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Imamura K, Kawai H, Ejiri M, Abe T, Yamashita M, Sasai H, Obuchi S, Suzuki H, Fujiwara Y, Awata S, Toba K. Association of the combination of social isolation and living alone with cognitive impairment in community-dwelling older adults: The IRIDE Cohort Study. Arch Gerontol Geriatr 2024; 127:105571. [PMID: 39002518 DOI: 10.1016/j.archger.2024.105571] [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: 04/23/2024] [Revised: 06/30/2024] [Accepted: 07/06/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Living alone has been associated with cognitive impairment; however, findings have been inconsistent. Social isolation among older adults who live alone may contribute to cognitive impairment. This study was carried out to examine the association of social isolation and living alone with cognitive impairment in community-dwelling older adults. METHODS In this cross-sectional study, data from the Integrated Research Initiative for Living Well with Dementia Cohort Study, which comprises pooled data from five community-based geriatric cohorts, was used. Social isolation was defined as infrequent interactions with others. Participants were categorized into four groups based on their social isolation and living alone statuses. Cognitive function was assessed using the Mini-Mental State Examination, with a score <24 indicating cognitive impairment. The association between social isolation combined with living alone and cognitive impairment was analyzed using logistic regression. RESULTS Of the 4362 participants included in the analysis (mean age 75.6 years, 44.3 % male), 11 % had cognitive impairment. Regardless of living alone, social isolation was associated with cognitive impairment (no social isolation x not living alone: reference, social isolation x not living alone; odds ratio (OR): 1.74, 95 % confidence interval (CI): 1.29-2.33, social isolation x living alone; OR: 2.10, 95 % CI: 1.46-3.01). CONCLUSIONS Social isolation is associated with cognitive impairment; however, living alone is not intrinsically associated with cognitive impairment in older adults. Healthcare providers must focus on social interactions to prevent cognitive impairment in older adults rather than simply focusing on living arrangements.
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Affiliation(s)
- Keigo Imamura
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan.
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Manami Ejiri
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Takumi Abe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan; School of Commerce, Meiji University, 1-9-1 Eifuku, Suginami-Ku, Tokyo 168-8555, Japan
| | - Mari Yamashita
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Hiroyuki Suzuki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Shuichi Awata
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Kenji Toba
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
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Schwartzman JD, McCall M, Ghattas Y, Pugazhendhi AS, Wei F, Ngo C, Ruiz J, Seal S, Coathup MJ. Multifunctional scaffolds for bone repair following age-related biological decline: Promising prospects for smart biomaterial-driven technologies. Biomaterials 2024; 311:122683. [PMID: 38954959 DOI: 10.1016/j.biomaterials.2024.122683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/09/2024] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
The repair of large bone defects due to trauma, disease, and infection can be exceptionally challenging in the elderly. Despite best clinical practice, bone regeneration within contemporary, surgically implanted synthetic scaffolds is often problematic, inconsistent, and insufficient where additional osteobiological support is required to restore bone. Emergent smart multifunctional biomaterials may drive important and dynamic cellular crosstalk that directly targets, signals, stimulates, and promotes an innate bone repair response following age-related biological decline and when in the presence of disease or infection. However, their role remains largely undetermined. By highlighting their mechanism/s and mode/s of action, this review spotlights smart technologies that favorably align in their conceivable ability to directly target and enhance bone repair and thus are highly promising for future discovery for use in the elderly. The four degrees of interactive scaffold smartness are presented, with a focus on bioactive, bioresponsive, and the yet-to-be-developed autonomous scaffold activity. Further, cell- and biomolecular-assisted approaches were excluded, allowing for contemporary examination of the capabilities, demands, vision, and future requisites of next-generation biomaterial-induced technologies only. Data strongly supports that smart scaffolds hold significant promise in the promotion of bone repair in patients with a reduced osteobiological response. Importantly, many techniques have yet to be tested in preclinical models of aging. Thus, greater clarity on their proficiency to counteract the many unresolved challenges within the scope of aging bone is highly warranted and is arguably the next frontier in the field. This review demonstrates that the use of multifunctional smart synthetic scaffolds with an engineered strategy to circumvent the biological insufficiencies associated with aging bone is a viable route for achieving next-generation therapeutic success in the elderly population.
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Affiliation(s)
| | - Max McCall
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Yasmine Ghattas
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Abinaya Sindu Pugazhendhi
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Fei Wei
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Christopher Ngo
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Jonathan Ruiz
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Sudipta Seal
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA; Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), Materials Science and Engineering, College of Medicine, University of Central Florida, USA, Orlando, FL
| | - Melanie J Coathup
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA.
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Quaranta A, Hui WL. L.O.V.E.R.R.S.: a conceptual framework to shape your purpose and a life of fulfilment. Minerva Dent Oral Sci 2024; 73:191-193. [PMID: 38498299 DOI: 10.23736/s2724-6329.23.04904-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Affiliation(s)
- Alessandro Quaranta
- Smile Specialists Suite, Sydney, Australia -
- Australasian Institute of Postgraduate Dentistry, Sydney, Australia -
- School of Dentistry, University of Sydney, Australia -
| | - Wang L Hui
- Smile Specialists Suite, Sydney, Australia
- Australasian Institute of Postgraduate Dentistry, Sydney, Australia
- Sydney Local Health District, Sydney, Australia
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Cha CH, Lin TK, Wu CN, Yang CH, Huang YW, Hwang CF. Relationship of Hearing Loss to Parkinson's Disease, Dementia, and APOE Genotype in Adults. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:703. [PMID: 38792885 PMCID: PMC11122976 DOI: 10.3390/medicina60050703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 05/26/2024]
Abstract
Background: Hearing loss has been recognized as a risk factor for dementia and non-motor features of Parkinson's disease (PD). The apolipoprotein E (APOE) protein contributes to maintenance and repair of neuronal cell membranes, causing age-related disorders. This study aimed to analyze the impact of hearing loss on cognitive impairment, PD severity, and APOE gene expression in these patients. Methods: A total of 72 out-patients diagnosed with either PD or hearing loss were enrolled in this study. The hearing assessment included pure-tone audiometry, speech reception thresholds, and speech discrimination ability. Dementia was assessed by filling out the Clinical Dementia Rating and Mini-Mental State Examination questionnaires. The severity of PD was assessed using the Modified Hoehn and Yahr scale. Blood samples were tested for the gene expression of APOE. Results: Out of the 72 cases, there were 44 males and 28 females, with an average age of 64.4 ± 9.1 years. A total of 41 out of 72 cases had dementia and had a worse hearing threshold than those without dementia (47.1 ± 24.4 vs. 31.7 ± 22.1 dB, p = 0.006). A total of 58 patients were diagnosed with PD, with 14 of them classified as having severe symptoms (Modified Hoehn and Yahr scale > 2). Patients with severe PD were found to have a worse hearing threshold (49.6 ± 28.3 vs. 30.3 ± 17.8 dB, p = 0.028) and higher prevalence of dementia (12/14 vs. 18/44, p = 0.006). Among 10 individuals with the APOE ε4 gene, the prevalence of dementia was higher than those without the ε4 allele (9/10 vs. 32/62, p = 0.036). Conclusions: Hearing loss is common in severe PD and in dementia patients. Severe PD has a negative impact on the hearing threshold and cognitive dysfunction. Patients with APOE ε4 have a higher prevalence of dementia.
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Affiliation(s)
- Chih-Hung Cha
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Kaohsiung 83301, Taiwan; (C.-H.C.)
| | - Tsu-Kung Lin
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Center of Parkinson’s Disease, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Ching-Nung Wu
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Kaohsiung 83301, Taiwan; (C.-H.C.)
| | - Chao-Hui Yang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Kaohsiung 83301, Taiwan; (C.-H.C.)
| | - Yi-Wen Huang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Chung-Feng Hwang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Kaohsiung 83301, Taiwan; (C.-H.C.)
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He M, Lian T, Liu Z, Li J, Qi J, Li J, Guo P, Zhang Y, Luo D, Guan H, Zhang W, Zheng Z, Yue H, Zhang W, Wang R, Zhang F, Zhang W. An investigation into the potential association between nutrition and Alzheimer's disease. Front Nutr 2024; 11:1306226. [PMID: 38515521 PMCID: PMC10955128 DOI: 10.3389/fnut.2024.1306226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
Background Malnutrition is the most common nutritional issue in Alzheimer's disease (AD) patients, but there is still a lack of a comprehensive evaluation of the nutritional status in AD patients. This study aimed to determine the potential association of various nutritional indices with AD at different stages. Methods Subjects, including individuals with normal cognition (NC) and patients diagnosed with AD, were consecutively enrolled in this cross-sectional study. Demographics, body composition, dietary patterns, nutritional assessment scales and nutrition-related laboratory variables were collected. Binary logistics regression analyses and receiver operating characteristic (ROC) curves were used to indicate the association between nutrition-related variables and AD at different stages. Results Totals of 266 subjects, including 73 subjects with NC, 72 subjects with mild cognitive impairment due to AD (AD-MCI) and 121 subjects with dementia due to AD (AD-D) were included. There was no significant difference in dietary patterns, including Mediterranean diet and Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet between the three groups. Lower BMI value, smaller hip and calf circumferences, lower Mini Nutritional Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI) scores, and lower levels of total protein, albumin, globulin, and apolipoprotein A1 were associated with AD (all p < 0.05). Total protein and albumin levels had the greatest ability to distinguish AD from non-AD (AUC 0.80, 95% CI 0.74-0.84, p < 0.001), increased by combining calf circumference, MNA score and albumin level (AUC 0.83, 95% CI 0.77-0.88, p < 0.001). Albumin level had the greatest ability to distinguish NC from AD-MCI (AUC 0.75, 95% CI 0.67-0.82, p < 0.001), and MNA score greatest ability to distinguish AD-MCI from AD-D (AUC 0.72, 95% CI 0.65-0.78, p < 0.001). Conclusion Nutritional status of AD patients is significantly compromised compared with normal controls, and tends to be worsened with AD progresses. Early identification and intervention of individuals with nutritional risk or malnutrition may be significantly beneficial for reducing the risk, development, and progression of AD.
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Affiliation(s)
- Mingyue He
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tenghong Lian
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhan Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinghui Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Qi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Guo
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanan Zhang
- Department of Blood Transfusion, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dongmei Luo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huiying Guan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Weijia Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zijing Zheng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hao Yue
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenjing Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ruidan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fan Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center of Parkinson’s Disease Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory on Parkinson Disease, Beijing, China
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Musonda E, Mumba P, Malungo JRS. Mortality from non-communicable diseases and associated risk factors in Zambia; analysis of the sample vital registration with verbal autopsy 2015/2016. BMC Public Health 2024; 24:666. [PMID: 38429671 PMCID: PMC10908156 DOI: 10.1186/s12889-024-18150-4] [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: 09/17/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) are the world's growing cause of preventable illness, disability, morbidity, and mortality which account for 71% of deaths. The aim of this study was to determine the factors associated with mortality from NCDs among persons aged 15 years and above in Zambia. METHODOLOGY The study used data from Sample Vital Registration with Verbal Autopsy (SAVVY) 2015/16 (Zambia). A total of 3529 Verbal Autopsy were completed in the study, with only 2599 of death where among people aged 15 years and above. Three-level data analysis was applied; univariate analysis, bivariate analysis, and multivariate analysis (binary logistic regression). FINDINGS The overall number of deaths from NCDs was 28.81%. Stratified analysis by gender showed that deaths from NCDs were higher among women (32.60%) as compared to men (26.25%). Among all persons, dying from NCDs was associated with tobacco use, age, and education. Tobacco use was negatively associated with mortality from NCDs (adjusted odds ratio [aOR] = 0.68; 95% confidence interval [CI]: 0.48-0.98). Age was positively associated with the odds of dying from NCDs among persons aged 45-59 years (aOR = 3.87, 95% CI: 2.13-7.01), 60-74 years (aOR = 12.05, 95% CI: 6.44-22.55), and 75 + years (aOR = 15.16, 95% CI: 7.93-28.97). The likelihood of dying from NCDs was higher among persons with secondary education as compared to those with no education (aOR = 1.93, 95% CI: 1.11-3.33). CONCLUSION The findings from this study suggest that public health interventions targeting NCDs need to consider behavioural factors, especially tobacco use which exposes people to second-hand smoke. We also recommend large-scale national-level studies to further examine the contribution of each factor leading to mortality from NCDs.
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Affiliation(s)
- Emmanuel Musonda
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
| | - Peter Mumba
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Jacob R S Malungo
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Løkken BI, Sund ER, Krokstad S, Bjerkeset O, Rangul V. Association between engagement in cultural activities and use of general practitioner consultations: 7-year follow-up of adults from the HUNT study, Norway. BMJ Open 2023; 13:e068004. [PMID: 37696637 PMCID: PMC10496689 DOI: 10.1136/bmjopen-2022-068004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 08/16/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE Assess whether engagement in a range of cultural activities, both 'passive' and 'active' (ie, receptive and creative) participation, is associated with later demand for general practitioner (GP) consultations. DESIGN Longitudinal prospective cohort study. SETTING Data from the population-based the third Survey of Trøndelag Health Study (2006-2008) in Norway was linked to an administrative register including service information from all GP offices nationwide. PARTICIPANTS This study included 17 396 (54.6%) women and 14 451 (45.4%) men aged 30-79 years. MAIN OUTCOME MEASURES Multilevel negative binomial regression models assessed the relationship between cultural engagement and GP consultations, and reported as rate ratios. RESULTS A mean of 3.57 GP visits per patient was recorded during the 7 years of follow-up. Participation in creative activities and a combination of both receptive and creative activities was associated with lower number of GP consultation. Gender-specific analyses suggest that these effects were attributable to men. The rate ratio of GP consultations among men taking part in creative activities less than once, twice and more than twice (<9 times) per week is 0.90, 0.89 and 0.87 times lower, respectively, compared with non-participants. Whereas weekly frequency of receptive and creative activity engagement showed a 0.92, 0.87 and 0.83 times lower rate ratio among engaged men. The variety of activities shows a similar pattern and participation in creative activities lowers the rate ratio among men. Engagement in a wide range/variety of activities, compared with non-engagement, was associated with lower numbers of GP consultations in men, but not women. CONCLUSIONS Engagement in creative or combined receptive and creative cultural activities was associated with lower numbers of GP consultations among men. Thus, facilitating and promoting a culturally engaged lifestyle, particularly in men, may affect primary healthcare use. However, this study design gives no evidence of a causal relationship between cultural engagement and use of GP consultations.
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Affiliation(s)
- Bente Irene Løkken
- Faculty of Nursing and Health Sciences, Nord Universitet - Levanger Campus, Levanger, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Erik R Sund
- Faculty of Nursing and Health Sciences, Nord Universitet - Levanger Campus, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord Universitet - Levanger Campus, Levanger, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vegar Rangul
- Faculty of Nursing and Health Sciences, Nord Universitet - Levanger Campus, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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Gelaw YA, Koye DN, Alene KA, Ahmed KY, Assefa Y, Erku DA, Tegegn HG, Tesema AG, Zeleke BM, Melaku YA. Socio-demographic correlates of unhealthy lifestyle in Ethiopia: a secondary analysis of a national survey. BMC Public Health 2023; 23:1528. [PMID: 37568091 PMCID: PMC10416504 DOI: 10.1186/s12889-023-16436-7] [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: 03/20/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Multiple lifestyle risk factors exhibit a stronger association with non-communicable diseases (NCDs) compared to a single factor, emphasizing the necessity of considering them collectively. By integrating these major lifestyle risk factors, we can identify individuals with an overall unhealthy lifestyle, which facilitates the provision of targeted interventions for those at significant risk of NCDs. The aim of this study was to evaluate the socio-demographic correlates of unhealthy lifestyles among adolescents and adults in Ethiopia. METHODS A national cross-sectional survey, based on the World Health Organization's NCD STEPS instruments, was conducted in Ethiopia. The survey, carried out in 2015, involved a total of 9,800 participants aged between 15 and 69 years. Lifestyle health scores, ranging from 0 (most healthy) to 5 (most unhealthy), were derived considering factors such as daily fruit and vegetable consumption, smoking status, prevalence of overweight/obesity, alcohol intake, and levels of physical activity. An unhealthy lifestyle was defined as the co-occurrence of three or more unhealthy behaviors. To determine the association of socio-demographic factors with unhealthy lifestyles, multivariable logistic regression models were utilized, adjusting for metabolic factors, specifically diabetes and high blood pressure. RESULTS Approximately one in eight participants (16.7%) exhibited three or more unhealthy lifestyle behaviors, which included low fruit/vegetable consumption (98.2%), tobacco use (5.4%), excessive alcohol intake (15%), inadequate physical activity (66%), and obesity (2.3%). Factors such as male sex, urban residency, older age, being married or in a common-law relationship, and a higher income were associated with these unhealthy lifestyles. On the other hand, a higher educational status was associated with lower odds of these behaviors. CONCLUSION In our analysis, we observed a higher prevalence of concurrent unhealthy lifestyles. Socio-demographic characteristics, such as sex, age, marital status, residence, income, and education, were found to correlate with individuals' lifestyles. Consequently, tailored interventions are imperative to mitigate the burden of unhealthy lifestyles in Ethiopia.
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Affiliation(s)
- Yalemzewod Assefa Gelaw
- Telethon Kids Institute, Perth Children's Hospital, Perth, WA, Australia.
- School of Population Health, Curtin University, Perth, WA, Australia.
| | - Digsu N Koye
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kefyalew Addis Alene
- Telethon Kids Institute, Perth Children's Hospital, Perth, WA, Australia
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Kedir Y Ahmed
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia
- Department of Public Health, Samara University, Samara, Afar, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Daniel Asfaw Erku
- Centre for Applied Health Economics, Griffith University, Nathan, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Henok Getachew Tegegn
- School of Rural Medicine, University of New England, Armidale, 2351, Australia
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Azeb Gebresilassie Tesema
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Berihun Megabiaw Zeleke
- Planetary Health Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yohannes Adama Melaku
- FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
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Nduka I, Kabasinguzi I, Ali N, Ochepo P, Abdy D, Cook EJ, Egbutah C, Cartwright S, Randhawa G. The impact of COVID-19 on the changes in health behaviours among Black, Asian and Minority Ethnic (BAME) communities in the United Kingdom (UK): a scoping review. BMC Public Health 2023; 23:1466. [PMID: 37525154 PMCID: PMC10391900 DOI: 10.1186/s12889-023-15978-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 05/24/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to changes in health behaviours, which include eating patterns and nutrition, smoking, alcohol consumption, sleeping patterns, physical activity and sedentary behaviour. There is a dearth of evidence reporting the impact of COVID-19 on the health behaviour of Black, Asian and minority ethnic (BAME) communities. This scoping review synthesises the available evidence on the impact of COVID-19 on the changes in health behaviours among BAME communities in the UK. METHODS Following a keyword strategy, 16 electronic databases were searched for articles that met the screening criteria. These articles were then reviewed in full text. Empirical studies that assessed COVID-19 related health behaviour changes among BAME communities in the UK, conducted during the COVID-19 pandemic between July 2020 and August 2021 and published in English language, were set as inclusion criteria. An initial 2160 studies were identified in the selected databases. After removing duplications and screening the title and abstracts of the 2154 studies, only 4 studies were selected to be reviewed as they met the inclusion criteria. The included studies employed different sample sizes which ranged from N = 47 to N = 30,375 and reported several health behaviour changes. Out of the 4 included studies, 3 studies included BAME groups within their sample as a subgroup while one study focused specifically on BAME groups. RESULTS The scoping review found that there were lower levels of physical activity among BAME groups compared to the White ethnic groups. About 41.7% of BAME groups reported drinking less alcohol than usual compared to their white counterparts who were 34%. Study participants from BAME backgrounds had the greatest effect of COVID-19 on decisions to purchase healthier food compared to those from white backgrounds whose decisions on purchasing healthier food were least affected. Some participants reported an increase in positive hygiene practices due to the COVID-19 pandemic. CONCLUSION COVID-19 had a significant impact on the health behaviours of BAME groups especially during the lockdowns as they reported changes to behaviour such as low levels of physical activities. Hence, it is important to promote health awareness among BAME groups to encourage healthy living. In addition, programmes such as physical fitness activities that favour BAME groups should be put in place, for example BAME women's walking groups to encourage people from BAME backgrounds to engage in physical activities. Furthermore, healthy food programmes such as food parcels can be given to people from BAME backgrounds who are not able to afford healthy food due to the impact of COVID-19. Nonetheless, the COVID-19 pandemic has increased positive hygiene among BAME groups which is important in preventing other diseases and infections.
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Affiliation(s)
- Ifunanya Nduka
- Institute for Health Research, University of Bedfordshire, Luton, UK
| | | | - Nasreen Ali
- Institute for Health Research, University of Bedfordshire, Luton, UK.
| | - Peter Ochepo
- Institute for Health Research, University of Bedfordshire, Luton, UK
| | - David Abdy
- Institute for Health Research, University of Bedfordshire, Luton, UK
| | | | | | | | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Luton, UK
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10
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Gabulova R, Marzà-Florensa A, Rahimov U, Isayeva M, Alasgarli S, Musayeva A, Gahramanova S, Ibrahimov F, Aliyev F, Imanov G, Rasulova R, Vaartjes I, Klipstein-Grobusch K, Graham I, Grobbee DE. Risk factors in cardiovascular patients: Challenges and opportunities to improve secondary prevention. World J Cardiol 2023; 15:342-353. [PMID: 37576543 PMCID: PMC10415862 DOI: 10.4330/wjc.v15.i7.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/14/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Effective management of major cardiovascular risk factors is of great importance to reduce mortality from cardiovascular disease (CVD). The Survey of Risk Factors in Coronary Heart Disease (SURF CHD) II study is a clinical audit of the recording and management of CHD risk factors. It was developed in collaboration with the European Association of Preventive Cardiology and the European Society of Cardiology (ESC). Previous studies have shown that control of major cardiovascular risk factors in patients with established atherosclerotic CVD is generally inadequate. Azerbaijan is a country in the South Caucasus, a region at a very high risk for CVD. AIM To assess adherence to ESC recommendations for secondary prevention of CVD based on the measurement of both modifiable major risk factors and their therapeutic management in patients with confirmed CHD at different hospitals in Baku (Azerbaijan). METHODS Six tertiary health care centers participated in the SURF CHD II study between 2019 and 2021. Information on demographics, risk factors, physical and laboratory data, and medications was collected using a standard questionnaire in consecutive patients aged ≥ 18 years with established CHD during outpatient visits. Data from 687 patients (mean age 59.6 ± 9.58 years; 24.9% female) were included in the study. RESULTS Only 15.1% of participants were involved in cardiac rehabilitation programs. The rate of uncontrolled risk factors was high: Systolic blood pressure (BP) (SBP) (54.6%), low-density lipoprotein cholesterol (LDL-C) (86.8%), diabetes mellitus (DM) (60.6%), as well as overweight (66.6%) and obesity (25%). In addition, significant differences in the prevalence and control of some risk factors [smoking, body mass index (BMI), waist circumference, blood glucose (BG), and SBP] between female and male participants were found. The cardiovascular health index score (CHIS) was calculated from the six risk factors: Non- or ex-smoker, BMI < 25 kg/m2, moderate/vigorous physical activity, controlled BP (< 140/90 mmHg; 140/80 mmHg for patients with DM), controlled LDL-C (< 70 mg/dL), and controlled BG (glycohemoglobin < 7% or BG < 126 mg/dL). Good, intermediate, and poor categories of CHIS were identified in 6%, 58.3%, and 35.7% of patients, respectively (without statistical differences between female and male patients). CONCLUSION Implementation of the current ESC recommendations for CHD secondary prevention and, in particular, the control rate of BP, are insufficient. Given the fact that patients with different comorbid pathologies are at a very high risk, this is of great importance in the management of such patients. This should be taken into account by healthcare organizers when planning secondary prevention activities and public health protection measures, especially in the regions at a high risk for CVD. A wide range of educational products based on the Clinical Practice Guidelines should be used to improve the adherence of healthcare professionals and patients to the management of CVD risk factors.
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Affiliation(s)
- Rahima Gabulova
- Teaching-Therapeutical Hospital, Azerbaijan Medical University, Baku AZ1022, Azerbaijan.
| | - Anna Marzà-Florensa
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht 3508 GA, Netherlands
| | - Uzeyir Rahimov
- Department of Cardiology, Baku Medical Plaza, Baku AZ1014, Azerbaijan
| | - Mahluga Isayeva
- Department of CHD and Arrhythmias, Scientific-Research Institute of Cardiology, Baku AZ1072, Azerbaijan
| | - Shahana Alasgarli
- Department of Cardiology, Central Clinic Hospital, Baku AZ1006, Azerbaijan
| | - Afag Musayeva
- Heart Center, Baku Health Center, Baku AZ1072, Azerbaijan
| | - Sona Gahramanova
- Teaching-Therapeutical Hospital, Azerbaijan Medical University, Baku AZ1022, Azerbaijan
| | - Firdovsi Ibrahimov
- Department of Cardiology, Central Clinic Hospital, Baku AZ1006, Azerbaijan
| | - Farid Aliyev
- Heart Center, Baku Health Center, Baku AZ1072, Azerbaijan
| | - Galib Imanov
- Teaching-Surgical Hospital, Azerbaijan Medical University, Baku AZ1022, Azerbaijan
| | - Rahmana Rasulova
- Department of Public Health, Azerbaijan Medical University, Baku AZ1022, Azerbaijan
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht 3508 GA, Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht 3508 GA, Netherlands
| | - Ian Graham
- Department of Cardiology, Trinity College Dublin, Dublin Dublin-2, Ireland
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht 3508 GA, Netherlands
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11
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Pessin E, Fuchs SC, Bruscato NM, Fuchs FC, Moriguchi EH. Mortality was predicted by depression and functional dependence in a cohort of elderly adults of Italian descent from southern Brazil. Sci Rep 2023; 13:5448. [PMID: 37012371 PMCID: PMC10070406 DOI: 10.1038/s41598-023-32617-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
The older population has an increasing burden of non-communicable disease, which can potentially be associated with physical and mental disabilities and shorten life spam. To investigate whether depression, loss of functionality for activities of daily living, and lower social support are associated with all-cause mortality in the older population of Italian descent. This population-based cohort study was conducted in Veranópolis, a country city from southern Brazil, among individuals aged 60 years or older. Interviews were performed in a systematic random sampling regarding demographic, socioeconomic, and psychosocial variables, in addition to depression (Geriatric Depression Scale), activities of daily living (Barthel Index), and social support (Medical Outcomes Study scale). In the follow-up, participants were reinterviewed or, in case of death, the next of kin, and hospital records were revised. Hierarchical analysis was used to determine characteristics independently associated with all-cause mortality, using Poisson regression with robust variance, expressed as relative risk with 95% confidence intervals (RR; 95%CI). A total of 997 participants were enrolled and 882 participants completed the study, after 7.24 ± 2.41 years; with 581 remaining alive. The mean age was 73.12 ± 8.03 years, 4% were nonagenarians or centennials, and 62% were women. Symptoms of depression (RR: 1.04; 1.01-1.06) and functional dependence for ADL (RR: 1.00; 0.99-1.00) were associated with all-cause mortality, even after controlling for confounding factors. Lower social support was not associated with mortality (RR: 1.00; 0.99-1.01). Depression and functional dependence are independent predictors of all-cause mortality in the older population from Italian descent.
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Affiliation(s)
- Emeline Pessin
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sandra C Fuchs
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Clinical Research Center, INCT PREVER, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil.
- Clinical Research Center, INCT PREVER, CPC, 5º and Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil.
| | - Neide M Bruscato
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felipe C Fuchs
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Division of Cardiology, Hospital de Clínicas de Porto Alegre, Av. Protásio Alves, no. 211, Santa Cecilia, Porto Alegre, RS, 90035-903, Brazil
| | - Emilio H Moriguchi
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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12
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Li Y, Fan X, Wei L, Yang K, Jiao M. The impact of high-risk lifestyle factors on all-cause mortality in the US non-communicable disease population. BMC Public Health 2023; 23:422. [PMID: 36864408 PMCID: PMC9979572 DOI: 10.1186/s12889-023-15319-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Previous studies have suggested that lifestyle factors are associated with mortality in different population. However, little is known about the impact of lifestyle factors on all-cause mortality in non-communicable disease (NCD) population. METHODS This study included 10,111 NCD patients from the National Health Interview Survey. The potential high-risk lifestyle factors were defined as smoking, excessive drinking, abnormal body mass index, abnormal sleep duration, insufficient physical activity (PA), overlong sedentary behavior (SB), high dietary inflammatory index (DII) and low diet quality. Cox proportional hazard model was used to evaluate the impact of the lifestyle factors and the combination on all-cause mortality. The interaction effects and all combinations of lifestyle factors were also analyzed. RESULTS During 49,972 person-years of follow-up, 1040 deaths (10.3%) were identified. Among eight potential high-risk lifestyle factors, smoking (HR = 1.25, 95% CI 1.09-1.43), insufficient PA (HR = 1.86, 95% CI 1.61-2.14), overlong SB (HR = 1.33, 95% CI 1.17-1.51) and high DII (HR = 1.24, 95% CI 1.07-1.44) were risk factors for all-cause mortality in the multivariable Cox proportional regression. The risk of all-cause mortality was increased linearly as the high-risk lifestyle score increased (P for trend < 0.01). The interaction analysis showed that lifestyle had stronger impact on all-cause mortality among patients with higher education and income level. The combinations of lifestyle factors involving insufficient PA and overlong SB had stronger associations with all-cause mortality than those with same number of factors. CONCLUSION Smoking, PA, SB, DII and their combination had significant impact on all-cause mortality of NCD patients. The synergistic effects of these factors were observed, suggesting some combinations of high-risk lifestyle factor may be more harmful than others.
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Affiliation(s)
- Ying Li
- Department of Science and Education, the Third People's Hospital of Longgang District Shenzhen, Shenzhen, 518100, China
| | - Xue Fan
- Department of Science and Education, the Third People's Hospital of Longgang District Shenzhen, Shenzhen, 518100, China
| | - Lifeng Wei
- The Personnel Department, Harbin Medical University, Harbin, 150086, China
| | - Kai Yang
- Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, 518001, China.
| | - Mingli Jiao
- Research Center of Health Policy and Hospital Management, School of Health Management, Harbin Medical University, Harbin, 150086, China.
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13
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Eze UIH, Adeniji BA, Iheanacho CO. Lifestyle, vulnerability to stress and prevailing health conditions of ambulatory older patients in a care facility. Afr Health Sci 2023; 23:553-564. [PMID: 37545965 PMCID: PMC10398498 DOI: 10.4314/ahs.v23i1.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Background Lifestyle and vulnerability to stress are major determinants of age-related health outcomes. Objectives To assess the lifestyle and health states of older adults, and evaluate their personality-related vulnerability to stress, to enable improved and targeted health promotional activities. Methods A hospital record review and a purposive cross-sectional study was conducted among 200 respondents who were ≥ 50 years old, and visited the General Hospital Oyo, South-western Nigeria. Descriptive statistics was performed using SPSS version 21. Analysis of vulnerability to stress was performed by the addition of scores from Marshal's personality stress prone test. Lifestyle were measured by frequencies and Chi-Square tests, while presence of chronic diseases was measured by respondents' past prescriptions, from the hospital case notes. P < 0.05 was considered statistically significant. Results A total of 200 respondents participated in the study. Majority, 156 (78.0%) were 50-59 years old and self-employed 96 (46.0%). Ninety-three (46.5%) smoked, 65 (32.3%) consumed alcohol, 128 (64.0%) had periodic exercise and 67 (33.3%) experienced insomnia. Majority (60.5%) were vulnerable to stress, and this was significantly associated with age (P=0.001), marital status (P=0.021), body weight (P=0.05), occupation (P=0.002) and income (P=0.002). From the retrospective study, most frequently prescribed drugs were anti-hypertensives 225 (69.7%), vitamins/minerals (49.5%), sedatives 158 (48.9%) and analgesics 158 (48.9%) respectively. Conclusion Periodic exercise, alcohol use, and smoking were reported at varying degrees. High prevalence of vulnerability to stress and use of anti-hypertensives were also observed, and vulnerability to stress was associated with selected socio-demographics. These findings reinforce the need for routine education of this category of populace on healthy lifestyle for improved health.
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Affiliation(s)
- Uchenna IH Eze
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria
| | - Babatunde A Adeniji
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria
| | - Chinonyerem O Iheanacho
- Department of Clinical Pharmacy and Public Health, Faculty of Pharmacy, University of Calabar, Cross River State, Nigeria
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14
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Jasuja GK, Reisman JI, Rao SR, Wolfe HL, Hughto JMW, Reisner SL, Shipherd JC. Social Stressors and Health Among Older Transgender and Gender Diverse Veterans. LGBT Health 2023; 10:148-157. [PMID: 36454239 PMCID: PMC10081710 DOI: 10.1089/lgbt.2022.0012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose: Health disparities in transgender and gender diverse (TGD) veterans compared with cisgender veterans have been documented. However, there is a paucity of literature focused on older TGD veterans. We assessed health conditions and social stressors in older TGD veterans compared with matched cisgender veterans. Methods: Using gender identity disorder diagnosis codes, we identified 1244 TGD veterans (65+ years of age) receiving care in the Veterans Health Administration (VHA) from 2006 to 2018. These TGD veterans were then matched to 3732 cisgender veterans based on age, VHA site, and date of care in VHA. Results: In adjusted models, TGD veterans compared with cisgender veterans were less likely to have alcohol use disorder (adjusted odds ratio [AOR; 95% confidence interval]: [0.70; 0.58-0.85]), drug use disorder (0.59; 0.47-0.74), tobacco use (0.75; 0.65-0.86), and anxiety (0.74; 0.62-0.90). However, compared with cisgender veterans, TGD veterans were more likely to experience depression (1.63; 1.39-1.93), Alzheimer's disease (8.95; 4.25-18.83), cancer (1.83; 1.56-2.14), violence (1.82; 1.14-2.91), social/familial problems (2.45; 1.99-3.02), lack of access to care/transportation (2.23; 1.48-3.37), and military sexual trauma (2.59; 1.93-3.46). Furthermore, compared with cisgender veterans, TGD veterans were more likely to have documentation of a higher count of social stressors: 1 or more stressors (1.64; 1.38-1.95) and 2 or more stressors (1.22; 1.01-1.49). Conclusion: Despite significant disparities in social stressors and health conditions compared with cisgender veterans, TGD veterans had a lower likelihood of substance use and anxiety. Interventions are needed to mitigate social stressors and improve health among the older TGD veteran population.
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Affiliation(s)
- Guneet K Jasuja
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA.,Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Joel I Reisman
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Sowmya R Rao
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Hill L Wolfe
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jaclyn M W Hughto
- Departments of Behavioral and Social Sciences and Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.,Center for Health Promotion and Health Equity, Brown University, Providence, Rhode Island, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.,General Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jillian C Shipherd
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,LGBTQ+ Health Program, Office of Patient Care Services, Department of Veterans Affairs, Washington, District of Columbia, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
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15
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Xie H, Li J, Zhu X, Li J, Yin J, Ma T, Luo Y, He L, Bai Y, Zhang G, Cheng X, Li C. Association between healthy lifestyle and the occurrence of cardiometabolic multimorbidity in hypertensive patients: a prospective cohort study of UK Biobank. Cardiovasc Diabetol 2022; 21:199. [PMID: 36183084 PMCID: PMC9526960 DOI: 10.1186/s12933-022-01632-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiometabolic multimorbidity (CMM) is becoming increasingly common in patients with hypertension, and it is well established that healthy lifestyle plays a key role in the prevention of hypertension. However, the association between combined lifestyle factors and CMM in patients with hypertension is uncertain. METHODS This prospective analysis included the data (obtained from the UK biobank) of participants with hypertension who did not have coronary heart disease (CHD), stroke, or diabetes. The outcome was the occurrence of CMM, defined as ≥ 1 disease of CHD, stroke, and diabetes that occurred in participants with hypertension. Four lifestyle factors (smoking, alcohol consumption, diet, and physical activity) were assessed using a weighted healthy lifestyle score, and participants were divided into four groups: the very unhealthy, unhealthy, healthy, and very healthy groups. The flexible parameter Royston-Parmar proportional hazard model was used to estimate hazard ratios (HRs) between lifestyles and CMM, as well as the difference in CMM-free life expectancy. RESULTS During a median follow-up of 12.2 years, 9812 (18.4%) of the 53,397 hypertensive patients occurred CMM. Compared with the very unhealthy group, the very healthy group had a 41% reduction in the risk for CMM in hypertensive patients and a 32-50% reduction in the risk for specific cardiometabolic diseases such as CHD, stroke, and diabetes. For each lifestyle factor, non-smoking had the greatest protective effect against CMM (HR: 0.64, 95% confidence interval (CI) 0.60-0.68). A lifestyle combining multiple healthy factors extended CMM-free life expectancy (e.g., six years longer at age 45 years for participants in the very healthy group). CONCLUSIONS Combined healthy lifestyle factors were associated with a lower risk for CMM in hypertensive patients. This suggests that combined healthy lifestyle should be supported to decrease disease burden.
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Affiliation(s)
- Hejian Xie
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jinchen Li
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xuanmeng Zhu
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jing Li
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jinghua Yin
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Tianqi Ma
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Luo
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Guogang Zhang
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, China.,Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Chuanchang Li
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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16
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Health behavior changes and mortality among South Korean cancer survivors. Sci Rep 2022; 12:16011. [PMID: 36163240 PMCID: PMC9513084 DOI: 10.1038/s41598-022-20092-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Considering the rapid growth in the number of cancer survivors, the successful management of their health behaviors requires further attention. However, there are lack of information about cancer survivors’ health behaviors and the risk of mortality using Korean cohort data. This study aimed to examine the effects of health behavior changes on mortality among cancer survivors and to develop a validated nomogram. This cohort study was conducted using claims data. Data from adult cancer survivors from the National Health Insurance Service–National Sample Cohort, conducted between 2002 and 2015, were included. Individuals who were alive for five years after their cancer diagnosis were defined as cancer survivors. Cox proportional-hazards regression was used to estimate the target associations. Discrimination (Harrell’s C-index) and calibration (Hosmer–Lemeshow test) were employed to validate the nomogram. Data from 9300 cancer survivors were used for analysis. Compared to non-smokers, those who started or quit smoking had a higher risk of all-cause mortality. Those who were physically inactive had a higher risk of all-cause mortality than those who were continuously active. In the nomogram, the C-index value was 0.79 in the training data and 0.81 in the testing data. Hosmer–Lemeshow test was not significant, demonstrating a good fit. We found that individuals with unhealthy behaviors had a higher risk of mortality, thereby highlighting the importance of managing health behaviors among cancer survivors. The development of a validated nomogram may provide useful insights regarding official policies and existing practices in healthcare systems, which would benefit cancer survivors. Our study could provide the evidence to inform the priority of guideline for managing the health behavior among cancer survivors.
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Incidence and Predictors of Mortality among Community-Dwelling Older Adults in Malaysia: A 5 Years Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158943. [PMID: 35897315 PMCID: PMC9331297 DOI: 10.3390/ijerph19158943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 02/04/2023]
Abstract
With older adults accounting for 10.7% of the Malaysian population, determining the predictors of mortality has now become crucial. Thus, this community-based longitudinal study aimed to investigate the predictors for mortality among community-dwelling older adults using a wide range of factors, including clinical or subclinical. A total of 2322 older adults were interviewed and assessed by trained fieldworkers using validated structured questionnaires. The questionnaire consisted of information on socio-demographic characteristics, health status, neuropsychological and psychosocial functions, lifestyle, dietary intake and biophysical measures. The incidence rate of mortality was 2.9 per 100 person-years. Cox regression analysis indicated that advancing age (Adjusted Hazard Ratio, Adj HR = 1.044, 95% CI: 1.024–1.064), male (Adj HR = 1.937, 95% CI: 1.402–2.675), non-married status (Adj HR = 1.410, 95% CI: 1.078–1.843), smoking (Adj HR = 1.314, 95% CI: 1.004–1.721), a higher fasting blood sugar (Adj HR = 1.075, 95% CI: 1.029–1.166), a lower serum albumin (Adj HR = 0.947, 95% CI: 0.905–0.990), a longer time to complete the TUG test (Adj HR = 1.059, 95% CI: 1.022–1.098), and a lower intake of total dietary fibre (Adj HR = 0.911, 95% CI: 0.873–0.980) were the predictors of mortality in this study. These findings provide an estimated rate of multiethnic mortality in middle-income countries and diet is one of the predictors. These predictors of mortality could be a reference in identifying new public health strategies to ensure longer healthier life spans with lower disability rate among community-dwelling older adults in Malaysia.
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Saadeh M, Hu X, Dekhtyar S, Welmer AK, Vetrano DL, Xu W, Fratiglioni L, Calderón-Larrañaga A. Profiles of behavioral, social and psychological well-being in old age and their association with mobility-limitation-free survival. Aging (Albany NY) 2022; 14:5984-6005. [PMID: 35852845 PMCID: PMC9417239 DOI: 10.18632/aging.204182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Marguerita Saadeh
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- SWEAH, Department of Health Sciences, Lund University, Lund, Sweden
| | - Xiaonan Hu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Functional Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Davide L. Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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Ooi TC, Singh DKA, Shahar S, Sharif R, Rivan NFM, Meramat A, Rajab NF. Higher Lead and Lower Calcium Levels Are Associated with Increased Risk of Mortality in Malaysian Older Population: Findings from the LRGS-TUA Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126955. [PMID: 35742205 PMCID: PMC9223054 DOI: 10.3390/ijerph19126955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 12/04/2022]
Abstract
The main objective of this study is to determine the association of various trace elements’ status with the 5-year mortality rate among community-dwelling older adults in Malaysia. This study was part of the Long-term Research Grant Scheme—Towards Useful Ageing (LRGS-TUA). The participants were followed up for five years, and their mortality status was identified through the Mortality Data Matching Service provided by the National Registration Department, Malaysia. Of the 303 participants included in this study, 34 (11.2%) participants had died within five years after baseline data collection. As compared to the survivors, participants who died earlier were more likely (p < 0.05) to be men, smokers, have a lower intake of total dietary fiber and molybdenum, higher intake of manganese, lower zinc levels in toenail samples, lower calcium and higher lead levels in hair samples during baseline. Following the multivariate Cox proportional hazard analysis, lower total dietary fiber intake (HR: 0.681; 0.532−0.871), lower calcium (HR: 0.999; 95% CI: 0.999−1.000) and higher lead (HR: 1.309; 95% CI: 1.061−1.616) levels in hair samples appeared as the predictors of mortality. In conclusion, higher lead and lower calcium levels are associated with higher risk of mortality among community-dwelling older adults in Malaysia. Our current findings provide a better understanding of how the trace elements’ status may affect older populations’ well-being and mortality rate.
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Affiliation(s)
- Theng Choon Ooi
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (T.C.O.); (D.K.A.S.); (S.S.); (R.S.); (N.F.M.R.)
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (T.C.O.); (D.K.A.S.); (S.S.); (R.S.); (N.F.M.R.)
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (T.C.O.); (D.K.A.S.); (S.S.); (R.S.); (N.F.M.R.)
| | - Razinah Sharif
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (T.C.O.); (D.K.A.S.); (S.S.); (R.S.); (N.F.M.R.)
| | - Nurul Fatin Malek Rivan
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (T.C.O.); (D.K.A.S.); (S.S.); (R.S.); (N.F.M.R.)
| | - Asheila Meramat
- Faculty of Health Sciences, Gong Badak Campus, Universiti Sultan Zainal Abidin, Kuala Nerus 21300, Malaysia;
| | - Nor Fadilah Rajab
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (T.C.O.); (D.K.A.S.); (S.S.); (R.S.); (N.F.M.R.)
- Correspondence: ; Tel.: +60-3-9289-7002
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Combined lifestyle factors on mortality among the elder population: evidence from a Chinese cohort study. BMC Geriatr 2022; 22:474. [PMID: 35650518 PMCID: PMC9158191 DOI: 10.1186/s12877-022-03017-3] [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: 07/09/2021] [Accepted: 03/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background Numerous studies have suggested that lifestyle-related factors are associated with mortality, however limited evidence is available for the Chinese elder population. Methods The data of this study was obtained from the Chinese Longitudinal Health Survey (CLHLS) during 2008 − 2018, lifestyle-related factors including body mass index (BMI), smoking, drinking, consumption of vegetables and fruits, physical activity and sleep duration were included as dependent variables in the analysis. A lifestyle risk score was created using six unhealthy behaviors: smoking, drinking, unhealthy weight, physical inactivity, not eat vegetables or fruits and short or prolonged sleep. The Kaplan–Meier curves were used to illustrate the cumulative effect of lifestyle factors on mortality and cox regression models were conducted to estimate the combined effects of lifestyle-related factors on total mortality. Results The results illustrated that low BMI, smoking, no fruit eating, and no physical inactivity were risk factors for total mortality. KM curves showed significant cumulative effect of unhealthy lifestyle factors on mortality. Compared with participants without any unhealthy factors, the hazard ratio (HR) for participants with six unhealthy factors was 1.335 (1.015,1.757) for all-cause mortality. Conclusions This study demonstrated poor adherence to a healthy lifestyle may increase all-cause mortality and specific combinations of lifestyle related factors have different effects on mortality among Chinese elderly population. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03017-3.
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21
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Go RE, Lee SM, Shin YJ, Kim MS, Park CM, Ko EB, Kim S, Choi KC. Time-dependent effect of inhaled cigarette smoke exposure in the bleomycin-induced lung injury rat model. ENVIRONMENTAL TOXICOLOGY 2022; 37:1231-1243. [PMID: 35112775 DOI: 10.1002/tox.23479] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/14/2022] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
Cigarette smoke (CS) substances are known to induce diverse ailments such as cancer, decreased immunity, and lung diseases. Although some studies have been actively conducted to evaluate cigarette toxicity, the current animal exposure methods, that is, exposure of 28- or 90-days, require considerable research cost and lead to obscure results of the CS effects. In a previous study, we compared the effects of CS in a rat model of bleomycin (BLM) and lipopolysaccharide (LPS) induced lung disease. We determined that compared to the LPS-induced rat model, the BLM-induced rat model was more sensitive to alterations in secreting cytokines and total cell number. In the current study, we further confirmed the time-point of effective inhalation exposure by CS in the BLM-induced lung injury rat model. Using an automatic video instillator, rats were administered a single dose of 2.5 mg/kg BLM (day 1), and subsequently exposed to CS via inhalation (nose-only) 4 h/day, for 1, 2, 3, and 4 weeks. The bronchoalveolar lavage fluid (BALF) was obtained from the right lung lobes, total cell numbers were counted, and chemokine and cytokine expressions were evaluated using Enzyme-Linked Immunosorbent Assay. For the 1-week exposure, we observed a greater increase of neutrophils in the BLM + CS 300 μg/L group than in the BLM or CS 300 μg/L groups. Exposure of CS in the BLM-induced lung injury rat model enhanced the secretions of chemokines and cytokines, such as CCL2/MCP-1, CXCL2/MIP-2 and TNF-α, at 1 week. Immunohistochemistry and Hematoxylin and Eosin staining of lungs at 1-2 weeks after exposure clearly confirmed this tendency in the increased levels of CCL2/MCP-1 and TNF-α. Taken together, these results indicate that the rat model of BLM-induced lung injury is more sensitive to CS exposure than other rat models, and may be an appropriate model to evaluate the effect of CS exposure at 1-2 weeks.
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Affiliation(s)
- Ryeo-Eun Go
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Sung-Moo Lee
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Young-Jun Shin
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea
| | - Min-Seok Kim
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea
| | - Chul-Min Park
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea
| | - Eul-Bee Ko
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Soochong Kim
- Laboratory of Pathology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Kyung-Chul Choi
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
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Lian Z, Zhu C, Yuan H, Chen Y. Combined impact of lifestyle-related factors on total mortality among the elder Chinese: a prospective cohort study. BMC Geriatr 2022; 22:325. [PMID: 35418015 PMCID: PMC9009055 DOI: 10.1186/s12877-022-02982-z] [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: 12/27/2021] [Accepted: 03/28/2022] [Indexed: 11/27/2022] Open
Abstract
Background The combined impact of healthy lifestyle factors on total mortality among elder Chinese is unclear. This study aimed to investigate the overall impact of lifestyle factors on total mortality in a senior Chinese population, and determine whether these associations were consistent in the presence of different characteristics, including physical comorbidities. Methods The Chinese Longitudinal Healthy Longevity Survey (CLHLS) is a large population-based prospective cohort study in 22 of 31 provinces from mainland China. We included 15,163 adults aged ≥65 years recruited from 1998- to 2002 and followed-up until 2014. A healthy lifestyle score was calculated considering five lifestyle factors (exercise, smoking, dietary diversity, body mass index and drinking). The scores ranged from zero to five points and were classified into the following three categories: unhealthy (0-1 point), intermediate (2-3 points) and healthy (4-5 points). Cox proportional hazards regression analyses were used to assess the associations between the combined healthy lifestyle score and total mortality, adjusting for demographic characteristics and physical comorbidities, as appropriate. Stratification analyses and interaction analyses were further performed. Results Among the 15,163 participants, the mean age (SD) was 86.2 (11.6) years. During an average follow-up period of 12.5 (SD = 3.9) years, 9655 deaths occurred. The adjusted hazard ratios (HRs) of total mortality decreased as the number of healthy lifestyle factors increased. Compared to the unhealthy lifestyle group, the healthy lifestyle group had a HR and 95% CI of 0.78 and 0.72-0.83. The population attributable risk of total death among those without a healthy lifestyle was 25.2%. A healthier lifestyle pattern was associated with a lower total mortality risk among individuals with different severities of physical comorbidities, although the associations were stronger among those with fatal physical comorbidities (p-interaction < .001). Conclusions In this large-scale study, a healthier lifestyle measured by regular exercise participation, never smoking, never drinking, good dietary diversity and normal weight, was inversely associated with total mortality, regardless of physical comorbidity status. These findings support the necessity of multiple lifestyle modifications to prevent premature death in both general elderly populations and those with physical comorbidities. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02982-z.
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Affiliation(s)
- Zhiwei Lian
- Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
| | - Chunsu Zhu
- Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China.
| | - Haowen Yuan
- School of Public Health, Peking University, 100191, Beijing, China
| | - Ying Chen
- Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
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The 90 plus: longevity and COVID-19 survival. Mol Psychiatry 2022; 27:1936-1944. [PMID: 35136227 DOI: 10.1038/s41380-022-01461-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/11/2022] [Accepted: 01/20/2022] [Indexed: 11/08/2022]
Abstract
The world population is getting older and studies aiming to enhance our comprehension of the underlying mechanisms responsible for health span are of utmost interest for longevity and as a measure for health care. In this review, we summarized previous genetic association studies (GWAS) and next-generation sequencing (NGS) of elderly cohorts. We also present the updated hypothesis for the aging process, together with the factors associated with healthy aging. We discuss the relevance of studying older individuals and build databanks to characterize the presence and resistance against late-onset disorders. The identification of about 2 million novel variants in our cohort of more than 1000 elderly Brazilians illustrates the importance of studying highly admixed populations of non-European ancestry. Finally, the ascertainment of nonagenarians and particularly of centenarians who were recovered from COVID-19 or remained asymptomatic opens new avenues of research aiming to enhance our comprehension of biological mechanisms associated with resistance against pathogens.
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Zhao YL, Qu Y, Ou YN, Zhang YR, Tan L, Yu JT. Environmental factors and risks of cognitive impairment and dementia: A systematic review and meta-analysis. Ageing Res Rev 2021; 72:101504. [PMID: 34755643 DOI: 10.1016/j.arr.2021.101504] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dementia is a challenging neurodegenerative disease. This systematic review aimed to summarize natural, physical, and social environmental factors that are associated with age-related cognitive impairment and dementia. METHODS We systematically searched PubMed, EMBASE, Web of Science, and PsychINFO till January 11, 2021 for observational studies. The hazard ratio (HR), relative risk (RR), and odds ratio (OR) with 95% confidence interval (CI) were aggregated using random-effects methods. The quality of evidence for each association was evaluated. RESULTS Of the 48,399 publications identified, there were 185 suitable for review across 44 environmental factors. Meta-analyses were performed for 22 factors. With high-to-moderate quality of evidence, risks were suggested in exposure to PM2.5 (HR=1.24, 95%CI: 1.17-1.31), NO2 (HR=1.07, 95%CI: 1.02-1.12), aluminum (OR=1.35, 95%CI: 1.14-1.59), solvents (OR=1.14, 95%CI: 1.07-1.22), road proximity (OR=1.08, 95%CI: 1.04-1.12) and other air pollutions, yet more frequent social contact (HR=0.82, 95%CI: 0.76-0.90) and more greenness (OR=0.97, 95%CI: 0.95-0.995) were protective. With low-to-very low quality, electromagnetic fields, pesticides, SO2, neighborhood socioeconomic status, and rural living were suggested risks, but more community cultural engagement might be protective. No significant associations were observed in exposure to PM10, NOx, noise, silicon, community group, and temperature. For the remaining 22 factors, only a descriptive analysis was undertaken as too few studies or lack of information. CONCLUSIONS This review highlights that air pollutions, especially PM2.5 and NO2 play important role in the risk for age-related cognitive impairment and dementia.
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Robinson SM, Westbury LD, Ward K, Syddall H, Cooper R, Cooper C, Sayer AA. Is lifestyle change around retirement associated with better physical performance in older age?: insights from a longitudinal cohort. Eur J Ageing 2021; 18:513-521. [PMID: 34786013 PMCID: PMC8563887 DOI: 10.1007/s10433-021-00607-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/29/2022] Open
Abstract
A growing evidence base links individual lifestyle factors to physical performance in older age, but much less is known about their combined effects, or the impact of lifestyle change. In a group of 937 participants from the MRC National Survey of Health and Development, we examined their number of lifestyle risk factors at 53 and 60-64 years in relation to their physical performance at 60-64, and the change in number of risk factors between these ages in relation to change in physical performance. At both assessments, information about lifestyle (physical activity, smoking, diet) was obtained via self-reports and height and weight were measured. Each participant's number of lifestyle risk factors out of: obesity (body mass index ≥ 30 kg/m2); inactivity (no leisure time physical activity over previous month); current smoking; poor diet (diet quality score in bottom quarter of distribution) was determined at both ages. Physical performance: measured grip strength, chair rise and standing balance times at both ages and conditional change (independent of baseline) in physical performance outcomes from 53 to 60-64 were assessed. There were some changes in the pattern of lifestyle risk factors between assessments: 227 (24%) participants had fewer risk factors by age 60-64; 249 (27%) had more. Reductions in risk factors were associated with better physical performance at 60-64 and smaller declines over time (all p < 0.05); these associations were robust to adjustment. Strategies to support reduction in number of lifestyle risk factors around typical retirement age may have beneficial effects on physical performance in early older age. SUPPLEMENTARY INFORMATION The online version of this article (10.1007/s10433-021-00607-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sian M. Robinson
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, NE4 5PL UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle Upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Leo D. Westbury
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Kate Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Holly Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Avan A. Sayer
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, NE4 5PL UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle Upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
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Puzhankara L, Janakiram C. Common Risk Factor Approach to Limit Noncommunicable Diseases and Periodontal Disease-The Molecular and Cellular Basis: A Narrative Review. J Int Soc Prev Community Dent 2021; 11:490-502. [PMID: 34760792 PMCID: PMC8533044 DOI: 10.4103/jispcd.jispcd_109_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/16/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction The link between periodontal disease and noncommunicable diseases (NCDs) has been the subject of major research over the past several years. The primary objective of this review is to understand the cellular and molecular components that link common risk factors (exposure) in adult patients (population) with periodontal disease and other NCDs (outcome). The secondary objective is to interpret from existing literature the possibility of identifying the molecular plausibility of the Common Risk Factor Approach (CRFA). Materials and Methods A literature search was performed in PubMed/MEDLINE, CINAHL, Web of Science, and Google Scholar for all published articles pertaining to the molecular and cellular basis of the risk factors between periodontal diseases and major NCDs. Data from all randomized and nonrandomized clinical trials, cross-sectional studies, case-control, cohort studies, literature, and systematic reviews were included. Results Periodontal pathogens, stress, obesity, smoking, and dietary factors are some of the common risk factors between periodontal disease and NCDs. Conclusion Understanding the molecular and cellular link of common risk factors between NCDs and periodontal disease would ensure the application of CRFA. The CRFA implies that controlling the risk factors associated with NCDs can have an incredible positive impact on regulating many chronic conditions, which would extend to periodontal health also.
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Affiliation(s)
- Lakshmi Puzhankara
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Chandrashekar Janakiram
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Maciel de Lima AP, Schneider BC, Bertoldi AD, Tomasi E, Gonzalez MC, Demarco FF, Domingues MR, Bielemann RM. NCD behavioral risk factors and mortality among older adults in Brazil. Clin Nutr ESPEN 2021; 45:462-468. [PMID: 34620356 DOI: 10.1016/j.clnesp.2021.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUNDS & AIMS Literature shows that the most studied concurrent risk factors for mortality in elderly individuals are smoking, inadequate diet, alcohol consumption and physical inactivity. The combination of such habits can increase from 3 to 11 times the chance of death. To measure the association between concurrence of behavioral risk factors (BRF) for non-communicable diseases (NCD's) and mortality up to three years among the elderly. METHODS Cohort study started in 2014 named "COMO VAI?" with community-dwelling aged ≥60 years in Pelotas, Rio Grande do Sul, Brazil. We investigated the deaths from all causes occurred until April 2017. The exposure was defined by the presence of physical inactivity, low-quality diet, alcohol consumption and smoking that composed a score ranging from 0 (none) to 4 (all). Cox proportional hazard regression models were used to evaluate the association between BRF concurrence and mortality. RESULTS In 2014, 1451 elderly people were interviewed, 145 deaths were identified (10%) by April 2017. Higher risk of death was observed for the combinations of physical inactivity + smoking and low-quality diet + physical inactivity. The simultaneous presence of three or more BRF was associated with a nearly six-fold higher risk of death. CONCLUSIONS Higher mortality during a 3-year period was observed among those with at least three BRF for NCD's.
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Affiliation(s)
| | | | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Elaine Tomasi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Renata Moraes Bielemann
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
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Vila J. Social Support and Longevity: Meta-Analysis-Based Evidence and Psychobiological Mechanisms. Front Psychol 2021; 12:717164. [PMID: 34589025 PMCID: PMC8473615 DOI: 10.3389/fpsyg.2021.717164] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/17/2021] [Indexed: 11/13/2022] Open
Abstract
Over the past 60 years, evidence has accumulated on the fundamental role of supportive social relationships in individual health and longevity. This paper first summarizes the results of 23 meta-analyses published between 1994 and 2021, which include 1,187 longitudinal and cross-sectional studies with more than 1,458 million participants. The effect sizes reported in these meta-analyses are highly consistent with regard to the predicted link between social support and reduced disease and mortality; the meta-analyses also highlight various theoretical and methodological issues concerning the multi-dimensionality of the social support concept and its measurements, and the need to control potential confounding and moderator variables. This is followed by an analysis of the experimental evidence from laboratory studies on psychobiological mechanisms that may explain the effect of social support on health and longevity. The stress-buffering hypothesis is examined and extended to incorporate recent findings on the inhibitory effect of social support figures (e.g., the face of loved ones) on fear learning and defensive reactions alongside evidence on the effect of social support on brain networks that down-regulate the autonomic nervous system, HPA axis, and immune system. Finally, the paper discusses the findings in the context of three emerging research areas that are helping to advance and consolidate the relevance of social factors for human health and longevity: (a) convergent evidence on the effects of social support and adversity in other social mammals, (b) longitudinal studies on the impact of social support and adversity across each stage of the human lifespan, and (c) studies that extend the social support framework from individual to community and societal levels, drawing implications for large-scale intervention policies to promote the culture of social support.
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Affiliation(s)
- Jaime Vila
- Human Psychophysiology and Health Laboratory, Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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Otsuka K, Ochiya T. Possible connection between diet and microRNA in cancer scenario. Semin Cancer Biol 2021; 73:4-18. [DOI: 10.1016/j.semcancer.2020.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023]
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Gaudel P, Neupane S, Koivisto AM, Kaunonen M, Rantanen A. Effects of a lifestyle-related risk factor modification intervention on lifestyle changes among patients with coronary artery disease in Nepal. PATIENT EDUCATION AND COUNSELING 2021; 104:1406-1414. [PMID: 33342580 DOI: 10.1016/j.pec.2020.11.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the effect of a lifestyle-related risk factor modification intervention on coronary artery disease (CAD) patients' lifestyle changes. METHOD A randomized controlled study was conducted in Nepal. A total of 224 CAD patients (112 in each study group) were included at baseline, and 196 patients (98 in each group) completed the one-month follow-up. Patients in the intervention group (IG) received nurse-led intervention in addition to the usual care. Face-to face and telephone interview was conducted using standard questionnaires to collect data on lifestyle-related risk factors; smoking, alcohol consumption, diet, body mass index, stress, adherence to medical therapy, and physical activity. General linear model repeated measure analysis was used to analyse the effects of the intervention. RESULTS Based on self-reported data we found significant improvement in lifestyle-related risk factor habits in the IG compared with the usual care group with respect to diet (p < 0.001), physical activity (p < 0.001), medication adherence (p < 0.001) and stress (p < 0.001) at one-month follow-up. CONCLUSION Lifestyle-related risk factor modification intervention can positively influence health risk habits, even when it is less intensive but supplemented with information leaflets. PRACTICAL IMPLICATIONS Nurse-led one-time intervention may successfully deliver counselling to improve healthy lifestyle among underserved CAD patients.
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Affiliation(s)
- Pramila Gaudel
- Faculty of Social Sciences, Unit of Health Sciences, Nursing Science, Tampere University, Arvo, 33520, Tampere, Finland.
| | - Subas Neupane
- Faculty of Social Sciences, Unit of Health Sciences, Epidemiology, Tampere University, Arvo, 33520, Tampere, Finland.
| | - Anna-Maija Koivisto
- Faculty of Social Sciences, Unit of Health Sciences, Biostatistics, Tampere University, Arvo, 33520, Tampere, Finland.
| | - Marja Kaunonen
- Faculty of Social Sciences, Unit of Health Sciences, Nursing Science, Tampere University, Arvo, and General Administration, Pirkanmaa Hospital District, 33520, Tampere, Finland.
| | - Anja Rantanen
- University Instructor, Faculty of Social Sciences, Unit of Health Sciences, Nursing Science, Tampere University, Arvo, 33520, Tampere, Finland.
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Bento JA, Santos JLF, Lebrão ML. Factors associated with the survival of elderly men in almost 15 years. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210021. [PMID: 34076089 DOI: 10.1590/1980-549720210021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/05/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify factors associated with a higher probability of survival for men aged 60 and over in the course of almost 15 years. METHODS Prospective cohort study, where time zero is the year 2000 and deaths (final event) were measured until November 2014. The independent variables were obtained from personal characteristics, childhood life, educational status, lifestyle, social support, work history, socioeconomic situation, and health condition. RESULTS At the end of the period, 25.8% of elderly men remained alive and the factors that stood out associated with a higher probability of survival were: performing 50% or more of the Basic and/or Instrumental Activities of Daily Living (95%CI 0.41 - 0.64), being the head of the family (95%CI 0.42 - 0.82), participating in the community (95%CI 0.52 - 0.88), working on their own (95%CI 0.54 - 0.88), and owning a home and goods (95%CI 0.56 - 0.92). CONCLUSION Characteristics related to a greater autonomy of the elderly men, even after almost 15 years, contributed to an increase in the probability of survival.
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Affiliation(s)
| | | | - Maria Lúcia Lebrão
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
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[Estimation of fat mass by anthropometric indicators in young people with Down syndrome]. NUTR HOSP 2021; 38:1040-1046. [PMID: 33845583 DOI: 10.20960/nh.03524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION the assessment of body composition is relevant and useful for designing interventions for healthy lifestyles and nutritional strategies. OBJECTIVE our goal was to verify the relationships between adiposity indicators with fat mass (FM), and to validate equations that allow predicting FM in young people with Down syndrome (SD). METHODS a cross-sectional study was carried out in 48 young people with DS (24 men and 24 women). Weight, height, waist circumference (WC), and hip circumference (HC) were evaluated. Body mass index (BMI), body adiposity index (BAI), waist-to-hip index (WHI), and waist-to-height index (WHtR) were calculated. FM was evaluated by dual energy X-ray absorptiometry (DXA). RESULTS age in men was 19.3 ± 3.0 years, and in women it was 18.9 ± 1.9 years; weight was 73.6 ± 14.3 kg in men and 75.8 ± 20.3 kg in women, and height in men was 168.9 ± 6.5 cm, and in women it was 156.3 ± 6.2 cm. In males the correlations between FM (DXA) with BMI, WC, HC, WHtR, BAI and WHtR ranged from r = 0.01 to r = 0.89, and in females from r = 0.10 to r = 0.97. The highest correlations were observed with BMI and WC in both sexes (males r = 0.78 to 0.92, and females r = 0.83 to 0.97). Regression equations were generated to estimate FM in males (R2 = 84 %) and in females (R2 = 96 %). Percentiles were calculated for MG per DXA and for each equation. CONCLUSIONS there were significant positive correlations between BMI and WC with FM. These indicators were decisive for developing equations that estimate FM in young people with DS. The results suggest its potential use and application to evaluate, classify and monitor body fat levels in clinical and epidemiological contexts.
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Cardiovascular risk profiles and 20-year mortality in older people: gender differences in the Pro.V.A. study. Eur J Ageing 2021; 19:37-47. [PMID: 35241998 PMCID: PMC8881539 DOI: 10.1007/s10433-021-00620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 10/26/2022] Open
Abstract
AbstractThe age- and gender-related cardio-metabolic changes may limit the applicability of guidelines for the prevention of cardiovascular diseases (CVD) in older people. We investigated the association of cardiovascular risk profile with 20-year all-cause and CVD-mortality in older adults, focusing on age- and gender-specific differences. This prospective study involved 2895 community-dwelling individuals aged ≥65 years who participated in the Pro.V.A study. The sum of achieved target levels (smoking, diet, physical activity, body weight, blood pressure, lipids, and diabetes) recommended by the European Society of Cardiology 2016 guidelines was assessed in each participant. From this sum, cardiovascular risk profile was categorised as very high (0–2), high (3), medium (4), low (5), and very low (6–7 target levels achieved). All-cause and CV mortality data over 20 years were obtained from health registers. At Cox regression, lower cardiovascular risk profile was associated with reduced 20-year all-cause mortality in both genders, with stronger results for women (HR = 0.42 [95%CI:0.25–0.69] and HR = 0.61 [95%CI:0.42–0.89] for very low vs. very high cardiovascular risk profile in women and men, respectively). This trend was more marked for CVD mortality. Lower cardiovascular risk profile was associated with reduced all-cause and CVD mortality only in men < 75 years, while the associations persisted in the oldest old women. A lower cardiovascular risk profile, as defined by current guidelines, may reduce all-cause and CVD mortality in older people, with stronger and longer benefits in women. These findings suggest that personalised and life-course approaches considering gender and age differences may improve the delivery of preventive actions in older people.
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Lee SM, Shin YJ, Go RE, Bae SH, Kim CW, Kim S, Kim MS, Choi KC. Inhalation exposure by cigarette smoke: Effects on the progression of bleomycin- and lipopolysaccharide-induced lung injuries in rat models. Toxicology 2021; 451:152695. [PMID: 33516805 DOI: 10.1016/j.tox.2021.152695] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/02/2021] [Accepted: 01/23/2021] [Indexed: 02/06/2023]
Abstract
The toxic substances of cigarette smoke (CS) induce inflammatory responses in the lung by recruiting inflammatory cells. In this study, we investigated the effects of CS on the progression of lung disease in bleomycin (BLM) and lipopolysaccharide (LPS)-induced lung injury rat models. Briefly, rats were exposed to CS via inhalation (nose-only) for 28 consecutive days, for 4 h per day. Using an automatic video instillator, rats were administered a single dose of 2.5 mg/kg BLM (day 1) or 0.5 mg/kg LPS (day 26), prepared in 50 μL phosphate-buffered saline (PBS) solution. Examination of the bronchoalveolar lavage fluid (BALF) revealed that the number of neutrophils increased in a concentration-dependent manner of CS. Exposure to CS also enhanced the expression of cytokines, i.e., CCL2 (MCP-1), CCL3 (MIP-1α), CXCL2 (CINC3), CXCL10 (IP-10), TNF-α, IFN-γ, IL-2, IL-4 in the BALF of the vehicle (VC) and BLM groups in a concentration-dependent manner. In particular, the expressions of CCL2, CXCL10 and TNF-α were remarkably upregulated in the BLM + CS 300 treatment as compared to VC, while there were no differences in these cytokine levels in the serum following CS exposure. Exposure to CS resulted in compacted alveolar spaces and macrophage aggregation in the lung tissues following BLM and LPS treatments. Compared to VC, pulmonary fibrosis and chronic inflammation of bronchioloalveoli were observed in the BLM + CS treatment and inflammatory cell infiltration of bronchioloalveoli was observed in the LPS + CS treatment in a concentration-dependent manner by CS. The expression levels of CCL2 and IFN-γ in the lung tissues were increased similar to the levels obtained in BALF, in a concentration-dependent manner by CS. Taken together, these results indicate that repeated exposure to CS may exacerbate the lung injury initially caused by BLM and LPS.
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Affiliation(s)
- Sung-Moo Lee
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Young-Jun Shin
- Inhalation Toxicology Research Group, Jeonbuk Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea
| | - Ryeo-Eun Go
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Seon-Hee Bae
- Inhalation Toxicology Research Group, Jeonbuk Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea
| | - Cho-Won Kim
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Soochong Kim
- Laboratory of Veterinary Pathology and Platelet Signaling, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Min-Seok Kim
- Inhalation Toxicology Research Group, Jeonbuk Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea
| | - Kyung-Chul Choi
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea.
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Fang EF, Xie C, Schenkel JA, Wu C, Long Q, Cui H, Aman Y, Frank J, Liao J, Zou H, Wang NY, Wu J, Liu X, Li T, Fang Y, Niu Z, Yang G, Hong J, Wang Q, Chen G, Li J, Chen HZ, Kang L, Su H, Gilmour BC, Zhu X, Jiang H, He N, Tao J, Leng SX, Tong T, Woo J. A research agenda for ageing in China in the 21st century (2nd edition): Focusing on basic and translational research, long-term care, policy and social networks. Ageing Res Rev 2020; 64:101174. [PMID: 32971255 PMCID: PMC7505078 DOI: 10.1016/j.arr.2020.101174] [Citation(s) in RCA: 252] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/13/2020] [Accepted: 09/03/2020] [Indexed: 12/18/2022]
Abstract
One of the key issues facing public healthcare is the global trend of an increasingly ageing society which continues to present policy makers and caregivers with formidable healthcare and socio-economic challenges. Ageing is the primary contributor to a broad spectrum of chronic disorders all associated with a lower quality of life in the elderly. In 2019, the Chinese population constituted 18 % of the world population, with 164.5 million Chinese citizens aged 65 and above (65+), and 26 million aged 80 or above (80+). China has become an ageing society, and as it continues to age it will continue to exacerbate the burden borne by current family and public healthcare systems. Major healthcare challenges involved with caring for the elderly in China include the management of chronic non-communicable diseases (CNCDs), physical frailty, neurodegenerative diseases, cardiovascular diseases, with emerging challenges such as providing sufficient dental care, combating the rising prevalence of sexually transmitted diseases among nursing home communities, providing support for increased incidences of immune diseases, and the growing necessity to provide palliative care for the elderly. At the governmental level, it is necessary to make long-term strategic plans to respond to the pressures of an ageing society, especially to establish a nationwide, affordable, annual health check system to facilitate early diagnosis and provide access to affordable treatments. China has begun work on several activities to address these issues including the recent completion of the of the Ten-year Health-Care Reform project, the implementation of the Healthy China 2030 Action Plan, and the opening of the National Clinical Research Center for Geriatric Disorders. There are also societal challenges, namely the shift from an extended family system in which the younger provide home care for their elderly family members, to the current trend in which young people are increasingly migrating towards major cities for work, increasing reliance on nursing homes to compensate, especially following the outcomes of the 'one child policy' and the 'empty-nest elderly' phenomenon. At the individual level, it is important to provide avenues for people to seek and improve their own knowledge of health and disease, to encourage them to seek medical check-ups to prevent/manage illness, and to find ways to promote modifiable health-related behaviors (social activity, exercise, healthy diets, reasonable diet supplements) to enable healthier, happier, longer, and more productive lives in the elderly. Finally, at the technological or treatment level, there is a focus on modern technologies to counteract the negative effects of ageing. Researchers are striving to produce drugs that can mimic the effects of 'exercising more, eating less', while other anti-ageing molecules from molecular gerontologists could help to improve 'healthspan' in the elderly. Machine learning, 'Big Data', and other novel technologies can also be used to monitor disease patterns at the population level and may be used to inform policy design in the future. Collectively, synergies across disciplines on policies, geriatric care, drug development, personal awareness, the use of big data, machine learning and personalized medicine will transform China into a country that enables the most for its elderly, maximizing and celebrating their longevity in the coming decades. This is the 2nd edition of the review paper (Fang EF et al., Ageing Re. Rev. 2015).
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Affiliation(s)
- Evandro F Fang
- Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, 1478 Lørenskog, Norway; The Norwegian Centre on Healthy Ageing (NO-Age), Oslo, Norway; Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University, 510080, Guangzhou, China; Institute of Geriatric Immunology, School of Medicine, Jinan University, 510632, Guangzhou, China; Department of Geriatrics, The First Affiliated Hospital, Zhengzhou University, 450052, Zhengzhou, China.
| | - Chenglong Xie
- Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, 1478 Lørenskog, Norway; Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Joseph A Schenkel
- Durham University Department of Sports and Exercise Sciences, Durham, United Kingdom.
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, 215316, Kunshan, China; Duke Global Health Institute, Duke University, Durham, 27710, North Carolina, USA.
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, 215316, Kunshan, China.
| | - Honghua Cui
- Department of Endodontics, Shanghai Stomatological Hospital, Fudan University, China; Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, China.
| | - Yahyah Aman
- Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, 1478 Lørenskog, Norway.
| | - Johannes Frank
- Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, 1478 Lørenskog, Norway.
| | - Jing Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 510275, Guangzhou, China; Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, 510275, Guangzhou, China.
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China; Kirby Institute, University of New South Wales, Sydney, Australia.
| | - Ninie Y Wang
- Pinetree Care Group, 515 Tower A, Guomen Plaza, Chaoyang District, 100028, Beijing, China.
| | - Jing Wu
- Department of Sociology and Work Science, University of Gothenburg, SE-405 30, Gothenburg, Sweden.
| | - Xiaoting Liu
- School of Public Affairs, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
| | - Tao Li
- BGI-Shenzhen, Beishan Industrial Zone, 518083, Shenzhen, China; China National GeneBank, BGI-Shenzhen, 518120, Shenzhen, China.
| | - Yuan Fang
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands.
| | - Zhangming Niu
- Aladdin Healthcare Technologies Ltd., 25 City Rd, Shoreditch, London EC1Y 1AA, UK.
| | - Guang Yang
- Cardiovascular Research Centre, Royal Brompton Hospital, London, SW3 6NP, UK; and National Heart and Lung Institute, Imperial College London, London, SW7 2AZ, United Kingdom.
| | | | - Qian Wang
- Department of Geriatrics, The First Affiliated Hospital, Zhengzhou University, 450052, Zhengzhou, China.
| | - Guobing Chen
- Institute of Geriatric Immunology, School of Medicine, Jinan University, 510632, Guangzhou, China.
| | - Jun Li
- Department of Biochemistry and Molecular Biology, The Institute of Basic Medical Sciences, The Chinese Academy of Medical Sciences (CAMS)& Peking Union Medical University (PUMC), 5 Dondan Santiao Road, Beijing, 100730, China.
| | - Hou-Zao Chen
- Department of Biochemistry and Molecular Biology, The Institute of Basic Medical Sciences, The Chinese Academy of Medical Sciences (CAMS)& Peking Union Medical University (PUMC), 5 Dondan Santiao Road, Beijing, 100730, China.
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Beijing, 100730, China.
| | - Huanxing Su
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
| | - Brian C Gilmour
- The Norwegian Centre on Healthy Ageing (NO-Age), Oslo, Norway.
| | - Xinqiang Zhu
- Department of Toxicology, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang, China; The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, Zhejiang, China.
| | - Hong Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
| | - Na He
- School of Public Health, Fudan University, 200032, Shanghai, China; Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, 200032, Shanghai, China; Key Laboratory of Health Technology Assessment of Ministry of Health, Fudan University, 200032, Shanghai, China.
| | - Jun Tao
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University, 510080, Guangzhou, China.
| | - Sean Xiao Leng
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, 5505 Hopkins Bayview Circle, Baltimore, MD 21224, USA.
| | - Tanjun Tong
- Research Center on Ageing, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Beijing, China.
| | - Jean Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Pignatti C, D’Adamo S, Stefanelli C, Flamigni F, Cetrullo S. Nutrients and Pathways that Regulate Health Span and Life Span. Geriatrics (Basel) 2020; 5:geriatrics5040095. [PMID: 33228041 PMCID: PMC7709628 DOI: 10.3390/geriatrics5040095] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023] Open
Abstract
Both life span and health span are influenced by genetic, environmental and lifestyle factors. With the genetic influence on human life span estimated to be about 20–25%, epigenetic changes play an important role in modulating individual health status and aging. Thus, a main part of life expectance and healthy aging is determined by dietary habits and nutritional factors. Excessive or restricted food consumption have direct effects on health status. Moreover, some dietary interventions including a reduced intake of dietary calories without malnutrition, or a restriction of specific dietary component may promote health benefits and decrease the incidence of aging-related comorbidities, thus representing intriguing potential approaches to improve healthy aging. However, the relationship between nutrition, health and aging is still not fully understood as well as the mechanisms by which nutrients and nutritional status may affect health span and longevity in model organisms. The broad effect of different nutritional conditions on health span and longevity occurs through multiple mechanisms that involve evolutionary conserved nutrient-sensing pathways in tissues and organs. These pathways interacting each other include the evolutionary conserved key regulators mammalian target of rapamycin, AMP-activated protein kinase, insulin/insulin-like growth factor 1 pathway and sirtuins. In this review we provide a summary of the main molecular mechanisms by which different nutritional conditions, i.e., specific nutrient abundance or restriction, may affect health span and life span.
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Affiliation(s)
- Carla Pignatti
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (C.P.); (F.F.)
| | - Stefania D’Adamo
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40136 Bologna, Italy;
- Laboratory of Immunorheumatology and Tissue Regeneration, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Claudio Stefanelli
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 47921 Rimini, Italy;
| | - Flavio Flamigni
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (C.P.); (F.F.)
| | - Silvia Cetrullo
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (C.P.); (F.F.)
- Correspondence: ; Tel.: +39-051-209-1241
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Evans IEM, Martyr A, Collins R, Brayne C, Clare L. Social Isolation and Cognitive Function in Later Life: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2020; 70:S119-S144. [PMID: 30372678 PMCID: PMC6700717 DOI: 10.3233/jad-180501] [Citation(s) in RCA: 250] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND There is some evidence to suggest that social isolation may be associated with poor cognitive function in later life. However, findings are inconsistent and there is wide variation in the measures used to assess social isolation. OBJECTIVE We conducted a systematic review and meta-analysis to investigate the association between social isolation and cognitive function in later life. METHODS A search for longitudinal studies assessing the relationship between aspects of social isolation (including social activity and social networks) and cognitive function (including global measures of cognition, memory, and executive function) was conducted in PsycInfo, CINAHL, PubMed, and AgeLine. A random effects meta-analysis was conducted to assess the overall association between measures of social isolation and cognitive function. Sub-analyses investigated the association between different aspects of social isolation and each of the measures of cognitive function. RESULTS Sixty-five articles were identified by the systematic review and 51 articles were included in the meta-analysis. Low levels of social isolation characterized by high engagement in social activity and large social networks were associated with better late-life cognitive function (r = 0.054, 95% CI: 0.043, 0.065). Sub-analyses suggested that the association between social isolation and measures of global cognitive function, memory, and executive function were similar and there was no difference according to gender or number of years follow-up. CONCLUSIONS Aspects of social isolation are associated with cognitive function in later life. There is wide variation in approaches to measuring social activity and social networks across studies which may contribute to inconsistencies in reported findings.
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Affiliation(s)
- Isobel E M Evans
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Anthony Martyr
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Rachel Collins
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Carol Brayne
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK.,University of Exeter Medical School, Exeter, UK.,Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK.,Centre for Research Excellence in Promoting Cognitive Health, University of New South Wales, Sydney, Australia
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The association of healthy behaviors with cognitive health expectancy in Chinese older adults: a population-based cohort study. Aging (Albany NY) 2020; 12:16999-17021. [PMID: 32903212 PMCID: PMC7521482 DOI: 10.18632/aging.103617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/22/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To examine how lifestyles and leisure activities are associated with cognitive health expectancy among older adults. RESULTS For young-old (aged 65), an absolute increase in life years without cognitive impairment was found among those with a healthy diet, engaging in mental activities and in social activities. For old-old (aged 85), an absolute increase was found for men engaging in physical activities besides those. Compared with counterparts in a high risk group, the young-old in a medium-low risk group had a smaller proportion of years without cognitive impairment. Old-old in a low risk group had a greater proportion. CONCLUSION Extra years of life gained by a healthy dietary pattern, mental activities, and social activities are free of cognitive impairment for both sexes across ages. The beneficial impact of individual and combined modifiable factors on cognitive health is most prominent in old-old. METHODS Data come from The Chinese Longitudinal Healthy Longevity Survey, a population-based cohort study of 27,193 participants aged 65+ conducted between 2002 and 2014. Smoking status, alcohol consumption, dietary pattern, marital status, physical, mental, social, and productive activities were assessed at baseline. Cognitive status was measured using the Chinese version of the MMSE.
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Chudasama YV, Khunti K, Gillies CL, Dhalwani NN, Davies MJ, Yates T, Zaccardi F. Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study. PLoS Med 2020; 17:e1003332. [PMID: 32960883 PMCID: PMC7508366 DOI: 10.1371/journal.pmed.1003332] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/18/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Whether a healthy lifestyle impacts longevity in the presence of multimorbidity is unclear. We investigated the associations between healthy lifestyle and life expectancy in people with and without multimorbidity. METHODS AND FINDINGS A total of 480,940 middle-aged adults (median age of 58 years [range 38-73], 46% male, 95% white) were analysed in the UK Biobank; this longitudinal study collected data between 2006 and 2010, and participants were followed up until 2016. We extracted 36 chronic conditions and defined multimorbidity as 2 or more conditions. Four lifestyle factors, based on national guidelines, were used: leisure-time physical activity, smoking, diet, and alcohol consumption. A combined weighted score was developed and grouped participants into 4 categories: very unhealthy, unhealthy, healthy, and very healthy. Survival models were applied to predict life expectancy, adjusting for ethnicity, working status, deprivation, body mass index, and sedentary time. A total of 93,746 (19.5%) participants had multimorbidity. During a mean follow-up of 7 (range 2-9) years, 11,006 deaths occurred. At 45 years, in men with multimorbidity an unhealthy score was associated with a gain of 1.5 (95% confidence interval [CI] -0.3 to 3.3; P = 0.102) additional life years compared to very unhealthy score, though the association was not significant, whilst a healthy score was significantly associated with a gain of 4.5 (3.3 to 5.7; P < 0.001) life years and a very healthy score with 6.3 (5.0 to 7.7; P < 0.001) years. Corresponding estimates in women were 3.5 (95% CI 0.7 to 6.3; P = 0.016), 6.4 (4.8 to 7.9; P < 0.001), and 7.6 (6.0 to 9.2; P < 0.001) years. Results were consistent in those without multimorbidity and in several sensitivity analyses. For individual lifestyle factors, no current smoking was associated with the largest survival benefit. The main limitations were that we could not explore the consistency of our results using a more restrictive definition of multimorbidity including only cardiometabolic conditions, and participants were not representative of the UK as a whole. CONCLUSIONS In this analysis of data from the UK Biobank, we found that regardless of the presence of multimorbidity, engaging in a healthier lifestyle was associated with up to 6.3 years longer life for men and 7.6 years for women; however, not all lifestyle risk factors equally correlated with life expectancy, with smoking being significantly worse than others.
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Affiliation(s)
- Yogini V. Chudasama
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research (NIHR) Applied Research Collaboration—East Midlands (ARC-EM) Leicester Diabetes Centre, Leicester, United Kingdom
- * E-mail:
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research (NIHR) Applied Research Collaboration—East Midlands (ARC-EM) Leicester Diabetes Centre, Leicester, United Kingdom
| | - Clare L. Gillies
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
| | - Nafeesa N. Dhalwani
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
| | - Melanie J. Davies
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester Diabetes Centre, Leicester, United Kingdom
| | - Thomas Yates
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester Diabetes Centre, Leicester, United Kingdom
| | - Francesco Zaccardi
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
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Wu MY, Wang JB, Zhu Y, Lu JM, Li D, Yu ZB, Shen P, Jiang DJ, Lin HB, Chen K. Impact of Individual and Combined Lifestyle Factors on Mortality in China: A Cohort Study. Am J Prev Med 2020; 59:461-468. [PMID: 32417020 DOI: 10.1016/j.amepre.2020.01.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Although numerous studies have suggested that lifestyle-related factors are associated with chronic diseases and preventable deaths, limited evidence is available for the Chinese population. METHODS This study established a prospective cohort of >360,000 residents on the basis of the Yinzhou Health Information System in China during 2004-2017 and calculated the combined effects of lifestyle-related factors, including BMI, smoking, alcohol consumption, and physical activity, using a points system. A Cox regression model estimated the combined effects of lifestyle-related factors on total mortality, and a competing risk model estimated the combined effects on cancer and cardiovascular disease mortality. All data analyses were conducted in 2018‒2019. RESULTS During 3,755,879 person-years of follow-up, 11,791 deaths were identified, including 4,983 from cancer and 3,143 from cardiovascular disease. Having a standard BMI, never smoking, never drinking, and engaging in physical activity more than 4 times per week had protective effects on total mortality. Overall, the risk of total and cause-specific mortality increased with the increment of risk score. Compared with subjects in the lowest quartile, the risk of total and cause-specific mortality peaked among individuals in the fourth quartile (total mortality: hazard ratio=1.87, 95% CI=1.77, 1.98; cancer mortality: hazard ratio=2.05, 95% CI=1.87, 2.25; cardiovascular disease mortality: hazard ratio=1.51, 95% CI=1.35, 1.68). Sensitivity analyses excluding individuals with follow-up <3 years did not materially change the results. CONCLUSIONS The combined effects of lifestyle-related factors, including BMI, smoking, alcohol drinking, and physical activity, are associated with total, cancer, and cardiovascular disease mortality among the Chinese population.
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Affiliation(s)
- Meng-Yin Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jian-Bing Wang
- Department of Epidemiology and Biostatistics, the Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yao Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jie-Ming Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Die Li
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Zhe-Bin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Dan-Jie Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Hong-Bo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Observational Retrospective Study on Patient Lifestyle in the Pretransplantation and Post-transplantation Period in the Emilia-Romagna Region. Transplant Proc 2020; 52:1552-1555. [PMID: 32402457 DOI: 10.1016/j.transproceed.2020.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/25/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Despite the well-known benefits of exercise during the pretransplantation and post-transplantation phases, adherence to active lifestyles is still reduced. The aim of the present study is to evaluate how many patients who have received organ transplants and candidates for organ transplantation carry out physical or sports activities in order to increase adherence to an active lifestyle. METHODS The patients who agreed to participate in the study were interviewed about their lifestyle habits by the staff at the nephrology, dialysis, and hepatology units of the Emilia-Romagna region. The interview investigated the patient's lifestyle (active or sedentary) and type of physical activity (walking, cycling, gardening, gym at least 3 to 40 minutes, 2 to 3 times per week) or sport (training > 2 times per week) routinely practiced. RESULTS We collected 1138 interviews from patients on the waiting list (n = 159) for organ transplant, those with kidney transplants (n = 756), and those with liver transplants (n = 223) monitored in the Emilia-Romagna hospitals (regional patients 67%, extraregional 33%). Eighty-four patients on the waiting list for a transplant (kidney) were sedentary, 75 practiced physical activity, and 10 of 75 physically active patients practiced sport. Four hundred fifteen patients with kidney transplants were sedentary, 341 practiced physical activity, and 31 of 341 physically active patients practiced sport. Among patients with liver transplants, 56 were sedentary, 167 practiced physical activity, and 20 of 167 physically active patients played sport. CONCLUSIONS In-line with the general population, we confirmed a high tendency toward a sedentary lifestyle (44% of respondents) among patients with organ transplants and those on waiting lists for organ transplants. Including a prescription for physical exercise as part of the therapeutic regimen can be useful for changing lifestyles during the pre- and post-transplantation period.
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Wu J, Hasselgren C, Zettergren A, Zetterberg H, Blennow K, Skoog I, Halleröd B. The impact of social networks and APOE ε4 on dementia among older adults: tests of possible interactions. Aging Ment Health 2020; 24:395-404. [PMID: 30587010 DOI: 10.1080/13607863.2018.1531368] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Emerging evidence suggests that social networks may protect against the development of dementia among older adults. In this study we analysed the association between social networks, the apolipoprotein E (APOE) ε4 allele, and dementia. We also investigated whether there were gender-specific patterns in this respect.Method: The analyses used population-based longitudinal data from Gothenburg, Sweden: the H70 Birth Cohort Study and the Prospective Population Study on Women (PPSW). A total of 580 individuals born in 1930 underwent semi-structured neuropsychiatric examinations in 2000-2001. Follow-up examinations were carried out in 2005-2006 and 2009-2010. The timing of dementia onset was analysed using Cox proportional hazards regression.Results: The presence of the APOE ε4 allele affected the risk of developing dementia in both genders. Among women, distant social networks had a protective effect on dementia, while among men the significant associations between close social networks and dementia did not remain after controlling for covariates. Significant interactions between social networks and the APOE ε4 allele were not found.Conclusion: Strong social networks do not seem to moderate the increased risk of dementia implied by the APOE ε4 allele. Nevertheless, our results underline the importance of strong social networks in postponing dementia onset and indicate that their impact may differ among men and women.
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Affiliation(s)
- Jing Wu
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Caroline Hasselgren
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Björn Halleröd
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
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de Sousa OV, Mendes J, Amaral TF. Nutritional and Functional Indicators and Their Association With Mortality Among Older Adults With Alzheimer's Disease. Am J Alzheimers Dis Other Demen 2020; 35:1533317520907168. [PMID: 32088972 PMCID: PMC10624010 DOI: 10.1177/1533317520907168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This study investigated how different nutritional and functional status indicators are associated with mortality in patients with Alzheimer's disease (AD). A prospective cohort study was conducted among 79 community-dwelling older adults with AD. Follow-up was 60 months. Undernutrition status was evaluated by Mini Nutritional Assessment (MNA), body mass index, mid-arm muscle circumference (MAMC), calf circumference, and phase angle. Functional status was assessed by handgrip strength, and usual gait speed. Twenty-two participants died (27.8%). Results show that undernutrition (hazard ratio [HR] 5.69, 95% confidence interval [CI] 2.21-14.61), weight loss (HR 3.82, 95% CI 1.37-10.63), underweight (HR 3.24, 95% CI 1.18-8.82), low MAMC (HR 4.54, 95% CI 1.65-12.48), calf circumference ≤ 31 (HR 4.27, 95% CI 1.63-11.16), low HGS (HR 3.11, 95% CI 1.18-8.17), and low gait speed (HR 4.73, 95% CI 1.68-13.27) were all associated with mortality. In conclusion, a poor nutritional and functional status was associated with a higher risk of mortality, regardless of sex, age, marital status, education, and cognitive function.
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Affiliation(s)
- O. Vicente de Sousa
- Psychogeriatrics Unit of Hospital de Magalhães Lemos E.P.E., Porto, Portugal
- UNIFAI/ICBAS (Research and Education Unit on Aging), Department of Behavioral Sciences, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - J. Mendes
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal
- I3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - T. F. Amaral
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- UISPA-IDMEC, Faculty of Engineering, University of Porto, Porto, Portugal
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Ekmekcioglu C. Nutrition and longevity – From mechanisms to uncertainties. Crit Rev Food Sci Nutr 2019; 60:3063-3082. [DOI: 10.1080/10408398.2019.1676698] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Cem Ekmekcioglu
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Chellappa K, Brinkman JA, Mukherjee S, Morrison M, Alotaibi MI, Carbajal KA, Alhadeff AL, Perron IJ, Yao R, Purdy CS, DeFelice DM, Wakai MH, Tomasiewicz J, Lin A, Meyer E, Peng Y, Arriola Apelo SI, Puglielli L, Betley JN, Paschos GK, Baur JA, Lamming DW. Hypothalamic mTORC2 is essential for metabolic health and longevity. Aging Cell 2019; 18:e13014. [PMID: 31373126 PMCID: PMC6718533 DOI: 10.1111/acel.13014] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 05/26/2019] [Accepted: 07/03/2019] [Indexed: 12/16/2022] Open
Abstract
The mechanistic target of rapamycin (mTOR) is an evolutionarily conserved protein kinase that regulates growth and metabolism. mTOR is found in two protein complexes, mTORC1 and mTORC2, that have distinct components and substrates and are both inhibited by rapamycin, a macrolide drug that robustly extends lifespan in multiple species including worms and mice. Although the beneficial effect of rapamycin on longevity is generally attributed to reduced mTORC1 signaling, disruption of mTORC2 signaling can also influence the longevity of worms, either positively or negatively depending on the temperature and food source. Here, we show that loss of hypothalamic mTORC2 signaling in mice decreases activity level, increases the set point for adiposity, and renders the animals susceptible to diet-induced obesity. Hypothalamic mTORC2 signaling normally increases with age, and mice lacking this pathway display higher fat mass and impaired glucose homeostasis throughout life, become more frail with age, and have decreased overall survival. We conclude that hypothalamic mTORC2 is essential for the normal metabolic health, fitness, and lifespan of mice. Our results have implications for the use of mTORC2-inhibiting pharmaceuticals in the treatment of brain cancer and diseases of aging.
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Affiliation(s)
- Karthikeyani Chellappa
- Department of Physiology and Institute for Diabetes, Obesity and Metabolism, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Jacqueline A. Brinkman
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
| | - Sarmistha Mukherjee
- Department of Physiology and Institute for Diabetes, Obesity and Metabolism, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Mark Morrison
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
| | - Mohammed I. Alotaibi
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
- Endocrinology and Reproductive Physiology Graduate Training ProgramUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Kathryn A. Carbajal
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
| | - Amber L. Alhadeff
- Department of Biology, School of Arts and SciencesUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Isaac J. Perron
- Center for Sleep and Circadian Neurobiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Rebecca Yao
- Department of Physiology and Institute for Diabetes, Obesity and Metabolism, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Cole S. Purdy
- Department of Physiology and Institute for Diabetes, Obesity and Metabolism, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Denise M. DeFelice
- Department of Physiology and Institute for Diabetes, Obesity and Metabolism, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Matthew H. Wakai
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
| | - Jay Tomasiewicz
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Amy Lin
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
- Department of Dairy ScienceUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Emma Meyer
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
- Department of Dairy ScienceUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Yajing Peng
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
- Waisman CenterUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Sebastian I. Arriola Apelo
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
- Department of Dairy ScienceUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Luigi Puglielli
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
- Waisman CenterUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - J. Nicholas Betley
- Department of Biology, School of Arts and SciencesUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Georgios K. Paschos
- Center for Sleep and Circadian Neurobiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
- The Institute for Translational Medicine and Therapeutics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Joseph A. Baur
- Department of Physiology and Institute for Diabetes, Obesity and Metabolism, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Dudley W. Lamming
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
- William S. Middleton Memorial Veterans HospitalMadisonWIUSA
- Endocrinology and Reproductive Physiology Graduate Training ProgramUniversity of Wisconsin‐MadisonMadisonWIUSA
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Imamura K, Tsutsumi A, Asai Y, Arima H, Ando E, Inoue A, Inoue R, Iwanaga M, Eguchi H, Otsuka Y, Kobayashi Y, Sakuraya A, Sasaki N, Tsuno K, Hino A, Watanabe K, Shimazu A, Kawakami N. Association between psychosocial factors at work and health outcomes after retirement: a protocol for a systematic review and meta-analysis. BMJ Open 2019; 9:e030773. [PMID: 31462485 PMCID: PMC6720328 DOI: 10.1136/bmjopen-2019-030773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The world's population is rapidly ageing, and health among older people is thus an important issue. Several previous studies have reported an association between adverse psychosocial factors at work before retirement and postretirement health. The objective of this systematic review and meta-analysis is to examine the association between psychosocial factors at work and health outcomes after retirement, based on a synthesis of well-designed prospective studies. METHODS AND ANALYSIS The participants, exposures, comparisons and outcomes of the studies in this systematic review and meta-analysis are defined as follows: (P) people who have retired from their job, (E) presence of adverse psychosocial factors at work before retirement, (C) absence of adverse psychosocial factors at work before retirement and (O) any physical and mental health outcomes after retirement. Published studies were searched using the following electronic databases: MEDLINE, EMBASE, PsycINFO, PsycARTICLES and Japan Medical Abstracts Society. The included studies will be statistically synthesised in a meta-analysis to estimate pooled coefficients and 95% CIs. The quality of each included study will be assessed using the Risk Of Bias In Non-randomised Studies-of Interventions. For the assessment of meta-bias, publication bias will be assessed by using Egger's test, as well as visually on a funnel plot. Heterogeneity will be assessed using the χ² test with Cochran's Q statistic and I2. ETHICS AND DISSEMINATION Results and findings will be submitted and published in a scientific peer-reviewed journal and will be disseminated broadly to researchers and policy-makers interested in the translatability of scientific evidence into good practices. PROSPERO REGISTRATION NUMBER CRD42018099043.
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Affiliation(s)
- Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yumi Asai
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideaki Arima
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emiko Ando
- Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Akiomi Inoue
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Reiko Inoue
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Mai Iwanaga
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisashi Eguchi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yasumasa Otsuka
- Faculty of Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yuka Kobayashi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Asuka Sakuraya
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kanami Tsuno
- School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akihito Shimazu
- Faculty of Policy Management, Keio University, Fujisawa, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Liao J, Mawditt C, Scholes S, Lu W, Umeda M, Muniz Terrera G, Hao Y, Mejía S. Similarities and differences in health-related behavior clustering among older adults in Eastern and Western countries: A latent class analysis of global aging cohorts. Geriatr Gerontol Int 2019; 19:930-937. [PMID: 31309695 DOI: 10.1111/ggi.13737] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 11/26/2022]
Abstract
AIM To quantify variations in health-related behaviors (HRB) clustering of older adults in Western and Eastern countries. METHODS Using six aging cohorts from the USA, England, Europe, Japan, Korea and China, latent class analysis was applied to access the clustering of smoking, alcohol consumption, physical activity and social activity. RESULTS A total of 104 552 participants (55% women) aged ≥50 years in 2010 were included. Despite a different number of clusters identified, three consistent cluster profiles emerged: "Multiple-HRB" (ex-/never smoking, moderate drinking, frequent physical and social activity); "Inactives" (socially and physically inactive without other risk behaviors); and "(ex-)Smokers with Risk Behaviors". Sex and cohort variations were shown. For men in Western cohorts, "Multiple-HRB" was the predominant cluster, whereas their Asian counterparts were more likely to be members of the "Smokers with risk behavior" and "Inactives" clusters. Most women, particularly those in Asian cohorts, were never smokers and non-drinkers, and most of them belonged to the socially "Inactives" cluster. CONCLUSIONS We provide a person-centered understanding of HRB clustering of older adults over selected countries by sex, informing tailored health promotion for the target population. Geriatr Gerontol Int 2019; 19: 930-937.
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Affiliation(s)
- Jing Liao
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Claire Mawditt
- Derby Teaching Hospitals NHS Foundation Trust, London, UK
| | - Shaun Scholes
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Wentian Lu
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Maki Umeda
- Research Centers, Global Health Nursing, Research Institute of Nursing Care for People and Community, University of Hyogo, Hyogo, Japan
| | - Graciela Muniz Terrera
- Research Centers, Center for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Shannon Mejía
- Department of Kinesiology & Community Health College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
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Tevik K, Selbæk G, Engedal K, Seim A, Krokstad S, Helvik AS. Mortality in older adults with frequent alcohol consumption and use of drugs with addiction potential - The Nord Trøndelag Health Study 2006-2008 (HUNT3), Norway, a population-based study. PLoS One 2019; 14:e0214813. [PMID: 30990815 PMCID: PMC6467384 DOI: 10.1371/journal.pone.0214813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/20/2019] [Indexed: 12/19/2022] Open
Abstract
Background The aim of this study was to investigate whether frequent drinking, use of drugs with addiction potential and the possible combination of frequent drinking and use of prescribed drugs with addiction potential were associated with all-cause mortality in older adults. Methods We used data from the Nord-Trøndelag Health Study (HUNT3 2006–08), a population-based study in Norway. A total of 11,545 (6,084 women) individuals 65 years and older at baseline participated. We assessed frequent drinking (≥ 4 days a week), occasional drinking (i.e. a few times a year), never drinking and non-drinking in the last year. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009. This information was drawn from the Norwegian Prescription Database. The main outcome was all-cause mortality with information drawn from the Norwegian Cause of Death Registry. Follow-up continued until death or latest at 31 December 2013. Logistic regression analyses were used to investigate all-cause mortality since date of study entry and exact age at time of death was unknown. Results The adjusted logistic regression analyses showed that frequent drinking was not associated with all-cause mortality compared to occasional drinking. Men who reported to be never drinkers and non-drinkers in the last year had higher odds of mortality compared to those who drank occasionally. Use of prescribed drugs with addiction potential was associated with increased mortality in men, but not in women. No association was found between the possible combination of frequent drinking and use of prescribed drugs with addiction potential and mortality. Conclusion Neither frequent drinking nor the possible combination of frequent drinking and use of prescribed drugs with addiction potential were associated with all-cause mortality in older women and men. Use of prescribed drugs with addiction potential was associated with higher odds of mortality in men. This finding should lead to more caution in prescribing drugs with addiction potential to this group.
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Affiliation(s)
- Kjerstin Tevik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- * E-mail:
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Arnfinn Seim
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), Levanger, Norway
- Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-S Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Sluppen, Trondheim, Norway
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Hu M, Lan Y, Lu A, Ma X, Zhang L. Glycan-based biomarkers for diagnosis of cancers and other diseases: Past, present, and future. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 162:1-24. [PMID: 30905444 DOI: 10.1016/bs.pmbts.2018.12.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Glycans are essential biomolecules in regulating human physiology and pathology ranging from signal transduction to microbial infections. Developing complex human diseases, such as cancer, diabetes, and cardiovascular diseases, are a combination of genetic and environmental factors. Genetics dominates embryonic development and the passing of genes to the next generation whereas the information in glycans reflects the impact of internal and external environmental factors, such as diseases, lifestyle, and social factors, on a person's health and disease. The reason behind this is that glycans are not directly encoded in a genetic template. Instead, they are assembled dynamically by hundreds of enzymes organized in more than 10 complex biosynthetic pathways. Any environmental changes affecting enzymatic activities or the availability of high-energy monosaccharide donors in a specific location will disturb the final structure of glycans. The glycan structure-dependent biological activities subsequently enable or disable gene expressions, which partially explain that it is difficult to pinpoint specific genetic defects to aging-associated diseases. Glycan-based biomarkers are currently used for diagnosis of diabetes, cancers, and other complex diseases. We will recapitulate the discovery of glucose, glycated proteins, glycan-, and glycoprotein-based biomarkers followed by summarizing clinically used glycan/glycoprotein-based biomarkers. The potential serum/plasma-derived N- and O-linked glycans as biomarkers will also be discussed.
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Affiliation(s)
- Minghui Hu
- Systems Biology and Medicine Center for Complex Diseases, Affiliated Hospital of Qingdao University, Qingdao, China; Clinical Laboratory, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Lan
- College of Food Science and Engineering, Northwest A&F University, Yangling, China
| | - Alexander Lu
- Program in Neuroscience, Saint Louis University, St. Louis, MO, United States
| | - Xuexiao Ma
- Department of Spine Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lijuan Zhang
- Systems Biology and Medicine Center for Complex Diseases, Affiliated Hospital of Qingdao University, Qingdao, China.
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Portela M, Schweinzer P. The parental co-immunization hypothesis: An observational competing risks analysis. Sci Rep 2019; 9:2493. [PMID: 30792444 PMCID: PMC6385205 DOI: 10.1038/s41598-019-39124-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 01/07/2019] [Indexed: 01/09/2023] Open
Abstract
The main interest of this study is the hypothesis that contact with small children may be beneficial for the parents’ later health and mortality (because of changes in their immune system). For this purpose, we document the relationship of a set of individual characteristics—including parenthood and marital state—and socioeconomic status with an individual’s cause of death. Using a novel and rich data set made available by the Office for National Statistics Longitudinal Study (ONS-LS), which follows 1% of the population of England and Wales along five census waves 1971, 1981, 1991, 2001, and 2011, our competing risks analysis yields several striking results: (1) Females with children have a 72.5% reduced risk of dying of cancer compared to childless females (for childless females of age 70, this corresponds to a risk of dying of cancer of 1.3% compared to a risk of about 1.3 × 0.275 = 0.4% for females with children). (2) Males have a 171% increased chance of dying of cancer when they are married (e.g., a baseline probability of 1.2% when 75 year old) compared to unmarried males. (3) Females with children have only a 34% risk of dying of heart disease (corresponding to a conditional probability of 0.3% when aged 65) relative to females without children and (4) a 53% chance of dying of infections (i.e., 0.1% at 65 years of age) compared to the risk for females without children. (5) At the same age, married men have an increased expectation of 123% of dying of heart disease (corresponding to an expected death probability of 0.7%) compared to unmarried men. (6) High income and house ownership is always associated with higher survival but less so than having children. While these results document a relationship between the presence of children and mortality, the specific transmission mechanisms remain unclear and we cannot make causality assertions.
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Affiliation(s)
- Miguel Portela
- NIPE, Universidade do Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Paul Schweinzer
- Alpen-Adria-Universität Klagenfurt, 9020, Klagenfurt, Austria.
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