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Ai F, Li E, Ji Q, Zhang H. Construction of a machine learning-based risk prediction model for depression in middle-aged and elderly hypertensive people in China: a longitudinal study. Front Psychiatry 2024; 15:1398596. [PMID: 38764471 PMCID: PMC11099225 DOI: 10.3389/fpsyt.2024.1398596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024] Open
Abstract
Background Hypertension is a common chronic disease that can trigger symptoms such as anxiety and depression. Therefore, it is essential to predict their risk of depression. The aim of this study is to find the best prediction model and provide effective intervention strategies for health professionals. Methods The study subjects were 2733 middle-aged and older adults who participated in the China Health and Retirement Longitudinal Study (CHARLS) between 2018 and 2020. R software was used for Lasso regression analysis to screen the best predictor variables, and logistic regression, random forest and XGBoost models were constructed. Finally, the prediction efficiency of the three models was compared. Results In this study, 18 variables were included, and LASSO regression screened out 10 variables that were important for the establishment of the model. Among the three models, Logistic Regression model showed the best performance in various evaluation indicators. Conclusion The prediction model based on machine learning can accurately assess the likelihood of depression in middle-aged and elderly patients with hypertension in the next three years. And by combining Logistic regression and nomograms, we were able to provide a clear interpretation of personalized risk predictions.
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Affiliation(s)
| | | | | | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
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2
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Yang Y, Sun Q, Ma S, Li X, Lang X, Zhang Q. Association of serum creatinine to cystatin C to waist circumference ratios and hypertension: evidence from China health and retirement longitudinal study. Front Endocrinol (Lausanne) 2024; 15:1375232. [PMID: 38752178 PMCID: PMC11094208 DOI: 10.3389/fendo.2024.1375232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Background The objective of this study was to explore the association between the ratio of serum creatinine to cystatin C to waist circumference (CCR/WC) and hypertension. Methods The study utilized data extracted from the China Health and Retirement Longitudinal Study. In the cross-sectional analysis, logistic regression analyses were employed to examine the association between the CCR/WC ratio and hypertension. By utilizing restricted cubic splines, potential non-linear associations between the CCR/WC ratio and hypertension were explored. In the longitudinal analysis, the association between CCR/WC quartiles (Q1-Q4) and the risk of new-onset hypertension was evaluated by Cox proportional-hazards models. Results In total, 7,253 participants were enrolled. The study unveiled an inverse association with hypertension, demonstrating an odds ratio (OR) of 0.29 (95% confidence interval [CI]: 0.23-0.37, P < 0.001). Among males, an OR of 0.38 (95% CI: 0.25-0.58, P < 0.001) was observed, while among females, an OR of 0.41 (95% CI: 0.28-0.60, P < 0.001) was noted. There was an absence of a nonlinear association between the CCR/WC ratio and hypertension. Cox regression analysis unveiled a reduced risk of hypertension in Q3 (Hazard ratios [HR]: 0.69, 95% CI: 0.58-0.82, P < 0.001) and Q4: (HR: 0.70, 95% CI: 0.59-0.83, P < 0.001) in compared to the Q1 of the CCR/WC ratio, and sex-specific analysis yielded consistent results. Conclusion This study emphasizes the potential association between an elevated CCR/WC ratio and a reduced risk of hypertension.
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Affiliation(s)
- Yang Yang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qi Sun
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Shuang Ma
- Nursing Department, The Fourth Affiliated Hospital of China Medical University, Shengyang, China
| | - Xiaodan Li
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Xinmiao Lang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qi Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Zhang L, Wei L, Fang Y. Spatial-temporal distribution patterns and influencing factors analysis of comorbidity prevalence of chronic diseases among middle-aged and elderly people in China: focusing on exposure to ambient fine particulate matter (PM 2.5). BMC Public Health 2024; 24:550. [PMID: 38383335 PMCID: PMC10882846 DOI: 10.1186/s12889-024-17986-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/04/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE This study describes regional differences and dynamic changes in the prevalence of comorbidities among middle-aged and elderly people with chronic diseases (PCMC) in China from 2011-2018, and explores distribution patterns and the relationship between PM2.5 and PCMC, aiming to provide data support for regional prevention and control measures for chronic disease comorbidities in China. METHODS This study utilized CHARLS follow-up data for ≥ 45-year-old individuals from 2011, 2013, 2015, and 2018 as research subjects. Missing values were filled using the random forest machine learning method. PCMC spatial clustering investigated using spatial autocorrelation methods. The relationship between macro factors and PCMC was examined using Geographically and Temporally Weighted Regression, Ordinary Linear Regression, and Geographically Weighted Regression. RESULTS PCMC in China showing a decreasing trend. Hotspots of PCMC appeared mainly in western and northern provinces, while cold spots were in southeastern coastal provinces. PM2.5 content was a risk factor for PCMC, the range of influence expanded from the southeastern coastal areas to inland areas, and the magnitude of influence decreased from the southeastern coastal areas to inland areas. CONCLUSION PM2.5 content, as a risk factor, should be given special attention, taking into account regional factors. In the future, policy-makers should develop stricter air pollution control policies based on different regional economic, demographic, and geographic factors, while promoting public education, increasing public transportation, and urban green coverage.
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Affiliation(s)
- Liangwen Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Linjiang Wei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China.
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Liu M, Yang J, Wang C, Yang S, Wang J, Hou C, Wang S, Li X, Li F, Yang H, Li H, Liu S, Chen S, Hu S, Li X, Li Z, Li R, Li H, Bao Y, Shi Y, Tang Z, Fang X, He Y. Cohort profile: Beijing Healthy Aging Cohort Study (BHACS). Eur J Epidemiol 2024; 39:101-110. [PMID: 38177569 DOI: 10.1007/s10654-023-01050-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/08/2023] [Indexed: 01/06/2024]
Abstract
The Beijing Healthy Aging Cohort Study (BHACS) was established to supplement the limited data of a large representative cohort of older people based on the general population and was designed to evaluate the prevalence, incidence, and natural history of cognitive decline, functional disability, and conventional vascular risk factors. The aim was to determine the evolution of these conditions by estimating the rates and determinants of progression and regression to adverse outcomes, including dementia, cardiovascular events, cancer, and all-cause death. It can therefore provide evidence to help policy makers develop better policies to promote healthy aging in China. BHACS consisted of three cohorts (BLSA, CCHS-Beijing, and BECHCS) in Beijing with a total population of 11 235 (6281 in urban and 4954 in rural areas) and an age range of 55 years or older (55-101 years) with a mean age of 70.35 ± 7.71 years (70.69 ± 7.62 years in urban and 69.92 ± 7.80 years in rural areas). BHACS-BLSA conducted the baseline survey in 2009 with a multistage stratification-random clustering procedure for people aged 55 years or older; BHACS-CCHS-Beijing conducted the baseline survey in 2013-2015 with a stratified multistage cluster random sampling method for people aged 55 years or older; and BHACS-BECHCS conducted the baseline survey in 2010-2014 with two-stage cluster random sampling method for people aged 60 years or older. Data were collected through questionnaires, physical measurements, and laboratory analyses. Topics covered by BHACS include a wide range of physical and mental health indicators, lifestyles and personal, family, and socio-economic determinants of health. There are no immediate plans to make the cohort data freely available to the public, but specific proposals for further collaboration are welcome. For further information and collaboration, please contact the corresponding author Yao He (e-mail: yhe301@x263.net).
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Affiliation(s)
- Miao Liu
- Graduate School, Medical School of Chinese PLA, Beijing, 100853, China
| | - Junhan Yang
- Graduate School, Medical School of Chinese PLA, Beijing, 100853, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Chunxiu Wang
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Shanshan Yang
- Department of Disease Prevention and Control, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jianhua Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Chengbei Hou
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiaoying Li
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Fang Li
- Department of Gerontology, Fuxing Hospital, Capital Medical University, Beijing, 100038, China
| | - Hongbing Yang
- Miyun County Hospital of Traditional Chinese Medicine, Beijing, 101500, China
| | - Haowei Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shaohua Liu
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shimin Chen
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shimin Hu
- Department of Gerontology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xuehang Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhiqiang Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Rongrong Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Huaihao Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yinghui Bao
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yueting Shi
- Graduate School, Medical School of Chinese PLA, Beijing, 100853, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xianghua Fang
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
- State Key Laboratory of Kidney Diseases, Beijing, 100853, China.
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Chang CT, Chan HK, Cheah WK, Tan MP, Ch'ng ASH, Thiam CN, Abu Bakar NA, Yau WK, Abu Hassan MR, Rajan P, Tan KC, Ambigapathy S, Vengadasalam P, Zaman Huri S, Arvinder-Singh HS, Thum CC, Chung WM, Ooi JH, Sabki NH, Lee HP, Mohd Shariff SM, Azman MA, Teoh SL, Lee SWH. Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study. J Pharm Policy Pract 2023; 16:122. [PMID: 37858273 PMCID: PMC10588247 DOI: 10.1186/s40545-023-00630-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Polypharmacy and potentially inappropriate medications (PIM) are common among older adults. To guide appropriate prescribing, healthcare professionals often rely on explicit criteria to identify and deprescribe inappropriate medications, or to start medications due to prescribing omission. However, most explicit PIM criteria were developed with inadequate guidance from quality metrics or integrating real-world data, which are rich and valuable data source. AIM To develop a list of medications to facilitate appropriate prescribing among older adults. METHODS A preliminary list of PIM and potential prescribing omission (PPO) were generated from systematic review, supplemented with local pharmacovigilance data of adverse reaction incidents among older people. Twenty-one experts from nine specialties participated in two Delphi to determine the list of PIM and PPO in February and March 2023. Items that did not reach consensus after the second Delphi round were adjudicated by six geriatricians. RESULTS The preliminary list included 406 potential candidates, categorised into three sections: PIM independent of diseases, disease dependent PIM and omitted drugs that could be restarted. At the end of Delphi, 92 items were decided as PIM, including medication classes, such as antacids, laxatives, antithrombotics, antihypertensives, hormones, analgesics, antipsychotics, antidepressants, and antihistamines. Forty-two disease-specific PIM criteria were included, covering circulatory system, nervous system, gastrointestinal system, genitourinary system, and respiratory system. Consensus to start potentially omitted treatment was achieved in 35 statements across nine domains. CONCLUSIONS The newly developed PIM criteria can serve as a useful tool to guide clinicians and pharmacists in identifying PIMs and PPOs during medication review and facilitating informed decision-making for appropriate prescribing.
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Affiliation(s)
- Chee Tao Chang
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia.
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia.
| | - Huan Keat Chan
- Clinical Research Centre, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Malaysia
- Clinical Research Centre, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia
| | - Wee Kooi Cheah
- Department of Medicine, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Alan Swee Hock Ch'ng
- Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health Malaysia, Seberang Jaya, Malaysia
| | - Chiann Ni Thiam
- Department of Medicine, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Malaysia
| | - Nor Azlina Abu Bakar
- Medical Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Weng Keong Yau
- Medical Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Radzi Abu Hassan
- Clinical Research Centre, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Malaysia
| | - Philip Rajan
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Kar Choon Tan
- Hepatological Department, Hospital Selayang, Ministry of Health Malaysia, Selayang, Malaysia
| | | | | | - Surina Zaman Huri
- Psychiatry Department, Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Bahru, Malaysia
| | - H S Arvinder-Singh
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
- Department of Community Medicine, Hospital University Kebangsaan Malaysia, Bangi, Malaysia
| | - Chern Choong Thum
- Department of Psychiatry, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Serdang, Malaysia
| | - Wai Mun Chung
- Emergency and Trauma Department, Hospital Taiping, Taiping, Malaysia
| | - Jun How Ooi
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Noor Hamizah Sabki
- Pharmacy Department, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia
| | - Hooi Peng Lee
- Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | | | - Muhammad Azuan Azman
- Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
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Zhang T, Su M, Li D, Zhang W, Yang F, Li W. Equity in health service utilisation among middle-aged and elderly people with multiple chronic conditions in China: evidence from longitudinal data of 2011-2018 CHARLS. BMJ Open 2023; 13:e072320. [PMID: 37816559 PMCID: PMC10565265 DOI: 10.1136/bmjopen-2023-072320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/04/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVES Equity in health service utilisation is a central objective for health systems. Middle-aged and elderly patients with multiple chronic conditions (MCCs) are particularly vulnerable to healthcare inequity. This study aimed to update the information on the trends in the incidence and equity of outpatient health service utilisation (OHSU) and inpatient health service utilisation (IHSU) for middle-aged and elderly MCCs patients in China, identify socioeconomic determinants that may contribute to inequity, and suggest optimisation strategies to mitigate this disparity. METHODS Panel data obtained from four waves of the China Health and Retirement Longitudinal Study (CHARLS) were used to determine the trends in OHSU and IHSU. The inequity in OHSU and IHSU was measured by the Concentration Index (CI) and Horizontal Inequity Index (HI), which is a valid measure of health service utilisation equity. The decomposition model of the CI was set up to explore the contribution of various determinants of overall equity. RESULTS The annual rate of OHSU gradually decreased from 29.32% in 2011 to 27.27% in 2018. The HI remained positive and decreased from 0.0803 in 2011 to 0.0662 in 2018, indicating the existence of pro-rich inequity. The annual rate of IHSU gradually increased from 13.31% in 2011 to 19.89% in 2018. The HI remained positive and showed a declining trend from 0.2363 in 2011 to 0.0574 in 2018, evidencing pro-rich inequity; however, a trend towards the easing of inequity was observed. CONCLUSIONS Pro-rich inequity was present in both OHSU and IHSU among middle-aged and elderly MCCs patients in China. Economic status, area, education and age were the main contributors to pro-rich inequity. Concerted efforts are needed to allocate resources for mitigating health service utilisation inequity in middle-aged and elderly people with MCCs.
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Affiliation(s)
- Tianjiao Zhang
- School of Public Administration, Inner Mongolia University, Hohhot, China
| | - Min Su
- School of Public Administration, Inner Mongolia University, Hohhot, China
| | - Dongxu Li
- School of Public Administration, Inner Mongolia University, Hohhot, China
| | - Weile Zhang
- School of Public Administration, Inner Mongolia University, Hohhot, China
| | - Fan Yang
- School of Public Administration, Inner Mongolia University, Hohhot, China
| | - Wenhui Li
- School of Public Administration, Inner Mongolia University, Hohhot, China
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Nhu NT, Kang JH, Yeh TS, Wu CC, Tsai CY, Piravej K, Lam C. Prediction of posttraumatic functional recovery in middle-aged and older patients through dynamic ensemble selection modeling. Front Public Health 2023; 11:1164820. [PMID: 37408743 PMCID: PMC10319009 DOI: 10.3389/fpubh.2023.1164820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/17/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction Age-specific risk factors may delay posttraumatic functional recovery; complex interactions exist between these factors. In this study, we investigated the prediction ability of machine learning models for posttraumatic (6 months) functional recovery in middle-aged and older patients on the basis of their preexisting health conditions. Methods Data obtained from injured patients aged ≥45 years were divided into training-validation (n = 368) and test (n = 159) data sets. The input features were the sociodemographic characteristics and baseline health conditions of the patients. The output feature was functional status 6 months after injury; this was assessed using the Barthel Index (BI). On the basis of their BI scores, the patients were categorized into functionally independent (BI >60) and functionally dependent (BI ≤60) groups. The permutation feature importance method was used for feature selection. Six algorithms were validated through cross-validation with hyperparameter optimization. The algorithms exhibiting satisfactory performance were subjected to bagging to construct stacking, voting, and dynamic ensemble selection models. The best model was evaluated on the test data set. Partial dependence (PD) and individual conditional expectation (ICE) plots were created. Results In total, nineteen of twenty-seven features were selected. Logistic regression, linear discrimination analysis, and Gaussian Naive Bayes algorithms exhibited satisfactory performances and were, therefore, used to construct ensemble models. The k-Nearest Oracle Elimination model outperformed the other models when evaluated on the training-validation data set (sensitivity: 0.732, 95% CI: 0.702-0.761; specificity: 0.813, 95% CI: 0.805-0.822); it exhibited compatible performance on the test data set (sensitivity: 0.779, 95% CI: 0.559-0.950; specificity: 0.859, 95% CI: 0.799-0.912). The PD and ICE plots showed consistent patterns with practical tendencies. Conclusion Preexisting health conditions can predict long-term functional outcomes in injured middle-aged and older patients, thus predicting prognosis and facilitating clinical decision-making.
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Affiliation(s)
- Nguyen Thanh Nhu
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Jiunn-Horng Kang
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tian-Shin Yeh
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Epidemiology and Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, United States
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Chia-Chieh Wu
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Yu Tsai
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Krisna Piravej
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Carlos Lam
- Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Ma Y, An K, Zhang K, Deng H, Deng R, Su Q. Exploring disease interrelationships in older inpatients: a single-centre, retrospective study. Front Public Health 2023; 11:1110014. [PMID: 37333559 PMCID: PMC10272409 DOI: 10.3389/fpubh.2023.1110014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
Background Comorbidity is a common phenomenon in the older population; it causes a heavy burden on societies and individuals. However, the relevant evidence, especially in the southwestern region of China, is insufficient. Objectives We aimed to examine current comorbidity characteristics as well as correlations among diseases in individuals aged >60 years. Design Retrospective study. Methods We included records of 2,995 inpatients treated at the Gerontological Department of Sichuan Geriatric Hospital from January 2018 to February 2022. The patients were divided into groups according to sex and age. Diseases were categorised based on the International Classification of Diseases and their Chinese names. We calculated the age-adjusted Charlson Comorbidity Index (ACCI), categorised diseases using the China Health and Retirement Longitudinal Study questionnaire, and visualised comorbidity using web graphs and the Apriori algorithm. Results The ACCI was generally high, and it increased with age. There were significant differences in the frequency of all diseases across age groups, especially in individuals aged ≥90 years. The most common comorbid diseases were liver diseases, stomach or other digestive diseases, and hypertension. Strong correlations between the most common digestive diseases and hypertension were observed. Conclusion Our findings provide insights into the current situation regarding comorbidity and the correlations among diseases in the older population. We expect our findings to inform future research directions as well as policies regarding general clinical practice and public health, especially for medical consortiums.
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Affiliation(s)
- Yiru Ma
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kang An
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Keni Zhang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Han Deng
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rui Deng
- Department of Internal Medicine, The Fifth People’s Hospital of Sichuan Province, Chengdu, Sichuan, China
| | - Qiaoli Su
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Yu Z, Chen Y, Xia Q, Qu Q, Dai T. Identification of status quo and association rules for chronic comorbidity among Chinese middle-aged and older adults rural residents. Front Public Health 2023; 11:1186248. [PMID: 37325337 PMCID: PMC10267321 DOI: 10.3389/fpubh.2023.1186248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/11/2023] [Indexed: 06/17/2023] Open
Abstract
Background Chronic comorbidity has become a major challenge in chronic disease prevention and control. This issue is particularly pronounced in rural areas of developing countries, where the prevalence of chronic disease comorbidity is high, especially among middle-aged and older adults populations. However, the health status of middle-aged and older adults individuals in rural areas of China has received inadequate attention. Therefore, it is crucial to investigate the correlation among chronic diseases to establish a reference basis for adjusting health policies aimed at promoting the prevention and management of chronic diseases among middle-aged and older adults individuals. Methods This study selected 2,262 middle-aged and older adults residents aged 50 years or older in Shangang Village, Jiangsu Province, China, as the study population. To analyze the chronic comorbidity of middle-aged and older adults residents with different characteristics, we used the χ2 test with SPSS statistical software. Data analysis was conducted using the Apriori algorithm of Python software, set to mine the strong association rules of positive correlation between chronic disease comorbidities of middle-aged and older adults residents. Results The prevalence of chronic comorbidity was 56.6%. The chronic disease comorbidity group with the highest prevalence rate was the lumbar osteopenia + hypertension group. There were significant differences in the prevalence of chronic disease comorbidity among middle-aged and older adults residents in terms of gender, BMI, and chronic disease management. The Apriori algorithm was used to screen 15 association rules for the whole population, 11 for genders, and 15 for age groups. According to the order of support, the most common association rules of comorbidity of three chronic diseases were: {lumbar osteopenia} → {hypertension} (support: 29.22%, confidence: 58.44%), {dyslipidemia} → {hypertension} (support: 19.14%, confidence: 65.91%) and {fatty liver} → {hypertension} (support: 17.82%, confidence: 64.17%). Conclusion The prevalence of chronic comorbidity among middle-aged and older adults rural residents in China is relatively high. We identified many association rules among chronic diseases, dyslipidemia is mostly the antecedent, and hypertension is primarily the result. In particular, the majority of comorbidity aggregation patterns consisted of hypertension and dyslipidemia. By implementing scientifically-proven prevention and control strategies, the development of healthy aging can be promoted.
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Affiliation(s)
- Zijing Yu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Qianhang Xia
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Qingru Qu
- PBC School of Finance, Tsinghua University, Beijing, China
| | - Tao Dai
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
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10
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Zheng J, Li J, Pei T, Zhu T, Li X, Wang H. Bidirectional associations and a causal mediation analysis between depressive symptoms and chronic digestive diseases: A longitudinal investigation. J Affect Disord 2023; 333:278-289. [PMID: 37105468 DOI: 10.1016/j.jad.2023.04.025] [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: 09/07/2022] [Revised: 03/21/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Chronic digestive diseases (CDDs) and depression shared major pathogeneses. We aimed to prospectively examine the bidirectional incidence associations between depressive symptoms and CDDs and explore biologically and behaviorally relevant mediators in the bidirectional associations. METHODS Multivariable-adjusted Cox proportional hazard models were used to examine baseline depressive symptoms in relation to incident CDDs among 10,974 adults and the relation of baseline CDDs with new-onset elevated depressive symptoms among 7489 participants in the China Health and Retirement Longitudinal Study of nationally representative middle-aged and older adults. Elevated depressive symptoms were defined as the 10-item Center for Epidemiologic Studies Depression scale (CES-D-10) score at or higher than 10 and CDDs (except for tumor and cancer) were determined by self-reported physician diagnoses. Causal mediation analysis was performed to assess the mediated effects of a priori selected blood biomarkers and lifestyle factors in the bidirectional associations. RESULTS Prevalence of elevated depressive symptoms and nonmalignant CDDs at baseline was 33.05 % and 17.8 % respectively. During a mean of 5.47 years of follow-up, elevated depressive symptoms significantly increased hazard of CDDs by 1.66 folds (95%CI = 1.49-1.84). Having CDDs at baseline was associated with a 27 % (95%CI = 16 %-39 %) increased hazard of developing elevated depressive symptoms. Shorter sleeping duration at night nominally significantly mediated 8.76 % of the association between depressive symptoms and incident CDDs while no significant mediators were identified in the converse association. LIMITATIONS Limited mediator information and inadequately long follow-up may reduce chance of identifying significant mediators. CONCLUSIONS Depressive symptoms and CDDs were mutual independent risk factors. Early screening and management of depressive symptoms and sleep disturbance are suggested in the prevention of CDDs and related comorbidities.
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Affiliation(s)
- Jiali Zheng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jingmeng Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Tianduo Pei
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Tianren Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaoguang Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Hui Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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11
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Fan YC, Lin SF, Chou CC, Bai CH. Developmental Trajectories and Predictors of Incident Dementia among Elderly Taiwanese People: A 14-Year Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3065. [PMID: 36833763 PMCID: PMC9962520 DOI: 10.3390/ijerph20043065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to identify dementia trajectories and their associated predictors among elderly Taiwanese people over a 14-year period using a nationwide representative longitudinal study. This retrospective cohort study was performed using the National Health Insurance Research Database. Group-based trajectory modeling (GBTM) was used to distinguish the specific trajectory groups of incident dementia during 2000-2013. All 42,407 patients were classified by GBTM to identify the trajectory of incident dementia, which included high- (n = 11,637, 29.0%), moderate- (n = 19,036, 44.9%), and low-incidence (n = 11,734, 26.1%) groups. Those diagnosed with hypertension (adjusted odds ratio [aOR] = 1.43; 95% confidence interval [CI] = 1.35-1.52), stroke (aOR = 1.45, 95% CI = 1.31-1.60), coronary heart disease (aOR = 1.29, 95% CI = 1.19-1.39), heart failure (aOR = 1.62, 95% CI = 1.36-1.93), and chronic obstructive pulmonary disease (aOR = 1.10, 95% CI = 1.02-1.18) at baseline revealed tendencies to be classified into high-incidence groups in dementia risk. The results from a 14-year longitudinal study identified three distinct trajectories of incident dementia among elderly Taiwanese people: patients with cardiovascular disease risk factors and cardiovascular disease events tended to be classified into high-incidence dementia groups. Early detection and management of these associated risk factors in the elderly may prevent or delay the deterioration of cognitive decline.
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Affiliation(s)
- Yen-Chun Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Sheng-Feng Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Chia-Chi Chou
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100025, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 204201, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
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12
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Quan XQ, Ruan L, Zhou HR, Gao WL, Zhang Q, Zhang CT. Age-related changes in peripheral T-cell subpopulations in elderly individuals: An observational study. Open Life Sci 2023; 18:20220557. [PMID: 36816803 PMCID: PMC9922058 DOI: 10.1515/biol-2022-0557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 11/23/2022] [Accepted: 01/02/2023] [Indexed: 02/11/2023] Open
Abstract
The age-related decline in T-cell function among elderly individuals remains unclear. We thus investigated the interrelationship between T-cell subsets and age to identify the changes in T-cell phenotypes and develop an age prediction model for the elderly population. A total of 127 individuals aged >60 years were divided into three groups (youngest-old group, 61-70 years, n = 34; middle-old group, 71-80 years, n = 53; and oldest-old group, ≥ 81 years, n = 40). The percentage of CD8+CD28- cells (P = 0.001) was highest in the oldest-old group and then followed by the middle-old group, while the youngest-old group was the lowest. Both females and males demonstrated significant decreases in the absolute counts of CD4+CD45RA+ cells (P = 0.020; P = 0.002) and CD8+CD28+ cells (P = 0.015; P = 0.005) with age. Multivariate linear regression showed that the percentage of CD8+CD28- cells (P < 0.001) was an independent predictor of aging after adjusting for sex, body mass index, hospitalization duration, smoking, drinking, chronic medical illness, and medications at admission. In conclusion, our results suggest that aging in elderly individuals is accompanied by a decrease in the counts of T-cell subpopulations. CD8+CD28- cells may be potential targets for elderly individuals in antiaging-related immunosenescence.
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Affiliation(s)
- Xiao-Qing Quan
- Department of Geriatrics, Department of General Practice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, 518000, China
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hai-Rong Zhou
- Department of Geriatrics, Department of General Practice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, 518000, China
| | - Wei-Liang Gao
- Department of Geriatrics, Department of General Practice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, 518000, China
| | - Qing Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Cun-Tai Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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13
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Jacob L, Gyasi RM, Koyanagi A, Haro JM, Smith L, Kostev K. Prevalence of and Risk Factors for Adhesive Capsulitis of the Shoulder in Older Adults from Germany. J Clin Med 2023; 12:jcm12020669. [PMID: 36675599 PMCID: PMC9866675 DOI: 10.3390/jcm12020669] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/26/2022] [Accepted: 01/11/2023] [Indexed: 01/17/2023] Open
Abstract
This study aimed to investigate the prevalence of and risk factors for adhesive capsulitis in older adults from Germany. The one-year and lifetime prevalence of adhesive capsulitis were assessed in adults aged ≥65 years with at least one visit to one of 1207 general practices in Germany in 2021. Associations between physical and psychiatric conditions and adhesive capsulitis were further assessed in older patients diagnosed for the first time with adhesive capsulitis in general practices in 2010-2021 (index date) and matched (1:5) to patients without adhesive capsulitis using a propensity score based on age, sex, and the index year. In adults without adhesive capsulitis, the index date was a randomly selected visit date in 2010-2021. The one-year and lifetime prevalence of adhesive capsulitis in older adults in 2021 were 0.4% and 2.4%, respectively. In 8439 patients with and 42,195 patients without adhesive capsulitis, 12 conditions were positively and significantly associated with adhesive capsulitis. Effect sizes were strongest for other and unspecified osteoarthritis (OR = 1.93), injury to the shoulder and upper arm (OR = 1.85), and injury to the thorax (OR = 1.47). Based on these findings, adhesive capsulitis can occur at older age, and osteoarthritis and injuries are major risk factors.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, 75010 Paris, France
| | - Razak M. Gyasi
- African Population and Health Research Center, Nairobi 00100, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys 23, 08010 Barcelona, Spain
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt, Germany
- Correspondence: ; Tel.: +49-(0)69-66-04-4878
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14
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Wuraola FO, Olasehinde O, Di Bernardo M, Akinkuolie AA, Adisa AO, Aderounmu AA, Mohammed TO, Omoyiola OZ, Kingham TP, Alatise OI. Breast cancer in elderly patients: a clinicopathological review of a Nigerian database. Ecancermedicalscience 2022; 16:1484. [PMID: 36819793 PMCID: PMC9934965 DOI: 10.3332/ecancer.2022.1484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Indexed: 12/13/2022] Open
Abstract
Background Breast cancer in the elderly population has not been evaluated in the Nigerian context. With the rising incidence of breast cancer and the changing demographics, it is likely that an increasing number of elderly patients will be managed in the coming years in Nigeria. This review describes the clinicopathological profile of elderly patients with breast cancer in a Nigerian database. Method From a prospective institutional database, elderly patients (65 years and above) managed for breast cancer over a 9-year period were reviewed. Details of their socio-demographic characteristics, patterns of presentation, pathology, treatment and outcome were obtained and analysed. Results Of the 607 patients managed during the study period, there were 87 older patients accounting for 14.3% of the total. There was a progressive rise in the number of patients with breast cancer towards the latter part of the study. Expectedly, they were all post-menopausal, with their ages ranging from 65 to 92 years, with a mean of 71 ± 6.58 years. Systemic hypertension was the commonest co-morbidity (29.8%). The mean tumour size at presentation was 10 cm, with the majority presenting with stage 3 disease. Invasive ductal carcinoma was the predominant histological type 83 (95.4%); 44.4% of those who had immunohistochemistry were oestrogen receptor-positive. Approximately half underwent mastectomy (52.8%), 63 (72.4%) had chemotherapy, 8 (44.4%) had hormonal therapy and only 6 (6.9%) had combined multimodal therapy in addition to surgery. Overall 5-year survival was 42.1%. Conclusion The pattern of presentation and outcomes of care in this elderly cohort is similar to the general population. Early presentation and use of multimodal treatment is still the mainstay of survival.
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Affiliation(s)
- Funmilola Olanike Wuraola
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | - Olalekan Olasehinde
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | | | - Akinbolaji A Akinkuolie
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Adewale O Adisa
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | - Adewale A Aderounmu
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | - Tajudeen O Mohammed
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | - Oluwatosin Z Omoyiola
- Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Thomas P Kingham
- African Research Group for Oncology, Ile-Ife, Nigeria,Memorial Sloan Kettering Cancer Center, NY, USA
| | - Olusegun I Alatise
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
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15
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Liu C, Li Y, Li J, Jin C, Zhong D. The Effect of Psychological Burden on Dyslipidemia Moderated by Greenness: A Nationwide Study from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14287. [PMID: 36361165 PMCID: PMC9659001 DOI: 10.3390/ijerph192114287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Globally, dyslipidemia is now become a leading risk factor for many adverse health outcomes, especially in the middle-aged and elderly. Recent evidence suggests that exposure to greenness and the relief of a psychological burden may decrease the prevalence of dyslipidemia. The objective of our study was to examine whether a green space can moderate the association between mental health status and dyslipidemia. Our study selected the datasets of depression symptoms, dyslipidemia from the China Health and Retirement Longitudinal Study (CHARLS), and the satellite-based normalized difference vegetation index (NDVI) from the 30 m annual maximum NDVI dataset in China in 2018. Ultimately, a total of 10,022 middle-aged and elderly Chinese were involved in our study. Multilevel logistic regressions were performed to examine the association between symptoms of depression and dyslipidemia, as well as the moderate effect of greenness exposure on the association. Our research suggested that adults diagnosed with depression symptoms were more likely to suffer from dyslipidemia. In addition, the NDVI was shown to moderate the effect of depression on dyslipidemia significantly, though the effect was attenuated as depression increased. Regarding the moderate effect of the NDVI on the above association across age, gender, and residence, the findings presented that females, the elderly, and respondents living in urban areas were at a greater risk of having dyslipidemia, although the protective effect of the NDVI was considered. Likewise, the moderate effect of the NDVI gradually decreased as the level of depression increased in different groups. The current study conducted in China provides insights into the association between mental health, green space, and dyslipidemia. Hence, improving mental health and green spaces can be potential targets for medical interventions to decrease the prevalence of dyslipidemia.
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Affiliation(s)
- Chengcheng Liu
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Yao Li
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Jing Li
- Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
| | - Chenggang Jin
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Deping Zhong
- National Institute of Natural Hazards, Ministry of Emergency Management of the People’s Republic of China, Beijing 100085, China
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16
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Liu X, Song F, Liu F, Mao Z, Qu S. Multiple chronic conditions among older adults in China: differences in socio-demographic characteristics. Heliyon 2022; 8:e11129. [PMID: 36281412 PMCID: PMC9586908 DOI: 10.1016/j.heliyon.2022.e11129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/21/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
Objective There are relatively few studies on multiple chronic conditions (MCC) among older adults in China. This study sought to assess the potential differences in the risk of MCC among different elderly populations, and thus to identify the most vulnerable populations at higher risk of developing the MCC. Methods A sample of 5320 adults aged 60 years or above from the China's Health-Related Quality of Life Survey for Older Adults 2018 (CHRQLS-OA 2018) were included in this study. Descriptive statistics frequencies and proportions were used to summarize the sample characteristics, and logistic regression models were conducted to identify the differences in the risk of having MCC among different populations. Results Overall, 52.6% of respondents had been clearly diagnosed with at least one chronic disease with 25.3% having MCC. The males ((adjusted odds ratio [AOR] = 0.84; 95% confidence interval [CI] = 0.73-0.98) were less likely to have MCC. This was also true among female elderly with a non-agricultural hukou (AOR = 0.75; 95% CI = 0.57-0.99). The elderly with a non-agricultural hukou aged 60-64 (AOR = 0.55; 95% CI = 0.34-0.88) had a lower risk of having MCC. Those whose average annual household income per capita were 15,000-30,000 RMB (AOR = 1.42; 95% CI = 1.03-1.96) were more likely to suffer from MCC. The odds ratios of having MCC were smaller as the personal savings increases in total samples (all P < 0.05). Conclusions The findings suggest that different policies or approaches should target these specific populations who are most in need and are most likely to suffer from MCC.
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Affiliation(s)
- Xiaojun Liu
- Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Fang Song
- Editorial Department of Medicine and Society, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengyu Liu
- Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zongfu Mao
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Shuming Qu
- Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou, China,Corresponding author.
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17
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Jin B, Zhang H, Song F, Wu G, Yang H. Interaction of sleep duration and depression on cardiovascular disease: a retrospective cohort study. BMC Public Health 2022; 22:1752. [PMID: 36109743 PMCID: PMC9479441 DOI: 10.1186/s12889-022-14143-3] [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: 01/12/2022] [Accepted: 08/30/2022] [Indexed: 11/22/2022] Open
Abstract
Background To assess the interaction of sleep duration and depression on the risk of cardiovascular disease (CVD). Methods A total of 13,488 eligible participants were enrolled in this retrospective cohort study eventually. Baseline characteristics were extracted from the China Health and Retirement Longitudinal Study (CHARLS) database, including age, sex, diabetes, high-density lipoprotein (HDL), blood glucose (GLU), glycosylated hemoglobin (GHB) etc. Univariate and multivariate negative binomial regression models were carried out to assess the statistical correlation of sleep duration and depression on CVD separately. Additionally, multivariate negative binomial regression model was used to estimate the interaction of sleep duration and depression on CVD risk. Results After adjusting for age, sex, educational background, hypertension, diabetes, dyslipidemia, the use of hypnotics, disability, nap, drinking, deposit, sleep disturbance, HDL, triglyceride, total cholesterol, GLU and GHB, the risk of CVD in participants with the short sleep duration was increased in comparison with the normal sleep duration [relative risk (RR)=1.02, 95% confidence interval (CI):1.01-1.03]; compared to the participants with non-depression, participants suffered from depression had an increased risk of CVD (RR=1.05, 95%CI:1.04-1.06). Additionally, the result also suggested that the interaction between short sleep duration and depression on the risk of CVD was statistically significant in these patients with diabetes and was a multiplicative interaction. Conclusion An interaction between short sleep duration and depression in relation to an increased risk of CVD among Chinese middle-aged and elderly individuals was noticed, which may provide a reference that people with diabetes should focus on their sleep duration and the occurrence of depression, and coexisting short sleep duration and depression may expose them to a higher risk of CVD. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14143-3.
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He X, Li D, Wang W, Liang H, Liang Y. Identifying patterns of clinical conditions among high-cost older adult health care users using claims data: a latent class approach. Int J Equity Health 2022; 21:86. [PMID: 35725607 PMCID: PMC9210624 DOI: 10.1186/s12939-022-01688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To identify patterns of clinical conditions among high-cost older adults health care users and explore the associations between characteristics of high-cost older adults and patterns of clinical conditions. Methods We analyzed data from the Shanghai Basic Social Medical Insurance Database, China. A total of 2927 older adults aged 60 years and over were included as the analysis sample. We used latent class analysis to identify patterns of clinical conditions among high-cost older adults health care users. Multinomial logistic regression models were also used to determine the associations between demographic characteristics, insurance types, and patterns of clinical conditions. Results Five clinically distinctive subgroups of high-cost older adults emerged. Classes included “cerebrovascular diseases” (10.6% of high-cost older adults), “malignant tumor” (9.1%), “arthrosis” (8.8%), “ischemic heart disease” (7.4%), and “other sporadic diseases” (64.1%). Age, sex, and type of medical insurance were predictors of high-cost older adult subgroups. Conclusions Profiling patterns of clinical conditions among high-cost older adults is potentially useful as a first step to inform the development of tailored management and intervention strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01688-3.
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Affiliation(s)
- Xiaolin He
- Department of Social Policy, Shanghai Administration Institute, Shanghai, China
| | - Danjin Li
- School of Nursing, Fudan University, Shanghai, China
| | - Wenyi Wang
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Hong Liang
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Yan Liang
- School of Nursing, Fudan University, Shanghai, China.
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Zhao Z, Guo M, An J, Zhang L, Tan P, Tian X, Zhao Y, Liu L, Wang X, Liu X, Guo X, Luo Y. Acute effect of air pollutants' peak-hour concentrations on ischemic stroke hospital admissions among hypertension patients in Beijing, China, from 2014 to 2018. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:41617-41627. [PMID: 35094263 DOI: 10.1007/s11356-021-18208-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Air pollutants' effect on ischemic stroke (IS) has been widely reported. But the effect of high-level concentrations during people's outdoor periods among hypertension patients was unknown. Peak-hour concentrations were defined considering air pollutants' high concentrations as well as people's outdoor periods. We conducted a time-series study and used the generalized additive model to analyze peak-hour concentrations' acute effect. A total of 315,499 IS patients comorbid with hypertension were admitted to secondary and above hospitals in Beijing from 2014 to 2018. A 10 µg/m3 (CO: 1 mg/m3) increase of the peak-hour concentrations was positively associated with IS hospital admissions among hypertension patients. The maximum effect sizes were as follows: for PM2.5, 0.17% (95% confidence interval [CI]: 0.10-0.24%) at Lag0 and 0.22% (95% CI: 0.12-0.33%) at Lag0-5; for PM10, 0.09% (95% CI: 0.05-0.13%) at Lag5 and 0.17% (95% CI: 0.09-0.26%) at Lag0-5; for SO2, 0.87% (95% CI: 0.46-1.29%) at Lag5; for NO2, 0.83% (95% CI: 0.62-1.04%) at Lag0 and 0.86% (95% CI: 0.59-1.13%) at Lag0-1; for CO 1.23% (95% CI: 0.66-1.80%) at Lag0 and 1.33% (95% CI: 0.33-2.35%) at Lag0-5; for O3 0.23% (95% CI: 0.12-0.35%) at Lag0 and 0.20% (95% CI: 0.05-0.34%) at Lag0-1. The effect sizes of PM2.5, NO2, and O3 remained significant after adjusting daily mean. Larger effect sizes were observed for PM2.5 and PM10 in cool season and for O3 in warm season. As significant exposure indicators of air pollution, peak-hour concentrations exposure increased the risk of IS hospital admissions among hypertension patients and it is worthy of consideration in relative environmental standard. It is suggested for hypertension patients to avoid outdoor activity during peak hours. More relevant searches are required to further illustrate air pollutant's effect on chronic disease population.
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Affiliation(s)
- Zemeng Zhao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Moning Guo
- Beijing Municipal Commission of Health and Family Planning Information Center, Beijing, 100034, China
| | - Ji An
- Department of Medical Engineering, Peking University Third Hospital, Beijing, 100191, China
| | - Licheng Zhang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
- Beijing Cancer Hospital, Beijing, 100142, China
| | - Peng Tan
- Beijing Municipal Commission of Health and Family Planning Information Center, Beijing, 100034, China
| | - Xue Tian
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Yuhan Zhao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Lulu Liu
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Xiaonan Wang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Xiangtong Liu
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Yanxia Luo
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China.
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Li J, Hui X, Lu Z, Ren X, Yan W, Yan P, Yao L, Yang K. PROTOCOL: The association between marital transitions and physical and mental health in late life: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1252. [PMID: 36911347 PMCID: PMC9175064 DOI: 10.1002/cl2.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: What is the association between marital transitions and physical health among people older than 60? What is the association between marital transitions and mental health among people older than 60? What is the role of gender, age, and education on the association between marital transitions and health among people older than 60? What is the influence of geographical region, housing, neighborhood, and social support on the association between marital transitions and health status among people older than 60?
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Affiliation(s)
- Jing Li
- School of Public Health, Evidence‐based Social Sciences Research Center, Health Technology Assessment CenterLanzhou UniversityLanzhouChina
| | - Xu Hui
- School of Public Health, Evidence‐based Social Sciences Research Center, Health Technology Assessment CenterLanzhou UniversityLanzhouChina
| | - Zhenxing Lu
- Institute of Medical ResearchNorthwestern Polytechnical UniversityXi'anChina
| | - Xiaocao Ren
- Clinical Medical CollegeLanzhou UniversityLanzhouChina
| | - Wenlong Yan
- Clinical Medical CollegeLanzhou UniversityLanzhouChina
| | - Peijing Yan
- School of Public Health, Evidence‐based Social Sciences Research Center, Health Technology Assessment CenterLanzhou UniversityLanzhouChina
| | - Liang Yao
- Department of Health Research Methodology, Evidence and ImpactMcMaster UniversityHamiltonCanada
| | - Kehu Yang
- School of Public Health, Evidence‐based Social Sciences Research Center, Health Technology Assessment CenterLanzhou UniversityLanzhouChina
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21
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Effect of Physical Activity, Smoking, and Sleep on Telomere Length: A Systematic Review of Observational and Intervention Studies. J Clin Med 2021; 11:jcm11010076. [PMID: 35011817 PMCID: PMC8745211 DOI: 10.3390/jcm11010076] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
Aging is a risk factor for several pathologies, restricting one’s health span, and promoting chronic diseases (e.g., cardiovascular and neurodegenerative diseases), as well as cancer. Telomeres are regions of repetitive DNA located at chromosomal ends. Telomere length has been inversely associated with chronological age and has been considered, for a long time, a good biomarker of aging. Several lifestyle factors have been linked with telomere shortening or maintenance. However, the consistency of results is hampered by some methodological issues, including study design, sample size, measurement approaches, and population characteristics, among others. Therefore, we aimed to systematically review the current literature on the effects of three relevant lifestyle factors on telomere length in human adults: physical activity, smoking, and sleep. We conducted a qualitative systematic review of observational and intervention studies using the Preferred Reporting Item for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The systematic literature search covered articles published in MEDLINE and EMBASE databases (from 2010 to 2020). A total of 1400 studies were identified; 83 were included after quality control. Although fewer sedentary activities, optimal sleep habits, and non- or ex-smoker status have been associated with less telomere shortening, several methodological issues were detected, including the need for more targeted interventions and standardized protocols to better understand how physical activity and sleep can impact telomere length and aging. We discuss the main findings and current limitations to gain more insights into the influence of these lifestyle factors on the healthy aging process.
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