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Vlietstra L, Kirk B, Duque G, Qualls C, Vellas B, Andrieu S, Morley JE, Waters DL. Using minimal clinically important differences to measure long-term transitions of osteosarcopenia: The New Mexico Aging Process Study. Exp Gerontol 2023; 173:112106. [PMID: 36708751 DOI: 10.1016/j.exger.2023.112106] [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: 09/20/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND/OBJECTIVE By having a better understanding of transitions in osteosarcopenia, interventions to reduce morbidity and mortality can be better targeted. The aim of this study was to show the rationale and method of using minimal clinically important differences (MCID's) to classify transitions, and the effects of demographic variables on transitions in a 9-year follow-up data from the New Mexico Aging Process Study (NMAPS). METHODS Transitions were identified in four aspects of osteosarcopenia: bone mineral density (BMD), appendicular skeletal muscle mass/body mass index ratio (ASM/BMI), grip strength and gait speed. Transitions were identified using a MCID score. As there is currently no available MCID for BMD and ASM/BMI, those were determined using a distribution-based and an anchor-based method. Total transitions were calculated for all four measures of osteosarcopenia in all transition categories (maintaining a health status, beneficial transition, harmful transitions). Poisson regression was used to test for effects of demographic variables, including age, sex, physical activity, medication, and health status, on transitions. RESULTS Over the 9-year follow-up, a total of 2163 MCID-derived BMD transitions were reported, 1689 ASM/BMI transitions, 2339 grip strength transitions, and 2151 gait speed transitions. Additionally, some MCID-derived transition categories were associated with sex, age, and health status. CONCLUSION Use of MCID-derived transitions reflected the fluctuation and the dynamic nature of health in older adults. Future research should focus on transitions of modifiable markers in osteosarcopenia to design intervention trials.
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Affiliation(s)
- Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Gustavo Duque
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia; Research Institute of the McGill University Health Centre, McGill University, Montreal, QC H4A 3J1, Canada
| | - Clifford Qualls
- Department of Mathematics & Statistics and School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Bruno Vellas
- Department of Internal and Geriatrics Medicine, Gerontopole, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
| | - Sandrine Andrieu
- Department of Clinical Epidemiology and Public Health, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University, 1402, South Grand Blvd, RoomM238, St. Louis, MO 63110-0250, USA
| | - Debra L Waters
- School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of Medicine, University of Otago, Dunedin, New Zealand; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA.
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Lanari D, Bussini O, Minelli L. The Effects of Immigrant Status and Age at Migration on Changes in Older Europeans’ Health. INTERNATIONAL MIGRATION REVIEW 2018. [DOI: 10.1177/0197918318766359] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to determine the differences between natives and immigrants in regard to transition probabilities among health states in self-rated health (SRH), depression, and activities of daily living for middle-aged and older adults in Europe. The Survey of Health, Aging, and Retirement allows us to investigate how successfully the immigrants have aged from 2004 to 2011 compared to natives, according to country of origin and age at migration. We showed that some groups, such as Eastern European immigrants, have higher probabilities of health deterioration in terms of SRH. Moreover, those immigrants who arrived in the host country during adulthood experienced relatively fast health decline.
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Zanjari N, Sharifian Sani M, Chavoshi MH, Rafiey H, Mohammadi Shahboulaghi F. Successful aging as a multidimensional concept: An integrative review. Med J Islam Repub Iran 2017; 31:100. [PMID: 29951401 PMCID: PMC6014811 DOI: 10.14196/mjiri.31.100] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Indexed: 11/18/2022] Open
Abstract
Background: Successful aging as an umbrella term with a large amount of literature has emerged with a variety of meanings and dimensions in different studies. This article aims at determining what dimensions contribute to constructing the concept of successful aging. Methods: The method used in this study is an integrative review of published literature related to successful aging. This method includes both qualitative and quantitative studies. Data searching was conducted during November and December 2014 and was then updated in October 2015. First, 2543 articles were identified, and after the screening phase, 76 articles were eligible for inclusion in the integrative review. Results: The results specified 14 subcategories and 5 main categories of successful aging: social well-being, psychological wellbeing, physical health, spirituality and transcendence, and environment and economic security. Conclusion: The present study provides a thorough understanding of successful aging dimensions and proposes the importance of the multidimensional concept of successful aging at the individual, interpersonal, and environmental levels for future studies and policymaking on population aging.
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Affiliation(s)
- Nasibeh Zanjari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maryam Sharifian Sani
- Department of Social Welfare, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Hassan Rafiey
- Department of Social Welfare, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Wood KN, Nikolov R, Shoemaker JK. Impact of Long-Term Endurance Training vs. Guideline-Based Physical Activity on Brain Structure in Healthy Aging. Front Aging Neurosci 2016; 8:155. [PMID: 27445798 PMCID: PMC4928447 DOI: 10.3389/fnagi.2016.00155] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/14/2016] [Indexed: 12/11/2022] Open
Abstract
Brain structure is a fundamental determinant of brain function, both of which decline with age in the adult. Whereas short-term exercise improves brain size in older adults, the impact of endurance training on brain structure when initiated early and sustained throughout life, remains unknown. We tested the hypothesis that long-term competitive aerobic training enhances cortical and subcortical mass compared to middle to older-aged healthy adults who adhere to the minimum physical activity guidelines. Observations were made in 16 masters athletes (MA; 53 ± 6 years, VO2max = 55 ± 10 ml/kg/min, training > 15 years), and 16 active, healthy, and cognitively intact subjects (HA; 58 ± 9 years, VO2max = 38 ± 7 ml/kg/min). T1-weighted structural acquisition at 3T enabled quantification of cortical thickness and subcortical gray and white matter volumes. Cardiorespiratory fitness correlated strongly with whole-brain cortical thickness. Subcortical volumetric mass at the lateral ventricles, R hippocampus, R amygdala, and anterior cingulate cortex, correlated with age but not fitness. In a region-of-interest (ROI) group-based analysis, MA expressed greater cortical thickness in the medial prefrontal cortex, pre and postcentral gyri, and insula. There was no effect of group on the rate of age-related cortical or subcortical decline. The current data suggest that lifelong endurance training that produces high levels of cardiorespiratory fitness, builds cortical reserve early in life, and sustains this benefit over the 40–70 year age span. This reserve likely has important implications for neurological health later in life.
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Affiliation(s)
- Katelyn N Wood
- Department of Kinesiology, Neurovascular Research Laboratory, School of Kinesiology, Western University London, ON, Canada
| | - Robert Nikolov
- Robarts Research Institute, Western University London, ON, Canada
| | - J Kevin Shoemaker
- Department of Kinesiology, Neurovascular Research Laboratory, School of Kinesiology, Western UniversityLondon, ON, Canada; Department of Physiology and Pharmacology, Western UniversityLondon, ON, Canada
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Liu PL, Cohen HJ, Fillenbaum GG, Burchett BM, Whitson HE. Association of Co-Existing Impairments in Cognition and Self-Rated Vision and Hearing With Health Outcomes in Older Adults. Gerontol Geriatr Med 2016; 2. [PMID: 27054148 PMCID: PMC4820285 DOI: 10.1177/2333721415623495] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The objective of this study was to assess the relationship of disability (activities of daily living [ADL] and instrumental ADL [IADL]), self-rated health (SRH), and 6-year mortality with co-existing impairments in vision (self-rated), hearing (self-rated), and/or cognition (Short Portable Mental Status Questionnaire) in older adults. Method: The study sample comprised of 3,871 participants from the North Carolina Established Populations for Epidemiologic Studies of the Elderly study (NC EPESE). Results: Persons with all three impairments had increased odds of ADL/IADL disability and low SRH. Participants with combined visual and cognitive impairments had increased odds of mortality. Whereas sensory impairments were associated with poor SRH, cognitive impairment was not unless both sensory impairments were present. Conclusion: Co-existent sensory and cognitive impairments were associated with higher risk of impaired functional status. Self-rated auditory impairment alone was not associated with higher odds of death, but mortality was linked to visual and, particularly, cognitive impairment, alone or combined.
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Affiliation(s)
- Phillip L Liu
- Center for the Study of Aging and Human Development, Duke University Durham, NC; Department of Medicine, Duke University, Durham, NC
| | - Harvey Jay Cohen
- Center for the Study of Aging and Human Development, Duke University Durham, NC; Department of Medicine, Duke University, Durham, NC; Durham VA Medical Center, Geriatrics Research Education and Clinical Center, Durham, NC
| | - Gerda G Fillenbaum
- Center for the Study of Aging and Human Development, Duke University Durham, NC
| | - Bruce M Burchett
- Center for the Study of Aging and Human Development, Duke University Durham, NC
| | - Heather E Whitson
- Center for the Study of Aging and Human Development, Duke University Durham, NC; Department of Medicine, Duke University, Durham, NC; Department of Ophthalmology, Duke University, Durham, NC; Durham VA Medical Center, Geriatrics Research Education and Clinical Center, Durham, NC
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Gurland BJ, Page W, Small B, McArdle JJ, Plassman BL. Heritability of Health and Aging Limitations on Personally Desired Activities. Health Psychol Res 2015; 3:1981. [PMID: 26973959 PMCID: PMC4768531 DOI: 10.4081/hpr.2015.1981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/16/2014] [Accepted: 12/18/2014] [Indexed: 11/23/2022] Open
Abstract
The aim of this study is to estimate heritability of incident limitations on personally desired activities within the eighth decade of life. We measured self-rated ability to perform ten personally desired activities in 1606 male veteran twin pairs at baseline and four years later. At follow-up, 33% of the cohort reported more limitations in desired activities. Among twins who completed both assessments, there were no statistically significant differences in incidence rates of limitations as a function of zygosity. Sensitivity tests showed the same for change scores; and that, if cognitive impairment or death are deemed to belong among limitations of desired activities, zygosity contributed 10% to new limitations at follow-up. Maintaining personally desired activities over four years in the eighth decade is not subject to substantial genetic influence. However, if death and cognitive impairment are added to incident limitations, then genetics plays a modest role. In all cases, unique environment is the predominant influence.
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Affiliation(s)
| | - William Page
- National Academy of Sciences-National Research Council Twin Registry , Tampa, FL, USA
| | - Brent Small
- University of South Florida , Tampa, FL, USA
| | - John J McArdle
- University of Southern California , Los Angeles, CA, USA
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Cooper DC, Trivedi RB, Nelson KM, Reiber GE, Eugenio EC, Beaver KA, Fan VS. Antidepressant adherence and risk of coronary artery disease hospitalizations in older and younger adults with depression. J Am Geriatr Soc 2014; 62:1238-45. [PMID: 24890000 DOI: 10.1111/jgs.12849] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To assess whether the relationship between antidepressant adherence and coronary artery disease (CAD) hospitalizations varied between older and younger adults with depression. DESIGN Retrospective cohort study. SETTING Department of Veterans Affairs outpatient clinics nationwide. PARTICIPANTS Chronically depressed individuals (n = 50,261; aged 20-97) who had been prescribed an antidepressant were identified from records indicating an outpatient clinic visit for depression (index depression visit) during fiscal years 2009 and 2010. Individuals were considered chronically depressed if they had had prior depression visits and treatment for depression within the previous 4 months. The sample was age-stratified into younger (<65) and older (≥ 65) groups. MEASUREMENTS After the index depression visit, medication possession ratios were calculated from pharmacy refill data to determine whether participants had 80% or greater adherence to antidepressant refills during a 6-month treatment observation period. International Classification of Diseases, Ninth Revision, codes were used to derive CAD-related hospitalizations during the follow-up period. Mean follow-up was 24 months. Data were analyzed using Cox proportional hazard models. RESULTS Older participants with 80% or greater antidepressant adherence had 26% lower risk of CAD hospitalizations (hazard ratio = 0.74, 95% confidence interval = 0.60-0.93). Antidepressant adherence was not significantly related to CAD hospitalizations in younger adults. CONCLUSION Older adults with chronic depression with 80% or greater antidepressant adherence had significantly lower risk of CAD hospitalizations at follow-up than those with less than 80% adherence. These preliminary results suggest that older adults with depression may derive cardiovascular benefits from clinical efforts to increase antidepressant adherence.
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Affiliation(s)
- Denise C Cooper
- Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veteran Affairs Puget Sound Health Care System, Seattle, Washington; Department of Health Services, University of Washington, Seattle, Washington
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Erickson KI, Leckie RL, Weinstein AM. Physical activity, fitness, and gray matter volume. Neurobiol Aging 2014; 35 Suppl 2:S20-8. [PMID: 24952993 DOI: 10.1016/j.neurobiolaging.2014.03.034] [Citation(s) in RCA: 374] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 02/28/2014] [Accepted: 03/11/2014] [Indexed: 12/11/2022]
Abstract
In this review, we explore the association among physical activity, cardiorespiratory fitness, and exercise on gray matter volume in older adults. We conclude that higher cardiorespiratory fitness levels are routinely associated with greater gray matter volume in the prefrontal cortex and hippocampus and less consistently in other regions. We also conclude that physical activity is associated with greater gray matter volume in the same regions that are associated with cardiorespiratory fitness including the prefrontal cortex and hippocampus. Some heterogeneity in the literature may be explained by effect moderation by age, stress, or other factors. Finally, we report promising results from randomized exercise interventions that suggest that the volume of the hippocampus and prefrontal cortex remain pliable and responsive to moderate intensity exercise for 6 months-1 year. Physical activity appears to be a propitious method for influencing gray matter volume in late adulthood, but additional well-controlled studies are necessary to inform public policies about the potential protective or therapeutic effects of exercise on brain volume.
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Affiliation(s)
- Kirk I Erickson
- Department of Psychology, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Regina L Leckie
- Department of Psychology, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrea M Weinstein
- Department of Psychology, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
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Patient transitions relevant to individuals requiring ongoing ventilatory assistance: a Delphi study. Can Respir J 2014; 21:287-92. [PMID: 24791254 DOI: 10.1155/2014/484835] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Various terms, including 'prolonged mechanical ventilation' (PMV) and 'long-term mechanical ventilation' (LTMV), are used interchangeably to distinguish patient cohorts requiring ventilation, making comparisons and timing of clinical decision making problematic. OBJECTIVE To develop expert, consensus-based criteria associated with care transitions to distinguish cohorts of ventilated patients. METHODS A four-round (R), web-based Delphi study with consensus defined as >70% was performed. In R1, participants listed, using free text, criteria perceived to should and should not define seven transitions. Transitions comprised: T1 - acute ventilation to PMV; T2 - PMV to LTMV; T3 - PMV or LTMV to acute ventilation (reverse transition); T4 - institutional to community care; T5 - no ventilation to requiring LTMV; T6 - pediatric to adult LTMV; and T7 - active treatment to end-of-life care. Subsequent Rs sought consensus. RESULTS Experts from intensive care (n=14), long-term care (n=14) and home ventilation (n=10), representing a variety of professional groups and geographical areas, completed all Rs. Consensus was reached on 14 of 20 statements defining T1 and 21 of 25 for T2. 'Physiological stability' had the highest consensus (97% and 100%, respectively). 'Duration of ventilation' did not achieve consensus. Consensus was achieved on 13 of 18 statements for T3 and 23 of 25 statements for T4. T4 statements reaching 100% consensus included: 'informed choice', 'patient stability', 'informal caregiver support', 'caregiver knowledge', 'environment modification', 'supportive network' and 'access to interprofessional care'. Consensus was achieved for 15 of 17 T5, 16 of 20 T6 and 21 of 24 T7 items. CONCLUSION Criteria to consider during key care transitions for ventilator-assisted individuals were identified. Such information will assist in furthering the consistency of clinical care plans, research trials and health care resource allocation.
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The contribution of diseases to the male-female disability-survival paradox in the very old: results from the Newcastle 85+ study. PLoS One 2014; 9:e88016. [PMID: 24516578 PMCID: PMC3917849 DOI: 10.1371/journal.pone.0088016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/02/2014] [Indexed: 11/29/2022] Open
Abstract
Background Explanations for the male-female disability-survival paradox - that woman live longer than men but with more disability - include sex differences in diseases and their impact on disability and death. Less is known about the paradox in the very old. We examine sex differences in the presence and impact of disabling and fatal diseases accounting for the male-female disability-survival paradox in very late life. Methods We use data from the Newcastle 85+ Study, a cohort of people born in 1921 and all recruited at age 85 in 2006. Participants underwent a health assessment (HA) at baseline, 18 months, 36 months, 60 months, and a review of their GP records (GPRR) at baseline and 36 months. We used multi-state modelling to assess the impact of specific diseases on disability and death. Disability (measured via ADLs/IADLs) was categorised as no disability (difficulty with 0 activities), or disabled (difficulty with one or more activities). Diseases were ascertained from review of general practice records and cognitive impairment which was defined as an sMMSE of 21 or less (from health assessment). Results In participants who had complete HA and GPRR, women had more arthritis (RR = 1.2, 95% CI: 1.1–1.3) and hypertension (RR = 1.2, 95%CI 1.0–1.3), more disability, and were more likely disabled at all follow-ups. From multistate models, women with cerebrovascular disease (HR: 2.6, 95% CI: 2.1–3.4) or respiratory disease (HR: 2.0, 95% CI: 1.4–3.0) were more likely to become disabled than those without but this did not hold for men (sex difference p<0.01). Men were more likely to die from respiratory disease (HR: 2.2, 95% CI: 1.8–2.8) but this did not hold for women (p = 0.002). Conclusion The disability-survival paradox was still evident at age 85 and appears due to sex differences in the types of diseases and their impact on the disability pathway.
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Diehr PH, Thielke SM, Newman AB, Hirsch C, Tracy R. Decline in health for older adults: five-year change in 13 key measures of standardized health. J Gerontol A Biol Sci Med Sci 2013; 68:1059-67. [PMID: 23666944 DOI: 10.1093/gerona/glt038] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The health of older adults declines over time, but there are many ways of measuring health. It is unclear whether all health measures decline at the same rate or whether some aspects of health are less sensitive to aging than others. METHODS We compared the decline in 13 measures of physical, mental, and functional health from the Cardiovascular Health Study: hospitalization, bed days, cognition, extremity strength, feelings about life as a whole, satisfaction with the purpose of life, self-rated health, depression, digit symbol substitution test, grip strength, activities of daily living, instrumental activities of daily living, and gait speed. Each measure was standardized against self-rated health. We compared the 5-year change to see which of the 13 measures declined the fastest and the slowest. RESULTS The 5-year change in standardized health varied from a decline of 12 points (out of 100) for hospitalization to a decline of 17 points for gait speed. In most comparisons, standardized health from hospitalization and bed days declined the least, whereas health measured by activities of daily living, instrumental activities of daily living, and gait speed declined the most. These rankings were independent of age, sex, mortality patterns, and the method of standardization. CONCLUSIONS All of the health variables declined, on average, with advancing age, but at significantly different rates. Standardized measures of mental health, cognition, quality of life, and hospital utilization did not decline as fast as gait speed, activities of daily living, and instrumental activities of daily living. Public health interventions to address problems with gait speed, activities of daily living, and instrumental activities of daily living may help older adults to remain healthier in all dimensions.
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Affiliation(s)
- Paula H Diehr
- Department of Biostatistics, University of Washington, 1959 NE Pacific Ave, Seattle, WA 98195, USA.
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The onset of widespread musculoskeletal pain is associated with a decrease in healthy ageing in older people: a population-based prospective study. PLoS One 2013; 8:e59858. [PMID: 23555810 PMCID: PMC3612101 DOI: 10.1371/journal.pone.0059858] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 02/21/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Chronic musculoskeletal pain is common in older adults but the nature of its relationship with ageing is unclear. The objective for this study was to test the hypothesis that the onset of widespread pain would be associated with a decrease in healthy ageing. METHODS Population-based prospective cohort study. A "healthy ageing" index was constructed across biomedical, physical, psychosocial and lay components. Analysis was performed with 2949 adults aged 50 years and over who had complete index scores at baseline, 3 and 6-year follow-ups. RESULTS At three and six year follow-up, 365 (16.8%) and 259 (14.3%) experienced the onset of widespread pain. The onset of widespread pain during the six-year period was associated with a 25% and a 46% decrease in healthy ageing index scores; this decrease was independent of age, sex, education, social networks, smoking status, alcohol consumption and physical inactivity. The decrease in healthy ageing attenuated to 20% and 39% following adjustment for diagnosed musculoskeletal conditions and analgesic and non-steroidal use. CONCLUSIONS The onset of widespread pain was associated with a decrease in healthy ageing throughout the six-year period. When pain increased over time, the markers of unhealthy ageing increased also. Strong analgesia was associated with unhealthy ageing. Research could now usefully test whether early identification, improved treatment and prevention of pain prior to old age may facilitate healthy ageing.
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Hörder HM, Frändin K, Larsson MEH. Self-respect through ability to keep fear of frailty at a distance: successful ageing from the perspective of community-dwelling older people. Int J Qual Stud Health Well-being 2013; 8:20194. [PMID: 23511089 PMCID: PMC3602434 DOI: 10.3402/qhw.v8i0.20194] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2013] [Indexed: 11/14/2022] Open
Abstract
With population ageing, there is an increased interest in how to promote a good old age. A predominant concept in these discussions is successful ageing, which is mainly based on researchers’ definitions. This article aims to explore successful ageing from the perspective of community-dwelling older people (24 persons aged 77–90 years). Individual open interviews were conducted and analysed according to qualitative content analysis. An overarching theme was formulated as “self-respect through ability to keep fear of frailty at a distance”. This embraced the content of four categories: “having sufficient bodily resources for security and opportunities”, “structures that promote security and opportunities”, “feeling valuable in relation to the outside world”, and “choosing gratitude instead of worries”. Ageing seems to be a dynamic process rather than a static structure and might therefore be susceptible to actions. Paying attention to attitudes and treating the older person with respect, particularly with regard to worries about increasing vulnerability, can lead to better ways of promoting successful ageing.
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Affiliation(s)
- Helena M Hörder
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
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