Minas Gerais Federal University, Belo Horizonte, MG, Brazil.
| | - Anita Liberalesso Neri
- Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University, Campinas, SP, Brazil.
| | - Roberto Alves Lourenço
- GeronLab, Internal Medicine Department, Health Science School, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.
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50
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Weight change and risk of hyperglycaemia in elderly women. Aging Clin Exp Res 2017; 29:1095-1104. [PMID: 28265973 DOI: 10.1007/s40520-016-0696-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/06/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Hyperglycaemia increases the risk of type 2 diabetes, heart disease and stroke, and is influenced by weight. However, the impact of preceding weight change on blood glycemia levels in late-life is less well understood. AIM We studied the interplay between weight change and risk of hyperglycaemia in a prospective cohort of elderly women. METHODS Elderly Caucasian women (age: 67.1 years at baseline, n = 1173) enrolled in the Prospective Epidemiological Risk Factor study with baseline and 13-year follow-up measurements of BMI and fasting glucose levels (FPG) and no previous history of diabetes or impaired fasting glucose. Multivariate logistic regression was used to determine risk of hyperglycaemia (FPG ≥ 5.6 mmol/L or HbA1c ≥ 42 mmol/mol) in normalweight (BMI ≤ 25 kg/m2), overweight (BMI = 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) women who either lost weight, were weight-stable or had gained weight at follow-up. RESULTS Overweight and obese elderly women who had gained weight at follow-up presented an increased risk of hyperglycaemia, OR = 2.7 (1.6-4.6) and OR = 3.2 (1.5-6.8), compared to weight-stable normalweight women. Overweight and obese women who lost weight decreased their risk of hyperglycaemia to a level comparable to weight-stable normalweight women. Overweight and obese women with stable weight presented a two-fold increased risk of hyperglycaemia compared to normalweight weight-stable women. CONCLUSIONS Losing weight in late life had a positive effect on the risk of hyperglycaemia in overweight and obese women, while further, weight gain increased the risk of hyperglycaemia. The study highlights that strategies to reduce weight in obese and overweight elderly women could have a positive influence on disease burden in late-life.
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