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Mazza E, Ferro Y, Maurotti S, Micale F, Boragina G, Russo R, Lascala L, Sciacqua A, Gazzaruso C, Montalcini T, Pujia A. Association of dietary patterns with sarcopenia in adults aged 50 years and older. Eur J Nutr 2024; 63:1651-1662. [PMID: 38568294 PMCID: PMC11329607 DOI: 10.1007/s00394-024-03370-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/01/2024] [Indexed: 08/18/2024]
Abstract
PURPOSE Although numerous studies have investigated the impact of dietary factors on the prevention of decreased muscle mass and function, limited research has examined the relationship between dietary patterns and sarcopenia. This study aimed to assess the associations between dietary patterns, and sarcopenia, muscle strength, and mass in adults following a Mediterranean diet residing in southern Italian cities. METHODS This cross-sectional study utilized data from an existing database, comprising 528 individuals aged 50 years or older who underwent health-screening tests at the Clinical Nutrition Unit of the "R.Dulbecco" University Hospital. Strength was assessed through handgrip strength, and appendicular skeletal muscle mass was estimated using bioelectrical impedance analysis. Dietary intake information was collected through a food frequency questionnaire linked to the MetaDieta 3.0.1 nutrient composition database. Principal Component Analysis, a statistical technique identifying underlying relationships among different nutrients, was employed to determine dietary patterns. Multinomial logistic regression analysis was conducted to estimate the odds ratio for sarcopenia or low handgrip strength in relation to the lowest tertile of dietary pattern adherence compared to the highest adherence. RESULTS The participants had a mean age of 61 ± 8 years. Four dietary patterns were identified, with only the Western and Mediterranean patterns showing correlations with handgrip strength and appendicular skeletal muscle mass. However, only the Mediterranean pattern exhibited a correlation with sarcopenia (r = - 0.17, p = 0.02). The highest tertile of adherence to the Mediterranean dietary pattern demonstrated significantly higher handgrip strength compared to the lowest tertile (III Tertile: 28.3 ± 0.5 kg vs I Tertile: 26.3 ± 0.5 kg; p = 0.01). Furthermore, even after adjustment, the highest tertile of adherence to the Mediterranean pattern showed a significantly lower prevalence of sarcopenia than the lowest adherence tertile (4% vs 16%, p = 0.04). The lowest adherence to the Mediterranean dietary pattern was associated with increased odds of having low muscle strength (OR = 2.38; p = 0.03; 95%CI = 1.05-5.37) and sarcopenia (OR = 9.69; p = 0.0295; %CI = 1.41-66.29). CONCLUSION A high adherence to the Mediterranean dietary pattern, characterized by increased consumption of legumes, cereals, fruits, vegetables, and limited amounts of meat, fish, and eggs, is positively associated with handgrip strength and appendicular skeletal muscle mass. The highest adherence to this dietary model is associated with the lowest odds of low muscle strength and sarcopenia. Despite the changes brought about by urbanization in southern Italy compared to the past, our findings continue to affirm the superior benefits of the Mediterranean diet in postponing the onset of frailty among older adults when compared to other dietary patterns that are rich in animal foods.
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Affiliation(s)
- Elisa Mazza
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100, Catanzaro, Italy
| | - Yvelise Ferro
- Department of Medical and Surgical Science, University Magna Grecia, 88100, Catanzaro, Italy
| | - Samantha Maurotti
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100, Catanzaro, Italy.
| | - Francesca Micale
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100, Catanzaro, Italy
| | - Giada Boragina
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100, Catanzaro, Italy
| | - Raffaella Russo
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100, Catanzaro, Italy
| | - Lidia Lascala
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100, Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Science, University Magna Grecia, 88100, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100, Catanzaro, Italy
| | - Carmine Gazzaruso
- Diabetes and Endocrine-Metabolic Diseases Unit, Istituto Clinico Beato Matteo, Gruppo Ospedaliero San Donato, Corso Pavia 84, 27029, Vigevano, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100, Catanzaro, Italy
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Grecia, 88100, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100, Catanzaro, Italy
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Perrott SL, Martin K, Keevil VL, Wareham NJ, Khaw KT, Myint PK. Calcaneal broadband ultrasound attenuation predicts physical capability: EPIC-Norfolk prospective population-based study. Maturitas 2023; 173:7-15. [PMID: 37146366 DOI: 10.1016/j.maturitas.2023.04.008] [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: 10/03/2022] [Revised: 03/02/2023] [Accepted: 04/15/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Calcaneal ultrasound (broadband ultrasound attenuation - BUA), a marker of bone strength, may predict future physical capability and thus provide a strategy to identify individuals at risk of age-related deterioration of health. This study aims to determine if BUA can predict future physical capability among middle-aged and older adults. METHODS Summary performance scores (SPS), an objective quantification of physical capability, were devised using participants' measures of standing balance, gait speed and timed chair rises. Associations between BUA and SPS, measured at least six years apart, were investigated using univariable and multivariate sex-specific linear and logistic regression, adjusting for confounders. RESULTS 5893 participants were included. In men and women, for every five points lower BUA, there was a 0.2-point decrease in SPS. In women, BUA less than one standard deviation below the mean was associated with low physical capability (defined as SPS 3-6); fully adjusted odds ratio (OR) (95 % confidence interval (CI)) 1.35 (1.01-1.84). No association existed among men; OR (95 % CI) 0.84 (0.59-1.19). Significant risk factors for low physical capability in men with baseline low BUA were: older age [OR 5.77]; high BMI [OR 2.85]; lower social class [OR 1.59]; low physical activity [OR 1.64]. Risk factors among women were: older age [OR 5.54]; high BMI [OR 2.08]; lower education [OR 1.42], low physical activity [OR 1.27]; steroid use [OR 2.05]; and stroke [OR 2.74]. CONCLUSION BUA may predict future physical capability in older adults. With further validation, BUA could stratify individuals at risk of deterioration in physical health.
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Affiliation(s)
- Sarah L Perrott
- Ageing Clinical & Experimental Research (ACER) Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
| | - Kathryn Martin
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; The Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK
| | | | | | - Kay-Tee Khaw
- Department of Medicine, University of Cambridge, UK
| | - Phyo Kyaw Myint
- Ageing Clinical & Experimental Research (ACER) Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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3
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Liu H, Hu T. Impact of socioeconomic status and health risk on fall inequality among older adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4961-e4974. [PMID: 35833421 DOI: 10.1111/hsc.13908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 05/17/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Socio-economic status (SES) is one of the important indicators reflecting individual social participation and resource allocation, and it plays an important role in individual health shock. Health shock indicates the body being in a non-healthy state, such as illness, injury and death. This study used data from the China Health and Retirement Longitudinal Study conducted in 2013, 2015 and 2018 and utilised the panel logit model, causal step-by-step analysis and path analysis to empirically test the impact of SES on fall inequality among the elderly and the mediating effect of health shock. The results demonstrated obvious group inequality in the fall risk among older adults, the core of which was the impact of SES on health, causing health inequality and affecting fall inequality. The activities of daily living and pain rate of the high-income group were 61.16% and 28.69%, respectively, that of the low-income group. The evaluation of good sight and hearing were 3.6833 and 3.8572 times, respectively, that of the low-income group. The non-depressive status was 38.4638 times of the low-income group. The path effect confirmed the mediating role of health shock. Therefore, this study concluded that SES had an important impact on the risk of falls among the elderly, and this impact was mainly from health shock. This study proposed that to reduce the incidence of falls among the elderly, differences in health shock risks among the elderly with different SES must be actively monitored and accurate and effective policy interventions should be implemented from the level of group heterogeneity.
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Affiliation(s)
- Huan Liu
- School of Society, Soochow University, Su Zhou, China
| | - Tiantian Hu
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
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4
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Park GR, Kim J. Coexistent physical and cognitive decline and the development of fear of falling among Korean older adults. Int J Geriatr Psychiatry 2022; 37. [PMID: 35334126 DOI: 10.1002/gps.5705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/15/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Although hand grip strength and cognitive function are associated with fear of falling (FOF), little is known about whether coexisting physical and cognitive decline is jointly related to FOF. This study examines whether grip strength and cognitive function interact to shape FOF and FOF-related activity restriction (FAR) among Korean older adults. METHODS/DESIGN This study used seven waves of the Korean Longitudinal Study of Ageing (N = 3373 older adults aged 65 or over). Grip strength was assessed by a handgrip dynamometer, and cognitive function by Korean Mini-mental State Examination (K-MMSE). Fixed effects models were estimated to account for time-invariant confounders such as genetic predispositions, innate ability, and health endowments. This study estimated a joint model that included interaction effects between grip strength and cognitive function. RESULTS Declines in grip strength and cognitive function were independently associated with FOF. Fixed effects estimates suggested that, despite some attenuation, controlling for individual heterogeneity does not confound the associations. The interaction model showed that coexistence of low grip strength and cognitive decline leads to a greater risk of FOF and FAR than having a single condition. Similar patterns were found for FAR. CONCLUSIONS This study provides evidence that coexistent cognitive and physical decline are a significant risk factor for FOF and FAR. Given the well-established adverse effects of FOF on older adults' health and well-being, results of this study lend support to interventions to target old adults with coexistent cognitive and physical decline to remove excessive concerns about FOF.
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Affiliation(s)
- Gum-Ryeong Park
- Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada.,Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea.,Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.,Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
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5
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Khalatbari-Soltani S, Stanaway F, Sherrington C, Blyth FM, Naganathan V, Handelsman DJ, Seibel MJ, Waite LM, Le Couteur DG, Cumming RG. The Prospective Association Between Socioeconomic Status and Falls Among Community-Dwelling Older Men. J Gerontol A Biol Sci Med Sci 2021; 76:1821-1828. [PMID: 33537735 DOI: 10.1093/gerona/glab038] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) has been suggested as a risk factor for falls but the few prospective studies to test this have had mixed results. We evaluated the prospective association between SES and falls in the Concord Health and Ageing in Men Project (CHAMP). METHODS CHAMP is a population-based prospective cohort study of men aged ≥70 years in Sydney, Australia. Incident falls were ascertained by triannual telephone calls for up to 4 years. SES was assessed with 4 indicators (education, occupation, source of income, home ownership) and cumulative SES score. We tested for interaction between SES indicators and country of birth and conducted stratified analyses. RESULTS We evaluated 1624 men (mean age: 77.3 ± 5.4 years). During a mean ± SD follow-up of 42.6 ± 8.7 months, 766 (47%) participants reported ≥1 incident falls. In nonstratified analyses, there were no associations between SES indicators and falls. In stratified analyses, falls rates were higher among Australian-born men with less formal education (incidence rate ratio [IRR] 1.66, 95% confidence interval [CI] 1.16-2.37, compared with those with more education) and those with low occupational position (1.45; 1.09-1.93). However, among men born in non-main English-speaking countries the rate of falls was lower among those with low educational level and no associations were evident for occupational position. CONCLUSIONS Lower educational level and occupational position predicted a higher falls rate in Australian-born men; the opposite relationship was evident for educational level among migrants born in non-main English-speaking countries. Further studies should test these relationships in different populations and settings and evaluate targeted interventions.
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Affiliation(s)
- Saman Khalatbari-Soltani
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Australia
| | - Fiona Stanaway
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia
| | - Cathie Sherrington
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.,Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Australia
| | - Fiona M Blyth
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Australia
| | - Markus J Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Australia
| | - Louise M Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, New South Wales, Australia
| | - Robert G Cumming
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Australia
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Pothisiri W, Prasitsiriphon O, Aekplakorn W. Extent of aging across education and income subgroups in Thailand: Application of a characteristic-based age approach. PLoS One 2020; 15:e0243081. [PMID: 33290428 PMCID: PMC7723296 DOI: 10.1371/journal.pone.0243081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 11/15/2020] [Indexed: 01/03/2023] Open
Abstract
Aim This study aimed to identify differences in physical performance across various socioeconomic groups within an older population and to convert those differences into a common metric to facilitate comparisons of aging speed across socioeconomic subgroups. Methods We employed data from the 2009 National Health Examination Survey of Thailand. Physical performance was assessed using three health characteristics: grip strength, as a measure of upper body strength; walking speed, as a measure of lower body strength; and a combined measure of grip strength and walking speed, to capture the strength of the whole body. Education level and income were used to distinguish socioeconomic subpopulations. We followed a characteristic-based age approach to transform these population characteristics, which were measured in different units, into a common and comparable aging metric, referred to as α − age. Results Physical aging trajectories varied by sex and socioeconomic status. Some education, particularly secondary or higher education levels, was significantly associated with greater physical strength in older age for both men and women, whereas higher income was significantly associated with physical strength only for men. Across the three health characteristics, having a primary education slowed age-related declines by up to 6.3 years among men and 2.8 years among women, whereas being in a higher income group slowed age-related declines by 8.2 years among men and up to 4.9 years among women. Conclusions This study adds new evidence from a developing Asian country regarding the difference in aging speeds across subpopulations associated with different levels of education and income.
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Affiliation(s)
- Wiraporn Pothisiri
- College of Population Studies, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Orawan Prasitsiriphon
- College of Population Studies, Chulalongkorn University, Pathumwan, Bangkok, Thailand
- Health Insurance System Research Office, Health System Research Institute, Bang Khen, Nonthaburi, Thailand
- * E-mail:
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, Thailand
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7
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Asada Y, Grignon M, Hurley J, Kirkland S. Cautionary tails of grip strength in health inequality studies: An analysis from the Canadian longitudinal study on aging. Soc Sci Med 2020; 265:113382. [PMID: 33010636 DOI: 10.1016/j.socscimed.2020.113382] [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] [Revised: 09/13/2020] [Accepted: 09/16/2020] [Indexed: 11/19/2022]
Abstract
Self-rated health is widely used in studies of the socioeconomic gradient of health in community-based populations. Its subjectivity may lead to under- or over-estimation of a true underlying socioeconomic gradient and has increased interest in searching for alternative, objective measures of health. Grip strength has emerged as one such alternative for community-based older populations, yet no study has directly assessed the relationship between these two measures and compared their associations with socioeconomic status and health behaviours. Using 26,754 participants aged 45-85 years in the baseline data of the Canadian Longitudinal Study on Aging Comprehensive Cohort, we estimated adjusted-grip strength through indirect standardization using age, sex, height, weight, and their square terms and used ANOVA to assess the variance of adjusted-grip strength within and between each self-rated health category. We ran four separate logistic regression models, examining unhealthy tails (those reporting poor health vs. not and those at the bottom 8th percentile of adjusted-grip strength vs. above) and healthy tails (those reporting excellent health vs. not and those at the top 20th percentile of adjusted-grip strength vs. below). Stronger adjusted-grip strength correlated with better self-rated health, but only 2% of the total variance of adjusted-grip strength was explained by variance between the self-rated health categories. While self-rated health largely showed the expected socioeconomic gradients and positive relationships with health enhancing behaviours, adjusted-grip strength showed no clear, consistent associations with either socioeconomic or health behaviour variables. The results give caution about using grip strength as an objective alternative to self-rated health in studies of social inequalities in health. Empirical approaches demand careful considerations as to which dimensions of health and corresponding measures of health are most relevant to the context being studied.
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Affiliation(s)
- Yukiko Asada
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia, B3H1V7, Canada.
| | - Michel Grignon
- Department of Economics, Department of Health, Aging & Society, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Ontario, L8S4M4, Canada.
| | - Jeremiah Hurley
- Department of Economics, McMaster University, Hamilton, Ontario, L8S4M4, Canada.
| | - Susan Kirkland
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia, B3H1V7, Canada.
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Duchowny KA, Hicken MT, Cawthon PM, Glymour MM, Clarke P. Life course trauma and muscle weakness in older adults by gender and race/ethnicity: Results from the U.S. health and Retirement Study. SSM Popul Health 2020; 11:100587. [PMID: 32490135 PMCID: PMC7260581 DOI: 10.1016/j.ssmph.2020.100587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/09/2020] [Accepted: 04/11/2020] [Indexed: 11/03/2022] Open
Abstract
Muscle weakness, as measured by handgrip strength, is a primary determinant of physical functioning and disability. There is a high burden of muscle weakness in the United States with close to 50 percent of older Americans meeting criteria for clinical muscle weakness. While previous racial/ethnic disparities have been documented among older adults, the extent to which lifecourse trauma shapes muscle strength trajectories is unknown. Using U.S. Health and Retirement Study (N = 20,472, Mean Age = 63.8 years) data on grip strength (2006-2014, up to 3 assessments) and retrospectively reported traumatic events, we fit gender-stratified growth curve models to investigate whether traumatic events experienced across the lifecourse or at distinct sensitive periods (childhood, early/emerging adulthood or mid-life) predicted later-life trajectories of grip strength. There was no association between cumulative trauma and trajectories of grip strength and the main effects for the life stage models were largely null. However, among White women, our results suggest that traumatic events experienced during childhood (β = -0.012; 95% CI = -0.024, 0.0004) compared to middle adulthood are associated with faster declines in grip strength in later life. Traumatic events reported during childhood was related to a slower decline in grip strength over time among Hispanic women compared to that for White women (β = 0.086, 95% CI = 0.044, 0.128). Among Black men, the association between traumatic events during early/emerging adulthood and age-related declines in grip strength was stronger for Black men than for White men (interaction β = -0.070; 95% CI = -0.138, 0.001). Traumatic events experienced during distinct life stages may influence later life declines in grip strength and exacerbate racial inequalities in later life. This study addresses an important gap by investigating the life course social determinants of later life muscle strength, which is a key driver of physical functioning and mobility.
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Affiliation(s)
- Kate A Duchowny
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Margaret T Hicken
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Peggy M Cawthon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.,Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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9
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Wood N, McMunn A, Webb E, Stafford M. Marriage and physical capability at mid to later life in England and the USA. PLoS One 2019; 14:e0209388. [PMID: 30673714 PMCID: PMC6343866 DOI: 10.1371/journal.pone.0209388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Married people have lower rates of mortality and report better physical and mental health at older ages, compared to their unmarried counterparts. However, there is limited evidence on the association between marriage and physical capability, the ability to carry out the tasks of daily living, which is predictive of future mortality and social care use. We investigate the association between marital status and physical capability at mid to later life in England and the United States. METHODS We examine the association between marriage and physical capability at mid to later life in England and the USA using two performance-based measures of physical capability: grip strength and walking speed. Multiple linear regression was carried out on Wave 4 (2008) of the English Longitudinal Study of Ageing (ELSA) and Waves 8 and 9 (2006 and 2008) of the US Health and Retirement Study (HRS). RESULTS In age adjusted models married men and women had better physical capability than their unmarried counterparts. Much of the marriage advantage was explained by the greater wealth of married people. However, remarried men were found to have stronger grip strength and widowed and never married men had a slower walking speed than men in their first marriage, which was not explained by wealth, demographic and socioeconomic characteristics, health behaviours, chronic disease or depressive symptoms. There were no differences in the association between England and the USA. CONCLUSIONS Marriage may be an important factor in maintaining physical capability in both England and the USA, particularly because of the greater wealth which married people have accrued by the time they reach older ages. The grip strength advantage for remarried men may be due to unobserved selective factors into remarriage.
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Affiliation(s)
- Natasha Wood
- CLOSER, UCL Institute of Education, London, United Kingdom
| | - Anne McMunn
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Elizabeth Webb
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Syddall HE, Simmonds SJ, Carter SA, Robinson SM, Dennison EM, Cooper C. The Hertfordshire Cohort Study: an overview. F1000Res 2019; 8:82. [PMID: 30828442 PMCID: PMC6381804 DOI: 10.12688/f1000research.17457.1] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 12/24/2022] Open
Abstract
The Hertfordshire Cohort Study is a nationally unique study of men and women born in the English county of Hertfordshire in the early part of the 20
th century. Records that detail their health in infancy and childhood have been preserved, their sociodemographic, lifestyle, medical and biological attributes have been characterised in later life, and routinely collected data on their hospital use and mortality have been acquired. This paper provides an overview of the study since its inception in the 1980s, including its methods, findings, and plans for its future.
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Affiliation(s)
- Holly E Syddall
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK
| | | | - Sarah A Carter
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK
| | - Sian M Robinson
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, Hampshire, SO16 6YD, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, Hampshire, SO16 6YD, UK.,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, Oxfordshire, OX3 7LD, UK
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11
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Carney C, Benzeval M. Social patterning in grip strength and in its association with age; a cross sectional analysis using the UK Household Longitudinal Study (UKHLS). BMC Public Health 2018; 18:385. [PMID: 29562880 PMCID: PMC5863489 DOI: 10.1186/s12889-018-5316-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Grip strength in early adulthood and midlife is an important predictor of disability, morbidity and mortality in later life. Understanding social patterning in grip strength at different life stages could improve insight into inequalities in age-related decline and when in the life course interventions could prevent the emergence of inequalities. METHODS Using United Kingdom Household Longitudinal Study (UKHLS) data on 19,292 people aged 16 to 99, fractional polynomial models were fitted to identify which function of age best described its association with grip strength. Linear regressions were used to establish whether socio-economic position (SEP), as measured by maternal education, highest educational qualification and income, was associated with grip strength. To test whether the association between age and grip strength was modified by SEP, interactions between SEP and the age terms were added. Differentiation was used to identify the age at which grip strength was highest for men and women and predicted levels of grip strength at peak were compared. RESULTS SEP is significantly associated with grip strength on all SEP measures, except education for men. Grip strength is highest at a younger age, and less strong for all measures of disadvantage for women and most measures for men. Interaction terms were not statistically significant indicating that the association between age and grip strength was not modified by SEP. Grip strength peak was 29.3 kg at age 33 for women with disadvantaged childhood SEP compared with 30.2 kg at age 35 for women with advantaged childhood SEP. CONCLUSION The SEP differences in age and level of peak grip strength could be indicative of decline in muscle strength beginning earlier and from a lower base for disadvantaged groups. This could impact on the capacity for healthy ageing for those with disadvantaged SEP.
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Affiliation(s)
- Caroline Carney
- Department of Health Policy, Cowdray House, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Michaela Benzeval
- Institute for Social and Economic Research (ISER), University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
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12
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Syddall HE, Westbury LD, Shaw SC, Dennison EM, Cooper C, Gale CR. Correlates of Level and Loss of Grip Strength in Later Life: Findings from the English Longitudinal Study of Ageing and the Hertfordshire Cohort Study. Calcif Tissue Int 2018; 102:53-63. [PMID: 29058059 PMCID: PMC5760591 DOI: 10.1007/s00223-017-0337-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/03/2017] [Indexed: 12/17/2022]
Abstract
Characterisation of grip strength (GS) using isometric dynamometry is central to the definition of sarcopenia. Determinants of low GS include: older age, shorter stature, low physical activity, poor nutrition, socioeconomic disadvantage and multimorbidity. Less is known about risk factors for accelerated loss of GS. We investigated determinants of level and 8-year loss of GS in 3703 men and women (aged 52-82 years) in the English Longitudinal Study of Ageing (ELSA). Four hundred and forty-one men and women (aged 59-71 years) who participated in a 10-year follow-up of the Hertfordshire Cohort Study (HCS) were used for replication. Variables were harmonised between cohorts. Change in GS was characterised using mixed-effects models in ELSA and a residual change approach in HCS and analysed for men and women combined. Men in ELSA and HCS had higher average levels of GS at baseline, and accelerated rates of loss, compared with women. In ELSA, older age, shorter stature and multimorbidity were correlated with lower level, and accelerated rate of loss, of GS in both sexes (accelerated loss of 0.04 (95% CI 0.00-0.08) standard deviation scores per additional morbidity after multivariable adjustment). Socioeconomic disadvantage, low level of physical activity and poorer self-reported health were also correlated with low GS level, but not loss rate, after multivariable adjustment. Analysis in HCS yielded similar results. Our results identify multimorbidity as a modifiable determinant of loss of muscle strength in later life, and raise the possibility that developmental influences may impact on rate of involutional decline in muscle strength.
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Affiliation(s)
- H E Syddall
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - L D Westbury
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - S C Shaw
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- Victoria University of Wellington, Wellington, New Zealand
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
| | - C R Gale
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
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13
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Abiri B, Vafa M. Nutrition and sarcopenia: A review of the evidence of nutritional influences. Crit Rev Food Sci Nutr 2017; 59:1456-1466. [DOI: 10.1080/10408398.2017.1412940] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Behnaz Abiri
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Comparison of Prognostic Impact between the Child-Pugh Score and Skeletal Muscle Mass for Patients with Liver Cirrhosis. Nutrients 2017; 9:nu9060595. [PMID: 28604642 PMCID: PMC5490574 DOI: 10.3390/nu9060595] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 06/08/2017] [Accepted: 06/09/2017] [Indexed: 02/06/2023] Open
Abstract
AIMS To investigate the influence of skeletal muscle mass index (SMI) as determined by bioimpedance analysis (BIA) (appendicular skeletal muscle mass/(height)²) on survival by comparing the Child-Pugh score in patients with liver cirrhosis (LC, n = 383, average age = 65.2 years). PATIENTS AND METHODS In terms of comparison of the effects of SMI and other markers on survival, we used time-dependent receiver operating characteristics (ROC) analysis. RESULTS The average SMI for male was 7.4 cm²/m² whereas that for female was 6.0 cm²/m² (p < 0.0001). As for the Child-Pugh score, five points were in the majority, both in males (51.7%, (106/205)) and females (44.9%, (80/178)). For both genders, the survival curve was well stratified according to SMI (p < 0.0001 for males and p = 0.0056 for females). In the multivariate analysis for survival, SMI and Child-Pugh scores were found to be significant both in males and females. In time-dependent ROC analyses, all area under the ROCs (AUROCs) for SMI in each time point were higher than those for Child-Pugh scores in males, while in females AUROCs for Child-Pugh scores at each time point were higher than those for SMI. CONCLUSION SMI using BIA can be helpful for predicting outcomes, at least in male LC patients.
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Chen YY, Wong GHY, Lum TY, Lou VWQ, Ho AHY, Luo H, Tong TLW. Neighborhood support network, perceived proximity to community facilities and depressive symptoms among low socioeconomic status Chinese elders. Aging Ment Health 2016; 20:423-31. [PMID: 25775108 DOI: 10.1080/13607863.2015.1018867] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Depressive symptoms are common in older people; most previous research on elderly depression focused on individual-level characteristics or neighborhood socioeconomic status. Modifiable neighborhood characteristics of older people dwelling in low-income communities are under-studied. This study aims to identify potentially modifiable social and physical neighborhood characteristics that influence depressive symptoms independent of individual-level characteristics among older Chinese. METHOD Data came from a cross-sectional survey conducted in four low-income public rental housing estates in Hong Kong in 2012. We interviewed a total of 400 elderly residents. The structured questionnaire covered demographics, activities of daily living, recent fall history, neighborhood support networks, and perceived proximity by walk to community facilities. Multiple regression was used to test whether inclusion of neighborhood factors in addition to individual characteristics increases model fit in explaining depressive symptoms in elders with low socioeconomic status. RESULTS At individual level, activities of daily living and income significantly predicted depressive symptoms. Receiving support from friends or neighbors is associated with fewer depressive symptoms. However, participants who received organizational support had a 1.17 points of increase on the 15-item Geriatric Depression Scale (GDS-15). At-ease walkable proximity to medical facilities was positively associated with a better GDS score. CONCLUSION Neighborhood support networks and perceived proximity by walk to community facilities contribute significantly to depressive symptoms among low-income elders. Programs and policies that facilitate neighborhood support and commuting or promote facility accessibility may help ameliorate depressive symptoms common among low-income elders.
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Affiliation(s)
- Yan-Yan Chen
- a Department of Social Work , Fudan University , Shanghai , China.,b Sau Po Center on Ageing , The University of Hong Kong , Hong Kong , China
| | - Gloria H Y Wong
- b Sau Po Center on Ageing , The University of Hong Kong , Hong Kong , China
| | - Terry Y Lum
- b Sau Po Center on Ageing , The University of Hong Kong , Hong Kong , China.,c Department of Social Work and Social Administration, Sau Po Center on Ageing , The University of Hong Kong , Hong Kong , China
| | - Vivian W Q Lou
- c Department of Social Work and Social Administration, Sau Po Center on Ageing , The University of Hong Kong , Hong Kong , China
| | - Andy H Y Ho
- d Division of Psychology, School of Humanities and Social Sciences , Nanyang Technological University , Singapore
| | - Hao Luo
- b Sau Po Center on Ageing , The University of Hong Kong , Hong Kong , China
| | - Tracy L W Tong
- b Sau Po Center on Ageing , The University of Hong Kong , Hong Kong , China
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Kappus MR, Mendoza MS, Nguyen D, Medici V, McClave SA. Sarcopenia in Patients with Chronic Liver Disease: Can It Be Altered by Diet and Exercise? Curr Gastroenterol Rep 2016; 18:43. [PMID: 27372291 DOI: 10.1007/s11894-016-0516-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Sarcopenia, a loss of muscle mass, is being increasingly recognized to have a deleterious effect on outcomes in patients with chronic liver disease. Factors related to diet and the inflammatory nature of chronic liver disease contribute to the occurrence of sarcopenia in these patients. Sarcopenia adversely influences quality of life, performance, morbidity, success of transplantation, and even mortality. Specific deficiencies in macronutrients (protein, polyunsaturated fatty acids) and micronutrients (vitamins C, D, and E, carotenoids, and selenium) have been linked to sarcopenia. Lessons learned from nutritional therapy in geriatric patient populations may provide strategies to manage sarcopenia in patients with liver disease. Combining diet modification and nutrient supplementation with an organized program of exercise may help ameliorate or even reverse the effects of sarcopenia on an already complex disease process.
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Affiliation(s)
- Matthew R Kappus
- Department of Medicine, Duke University Medical Center, DUMS 03142, Orange Zone, Durham, NC, 27710, USA.
| | | | - Douglas Nguyen
- Department of Medicine, College of Medicine, University of California-Irvine, Irvine, CA, USA
| | - Valentina Medici
- Department of Medicine, University of California-Davis, Davis, CA, USA
| | - Stephen A McClave
- Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, USA
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Walker-Bone K, D'Angelo S, Syddall HE, Palmer KT, Cooper C, Coggon D, Sayer AA. Heavy manual work throughout the working lifetime and muscle strength among men at retirement age. Occup Environ Med 2016; 73:284-6. [PMID: 26896253 PMCID: PMC4817232 DOI: 10.1136/oemed-2015-103293] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 02/05/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Reductions in heavy manual work as a consequence of mechanisation might adversely impact muscle strength at older ages. We investigated the association between grip strength at retirement age and lifetime occupational exposure to physically demanding activities. Grip strength is an important predictor of long-term health and physical function in older people. METHODS Grip strength (maximum of three readings in each hand) was measured in men from the Hertfordshire Cohort Study at a single examination when their mean age was 65.8 (SD 2.9) years. Associations with lifetime occupational exposure (ascertained by questionnaire) to three activities (standing/walking ≥ 4 h/day; lifting ≥ 25 kg; and energetic work sufficient to induce sweating) were assessed by multivariable linear regression with adjustment for various potential confounders. RESULTS Complete data were available from 1418 men who had worked for at least 20 years. After adjustment for age, height and weight, those with longer exposures to walking/standing and heavy lifting had lower grip strength, but the relationship disappeared after further adjustment for confounders. Working at physical intensity sufficient to induce sweating was not significantly associated with grip strength. CONCLUSIONS We found no evidence that physically demanding occupational activities increase hand grip strength at normal retirement age. Any advantages of regular physical occupational activity may have been obscured by unmeasured socioeconomic confounders.
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Affiliation(s)
- K Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - H E Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K T Palmer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Southampton, UK
| | - D Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - A A Sayer
- 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 Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK NIHR Collaboration for Leadership in Applied Health Research and Care, Wessex, UK Newcastle University Institute for Ageing and Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
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18
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Hansen ÅM, Andersen LL, Mendes de Leon CF, Bruunsgaard H, Lund R. School education, physical performance in late midlife and allostatic load: a retrospective cohort study. J Epidemiol Community Health 2016; 70:748-54. [DOI: 10.1136/jech-2015-205664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 12/22/2015] [Indexed: 11/04/2022]
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Hoffman GJ, Rodriguez HP. Examining Contextual Influences on Fall-Related Injuries Among Older Adults for Population Health Management. Popul Health Manag 2015; 18:437-48. [PMID: 25919228 PMCID: PMC4688459 DOI: 10.1089/pop.2014.0156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objectives were to assess the associations between fall-related injuries (FRIs) treated in the emergency department (ED) among older adults in California and contextual county-level physical, social, and economic characteristics, and to assess how county-level economic conditions are associated with FRIs when controlling for other county-level factors. Data from 2008 California ED discharge, Medicare Impact File, and County Health Rankings were used. Random effects logistic regression models estimated contextual associations between county-level factors representing economic conditions, the built environment, community safety, access to care, and obesity with patient-level FRI treatment among 1,712,409 older adults, controlling for patient-level and hospital-level characteristics. Patient-level predictors of FRI treatment were consistent with previous studies not accounting for contextual associations. Larger and rural hospitals had higher odds of FRI treatment, while teaching and safety net hospitals had lower odds. Better county economic conditions were associated with greater odds (ß=0.73, P=0.001) and higher county-level obesity were associated with lower odds (ß=-0.37, P=0.004), but safer built environments (ß=-0.31, P=0.38) were not associated with FRI treatment. The magnitude of association between county-level economic conditions and FRI treatment attenuated with the inclusion of county-level obesity rates. FRI treatment was most strongly and consistently related to more favorable county economic conditions, suggesting differences in treatment or preferences for treatment for FRIs among older individuals in communities of varying resource levels. Using population health data on FRIs, policy makers may be able to remove barriers unique to local contexts when implementing falls prevention educational programs and built environment modifications.
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Affiliation(s)
- Geoffrey J. Hoffman
- Department of Health Policy and Management, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California
| | - Hector P. Rodriguez
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, California
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20
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Keevil VL, Wijndaele K, Luben R, Sayer AA, Wareham NJ, Khaw KT. Television viewing, walking speed, and grip strength in a prospective cohort study. Med Sci Sports Exerc 2015; 47:735-42. [PMID: 25785826 PMCID: PMC5642351 DOI: 10.1249/mss.0000000000000453] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Television (TV) watching is the most prevalent sedentary leisure time activity in the United Kingdom. We examined associations between TV viewing time, measured over 10 yr, and two objective measures of physical capability, usual walking speed (UWS) and grip strength. METHODS Community-based participants (n = 8623; 48-92 yr old) enrolled in the European Prospective Investigation of Cancer-Norfolk study attended a third health examination (3HC, 2006-2011) for measurement of maximum grip strength (Smedley dynamometer) and UWS. TV viewing time was estimated using a validated questionnaire (n = 6086) administered during two periods (3HC, 2006-2007; 2HC, 1998-2000). Associations between physical capability and TV viewing time category (<2, 2 < 3, 3 < 4, and ≥4 h·d) at the 3HC, 2HC, and using an average of the two measures were explored. Sex-stratified analyses were adjusted for age, physical activity, anthropometry, wealth, comorbidity, smoking, and alcohol intake and combined if no sex-TV viewing time interactions were identified. RESULTS Men and women who watched the least TV at the 2HC or 3HC walked at a faster usual pace than those who watched the most TV. There was no evidence of effect modification by sex (Pinteraction = 0.09), and in combined analyses, participants who watched for <2 h·d on average walked 4.29 cm·s (95% confidence interval, 2.56-6.03) faster than those who watched for ≥4 h·d, with evidence of a dose-response association (Ptrend < 0.001). However, no strong associations with grip strength were found. CONCLUSIONS TV viewing time predicted UWS in older adults. More research is needed to inform public health policy and prospective associations between other measures of sedentariness, such as total sitting time or objectively measured sedentary time, and physical capability should be explored.
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Affiliation(s)
- Victoria L Keevil
- 1Strangeways Research Laboratory, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UNITED KINGDOM; 2Medical Research Council Epidemiology Unit, Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge, UNITED KINGDOM; and 3Academic Geriatric Medicine, Medical Research Council Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton, Southampton, UNITED KINGDOM
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Oksuzyan A, Shkolnikova M, Vaupel JW, Christensen K, Shkolnikov VM. Sex Differences in Biological Markers of Health in the Study of Stress, Aging and Health in Russia. PLoS One 2015; 10:e0131691. [PMID: 26121035 PMCID: PMC4484801 DOI: 10.1371/journal.pone.0131691] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 06/05/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The apparent contradiction that women live longer but have worse health than men, the so called male-female health-survival paradox, is very pronounced in Russia. The present study investigates whether men in Moscow are healthier than women at the level of biomarkers, and whether the associations between biomarkers and subjective health have sex-specific patterns. MATERIALS Previously collected data in the study of Stress, Aging, and Health in Russia (SAHR, n = 1800) were used to examine sex differences in biomarkers and their associations with physical functioning and self-rated health. RESULTS The present study found mixed directions and magnitudes for sex differences in biomarkers. Women were significantly disadvantaged with regard to obesity and waist circumference, whereas men had a tendency toward higher prevalence of electrocardiographic abnormalities. No sex differences were indicated in the prevalence of immunological biomarkers, and mixed patterns were found for lipid profiles. Many biomarkers were associated with physical functioning and general health. Obesity and waist circumference were related to lower physical functioning among females only, while major Q-wave abnormalities with high probabilities of myocardial infarction and atrial fibrillation or atrial flutter were associated with physical functioning and self-rated health among males only. CONCLUSION No clear patterns of sex differences in prevalence of high-risk levels of biomarkers suggest that the male-female health-survival paradox is weaker at the level of health biomarkers. We found some evidence that certain biomarkers reflecting pathophysiological changes in the organism that do not possess acute health risks, but over many years may lead to physical disability, are associated with physical functioning and self-rated health in women, whereas others reflecting more serious life-threatening pathophysiological changes are associated with physical functioning and self-rated health in men.
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Affiliation(s)
- Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Maria Shkolnikova
- Scientific and Clinical Institute of Pediatry at the Pirogov Moscow Medical University, Moscow, Russian Federation
| | - James W. Vaupel
- Max Planck Institute for Demographic Research, Rostock, Germany
- Max-Planck Odense Center on the Biodemography of Aging, Odense, Denmark
| | - Kaare Christensen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- Max-Planck Odense Center on the Biodemography of Aging, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Vladimir M. Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, Germany
- New Economic School, Moscow, Russian Federation
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22
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Botoseneanu A, Bennett JM, Nyquist L, Shinkai S, Fujiwara Y, Yoshida H, Aiello A, Cigolle CT, Liang J. Cardiometabolic Risk, Socio-Psychological Factors, and Trajectory of Grip Strength Among Older Japanese Adults. J Aging Health 2015; 27:1123-46. [PMID: 25903979 DOI: 10.1177/0898264315577587] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To examine the association between cardiometabolic risk (percent body fat [BF%], triglycerides [TG], high-density lipoprotein [HDL]-cholesterol, hemoglobin A1c [HbA1c]), socio-psychological factors (education and self-rated health [SRH]), and trajectories of grip strength (GS) in older adults. METHOD Longitudinal 8-year data from 1,381 Japanese adults aged 65 years or above were analyzed using hierarchical linear models, stratified according to gender. RESULTS GS declined following a linear trajectory. In both genders, higher BF% was associated with weaker GS, but not with the rate of decline. GS trajectory did not correlate with baseline TG, HDL-C, or HbA1c. Cardiometabolic factors mediated educational differences in GS intercept in both genders. In women, better SRH predicted stronger GS. The effect of SRH was robust to adjustments for cardiometabolic risk. DISCUSSION In older adults, GS and its rate of decline are selectively associated with both cardiometabolic risk and socio-psychological characteristics. Cardiometabolic risk mediates educational disparities in GS but not differences in subjective assessments of health.
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Affiliation(s)
- Anda Botoseneanu
- Yale University, New Haven, CT, USA University of Michigan-Dearborn, USA
| | | | | | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Hiroto Yoshida
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | | | - Jersey Liang
- University of Michigan-Dearborn, USA University of Michigan, Ann Arbor, USA
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23
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Lum TYS, Lou VWQ, Chen Y, Wong GHY, Luo H, Tong TLW. Neighborhood Support and Aging-in-Place Preference Among Low-Income Elderly Chinese City-Dwellers. J Gerontol B Psychol Sci Soc Sci 2014; 71:98-105. [PMID: 25384636 DOI: 10.1093/geronb/gbu154] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 09/24/2014] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Preferences for aging-in-place are unclear among low-income elderly Chinese city-dwellers, who are more likely to be geographically bound, to have little care support, but possess strong filial values and family cohesiveness. This study investigated the preferences for aging-in-place and its contributing neighborhood factors among low-income Chinese elderly in a metropolitan city. METHOD We conducted interviews with 400 older people residing in public housing estates in Hong Kong. RESULTS The majority of low-income elderly persons (80.4%) prefer to age in place even if their health and functioning has deteriorated beyond independent living. Logistic regression showed that (a) having very low income (<HK$2,000/month) and not receiving means-tested welfare predicted lower preference for this option [odd ratios (OR) = 0.27]; and (b) having medical facilities within reach (OR =9.02); and (c) an elderly center in the area (OR = 2.98) were associated with a preference for aging in place, after controlling for demographic, and functioning characteristics. DISCUSSION Low-income elderly Chinese city-dwellers prefer to age in place, given appropriate neighborhood support. These findings can be interpreted in light of Lawton's ecological theory of aging and suggest a service model similar to the Naturally Occurring Retirement Community with Supportive Service Programs.
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Affiliation(s)
- Terry Y S Lum
- Department of Social Work and Social Administration and Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, Hong Kong.
| | - Vivian W Q Lou
- Department of Social Work and Social Administration and Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, Hong Kong
| | - Yanyan Chen
- Department of Social Work, Fudan University, Shanghai, China
| | - Gloria H Y Wong
- Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, Hong Kong
| | - Hao Luo
- Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, Hong Kong
| | - Tracy L W Tong
- Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, Hong Kong
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Abstract
Sarcopenia, the loss of muscle mass and function with age, is highly relevant to clinical practice as it has been associated with a wide range of ageing outcomes including disability and shorter survival times. As such it is now a major focus for research and drug discovery. There has been recent progress in the development of consensus definitions for the diagnosis of sarcopenia, taking the form of measurements of muscle mass and strength or physical performance. These definitions form potential inclusion criteria for use in trials, although the optimum choice of outcome measures is less clear. Prevalence estimates using these new definitions vary, although they suggest that sarcopenia is a common (approximately 13% from one study) clinical problem in older people. A range of lifestyle factors have been investigated in regard to the development of this condition, and progressive resistance training is the most well-established intervention so far. There is also marked research interest in the role of diet, although so far the value of supplementation is less clear. Other potential treatments for sarcopenia include the angiotensin-converting enzyme inhibitors, with some evidence that they can improve physical performance in older people. Future research directions include an increased understanding of the molecular and cellular mechanisms of sarcopenia and the use of a life course approach to explore the possibility of earlier intervention and prevention.
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Affiliation(s)
- Richard Dodds
- University of Southampton, UK; University of Southampton, UK
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Lee KH, GlenMaye LF. Stressors, coping resources, functioning, and role limitations among older korean immigrants: gender differences. J Women Aging 2014; 26:66-83. [PMID: 24483283 DOI: 10.1080/08952841.2014.858578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study explored the differential impacts of stressors and coping resources on the functioning and roles of 246 older Korean immigrant men and women. Older Korean immigrant women were significantly more likely than men to have acculturation and socioeconomic stressors, physical/social functioning problems, and role limitations. English-language barriers and lack of transportation were significantly related to lower functioning and higher role limitations of older Korean women compared to those of older men. Providing social and health care services with bilingual and transportation services to older Korean immigrant women is recommended to increase their physical/social functioning and role performance.
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Affiliation(s)
- Kyoung Hag Lee
- a School of Social Work , Wichita State University , Wichita , KS
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Carmeli E, Imam B, Levi R, Merrick J. Hand Grip Strength is Associated With Body Sway Rate Among Older Adults With Intellectual Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2013. [DOI: 10.1111/jppi.12055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Eli Carmeli
- Neve Ram Residential Care Center; Rechasim Israel
- Department of Physical Therapy; Faculty of Social Welfare and Health Sciences; Haifa University; Mt Carmel Israel
| | - Bita Imam
- Department of Occupational Science and Occupational Therapy; University of British Columbia; Vancouver BC Canada
| | - Ran Levi
- Neve Ram Residential Care Center; Rechasim Israel
| | - Joav Merrick
- National Institute of Child Health and Human Development; Ministry of Social Affairs and Social Services; Jerusalem Israel
- Division of Pediatrics; Hadassah Hebrew University Medical Center; Jerusalem Israel
- Kentucky Children's Hospital; University of Kentucky; Lexington KY USA
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Keevil VL, Hayat S, Dalzell N, Moore S, Bhaniani A, Luben R, Wareham NJ, Khaw KT. The physical capability of community-based men and women from a British cohort: the European Prospective Investigation into Cancer (EPIC)-Norfolk study. BMC Geriatr 2013; 13:93. [PMID: 24020915 PMCID: PMC3846689 DOI: 10.1186/1471-2318-13-93] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 09/02/2013] [Indexed: 11/20/2022] Open
Abstract
Background The European Working Group for Sarcopenia in Older People (EWGSOP) published a case-finding algorithm for sarcopenia, recommending muscle mass measurement in older adults with low grip strength (women <20 kg; men <30 kg) or slow walking speed (≤0.8 m/s). However, the implications of adopting this algorithm into clinical practice are unclear. Therefore, we aimed to explore the physical capability of men and women from a British population-based cohort study. Methods In the European Prospective Investigation into Cancer-Norfolk study, 8,623 community-based adults (48-92 years old) underwent assessment of grip strength, walking speed, timed chair stands and standing balance. The proportion of older men and women (≥65 years) fulfilling EWGSOP criteria for muscle mass measurement was estimated. Additionally, cross-sectional associations of physical capability with age and sex were explored using linear and logistic regression. Results Approximately 1 in 4 older participants (28.8%) fulfilled criteria for muscle mass measurement with a greater proportion of women than men falling below threshold criteria (33.6% versus 23.6%). Even after adjustment for anthropometry, women were 12.4 kg (95% Confidence Interval [CI] 12.0, 12.7) weaker, took 12.0% (95% CI 10.0, 14.0) longer to perform five chair stands and were 1.82 (95% CI 1.48, 2.23) times more likely to be unable to hold a tandem stand for 10 seconds than men, although usual walking speed was similar. Physical capability was inversely associated with age and per year, walking speed decreased by 0.01 m/s (95% CI 0.01, 0.01) and grip strength decreased by 0.49 kg (men; 95% CI 0.46, 0.51) and 0.25 kg (women; 95% CI 0.23, 0.27). Despite this, there was still variation within age-groups and not all older people had low physical capability. Conclusions Every effort to optimise functional health in later life should be made since poor function is not inevitable. However, if the EWGSOP sarcopenia case-finding algorithm is endorsed, large proportions of older people could qualify for muscle mass measurement which is not commonly available. Considering population ageing, further discussion is needed over the utility of muscle mass measurement in clinical practice.
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Affiliation(s)
- Victoria L Keevil
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge CB1 8RN, UK.
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Valkeinen H, Harald K, Borodulin K, Mäkinen TE, Heliövaara M, Leino-Arjas P, Sainio P, Kestilä L, Kunst A, Rahkonen O, Tammelin T, Härkänen T, Prättälä R. Educational differences in estimated and measured physical fitness. Eur J Public Health 2013; 23:998-1002. [PMID: 23729485 DOI: 10.1093/eurpub/ckt049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Available information about the association between education and physical fitness (PF) is scarce. The purpose of this study was to examine educational differences in PF in the working age population using different methods to assess PF. METHODS The Health 2000 Survey was carried out for adults aged ≥ 30 years (n = 8028) in Finland. For this study, 30-54-year-old men and women with data on PF and physical activity (PA) were selected (n = 3724). PF was assessed by self-estimated overall physical fitness and running ability, a physician's estimation of a participant's working capacity, the trunk extensors' endurance and hand grip strength tests. The highest educational qualification taken by the participant was used as a measure of education. The analyses were adjusted for age, PA, BMI, smoking and chronic diseases. RESULTS PF was best in the high-educated men and women. The educational differences were minor in self-estimated overall PF. Adjusting for the covariates, the differences in self-estimated running ability and working capacity decreased. The educational differences in the trunk extensors' endurance test were independent of covariates. PA and other health behaviours contributed most to the differences. CONCLUSION People with high education had better PF irrespective of the method used to assess PF. A large amount of the educational differences could be explained by PA and other health behaviours. More research is needed to understand the determinants of educational differences in PF.
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Affiliation(s)
- Heli Valkeinen
- 1 Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare (THL), Helsinki, Finland
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Do YK, Kim CS. Home ownership and fall-related outcomes among older adults in South Korea. Geriatr Gerontol Int 2012; 13:867-73. [PMID: 23253045 DOI: 10.1111/ggi.12015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2012] [Indexed: 11/27/2022]
Abstract
AIM Many of the previously identified environmental risk factors for fall-related outcomes (e.g. flooring, stairs and steps, kitchen, and bathrooms) are amenable to change, but the extent of the changes on these home-related risk factors are conditional on home ownership of the elderly. This study aims to test whether lack of home ownership is associated with a higher risk of falls, and a higher likelihood of reporting fear of falling and activity limitations due to fear of falling among older adults in South Korea. METHODS Using data from the first two waves (2006 and 2008) of the Korean Longitudinal Study of Aging, the associations between home ownership variables and three fall-related outcomes were examined in two regression models. A logistic regression model of any falls in the past 2 years was estimated to examine whether older adults living in short-term rental homes based on monthly rent have an increased risk of falls. A probit model accounting for sample selection was estimated to examine whether the two related outcomes, fear of falling and limiting activities due to fear of falling, are associated with home ownership status. RESULTS Compared with owned home, short-term rental home predicted a higher likelihood of incident of falls and activity limitation due to fear of falling. CONCLUSIONS The study findings suggest that the lack of home ownership with unstable housing tenure is an important risk factor for fall-related outcomes among older adults in South Korea.
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Affiliation(s)
- Young Kyung Do
- Program in Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore, Singapore
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Sandercock GRH, Cohen DD, Griffin M. Evaluation of a multicomponent intervention to improve weight status and fitness in children: Upstarts. Pediatr Int 2012; 54:911-7. [PMID: 22882182 DOI: 10.1111/j.1442-200x.2012.03710.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 05/22/2012] [Accepted: 07/11/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many physical activity intervention programs are unable to sustain long-term improvements in activity levels and are often not cost-effective. The aim of this study was to determine if a low-cost school- and community-centered sports coaching program was able to improve health-related fitness in children. METHODS Children from three schools in socially deprived areas took part in weekly coaching sessions over two 10 week periods during the school year. Coaching was provided by local community-based sports clubs. Body mass index (BMI), jump height, handgrip strength, and 20 m shuttle run test (20mSRT) performance were assessed before and after each of the two intervention periods, to determine short- and long-term changes in health-related fitness. Age- and sex-normalized z-scores were calculated using normative UK reference data for each measure. RESULTS BMI z-score did not change in the short term, as expected, but importantly was significantly lower at the end of the study. Both handgrip and 20mSRT performance scores increased after the first 10 week period. Only improvements in handgrip were maintained for the whole study period. Jump height actually decreased over the entire study period. CONCLUSION There were some notable benefits of this novel, cost-effective, naturalistic intervention but future studies should examine seasonal variation and motivational factors as potential confounding variables.
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Diderichsen F, Andersen I, Manuel C, Andersen AMN, Bach E, Baadsgaard M, Brønnum-Hansen H, Hansen FK, Jeune B, Jørgensen T, Søgaard J. Health Inequality - determinants and policies. Scand J Public Health 2012; 40:12-105. [DOI: 10.1177/1403494812457734] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Finn Diderichsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ingelise Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Celie Manuel
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Elsa Bach
- The National Research Centre for the Working Environment
| | | | | | | | | | | | - Jes Søgaard
- The Danish Institute for Health Services Research
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Physical capability and the advantages and disadvantages of ageing: perceptions of older age by men and women in two British cohorts. AGEING & SOCIETY 2012. [DOI: 10.1017/s0144686x12001067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTIn an increasingly ageing society, its older members are receiving considerable political and policy attention. However, much remains to be learnt about public perceptions of older age, particularly the views and experiences of older individuals themselves. Drawing on qualitative interviews carried out with members of two British cohorts (N = 60) who have reached the ‘third age’, this paper discusses perceptions of age, focusing particularly on how perceived advantages and disadvantages differ by respondents' self-reported physical capability. The interviews were carried out in 2010 as part of the HALCyon (Healthy Ageing across the Life Course) collaborative research programme. Findings suggest there is some difference in the way older people view aspects of ageing by capability and that although advantages are widely perceived, physical decline and associated health concerns were the overwhelming theme across the conversations. The article concludes by making tentative suggestions to inform the positive ageing agenda and its related policies.
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Robinson S, Cooper C, Aihie Sayer A. Nutrition and sarcopenia: a review of the evidence and implications for preventive strategies. J Aging Res 2012; 2012:510801. [PMID: 22506112 PMCID: PMC3312288 DOI: 10.1155/2012/510801] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 01/09/2012] [Indexed: 01/16/2023] Open
Abstract
Prevention of age-related losses in muscle mass and strength is key to protecting physical capability in older age and enabling independent living. To develop preventive strategies, a better understanding is needed of the lifestyle factors that influence sarcopenia and the mechanisms involved. Existing evidence indicates the potential importance of diets of adequate quality, to ensure sufficient intakes of protein, vitamin D, and antioxidant nutrients. Although much of this evidence is observational, the prevalence of low nutrient intakes and poor status among older adults make this a current concern. However, as muscle mass and strength in later life are a reflection of both the rate of muscle loss and the peak attained in early life, efforts to prevent sarcopenia also need to consider diet across the lifecourse and the potential effectiveness of early interventions. Optimising diet and nutrition throughout life may be key to preventing sarcopenia and promoting physical capability in older age.
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Affiliation(s)
- Siân Robinson
- MRC Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
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Goins RT, Pignataro RM, Dong L, Rogers JC. Handgrip strength among older American Indians: the Native Elder Care Study. Age Ageing 2011; 40:523-7. [PMID: 21551459 DOI: 10.1093/ageing/afr042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Lifelong socioeconomic position and physical performance in midlife: results from the British 1946 birth cohort. Eur J Epidemiol 2011; 26:475-83. [PMID: 21416275 PMCID: PMC3246593 DOI: 10.1007/s10654-011-9562-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 03/04/2011] [Indexed: 12/20/2022]
Abstract
Socioeconomic position (SEP) across life is found to be related to adult physical performance, but the underlying pathways are not well characterized. Using a British birth cohort (N = 2956), the associations of SEP from childhood into midlife with objective physical performance measures in midlife were examined, adjusting for possible confounders or mediators, including indicators of muscle development and central nervous system function. Childhood and adulthood SEP were positively related to standing balance and chair rise performance, but not to grip strength after basic adjustments. When both father’s occupation and mother’s education were included in the same model, having a mother with low education was associated with 0.6 standard deviations (SD) (95% confidence interval (CI: 0.3, 0.8)) poorer standing balance time compared with having a mother with the highest educational level, and having a father in the lowest occupational group was associated with a 0.3 SD (95% CI: 0.1, 0.6) lower chair rise score compared with having a father in the highest occupational group. These associations were maintained, albeit attenuated, after adjustment. In contrast, the associations of own education and adult occupation with physical performance were generally not maintained after adjustment. SEP across life impacts on midlife physical performance, and thereby the ageing process.
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Birnie K, Cooper R, Martin RM, Kuh D, Sayer AA, Alvarado BE, Bayer A, Christensen K, Cho SI, Cooper C, Corley J, Craig L, Deary IJ, Demakakos P, Ebrahim S, Gallacher J, Gow AJ, Gunnell D, Haas S, Hemmingsson T, Inskip H, Jang SN, Noronha K, Osler M, Palloni A, Rasmussen F, Santos-Eggimann B, Spagnoli J, Starr J, Steptoe A, Syddall H, Tynelius P, Weir D, Whalley LJ, Zunzunegui MV, Ben-Shlomo Y, Hardy R. Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis. PLoS One 2011; 6:e15564. [PMID: 21297868 PMCID: PMC3027621 DOI: 10.1371/journal.pone.0015564] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 11/12/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood. METHODS AND FINDINGS Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations. CONCLUSIONS Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.
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Affiliation(s)
- Kate Birnie
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Rachel Cooper
- Medical Research Council Unit for Lifelong Health and Ageing and Division of Population Health, University College London, London, United Kingdom
| | - Richard M. Martin
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing and Division of Population Health, University College London, London, United Kingdom
| | - Avan Aihie Sayer
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Beatriz E. Alvarado
- Department of Community Health and Epidemiology, Queen's University, Kingston, Canada
| | - Antony Bayer
- Department of Primary Care and Public Health, Centre for Health Sciences Research, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Kaare Christensen
- The Danish Twin Registry and The Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sung-il Cho
- Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- National Institute for Health and Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, United Kingdom
| | - Janie Corley
- Department of Psychology and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - Leone Craig
- Institute of Applied Health Sciences and Rowett Institute of Nutrition and Health, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
| | - Ian J. Deary
- Department of Psychology and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - Panayotes Demakakos
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Shah Ebrahim
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - John Gallacher
- Department of Primary Care and Public Health, Centre for Health Sciences Research, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Alan J. Gow
- Department of Psychology and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - David Gunnell
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Steven Haas
- School of Social and Family Dynamics, Arizona State University, Tempe, Arizona, United States of America
| | - Tomas Hemmingsson
- Division of Occupational and Environmental Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Hazel Inskip
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Soong-nang Jang
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Kenya Noronha
- Economics Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Merete Osler
- Research Center for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
| | - Alberto Palloni
- Center for Demography and Ecology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Finn Rasmussen
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Brigitte Santos-Eggimann
- Institute of Social and Preventive Medicine, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Jacques Spagnoli
- Institute of Social and Preventive Medicine, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - John Starr
- Department of Geriatric Medicine and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Holly Syddall
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Per Tynelius
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - David Weir
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Lawrence J. Whalley
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | | | - Yoav Ben-Shlomo
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Rebecca Hardy
- Medical Research Council Unit for Lifelong Health and Ageing and Division of Population Health, University College London, London, United Kingdom
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