1
|
Lee SM, Baek JC. Serum Vitamin Levels, Cardiovascular Disease Risk Factors, and Their Association with Depression in Korean Women: A Cross-Sectional Study of a Nationally Representative Sample. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2183. [PMID: 38138286 PMCID: PMC10744936 DOI: 10.3390/medicina59122183] [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: 11/04/2023] [Revised: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Serum vitamin levels, cardiovascular disease risk factors, and their association with depression is a complex issue that has been the subject of much research. Therefore, we investigated the relationship between vitamin A, B9, and E levels, cardiovascular risk factors, and depression in premenopausal and menopausal South Korean women. Materials and Methods: This cross-sectional study used the 2016-2018 Korea National Health and Nutrition Examination Survey data. Depression was assessed using a questionnaire to check for symptoms of depression or the Patient Health Questionnaire-9. Blood samples were collected from the antecubital vein in the morning after an overnight fast. Covariates were defined as self-reported physician diagnoses. Well-trained medical staff performed the standard procedures. Statistical analysis was performed using the complex sample analysis method of SPSS, using two separate logistic regression models (model 1: adjusted for age; model 2: adjusted for age, marital status, smoking, and alcohol consumption). Results: A total of 3313 women aged over 20 years were enrolled. The association between vitamin A levels and depression was as follows: lower levels of vitamin A were associated with an increased risk of depression in premenopausal women in model 1 and model 2. The levels of serum vitamins E and B9 were not correlated with depression in premenopausal and postmenopausal women. In the premenopausal group, depression increased in the obesity (model 1: p = 0.037; model 2: p = 0.047) and diabetes mellitus (model 1: p = 0.010; model 2: p = 0.009) groups. The menopausal group with depression had higher rates of stroke (model 1: p = 0.017; model 2: p = 0.039) and myocardial infarction (model 1: p = 0.004; model 2: p = 0.008) than the group without depression. Conclusions: Depression is correlated with lower blood levels of vitamin A in premenopausal women. Vitamin B9 and E levels were not associated with depression independent of menopausal status. Depression is associated with obesity and diabetes mellitus in premenopausal women and with stroke and myocardial infarction in postmenopausal women.
Collapse
Affiliation(s)
- Seon Mi Lee
- Department of Obstetrics and Gynecology, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea;
| | - Jong Chul Baek
- Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Republic of Korea
- Department of Obstetrics and Gynecology, Gyeongsang National University School of Medicine, Jinju 52727, Republic of Korea
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| |
Collapse
|
2
|
Associations between Serum Folate Concentrations and Functional Disability in Older Adults. Antioxidants (Basel) 2023; 12:antiox12030619. [PMID: 36978867 PMCID: PMC10045063 DOI: 10.3390/antiox12030619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Folate may have beneficial effects on physical function through its antioxidant effect. Thus, we investigated the associations between serum folate and functional disability in older adults. Data from the National Health and Nutrition Examination Survey 2011–2018 were used. Serum folate included 5-methyltetrahydrofolate and total folate. Five domains of functional disability, including lower extremity mobility (LEM), instrumental activities of daily living (IADL), activities of daily living (ADL), leisure and social activities (LSA), and general physical activities (GPA), were self-reported. Multivariable-adjusted logistic regression models and restricted cubic splines were employed. 5-Methyltetrahydrofolate was inversely associated with IADL and GPA disability, and the multivariate-adjusted ORs (95% CIs) in the highest versus lowest quartiles were 0.65 (0.46–0.91) and 0.70 (0.50–0.96), respectively. The total folate was also inversely associated with IADL (OR quartile 4vs1 = 0.65, 95% CI: 0.46–0.90) and GPA (OR quartile 3vs1 = 0.66, 95% CI: 0.44–0.99) disability. The dose–response relationships showed a gradual decrease in the risk of IADL and GPA disability as serum folate increased. In the sex, age, BMI, and alcohol consumption subgroup analyses, we saw that the associations were primarily found in females, under 80 years old, normal weight, and non-drinkers. Sensitivity analyses further confirmed the robustness of our results. Our results indicated that serum folate concentrations were negatively associated with IADL and GPA disability, especially in females. In other subgroup analyses, we discovered that these negative associations were primarily prevalent in participants under 80 years old, normal weight, and non-drinkers.
Collapse
|
3
|
Impact of Vitamin B12 Insufficiency on the Incidence of Sarcopenia in Korean Community-Dwelling Older Adults: A Two-Year Longitudinal Study. Nutrients 2023; 15:nu15040936. [PMID: 36839293 PMCID: PMC9967932 DOI: 10.3390/nu15040936] [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: 01/18/2023] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
The longitudinal effect of B12 insufficiency on sarcopenia has not yet been investigated in older adults. We aimed to study the impact of B12 levels on alterations in muscle mass, function and strength over two years. Non-sarcopenic older adults (n = 926) aged 70-84 were included. Using the Korean Frailty and Aging Cohort Study, this two-year longitudinal study used data across South Korea. The tools used for assessing muscle criteria were based on the Asian Working Group for Sarcopenia guidelines. Participants were divided into the insufficiency (initial serum B12 concentration < 350 pg/mL) and sufficiency groups (≥350 pg/mL). Logistic regression analyses were performed to evaluate the effect of initial B12 concentration on sarcopenia parameters over a two-year period. In women, multivariate analysis showed that the B12 insufficiency group had a significantly higher incidence of low SPPB scores (odds ratio [OR] = 3.28, 95% confidence interval [CI] = 1.59-6.76) and sarcopenia (OR = 3.72, 95% CI = 1.10-12.62). However, the B12 insufficiency group did not have a greater incidence of sarcopenia or other parameters in men. Our findings suggest B12 insufficiency negatively impacts physical performance and increases the incidence of sarcopenia only in women.
Collapse
|
4
|
Cross-sectional and prospective associations between homocysteine and a frailty index: A post-hoc analysis of the multidomain Alzheimer's prevention trial (MAPT). Exp Gerontol 2023; 172:112066. [PMID: 36549548 DOI: 10.1016/j.exger.2022.112066] [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: 09/23/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Homocysteine (Hcy) has been associated with several health problems, including reduced physical capacity. No study appears to have looked at the role of Hcy values longitudinally on physical capacity deterioration in older adults. The objective is to examine cross-sectional and prospective associations between Hcy values and frailty in the elderly and investigate Hcy potential association with the onset of frailty. METHODS 769 community-dwelling older adults from the MAPT study were recruited for this study. Total Hcy was measured at baseline. Frailty was evaluated at 5 different collection timepoints: baseline, 6-month, 1-, 2-, and 3-year using a frailty index (FI) composed of 19 items. Linear regressions adjusted for all the confounders (age, gender, educational level, MAPT group allocation and Omega-3) were performed to examine the cross-sectional associations of homocysteine values with the FI. A cox model was used to test the association of Hcy with the onset of frailty. RESULTS Mean Hcy values (15.9 ± 5.6 μmol\L) were obtained from 769 community-dwelling adults (75.7 ± 4.6 years old). After adjustments, a significant (β = 0.002, (00002-0.003)) and positive association between baseline Hcy values and FI was found (ß = 0.002). Additionally, higher values of Hcy were associated with a worsening of FI after 3 years (ß = 0.002, p = 0.003). A significant association between baseline Hcy values and the likelihood of developing frailty was discovered by incident event analysis (HR: 1.04 (1.01-1.06), p = 0.004). CONCLUSION High levels of Hcy are associated with the fragility process in community-dwelling older adults.
Collapse
|
5
|
Chae SA, Kim HS, Lee JH, Yun DH, Chon J, Yoo MC, Yun Y, Yoo SD, Kim DH, Lee SA, Chung SJ, Soh Y, Won CW. Impact of Vitamin B12 Insufficiency on Sarcopenia in Community-Dwelling Older Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312433. [PMID: 34886159 PMCID: PMC8656801 DOI: 10.3390/ijerph182312433] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 10/31/2022]
Abstract
Vitamin B12 (B12) is involved as a cofactor in the synthesis of myelin. A lack of B12 impairs peripheral nerve production, which can contribute to sarcopenia. In this cross-sectional study, we aimed to investigate the relationship between B12 insufficiency and sarcopenia in community-dwelling older Korean adults. A total of 2325 (1112 men; 1213 women) adults aged 70-84 years were recruited. The tools used for sarcopenia were based on the Asian Working Group for Sarcopenia (AWGS) guidelines. Individuals with low appendicular skeletal muscle mass index (ASMI) (<7.0 kg/m2 for men; <5.4 kg/m2 for women) and low hand grip strength (HGS) (<28 kg for men; <18 kg for women) were defined as the sarcopenia group. Among this group, those who showed low physical performance (≤9 points on the Short Physical Performance Battery (SPPB)) were defined as the severe sarcopenia group. B12 concentrations were classified into insufficient (<350 pg/mL) and sufficient (≥350 pg/mL). Univariate and multivariate logistic regression analyses were used to evaluate the relationship between sarcopenia and B12 levels. Low ASMI showed a high incidence in the B12-insufficient group. However, HGS, SPPB, and the severity of sarcopenia showed no correlation with B12. Further, insufficient B12 may affect muscle quantity rather than muscle strength or physical performance.
Collapse
Affiliation(s)
- Seon A Chae
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea; (S.A.C.); (H.-S.K.); (J.H.L.); (D.H.Y.); (J.C.); (M.C.Y.); (Y.Y.)
| | - Hee-Sang Kim
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea; (S.A.C.); (H.-S.K.); (J.H.L.); (D.H.Y.); (J.C.); (M.C.Y.); (Y.Y.)
| | - Jong Ha Lee
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea; (S.A.C.); (H.-S.K.); (J.H.L.); (D.H.Y.); (J.C.); (M.C.Y.); (Y.Y.)
| | - Dong Hwan Yun
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea; (S.A.C.); (H.-S.K.); (J.H.L.); (D.H.Y.); (J.C.); (M.C.Y.); (Y.Y.)
| | - Jinmann Chon
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea; (S.A.C.); (H.-S.K.); (J.H.L.); (D.H.Y.); (J.C.); (M.C.Y.); (Y.Y.)
| | - Myung Chul Yoo
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea; (S.A.C.); (H.-S.K.); (J.H.L.); (D.H.Y.); (J.C.); (M.C.Y.); (Y.Y.)
| | - Yeocheon Yun
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea; (S.A.C.); (H.-S.K.); (J.H.L.); (D.H.Y.); (J.C.); (M.C.Y.); (Y.Y.)
| | - Seung Don Yoo
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea; (S.D.Y.); (D.H.K.); (S.A.L.); (S.J.C.)
| | - Dong Hwan Kim
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea; (S.D.Y.); (D.H.K.); (S.A.L.); (S.J.C.)
| | - Seung Ah Lee
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea; (S.D.Y.); (D.H.K.); (S.A.L.); (S.J.C.)
| | - Sung Joon Chung
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea; (S.D.Y.); (D.H.K.); (S.A.L.); (S.J.C.)
| | - Yunsoo Soh
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea; (S.A.C.); (H.-S.K.); (J.H.L.); (D.H.Y.); (J.C.); (M.C.Y.); (Y.Y.)
- Correspondence: (Y.S.); (C.W.W.)
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul 02447, Korea
- Correspondence: (Y.S.); (C.W.W.)
| |
Collapse
|
6
|
Abstract
Sarcopenia, a skeletal muscle disorder that is characterised by loss of muscle strength and mass, is common in older populations and associated with poorer health outcomes. Although the individual and economic costs of sarcopenia are widely recognised, current understanding of its pathophysiology is incomplete, limiting efforts to translate research evidence into effective preventive and treatment strategies. While nutrition is a key field of sarcopenia research, the role of differences in habitual diets, and the effectiveness of dietary change as a prevention or treatment strategy, is uncertain. There is a growing evidence base that links low micronutrient intakes to sarcopenia risk and/or its components (low muscle strength and mass, impaired physical performance), although there remain many gaps in understanding. There is some consistency in findings across studies highlighting potential roles for antioxidant nutrients, B vitamins and magnesium; however, the evidence is largely observational and from cross-sectional studies, often describing associations with different muscle outcomes. As low intakes of some micronutrients are common in older populations, there is a need for new research, particularly from well-characterised prospective cohorts, to improve the understanding of their role and importance in the aetiology of sarcopenia and to generate the evidence needed to inform dietary guidelines to promote muscle health.
Collapse
|
7
|
Risk factors for high fall risk in elderly patients with chronic kidney disease. Int Urol Nephrol 2021; 54:349-356. [PMID: 33966153 DOI: 10.1007/s11255-021-02884-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/01/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE Patients with chronic kidney disease (CKD) usually represent an aging population, and both older age and CKD are associated with a higher risk of falling. Studies on risk factors among subjects with CKD are lacking. METHODS Records of outpatients from one geriatric clinic in Turkey were retrospectively reviewed. A result of ≥ 13.5 s on the timed up and go (TUG) test was accepted as a high risk of falls. Independent predictors of an increased risk of falls among subjects with CKD (estimated glomerular filtration rate of < 60 mL/min/1.73 m2) were identified using logistic regression models. RESULTS Patients with CKD (n = 205), represented the 20.2% of the entire cohort and was identified as an independent predictor of increased fall risk (OR 2.59). Within the CKD cohort, serum folic acid levels and frailty were independent predictors of an increased risk of falls. The CKD/fall risk group was older, had a lower median years of education, lower vitamin D levels, and lower serum folic acid levels than the CKD/non-fall risk group. In addition to higher serum creatinine and potassium levels, the only significant difference between patients with CKD/fall risk and a matched non-CKD/fall risk was a lower median folic acid level in the former group. CONCLUSIONS Frailty and low folic acid levels are independently associated with an increased risk of falls among elderly outpatients with CKD. Prevention of frailty may reduce the risk of falls in these subjects. Possible benefit of folic acid supplementation requires further studies.
Collapse
|
8
|
Talegawkar SA, Jin Y, Xue QL, Tanaka T, Simonsick EM, Tucker KL, Ferrucci L. Dietary Pattern Trajectories in Middle Age and Physical Function in Older Age. J Gerontol A Biol Sci Med Sci 2021; 76:513-519. [PMID: 33216872 DOI: 10.1093/gerona/glaa287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increasingly, lifestyle factors in midlife are reported to impact health and functional status in old age. This work examines associations between dietary trajectories in middle age and subsequent impairments in physical function. METHOD Data are from 851 participants (61% men, mean age at first dietary assessment = 47 years, range 30-59 years) from the Baltimore Longitudinal Study of Aging. We used latent class analysis to derive dietary trajectories based on adherence to the Alternative Healthy Eating Index-2010 (AHEI), and further classified them based on tertiles, as poor (score <39.3), intermediate (39.3-48.9), or good (>48.9). Physical function was assessed with the Short Physical Performance Battery (SPPB). Random effects tobit regression models were used to examine associations between dietary trajectories and later physical function. RESULTS Two latent classes of AHEI scores were generated and labeled "greatly improved" or "moderately improved." In the greatly improved class, participants showed a trend in overall AHEI score from poor/intermediate to good diet categories across dietary assessments with age, over time. In the moderately improved class, the overall AHEI score shifted from poor to intermediate diet categories over time, and the prevalence of the good diet category remained low. Mean AHEI score between ages 30 and 59 years was higher in the greatly, than moderately, improved class. The moderately improved class had 1.6 points lower SPPB score (indicating poorer physical function) at older age than the greatly improved class (p = .022). CONCLUSIONS Findings suggest that improving diet quality in middle age may contribute to better physical function in older age.
Collapse
Affiliation(s)
- Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA
| | - Yichen Jin
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA
| | - Qian-Li Xue
- Department of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Eleanor M Simonsick
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Katherine L Tucker
- Department of Biomedical & Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
| |
Collapse
|
9
|
Grootswagers P, Mensink M, Berendsen AAM, Deen CPJ, Kema IP, Bakker SJL, Santoro A, Franceschi C, Meunier N, Malpuech-Brugère C, Bialecka-Debek A, Rolf K, Fairweather-Tait S, Jennings A, Feskens EJM, de Groot LCPGM. Vitamin B-6 intake is related to physical performance in European older adults: results of the New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe (NU-AGE) study. Am J Clin Nutr 2021; 113:781-789. [PMID: 33515034 PMCID: PMC8024000 DOI: 10.1093/ajcn/nqaa368] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/13/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Maintenance of high physical performance during aging might be supported by an adequate dietary intake of niacin, vitamins B-6 and B-12, and folate because these B vitamins are involved in multiple processes related to muscle functioning. However, not much is known about the association between dietary intake of these B vitamins and physical performance. OBJECTIVES The objectives of this study were to investigate the association between dietary intake of niacin, vitamins B-6 and B-12, and folate and physical performance in older adults and to explore mediation by niacin status and homocysteine concentrations. METHODS We used baseline data from the New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe (NU-AGE) trial, which included n = 1249 healthy older adults (aged 65-79 y) with complete data on dietary intake measured with 7-d food records and questionnaires on vitamin supplement use and physical performance measured with the short physical performance battery and handgrip dynamometry. Associations were assessed by adjusted linear mixed models. RESULTS Intake of vitamin B-6 was related to lower chair rise test time [β: -0.033 ± 0.016 s (log); P = 0.043]. Vitamin B-6 intake was also significantly associated with handgrip strength, but for this association, a significant interaction effect between vitamin B-6 intake and physical activity level was found. In participants with the lowest level of physical activity, higher intake of vitamin B-6 tended to be associated with greater handgrip strength (β: 1.5 ± 0.8 kg; P = 0.051), whereas in participants in the highest quartile of physical activity, higher intake was associated with lower handgrip strength (β: -1.4 ± 0.7 kg; P = 0.041). No evidence was found for an association between intake of niacin, vitamin B-12, or folate and physical performance or for mediation by niacin status or homocysteine concentrations. CONCLUSIONS Vitamin B-6 intake was associated with better chair rise test time in a population of European healthy older adults and also with greater handgrip strength in participants with low physical activity only. Homocysteine concentrations did not mediate these associations. The NU-AGE trial was registered at clinicaltrials.gov as NCT01754012.
Collapse
Affiliation(s)
| | - Marco Mensink
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Agnes A M Berendsen
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Carolien P J Deen
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ido P Kema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Aurelia Santoro
- Department of Experimental, Diagnostic, and Specialty Medicine and CIG Interdepartmental Center “L. Galvani,” Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic, and Specialty Medicine and CIG Interdepartmental Center “L. Galvani,” Alma Mater Studiorum, University of Bologna, Bologna, Italy,Department of Experimental, Diagnostic, and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy,Department of Applied Mathematics, Institute of Information Technology, Mathematics, and Mechanics, Lobachevsky State University of Nizhny Novgorod–National Research University, Nizhny Novgorod, Russia
| | | | - Corinne Malpuech-Brugère
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000 Clermont-Ferrand, France
| | - Agata Bialecka-Debek
- Department of Human Nutrition, Warsaw University of Life Sciences–SGGW, Warsaw, Poland
| | - Katarzyna Rolf
- Department of Human Nutrition, Warsaw University of Life Sciences–SGGW, Warsaw, Poland
| | - Susan Fairweather-Tait
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Amy Jennings
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | | |
Collapse
|
10
|
Yokoyama Y, Kitamura A, Seino S, Kim H, Obuchi S, Kawai H, Hirano H, Watanabe Y, Motokawa K, Narita M, Shinkai S. Association of nutrient-derived dietary patterns with sarcopenia and its components in community-dwelling older Japanese: a cross-sectional study. Nutr J 2021; 20:7. [PMID: 33461556 PMCID: PMC7814431 DOI: 10.1186/s12937-021-00665-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 01/13/2021] [Indexed: 12/13/2022] Open
Abstract
Background Diet is a modifiable factor affecting sarcopenia, and accumulating evidence links dietary factors to muscle mass, strength, and function in older adults. However, few studies have examined the association of dietary patterns with sarcopenia. This study examined the association of dietary patterns derived by reduced-rank regression (RRR) with sarcopenia and its components in community-dwelling older Japanese. Methods We conducted a cross-sectional study of 1606 community-dwelling adults aged 65 years or older. Dietary intake was assessed by a validated, self-administered diet history questionnaire. Nutrient-derived dietary patterns were identified by using RRR, with sarcopenia-related nutrients (protein, vitamin D, vitamin C, vitamin E, folate, vitamin K, magnesium, iron, and calcium intakes) as response variables. Sarcopenia was defined by using the algorithm of the Asian Working Group for Sarcopenia 2019. Multivariate regression and logistic regression were used to examine the association of dietary patterns with sarcopenia and its components. Results The first RRR dietary pattern was characterized by high intakes of fish, soybean products, potatoes, most vegetables, mushrooms, seaweeds, and fruit and a low intake of rice and was associated with decreased prevalence of sarcopenia: the multivariable-adjusted odds ratio of sarcopenia was 0.57 (95% confidence interval, 0.34–0.94; p for trend=0.022) in the highest versus the lowest tertile of dietary pattern. This dietary pattern was also significantly positively associated with usual gait speed (β: 0.02, p=0.024). Conclusions A dietary pattern characterized by high intakes of fish, soybean products, potatoes, most vegetables, mushrooms, seaweeds, and fruits and low rice intake was inversely associated with sarcopenia in community-dwelling older Japanese. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00665-w.
Collapse
Affiliation(s)
- Yuri Yokoyama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.,Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Nishi-7, Kita-13, Kita-ku, Sapporo, Hokkaido, 060-8586, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Miki Narita
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| |
Collapse
|
11
|
Abstract
As the silver tsunami hits the world, older patients with hip fractures are expected to increase to 6.3 million by the year 2050, of which the majority will occur in Asia. The estimated global cost of hip fractures in the year 2050 is estimated to reach U.S. $130 billion. Hence, in addition to implementation of prevention strategies, it is important to develop an optimal model of care for older patients with hip fracture to minimize the huge medical and socioeconomic burden, especially in rapidly aging nations. This review summarizes the complications of hip fractures, importance of comprehensive geriatric assessment, and multidisciplinary rehabilitation, as well as predictors of rehabilitation outcome in older patients with hip fracture.
Collapse
|
12
|
Hou L, Liu Y, Li X, Huo C, Jia X, Yang J, Lei Y, Xu R, Sun C, Wang X. Changes and Risk Factors of Skeletal Muscle Mass and Strength in Patients with Type 2 Diabetes over 60 Years Old: A Cross-Sectional Study from China. J Diabetes Res 2020; 2020:9815485. [PMID: 33381601 PMCID: PMC7759389 DOI: 10.1155/2020/9815485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/10/2020] [Accepted: 09/03/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The accelerate loss of skeletal muscle mass, strength, and function, named sarcopenia, is a progressive and generalised skeletal muscle disorder, and it is always associated with increased outcomes including falls, frailty, and disability. Diabetes mellitus is associated with significant muscle and physical complications. We aimed at clarifying the changes and risk factors of skeletal muscle mass and strength in elderly with type 2 diabetes. METHODS The study consisted of patients with type 2 diabetes (n = 120) and an older general population (n = 126). The skeletal muscle mass and muscle strength, as well as the serum levels of chronic inflammation, oxidative stress, homocysteine, and insulin-like factor-1 were assessed, and the correlation and regression analysis were conducted to evaluate outcomes. RESULTS T2DM patients exhibited lower muscle strength compared with the non-T2DM subjects (P < 0.01). Among T2DM patients, serum IGF-1 levels were positively correlated with muscle strength (r = 0.255, P < 0.01) and muscle mass (r = 0.209, P < 0.05), levels of 8-OHdG were inversely correlated with muscle strength (r = -0.252, P < 0.01), and there was a negative association between HCY and muscle mass (r = -0.185, P < 0.05). Muscle mass and strength of patients with higher education level were significantly higher than those with lower education level (P < 0.05), in male patients, muscle mass and muscle strength were significantly lower in smokers (P < 0.01), and muscle mass was lower in chronic drinkers (P < 0.05). CONCLUSIONS These findings suggest that diabetic patients may be more susceptible to sarcopenia at an older age. And it also provides evidences that among elderly with diabetes mellitus, oxidative damage and HCY as well as IGF-1 are important predictors of age-dependent sarcopenia.
Collapse
Affiliation(s)
- Liming Hou
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| | - Yan Liu
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| | - Xing Li
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
| | - Cong Huo
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| | - Xin Jia
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| | - Jie Yang
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| | - Yunzhen Lei
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| | - Rong Xu
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| | - Chao Sun
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| | - Xiaoming Wang
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, China
- Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xi'an, Shaanxi Province 710032, China
| |
Collapse
|
13
|
Campbell JM, Stephenson MD, de Courten B, Chapman I, Bellman SM, Aromataris E. Metformin Use Associated with Reduced Risk of Dementia in Patients with Diabetes: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2019; 65:1225-1236. [PMID: 30149446 PMCID: PMC6218120 DOI: 10.3233/jad-180263] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Metformin, a first line antihyperglycemic medication, is an AMPK activator and has been hypothesized to act as a geroprotective agent. Studies on its association with various classifications of age-related cognitive decline have shown mixed results with positive and negative findings. Objective: To synthesize the best available evidence on the association of metformin-use with risk, progression, and severity of dementia. Method: Eligible research investigated the effect of metformin on dementia, Alzheimer’s disease, or any measure of cognitive impairment compared to any control group who were not receiving metformin. The initial search resulted in 862 citations from which 14 studies (seven cohort, four cross-sectional, two RCTs, and one case control) were included. Results: Meta-analysis of three studies showed that cognitive impairment was significantly less prevalent in diabetic metformin (Odds ratio = 0.55, 95% CI 0.38 to 0.78), while six studies showed that dementia incidence was also significantly reduced (Hazard ratio = 0.76, 95% CI 0.39 to 0.88). Mini-Mental State Examination scores were not significantly affected by metformin-use, although both RCTs showed that metformin had a neuroprotective effect compared to placebo. Some studies found negative or neutral effects for metformin use by people with diabetes; the potential mechanism of metformin-induced vitamin B12 deficiency is discussed. Conclusions: Metformin should continue to be used as a first line therapy for diabetes in patients at risk of developing dementia or Alzheimer’s disease. The use of metformin by individuals without diabetes for the prevention of dementia is not supported by the available evidence.
Collapse
Affiliation(s)
- Jared M Campbell
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia.,Centre for Nanoscale BioPhotonics, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales
| | - Matthew D Stephenson
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia
| | - Barbora de Courten
- Monash Centre for Health, Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ian Chapman
- Discipline of Medicine, National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia
| | - Susan M Bellman
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia
| | - Edoardo Aromataris
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia
| |
Collapse
|
14
|
Hyperhomocysteinemia Associated with Low Muscle Mass, Muscle Function in Elderly Hemodialysis Patients: An Analysis of Multiple Dialysis Centers. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9276097. [PMID: 31281847 PMCID: PMC6590600 DOI: 10.1155/2019/9276097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 05/23/2019] [Indexed: 11/18/2022]
Abstract
Background The hyperhomocysteinemia was with high prevalence and has been considered as a risk factor for cardiovascular disease in hemodialysis patients. These patients also experienced a high risk of muscle wasting caused by the comorbidity, malnutrition, and low physical activity. We investigated the associations of homocysteinemia with muscle mass, muscle function in elderly hemodialysis patients. Methods A clinical cross-sectional study was conducted on 138 hemodialysis patients aged 65 years and above in seven hospital-based hemodialysis centers in Taiwan. The data on anthropometry, laboratory, and 3-day dietary intake was examined. The skeletal muscle mass (SMM) was measured by the bioelectrical impedance analysis; the SMM was adjusted by height or weight as SMMHt2 (kg/m2) and SMMWt (%). Muscle function was defined as handgrip strength (HGS) (kg) measured by handgrip dynamometer. Statistical analyses were conducted using simple regression and multivariable stepwise regression analysis. Results In the total sample, 74.6 % of hemodialysis patients were hyperhomocysteinemia (≥ 15 μmol/L). The means of SMMHt2, SMMWt, arm lean mass, hand grip strength, and muscle quality were 8.7 ± 1.2, 37.7 ± 5.6, 1.7 ± 0.5, 21.1 ± 7.4, and 10.0 ± 3.0, respectively. The multivariable stepwise regression analysis showed that homocysteinemia level was significantly inversely associated with SMMWt (B-coeff. = -0.03, p = 0.02) in hemodialysis patients above 65 years old, but not with muscle function. Conclusions Hyperhomocysteinemia is common and associated with decreased muscle mass in the elderly hemodialysis patients. Future studies are suggested to explore the impact of the homocysteine-lowering therapy on muscle decline.
Collapse
|
15
|
Sandoval-Insausti H, Blanco-Rojo R, Graciani A, López-García E, Moreno-Franco B, Laclaustra M, Donat-Vargas C, Ordovás JM, Rodríguez-Artalejo F, Guallar-Castillón P. Ultra-processed Food Consumption and Incident Frailty: A Prospective Cohort Study of Older Adults. J Gerontol A Biol Sci Med Sci 2019; 75:1126-1133. [DOI: 10.1093/gerona/glz140] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Indexed: 12/19/2022] Open
Abstract
Abstract
Background
Ultra-processed food intake has been associated with chronic conditions and mortality. The aim of this study was to assess the relationship between ultra-processed food intake and incident frailty in community-dwelling older adults.
Methods
Prospective cohort study with 1,822 individuals aged at least 60 years who were recruited during 2008–2010 in Spain. At baseline, food consumption was obtained using a validated computerized face-to-face dietary history. Ultra-processed foods were identified according to the nature and extent of their industrial processing (NOVA classification). In 2012, incident frailty was ascertained based on Fried’s criteria. Statistical analyses were performed with logistic regression and adjusted for the main potential confounders.
Results
After a mean follow-up of 3.5 years, 132 cases of frailty were identified. The fully adjusted risks of frailty across increasing quartiles of the percentage of total energy intake from ultra-processed foods were the following: 0.04 (0.02–0.05), 0.05 (0.03–0.07), 0.09 (0.07–0.12), and 0.11 (0.08–0.14). Results were similar when food consumption was expressed as gram per day/body weight. Regarding ultra-processed food groups, the highest versus the lowest tertiles of consumption of yogurts and fermented milks, cakes and pastries, as well as nonalcoholic beverages (instant coffee and cocoa, packaged juices, and other nonalcoholic drinks, excluding soft drinks) were also significantly related to incident frailty.
Conclusions
Consumption of ultra-processed foods is strongly associated with frailty risk in older adults. Substituting unprocessed or minimally processed foods for ultra-processed foods would play an important role in the prevention of age-related frailty.
Trial registration
NCT02804672.
Collapse
Affiliation(s)
- Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid
| | - Belén Moreno-Franco
- Universidad de Zaragoza, Translational Research Unit. Hospital Universitario Miguel Servet, CIBERCV (CIBER of Cardiovascular Diseases), Zaragoza
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Translational Research Unit. Hospital Universitario Miguel Servet, CIBERCV (CIBER of Cardiovascular Diseases), Zaragoza
| | - Martín Laclaustra
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Translational Research Unit. Hospital Universitario Miguel Servet, CIBERCV (CIBER of Cardiovascular Diseases), Zaragoza
- Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), Zaragoza, Spain
| | - Carolina Donat-Vargas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - José M Ordovás
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
- U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
16
|
Prenatal hyperhomocysteinemia induces oxidative stress and accelerates ‘aging’ of mammalian neuromuscular synapses. Int J Dev Neurosci 2019; 75:1-12. [DOI: 10.1016/j.ijdevneu.2019.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/06/2019] [Accepted: 03/21/2019] [Indexed: 01/17/2023] Open
|
17
|
Struijk EA, Guallar-Castillón P, Rodríguez-Artalejo F, López-García E. Mediterranean Dietary Patterns and Impaired Physical Function in Older Adults. J Gerontol A Biol Sci Med Sci 2019; 73:333-339. [PMID: 28329809 DOI: 10.1093/gerona/glw208] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 09/26/2016] [Indexed: 11/14/2022] Open
Abstract
Background Information about nutritional risk factors of functional limitation is scarce. The aim of this study was to examine the association between the Mediterranean diet and risk of physical function impairment in older adults. Methods We used data from 1,630 participants in the Seniors-ENRICA cohort aged ≥60 years. In 2008-2010, adherence to the Mediterranean diet pattern was measured with the Mediterranean Diet Score (MDS) and the Mediterranean Diet Adherence Screener (MEDAS). Study participants were followed up through 2012 to assess incident impairment in agility and mobility as well as impairment in overall physical functioning, defined as a ≥5-point decrease from baseline to follow-up in the physical component summary of the 12-Item Short-Form Health Survey. Results Over a median follow-up of 3.5 years, we identified 343 individuals with agility limitation, 212 with mobility limitation, and 457 with decreased overall physical functioning. No association was found between the MDS score and the likelihood of impaired agility or mobility, although a 2-point increment in the MDS score was marginally associated with lower likelihood for decreased overall physical function. Compared to individuals in the lowest tertile of the MEDAS score, those in the highest tertile showed a lower odds of agility limitation (odds ratio: 0.67, 95% confidence interval: 0.48; 0.94, p trend = .02), mobility limitation (odds ratio: 0.69, 95% confidence interval: 0.40; 0.88, p trend = .01), and decreased overall physical functioning (odds ratio: 0.60, 95% confidence interval: 0.45; 0.79, p trend < .001). Conclusions In this prospective cohort study, a Mediterranean-style dietary pattern, especially when measured with the MEDAS, was associated with a lower likelihood of physical function impairment in older adults.
Collapse
Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| |
Collapse
|
18
|
Vidoni ML, Pettee Gabriel K, Luo ST, Simonsick EM, Day RS. Relationship between Homocysteine and Muscle Strength Decline: The Baltimore Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci 2019; 73:546-551. [PMID: 28958086 DOI: 10.1093/gerona/glx161] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 08/18/2017] [Indexed: 12/30/2022] Open
Abstract
Background Decreased muscle strength is strongly associated with future mobility limitations in older adults. Homocysteine is a risk factor for vascular disease and may exacerbate muscle strength decline. The present study aimed to examine the association between homocysteine levels and muscle strength in adults aged 50 years or older. Methods Data were from 1,101 participants of The Baltimore Longitudinal Study of Aging between December 2004 and March 2015. Muscle strength was measured using grip strength. Mixed effects linear regression was used to estimate the association between homocysteine and muscle strength in men and women, separately. Results Total mean follow-up time was 4.7 ± 3.1 years, range from 0 to 10.1 years. Baseline mean grip strength was 39.9 kg for men and 25.5 kg for women. Grip strength declined over the follow-up time for both men and women. Among women, there was a significant inverse relationship between homocysteine and grip strength, where grip strength declined as a function of increasing homocysteine over time (β = -0.05, p = .031). Among men, an increase of 1 μmol/L in homocysteine was associated with -0.10 kg decrease in grip strength, though not significantly. Conclusions In this study of healthy older adults aged 50 years or older, higher homocysteine was related to lower muscle strength in women. This is the first study to characterize the relationship over a long follow-up period. Future research should focus on assessing homocysteine as a marker of physical function decline and translating the relationship into clinical and public health practice.
Collapse
Affiliation(s)
- Michelle L Vidoni
- Division of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston School of Public Health
| | - Kelley Pettee Gabriel
- Division of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston School of Public Health in Austin
| | - Sheng T Luo
- Division of Biostatistics, The University of Texas Health Science Center at Houston School of Public Health
| | - Eleanor M Simonsick
- Division of Geriatric Medicine and Gerontology, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - R Sue Day
- Division of Epidemiology, Human Genetics, and Environmental Science, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health
| |
Collapse
|
19
|
Pourhassan M, Angersbach B, Lueg G, Klimek CN, Wirth R. Blood Thiamine Level and Cognitive Function in Older Hospitalized Patients. J Geriatr Psychiatry Neurol 2019; 32:90-96. [PMID: 30572755 DOI: 10.1177/0891988718819862] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM We sought to identify any association between whole blood thiamine level and functional status in older hospitalized patients. METHODS This cross-sectional study retrospectively analyzed the results of routine measurements of whole blood thiamine levels of 233 older patients who were consecutively hospitalized to a geriatric acute care ward. Nutritional status, depression, and the participants' cognitive impairment were evaluated using the Mini Nutritional Assessment-Short Form, Depression in Old Age Scale, and Montreal Cognitive Assessment, respectively. Activities of daily living were determined using Barthel Index (BI) on admission and at the time of discharge. Diagnoses of dementia and delirium were derived from the patients' medical records. RESULTS Of 233 participants (mean age 82.1 [7.1]), 47.0% and 39.0% were at risk of malnutrition and malnourished, respectively. There was no thiamine deficiency (<20 ng/mL) in total population. Nearly all patients (95%) were screened with impaired cognitive function, in which 36% and 9% had the diagnosis of dementia and delirium, respectively. Patients with dementia (P = .040) and delirium (P = .002) demonstrated lower mean thiamine blood levels compared to patients without. Mean blood vitamin B1 was higher in patients with functional recovery (change in BI ≥5 points during hospitalization; P = .018). In a binary logistic regression analysis, blood vitamin B1, weight loss, and female gender were the major independent risk factors for delirium but not for dementia. CONCLUSION Despite the absence of thiamine deficiency, whole blood thiamine was lower in patients with dementia and delirium compared to those without. Higher thiamine levels were significantly associated with functional recovery during hospitalization.
Collapse
Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Bjoern Angersbach
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Gero Lueg
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Christiane Nicola Klimek
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
20
|
AO M, INUIYA N, OHTA J, KUROSE S, TAKAOKA H, ABE Y, NIKI N, INOUE S, TANAKA S, MIYAWAKI T, TANAKA K. Relationship between Homocysteine, Folate, Vitamin B 12 and Physical Performance in the Institutionalized Elderly. J Nutr Sci Vitaminol (Tokyo) 2019; 65:1-7. [DOI: 10.3177/jnsv.65.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Misora AO
- Department of Food and Nutrition, Kyoto Women’s University
| | - Nao INUIYA
- Department of Food and Nutrition, Kyoto Women’s University
| | - Junko OHTA
- Faculty of Nutrition, Kobe Gakuin University
| | - Satoshi KUROSE
- Department of Health Science, Graduate School of Medicine, Kansai Medical University
| | | | | | - Naho NIKI
- Nursing Care Center, Care House Ajisai
| | | | | | | | - Kiyoshi TANAKA
- Department of Food and Nutrition, Kyoto Women’s University
- Faculty of Nutrition, Kobe Gakuin University
| |
Collapse
|
21
|
Fu S, Yao Y, Lv F, Zhang F, Zhao Y, Luan F. Serum Homocysteine Levels Had Important Associations with Activity and Quality of Daily Living in Chinese Centenarians. J Nutr Health Aging 2019; 23:479-482. [PMID: 31021366 DOI: 10.1007/s12603-019-1189-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Population aging is an important problem worldwide, with activity and quality of daily living commonly reduced in elderly people. leading to increased hospitalization and mortality rates, and substantial individual and social burdens. OBJECTIVE This study was designed to investigate the associations of serum homocysteine levels with activity and quality of daily living in Chinese centenarians for the first time. PARTICIPANTS The China Hainan Centenarian Cohort Study was performed in 18 cities and counties of Hainan Province. MAIN MEASURES Home interview, physical examination and blood analysis were performed in 787 centenarians following standard procedures. KEY RESULTS The median age was 102 years, ranging between 100 and 115 years. There were 634 females (80.6%) and 153 males (19.4%) in all. The median level of serum homocysteine was 23.80 (18.80-29.90) umol/L, whereas median values of Barthel Index and EuroQol 5 Dimensions were 85(60-95) and 0.661(0.558-0.766), respectively. The centenarians with serum homocysteine levels ≥23.8μmol/L were more likely to had lower values of Barthel Index and EuroQol 5 Dimensions than those with serum homocysteine levels <23.8μmol/L (P<0.05 for all). In multivariate linear regression analyses, serum homocysteine levels were significantly associated with Barthel Index and EuroQol 5 Dimensions (P<0.05 for all). CONCLUSIONS Serum homocysteine levels had important associations with activity and quality of daily living in Chinese centenarians. Future research should focus on the value of intervening in serum homocysteine levels by supplying folic acid (vitamin B9) and vitamin B12 on improving activity and quality of daily living in elderly people.
Collapse
Affiliation(s)
- S Fu
- Yali Zhao, Central Laboratory, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya 572013, China
| | | | | | | | | | | |
Collapse
|
22
|
Woo J, Ong S, Chan R, Li L, Sun J, Chan YM, Wee SL, Thu NN, Thang P, Setiati S, Huang YC, Wahlqvist ML, de Groot LCPGM. Nutrition, sarcopenia and frailty: An Asian perspective. TRANSLATIONAL MEDICINE OF AGING 2019. [DOI: 10.1016/j.tma.2019.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|
23
|
Intake of B vitamins and impairment in physical function in older adults. Clin Nutr 2018; 37:1271-1278. [DOI: 10.1016/j.clnu.2017.05.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 04/13/2017] [Accepted: 05/14/2017] [Indexed: 11/23/2022]
|
24
|
Association between Serum Vitamin Levels and Depression in U.S. Adults 20 Years or Older Based on National Health and Nutrition Examination Survey 2005⁻2006. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061215. [PMID: 29890739 PMCID: PMC6025280 DOI: 10.3390/ijerph15061215] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 12/14/2022]
Abstract
Depression is one of the leading causes of disability around the world. Although several studies have been conducted to analyze the association between vitamins and depression, the results have been inconsistent. Based on the database of National Health and Nutrition Examination Survey (NHANES) (2005–2006), a cross-sectional analysis was conducted to uncover the correlations between serum vitamin concentrations and depression in 2791 participants over 20 years of age. Vitamin concentrations in serum were measured by high performance liquid chromatography (HPLC), a standardized liquid chromatography-tandem mass spectrometry (LC-MS/MS) or radioassay kit method. A nine-item Patient Health Questionnaire (PHQ-9) was used to assess depression symptoms. The binary logistic regression model was applied to analyze the association between vitamins and depression. In the whole population, negative associations were discovered between folate concentrations (p for trend = 0.02), trans-β-carotene (p for trend = 0.01) and depression, while positive associations were found among vitamin B12 concentrations (p for trend = 0.008), vitamin A concentrations (p for trend = 0.01) and depression. In order to evaluate the influence of gender on the pathogenesis of depression of vitamins exposure, we performed gender-stratified analysis. In females, folate concentrations (p for trend = 0.03) and vitamin B12 concentrations (p for trend = 0.02) were correlated with depression. In males, no significant association was found between depression and serum vitamin concentrations. The correlation of vitamins with depression deserves further investigation in larger and diverse populations, especially in females.
Collapse
|
25
|
Machado-Fragua MD, Struijk EA, Graciani A, Guallar-Castillon P, Rodríguez-Artalejo F, Lopez-Garcia E. Coffee consumption and risk of physical function impairment, frailty and disability in older adults. Eur J Nutr 2018; 58:1415-1427. [PMID: 29549497 DOI: 10.1007/s00394-018-1664-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/09/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Habitual coffee consumption has been associated with lower risk of type 2 diabetes and cardiovascular disease. Since these diseases are main determinants of functional limitations, we have tested the hypothesis that coffee intake is associated with lower risk of physical function impairment, frailty and disability in older adults. We focused on women and those with obesity, hypertension or type 2 diabetes because they are at higher risk of functional limitations. METHODS Prospective study with 3289 individuals ≥ 60 years from the Seniors-ENRICA cohort. In 2008-2010 coffee consumption was measured through a validated dietary history. Participants were followed up until 2015 to ascertain incident impaired physical function, frailty and disability, assessed by both self-report and objective measures. RESULTS Compared with non-drinking coffee, consumption of ≥ 2 cups of coffee/day was associated with lower risk of impaired agility in women (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.51-0.97, P trend 0.04) and in those with obesity (HR 0.60; 95% CI 0.40-0.90, P trend 0.04). Intake of ≥ 2 cups of coffee/day was also linked to reduced risk of impaired mobility in women (HR 0.66; 95% CI 0.46-0.95, P trend 0.02) and among individuals with hypertension (HR 0.70, 95% CI 0.48-1.00, P trend 0.05). Moreover, among subjects with diabetes, those who consumed ≥ 2 cups/day had lower risk of disability in activities of daily living (HR 0.30, 95% CI 0.11-0.76, P trend 0.01). CONCLUSIONS In older people, habitual coffee consumption was not associated with increased risk of functional impairment, and it might even be beneficial in women and those with hypertension, obesity or diabetes.
Collapse
Affiliation(s)
- Marcos D Machado-Fragua
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain. .,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain. .,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pilar Guallar-Castillon
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain. .,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain. .,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain. .,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
| |
Collapse
|
26
|
Selected B vitamins and their possible link to the aetiology of age-related sarcopenia: relevance of UK dietary recommendations. Nutr Res Rev 2018; 31:204-224. [DOI: 10.1017/s0954422418000045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractThe possible roles of selected B vitamins in the development and progression of sarcopenia are reviewed. Age-related declines in muscle mass and function are associated with huge and increasing costs to healthcare providers. Falls and loss of mobility and independence due to declining muscle mass/function are associated with poor clinical outcomes and their prevention and management are attractive research targets. Nutritional status appears a key modifiable and affordable intervention. There is emerging evidence of sarcopenia being the result not only of diminished anabolic activity but also of declining neurological integrity in older age, which is emerging as an important aspect of the development of age-related decline in muscle mass/function. In this connection, several B vitamins can be viewed as not only cofactors in muscle synthetic processes, but also as neurotrophic agents with involvements in both bioenergetic and trophic pathways. The B vitamins thus selected are examined with respect to their relevance to multiple aspects of neuromuscular function and evidence is considered that requirements, intakes or absorption may be altered in the elderly. In addition, the evidence base for recommended intakes (UK recommended daily allowance) is examined with particular reference to original datasets and their relevance to older individuals. It is possible that inconsistencies in the literature with respect to the nutritional management of sarcopenia may, in part at least, be the result of compromised micronutrient status in some study participants. It is suggested that in order, for example, for intervention with amino acids to be successful, underlying micronutrient deficiencies must first be addressed/eliminated.
Collapse
|
27
|
Midttun Ø, Theofylaktopoulou D, McCann A, Fanidi A, Muller DC, Meyer K, Ulvik A, Zheng W, Shu XO, Xiang YB, Prentice R, Thomson CA, Pettinger M, Giles GG, Hodge A, Cai Q, Blot WJ, Wu J, Johansson M, Hultdin J, Grankvist K, Stevens VL, McCullough ML, Weinstein SJ, Albanes D, Langhammer A, Hveem K, Næss M, Sesso HD, Gaziano JM, Buring JE, Lee IM, Severi G, Zhang X, Han J, Stampfer MJ, Smith-Warner SA, Zeleniuch-Jacquotte A, le Marchand L, Yuan JM, Butler LM, Koh WP, Wang R, Gao YT, Ericson U, Sonestedt E, Ziegler RG, Freedman ND, Visvanathan K, Jones MR, Relton C, Brennan P, Johansson M, Ueland PM. Circulating concentrations of biomarkers and metabolites related to vitamin status, one-carbon and the kynurenine pathways in US, Nordic, Asian, and Australian populations. Am J Clin Nutr 2017; 105:1314-1326. [PMID: 28424186 PMCID: PMC5445679 DOI: 10.3945/ajcn.116.151241] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/16/2017] [Indexed: 12/21/2022] Open
Abstract
Background: Circulating concentrations of biomarkers that are related to vitamin status vary by factors such as diet, fortification, and supplement use. Published biomarker concentrations have also been influenced by the variation across laboratories, which complicates a comparison of results from different studies.Objective: We robustly and comprehensively assessed differences in biomarkers that are related to vitamin status across geographic regions.Design: The trial was a cross-sectional study in which we investigated 38 biomarkers that are related to vitamin status and one-carbon and tryptophan metabolism in serum and plasma from 5314 healthy control subjects representing 20 cohorts recruited from the United States, Nordic countries, Asia, and Australia, participating in the Lung Cancer Cohort Consortium. All samples were analyzed in a centralized laboratory.Results: Circulating concentrations of riboflavin, pyridoxal 5'-phosphate, folate, vitamin B-12, all-trans retinol, 25-hydroxyvitamin D, and α-tocopherol as well as combined vitamin scores that were based on these nutrients showed that the general B-vitamin concentration was highest in the United States and that the B vitamins and lipid soluble vitamins were low in Asians. Conversely, circulating concentrations of metabolites that are inversely related to B vitamins involved in the one-carbon and kynurenine pathways were high in Asians. The high B-vitamin concentration in the United States appears to be driven mainly by multivitamin-supplement users.Conclusions: The observed differences likely reflect the variation in intake of vitamins and, in particular, the widespread multivitamin-supplement use in the United States. The results provide valuable information about the differences in biomarker concentrations in populations across continents.
Collapse
Affiliation(s)
| | | | | | - Anouar Fanidi
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - David C Muller
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | | | | | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ross Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Cynthia A Thomson
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Graham G Giles
- Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, Victoria, Australia
- Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Allison Hodge
- Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, Victoria, Australia
- Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - William J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
- International Epidemiology Institute, Rockville, MD
| | - Jie Wu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | | | - Johan Hultdin
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | | | | | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD
| | - Arnulf Langhammer
- Nord-Trøndelag Health Study Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Levanger, Norway
| | - Kristian Hveem
- Nord-Trøndelag Health Study Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Levanger, Norway
| | - Marit Næss
- Nord-Trøndelag Health Study Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Levanger, Norway
| | - Howard D Sesso
- Divisions of Preventive Medicine and
- Aging, Brigham and Women's Hospital, Boston, MA
- Departments of Epidemiology and
| | - J Michael Gaziano
- Aging, Brigham and Women's Hospital, Boston, MA
- VA Boston Healthcare System, Boston, MA
| | - Julie E Buring
- Divisions of Preventive Medicine and
- Departments of Epidemiology and
| | - I-Min Lee
- Divisions of Preventive Medicine and
- Departments of Epidemiology and
| | - Gianluca Severi
- Human Genetics Foundation, Turin, Italy
- Centre for Research in Epidemiology and Population Health (U1018 French National Institute of Health and Medical Research), Facultés de Médecine Université Paris-Sud, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, Villejuif, France
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | | | - Meir J Stampfer
- Departments of Epidemiology and
- Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | | | | | - Loic le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Lesley M Butler
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Woon-Puay Koh
- Duke-National University of Singapore (NSU) Medical School, Singapore, and Saw Swee Hock School of Public Health, NSU, Singapore, Singapore
| | - Renwei Wang
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai Jiaotong University, Shanghai, China
| | - Ulrika Ericson
- Department of clinical sciences Malmö, Lund University, Lund, Sweden
| | - Emily Sonestedt
- Department of clinical sciences Malmö, Lund University, Lund, Sweden
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD
| | - Kala Visvanathan
- Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Sidney Kimmel Comprehensive Center, School of Medicine, Baltimore, MD
| | - Miranda R Jones
- Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Sidney Kimmel Comprehensive Center, School of Medicine, Baltimore, MD
| | - Caroline Relton
- Institute of Genetic Medicine, Newcastle University, Newcastle, United Kingdom
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; and
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Mattias Johansson
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Per M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
28
|
Vidoni ML, Pettee Gabriel K, Luo ST, Simonsick EM, Day RS. Vitamin B12 and Homocysteine Associations with Gait Speed in Older Adults: The Baltimore Longitudinal Study of Aging. J Nutr Health Aging 2017; 21:1321-1328. [PMID: 29188896 PMCID: PMC5726303 DOI: 10.1007/s12603-017-0893-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to assess the independent associations of serum levels of vitamin B12 and plasma concentrations of homocysteine with gait speed decline. DESIGN, SETTING, PARTICIPANTS This study utilized longitudinal analysis of participants 50 years or older from The Baltimore Longitudinal Study of Aging, N=774. MEASUREMENTS Gait speed (m/s) was assessed using the 6-meter usual pace test. Vitamin B12 and homocysteine concentrations were collected using standard clinical protocols. Linear mixed effects regression was stratified by baseline age category (50-69, 70-79, and ≥80 years old). RESULTS Mean follow-up time for the total study sample was 5.4 ± 2.0 years. No association between vitamin B12 and gait speed decline over the follow-up time for any age group was found. Elevated homocysteine concentrations were associated with decline in gait speed after adjustment for covariates (50-69: β= -0.005, p=.057; 70-79: β= -0.013, p<.001, ≥80: β= -0.007, p=.054). CONCLUSION Homocysteine and vitamin B12 are inversely related, yet only homocysteine was associated with gait speed decline in this population of healthy older adults. Given these results, future research should be directed towards investigating the relationship in populations with greater variation in vitamin B12 concentrations and other mechanisms influencing homocysteine concentrations.
Collapse
Affiliation(s)
- M L Vidoni
- R. Sue Day, University of Texas Health Science Center at Houston School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Science, Michael and Susan Dell Center for Healthy Living, Houston, TX, USA,
| | | | | | | | | |
Collapse
|
29
|
de Koning EJ, van der Zwaluw NL, van Wijngaarden JP, Sohl E, Brouwer-Brolsma EM, van Marwijk HWJ, Enneman AW, Swart KMA, van Dijk SC, Ham AC, van der Velde N, Uitterlinden AG, Penninx BWJH, Elders PJM, Lips P, Dhonukshe-Rutten RAM, van Schoor NM, de Groot LCPGM. Effects of Two-Year Vitamin B 12 and Folic Acid Supplementation on Depressive Symptoms and Quality of Life in Older Adults with Elevated Homocysteine Concentrations: Additional Results from the B-PROOF Study, an RCT. Nutrients 2016; 8:nu8110748. [PMID: 27886078 PMCID: PMC5133130 DOI: 10.3390/nu8110748] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 12/31/2022] Open
Abstract
Lowering elevated plasma homocysteine (Hcy) concentrations by supplementing vitamin B12 and folic acid may reduce depressive symptoms and improve health-related quality of life (HR-QoL) in older adults. This study aimed to test this hypothesis in a randomized controlled trial. Participants (N = 2919, ≥65 years, Hcy concentrations ≥12 µmol/L) received either 500 µg vitamin B12 and 400 µg folic acid daily or placebo for two years. Both tablets contained 15 µg vitamin D3. Depressive symptoms were measured with the Geriatric Depression Scale-15 (GDS-15). HR-QoL was assessed with the SF-12 Mental and Physical component summary scores and the EQ-5D Index score and Visual Analogue Scale. Differences in two-year change scores were analyzed with Analysis of Covariance (ANCOVA). Hcy concentrations decreased more in the intervention group, but two-year change scores of the GDS-15 and three of four HR-QoL measures did not differ between groups. The EQ-5D Index score declined less in the intervention group than in the placebo group (mean change 0.00 vs. −0.02, p = 0.004). In conclusion, two-year supplementation with vitamin B12 and folic acid in older adults with hyperhomocysteinemia showed that lowering Hcy concentrations does not reduce depressive symptoms, but it may have a small positive effect on HR-QoL.
Collapse
Affiliation(s)
- Elisa J de Koning
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Nikita L van der Zwaluw
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| | - Janneke P van Wijngaarden
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| | - Evelien Sohl
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Elske M Brouwer-Brolsma
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| | - Harm W J van Marwijk
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Primary Care Research Center, Institute of Population Health, University of Manchester, Oxford Road, M13 9PL Manchester, UK.
| | - Anke W Enneman
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Karin M A Swart
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Suzanne C van Dijk
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Annelies C Ham
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Brenda W J H Penninx
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Psychiatry, VU University Medical Center/GGZ inGeest, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Petra J M Elders
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Paul Lips
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Internal Medicine/Endocrinology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | | | - Natasja M van Schoor
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Lisette C P G M de Groot
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| |
Collapse
|
30
|
Wee AKH. Serum folate predicts muscle strength: a pilot cross-sectional study of the association between serum vitamin levels and muscle strength and gait measures in patients >65 years old with diabetes mellitus in a primary care setting. Nutr J 2016; 15:89. [PMID: 27756315 PMCID: PMC5070191 DOI: 10.1186/s12937-016-0208-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/06/2016] [Indexed: 12/27/2022] Open
Abstract
Background Old age and diabetes mellitus are risk factors for vitamin deficiencies, weakness and falls. Deficiencies of vitamin D, and possibly vitamin B12 and folate (which are associated with hyperhomocysteinaemia), contribute to sarcopenia. Determination of the physical effects of vitamin deficiencies in specific groups of people can help to guide public health policy with regard to vitamin supplementation. Methods A pilot cross-sectional study was conducted to determine the association of levels of vitamin D, vitamin B12, folate and homocysteine with muscle strength, gait and fall history in 56 patients >65 years old with diabetes mellitus in primary care in Singapore. Hand-grip and leg-quadriceps strength measures were obtained and divided by body mass index (BMI). The timed up-and-go and Tinetti tests were used to measure gait. A history of “at least one fall in the preceding year” was obtained. Results Vitamin B12 deficiency (<150 pmol/l) was present in 43 % of patients, folate deficiency (<13.5 mmol/l) in 20 %, hyperhomocysteinaemia (≥15.0 μmol/l) in 52 % and vitamin D deficiency (<49.9 nmol/l) in 25 %. Levels of vitamin D, vitamin B12 and homocysteine did not significantly predict muscle strength in regression analyses. Folate (B = 0.010, P < 0.01) and gender (B = 0.356, P < 0.001) predicted average grip strength corrected for BMI (F(2,53) = 17.74, P < 0.001, R2 = 0.40) Folate (B = 0.011, P < 0.05) and gender (B = 0.367, P < 0.001) also predicted average leg quadriceps strength corrected for BMI (F(2,53) = 9.79, P < 0.001, R2 = 0.27). Average leg strength and average leg strength corrected for BMI were both negatively associated with the risk of having fallen in the preceding year (odds ratio (OR) = 0.89, 95 % CI 0.80–0.98, P < 0.05 and OR = 0.12, 95 % CI 0.02–0.92, P < 0.05, respectively). Conclusions The prevalence of vitamin deficiency was very high in our sample of patients >65 years old with diabetes mellitus. Folate levels were significantly correlated with grip and leg strength (with correction for BMI). Leg strength was positively correlated with gait measures and negatively correlated with a history of falls. The role of folate in muscle weakness and falls warrants further study.
Collapse
Affiliation(s)
- Andrew Kien Han Wee
- SingHealth Polyclinics, Marine Parade Polyclinic, Blk 80 Marine Parade Central, #01-792, Singapore, 440080, Singapore.
| |
Collapse
|
31
|
Chen LJ, Steptoe A, Ku PW. Obesity, Apolipoprotein E ε4, and Difficulties in Activities of Daily Living Among Older Adults: a 6-Year Follow-up Study. Ann Behav Med 2016; 51:251-260. [PMID: 27738971 DOI: 10.1007/s12160-016-9848-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity has been associated with increased physical limitations among older adults, although few studies have adjusted for important covariates. There is limited information about the relationship between apolipoprotein E (APOE) polymorphisms and physical limitations, and the findings have been inconsistent. PURPOSE This study examined the longitudinal associations of obesity and APOE ε4 with difficulties in activities of daily living (ADLs) over a 6-year follow-up period controlling for multiple covariates. METHODS Data were analyzed from the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age = 66). Body mass index (BMI) was used to define obesity at a baseline, and the APOE genotype was classified into an APOE ε4 carrier and non-carrier status. The combination of basic and instrumental activities of daily living (ADLs and IADLs) was used to define impaired ADLs. RESULTS APOE ε4 carriers had greater difficulties in combined ADLs (incident rate ratio; IRR = 1.87, 95 % CI = 1.40-2.51) than non-carriers. Obese but not overweight adults had greater difficulties in activities of daily living (IRR = 1.59, 95 % CI = 1.20-2.10) compared with the normal/underweight group. Obese older adults without APOE ε4 had greater subsequent difficulties in ADLs than non-obese non-carriers. Among APOE ε4 carriers, obesity was not a significant risk factor for the development of impaired ADLs in older adults, indicating an interaction between genotype and obesity. CONCLUSIONS The interaction between genotype and obesity phenotype adds new information about the determinants of physical impairment.
Collapse
Affiliation(s)
- Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Po-Wen Ku
- Department of Epidemiology and Public Health, University College London, London, UK. .,Graduate Institute of Sports and Health, National Changhua University of Education, No.1, Jinde Rd, Changhua City, 500, Taiwan.
| |
Collapse
|
32
|
Petridou ET, Kousoulis AA, Michelakos T, Papathoma P, Dessypris N, Papadopoulos FC, Stefanadis C. Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis. Aging Ment Health 2016; 20:965-73. [PMID: 26055921 DOI: 10.1080/13607863.2015.1049115] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To systematically review and meta-analyse existing evidence on the association between folate/B12, and depression among the aged people. METHODS Following PRISMA/STROBE guidelines, the Medline abstracts were retrieved using an algorithm comprising relevant MeSH terms. Publications on the association of folate/B12 serum measurements with depression were abstracted independently by two reviewers and included in both gender and gender-specific meta-analyses, following recarculations of published data as appropriate. The Newcastle-Ottawa scale was used to evaluate the quality of included studies. RESULTS Both gender data were contributed by 11 folate-related (7949 individuals) and 9 B12-related studies (6308 individuals), whereas gender-specific data by 4 folate-related (3409 individuals) and 3 B12-related studies (1934 individuals). A statistically significant overall association between both exposures of interest (low folate and B12 levels) and depression was observed (ORfolate:1.23, 95%CI:1.07-1.43, ORB12:1.20, 95%CI:1.02-1.42). Gender-specific estimates pointed to a statistically significant positive association between low B12 levels and depression only among women (OR:1.33, 95%CI:1.02-1.74); the gender specific associations of low folate levels with depression were, however, non-significant and of counter-direction (ORfemales:1.37, 95%CI:0.90-2.07; ORmales:0.84, 95%CI:0.57-1.25). CONCLUSION Low folate and B12 serum levels seem to be associated with depression in the aged. The gender-specific analyses are confined to a positive association of low B12 with depression among older women and call for further research in this direction.
Collapse
Affiliation(s)
- Eleni Th Petridou
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Antonis A Kousoulis
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Theodoros Michelakos
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Paraskevi Papathoma
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Nick Dessypris
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Fotios C Papadopoulos
- b Department of Neuroscience , Psychiatry, Uppsala University Hospital, Uppsala University , Uppsala , Sweden
| | - Christodoulos Stefanadis
- c First Department of Cardiology , Athens University Medical School, Hippokration Hospital , Athens , Greece
| |
Collapse
|
33
|
Swart KMA, Ham AC, van Wijngaarden JP, Enneman AW, van Dijk SC, Sohl E, Brouwer-Brolsma EM, van der Zwaluw NL, Zillikens MC, Dhonukshe-Rutten RAM, van der Velde N, Brug J, Uitterlinden AG, de Groot LCPGM, Lips P, van Schoor NM. A Randomized Controlled Trial to Examine the Effect of 2-Year Vitamin B12 and Folic Acid Supplementation on Physical Performance, Strength, and Falling: Additional Findings from the B-PROOF Study. Calcif Tissue Int 2016; 98:18-27. [PMID: 26412463 PMCID: PMC4703626 DOI: 10.1007/s00223-015-0059-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 08/22/2015] [Indexed: 11/26/2022]
Abstract
Elevated homocysteine concentrations are associated with a decline in physical function in elderly persons. Homocysteine-lowering therapy may slow down this decline. This study aimed to examine the effect of a 2-year intervention of vitamin B12 and folic acid supplementation on physical performance, handgrip strength, and risk of falling in elderly subjects in a double-blind, randomized placebo-controlled trial. Participants aged ≥65 years with elevated plasma homocysteine concentrations [12-50 µmol/L (n = 2919)] were randomly assigned to daily supplementation of 500 µg vitamin B12, 400 µg folic acid, and 600 IU vitamin D3, or to placebo with 600 IU vitamin D3. Physical performance (range 0-12) and handgrip strength (kg) were measured at baseline and after 2 years. Falls were reported prospectively on a research calendar. Intention-to-treat (primary) and per-protocol (secondary) analyses were performed. Physical performance level and handgrip strength significantly decreased during the follow-up period, but this decline did not differ between groups. Moreover, time to first fall was not significantly different (HR: 1.0, 95% CI 0.9-1.2). Secondary analyses on a per-protocol base identified an interaction effect with age on physical performance. In addition, the treatment was associated with higher follow-up scores on the walking test (cumulative OR: 1.3, 95% CI 1.1-1.5). Two-year supplementation of vitamin B12 and folic acid was neither effective in reducing the age-related decline in physical performance and handgrip strength, nor in the prevention of falling in elderly persons. Despite the overall null-effect, the results provide indications for a positive effect of the intervention on gait, as well as on physical performance among compliant persons >80 years. These effects should be further tested in future studies.
Collapse
Affiliation(s)
- Karin M A Swart
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Annelies C Ham
- Department of Internal Medicine, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Janneke P van Wijngaarden
- Department of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands
| | - Anke W Enneman
- Department of Internal Medicine, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Suzanne C van Dijk
- Department of Internal Medicine, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Evelien Sohl
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Elske M Brouwer-Brolsma
- Department of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands
| | - Nikita L van der Zwaluw
- Department of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | | | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Johannes Brug
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Lisette C P G M de Groot
- Department of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section and the EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| |
Collapse
|
34
|
Abstract
Older adults are becoming a significant percentage of the world's population. A multitude of factors, from the normal aging process to the progression of chronic disease, influence the nutrition needs of this very diverse group of people. Appropriate micronutrient intake is of particular importance but is often suboptimal. Here we review the available data regarding micronutrient needs and the consequences of deficiencies in the ever growing aged population.
Collapse
Affiliation(s)
- Stephanie C Montgomery
- Division of General Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Stephanie M Streit
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Mara Lee Beebe
- Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina
| | - Pinckney J Maxwell
- Division of Gastrointestinal and Laparoscopic Surgery, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
35
|
Veeranki S, Tyagi SC. Defective homocysteine metabolism: potential implications for skeletal muscle malfunction. Int J Mol Sci 2013; 14:15074-91. [PMID: 23873298 PMCID: PMC3742288 DOI: 10.3390/ijms140715074] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 06/24/2013] [Accepted: 07/11/2013] [Indexed: 12/13/2022] Open
Abstract
Hyperhomocysteinemia (HHcy) is a systemic medical condition and has been attributed to multi-organ pathologies. Genetic, nutritional, hormonal, age and gender differences are involved in abnormal homocysteine (Hcy) metabolism that produces HHcy. Homocysteine is an intermediate for many key processes such as cellular methylation and cellular antioxidant potential and imbalances in Hcy production and/or catabolism impacts gene expression and cell signaling including GPCR signaling. Furthermore, HHcy might damage the vagus nerve and superior cervical ganglion and affects various GPCR functions; therefore it can impair both the parasympathetic and sympathetic regulation in the blood vessels of skeletal muscle and affect long-term muscle function. Understanding cellular targets of Hcy during HHcy in different contexts and its role either as a primary risk factor or as an aggravator of certain disease conditions would provide better interventions. In this review we have provided recent Hcy mediated mechanistic insights into different diseases and presented potential implications in the context of reduced muscle function and integrity. Overall, the impact of HHcy in various skeletal muscle malfunctions is underappreciated; future studies in this area will provide deeper insights and improve our understanding of the association between HHcy and diminished physical function.
Collapse
Affiliation(s)
- Sudhakar Veeranki
- Authors to whom correspondence should be addressed; E-Mails: (S.V.); (S.C.T.); Tel.: +1-973-610-1160 (S.V.); +1-502-852-3381 (S.C.T.); Fax: +1-502-852-6239 (S.C.T.)
| | - Suresh C. Tyagi
- Authors to whom correspondence should be addressed; E-Mails: (S.V.); (S.C.T.); Tel.: +1-973-610-1160 (S.V.); +1-502-852-3381 (S.C.T.); Fax: +1-502-852-6239 (S.C.T.)
| |
Collapse
|