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Risk factors associated with the onset and progression of Alzheimer’s disease: A systematic review of the evidence. Neurotoxicology 2017; 61:143-187. [DOI: 10.1016/j.neuro.2017.03.006] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 03/22/2017] [Indexed: 12/25/2022]
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Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O'Donnell M, Sullivan R, Yusuf S. The burden of disease in older people and implications for health policy and practice. Lancet 2015; 385:549-62. [PMID: 25468153 DOI: 10.1016/s0140-6736(14)61347-7] [Citation(s) in RCA: 1163] [Impact Index Per Article: 129.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
23% of the total global burden of disease is attributable to disorders in people aged 60 years and older. Although the proportion of the burden arising from older people (≥60 years) is highest in high-income regions, disability-adjusted life years (DALYs) per head are 40% higher in low-income and middle-income regions, accounted for by the increased burden per head of population arising from cardiovascular diseases, and sensory, respiratory, and infectious disorders. The leading contributors to disease burden in older people are cardiovascular diseases (30·3% of the total burden in people aged 60 years and older), malignant neoplasms (15·1%), chronic respiratory diseases (9·5%), musculoskeletal diseases (7·5%), and neurological and mental disorders (6·6%). A substantial and increased proportion of morbidity and mortality due to chronic disease occurs in older people. Primary prevention in adults aged younger than 60 years will improve health in successive cohorts of older people, but much of the potential to reduce disease burden will come from more effective primary, secondary, and tertiary prevention targeting older people. Obstacles include misplaced global health priorities, ageism, the poor preparedness of health systems to deliver age-appropriate care for chronic diseases, and the complexity of integrating care for complex multimorbidities. Although population ageing is driving the worldwide epidemic of chronic diseases, substantial untapped potential exists to modify the relation between chronological age and health. This objective is especially important for the most age-dependent disorders (ie, dementia, stroke, chronic obstructive pulmonary disease, and vision impairment), for which the burden of disease arises more from disability than from mortality, and for which long-term care costs outweigh health expenditure. The societal cost of these disorders is enormous.
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Affiliation(s)
| | - Fan Wu
- Shanghai Institutes of Preventative Medicine and the Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Yanfei Guo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Luis M Gutierrez Robledo
- Instituto Nacional De Geriatría, and Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | | | - Richard Sullivan
- Kings Health Partners Cancer Centre, and Institute of Cancer Policy, Kings Health Partners Integrated Cancer, and Centre for Global Health, King's College London, London, UK
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Dudina A, Cooney MT, Bacquer DD, Backer GD, Ducimetière P, Jousilahti P, Keil U, Menotti A, Njølstad I, Oganov R, Sans S, Thomsen T, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Conroy R, Fitzgerald A, Graham I. Relationships between body mass index, cardiovascular mortality, and risk factors: a report from the SCORE investigators. ACTA ACUST UNITED AC 2011; 18:731-42. [DOI: 10.1177/1741826711412039] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Alexandra Dudina
- Department of Cardiology Adelaide Meath Hospital, Tallaght, Dublin, Ireland
| | | | - Dirk De Bacquer
- Department of Public Health, University of Ghent, Ghent, Belgium
| | - Guy De Backer
- Department of Public Health, University of Ghent, Ghent, Belgium
| | - Pierre Ducimetière
- National Institute for Health and Medical Research (INSERM), Villejuif, France
| | - Pekka Jousilahti
- Department of Epidemiology and Health Promotion, National Public Health Institute, Finland
| | - Ulrich Keil
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | | | - Inger Njølstad
- Institute of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Rafael Oganov
- National Research Centre for Preventive Medicine, Russian Ministry of Health, Moscow, Russia
| | - Susana Sans
- Institute of Health Studies, The Catalan Department of Health, Barcelona, Spain
| | - Troels Thomsen
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
| | - Aage Tverdal
- Norwegian Institute of Public Health, Oslo, Norway
| | - Hans Wedel
- Section of Preventive Cardiology, University of Gothenburg, Gothenburg, Sweden
| | - Peter Whincup
- Division of Community Health Sciences, St George′s, University of London, London, UK
| | - Lars Wilhelmsen
- Section of Preventive Cardiology, University of Gothenburg, Gothenburg, Sweden
| | - Ronan Conroy
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland
| | - Anthony Fitzgerald
- Department of Epidemiology and Public Health and Department Statistics, University College, Cork, Ireland
| | - Ian Graham
- Department of Cardiology Adelaide Meath Hospital, Tallaght, Dublin, Ireland
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Spindler SR. Caloric restriction: from soup to nuts. Ageing Res Rev 2010; 9:324-53. [PMID: 19853062 DOI: 10.1016/j.arr.2009.10.003] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 10/07/2009] [Accepted: 10/09/2009] [Indexed: 12/25/2022]
Abstract
Caloric restriction (CR), reduced protein, methionine, or tryptophan diets; and reduced insulin and/or IGFI intracellular signaling can extend mean and/or maximum lifespan and delay deleterious age-related physiological changes in animals. Mice and flies can shift readily between the control and CR physiological states, even at older ages. Many health benefits are induced by even brief periods of CR in flies, rodents, monkeys, and humans. In humans and nonhuman primates, CR produces most of the physiologic, hematologic, hormonal, and biochemical changes it produces in other animals. In primates, CR provides protection from type 2 diabetes, cardiovascular and cerebral vascular diseases, immunological decline, malignancy, hepatotoxicity, liver fibrosis and failure, sarcopenia, inflammation, and DNA damage. It also enhances muscle mitochondrial biogenesis, affords neuroprotection; and extends mean and maximum lifespan. CR rapidly induces antineoplastic effects in mice. Most claims of lifespan extension in rodents by drugs or nutrients are confounded by CR effects. Transcription factors and co-activators involved in the regulation of mitochondrial biogenesis and energy metabolism, including SirT1, PGC-1alpha, AMPK and TOR may be involved in the lifespan effects of CR. Paradoxically, low body weight in middle aged and elderly humans is associated with increased mortality. Thus, enhancement of human longevity may require pharmaceutical interventions.
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Jotheeswaran AT, Williams JD, Prince MJ. Predictors of mortality among elderly people living in a south Indian urban community; a 10/66 Dementia Research Group prospective population-based cohort study. BMC Public Health 2010; 10:366. [PMID: 20573243 PMCID: PMC2910676 DOI: 10.1186/1471-2458-10-366] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2009] [Accepted: 06/23/2010] [Indexed: 11/24/2022] Open
Abstract
Background Eighty percent of deaths occur in low and middle income countries (LMIC), where chronic diseases are the leading cause. Most of these deaths are of older people, but there is little information on the extent, pattern and predictors of their mortality. We studied these among people aged 65 years and over living in urban catchment areas in Chennai, south India. Methods In a prospective population cohort study, 1005 participants were followed-up after three years. Baseline assessment included sociodemographic and socioeconomic characteristics, health behaviours, physical, mental and cognitive disorders, disability and subjective global health. Results At follow-up, 257 (25.6%) were not traced. Baseline characteristics were similar to the 748 whose vital status was ascertained; 154 (20.6%) had died. The mortality rate was 92.5/1000 per annum for men and 51.0/1000 per annum for women. Adjusting for age and sex, mortality was associated with older age, male sex, having no friends, physical inactivity, smaller arm circumference, dementia, depression, poor self-rated health and disability. A parsimonious model included, in order of aetiologic force, male sex, smaller arm circumference, age, disability, and dementia. The total population attributable risk fraction was 0.90. Conclusion A balanced approach to prevention of chronic disease deaths requires some attention to proximal risk factors in older people. Smoking and obesity seem much less relevant than in younger people. Undernutrition is preventable. While dementia makes the largest contribution to disability and dependency, comorbidity is the rule, and more attention should be given to the chronic care needs of those affected, and their carers.
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Affiliation(s)
- A T Jotheeswaran
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, P060, De Crespigny Park, London SE58AF, UK
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Impact of resistance training with or without caloric restriction on physical capacity in obese older women. Menopause 2009; 16:66-72. [PMID: 18779759 DOI: 10.1097/gme.0b013e31817dacf7] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the specific impact of resistance training (RT) with or without caloric restriction (CR) on physical capacity in obese older women. DESIGN Forty-eight postmenopausal obese women, physically independent and between the ages of 55 and 75 years were recruited. The women were randomly assigned to one of four groups (1: RT [n = 12], 2: CR [n = 12], 3: CR + RT [n = 12], or 4: control group [C; n = 12]) for 3 months. CR and CR + RT groups participated in a weekly group session on nutrition, and RT and CR + RT groups took part in a resistance training program. Physical capacity was measured with 11 different performance tests. A global physical capacity score (range, 0-44) was then computed using quartiles of each test. Body composition was measured by dual-energy x-ray absorptiometry. RESULTS Body weight, total fat mass, percentage of fat mass, and body mass index (kg/m) significantly decreased in the CR and CR + RT groups (P < 0.01), whereas only the CR group showed a significant decrease in lean body mass (P < 0.05) after the 3-month program. The global physical capacity score significantly improved in the RT group (10.0 +/- 8.8%; P < 0.01), compared with the C group after 3 months. CONCLUSION Overall, the 3-month RT program alone had a greater effect on physical capacity than CR or CR + RT. Thus, a 3-month RT could help prevent long-term decreases in physical capacity in obese older women.
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Takata Y, Ansai T, Soh I, Akifusa S, Sonoki K, Fujisawa K, Awano S, Kagiyama S, Hamasaki T, Nakamichi I, Yoshida A, Takehara T. Association Between Body Mass Index and Mortality in an 80-Year-Old Population. J Am Geriatr Soc 2007; 55:913-7. [PMID: 17537093 DOI: 10.1111/j.1532-5415.2007.01170.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the association between body mass index (BMI) and all-cause mortality and cardiovascular disease (CVD) in an 80-year-old population. DESIGN Cohort study. SETTING Community-based. PARTICIPANTS Six hundred ninety-seven of 1,282 (54.4%) 80-year-old candidate individuals. MEASUREMENTS The dates and causes of all deaths were followed up for 4 years. RESULTS The relative hazard ratios (HRs) for all-cause mortality were lower in overweight subjects (BMI > or= 25.0) than in underweight (BMI<18.5) or normal-weight (BMI 18.5-24.9) subjects. Similarly, the HRs for mortality due to CVD in overweight subjects were 78% less (HR=0.22, 95% confidence interval (CI)=0.06-0.77) than those in underweight subjects, and those in normal weight subjects were 78% less (HR=0.22, 95% CI=0.08-0.60) than those in underweight subjects. Mortality due to CVD was 4.6 times (HR 4.64, 95% CI=1.68-12.80) as high in underweight subjects as in normal-weight subjects, and mortality due to cancers was 88% lower (HR=0.12, 95% CI=0.02-0.78) in the overweight group than in the underweight group. There were no differences in mortality due to pneumonia. CONCLUSION Overweight status was associated with longevity and underweight with short life, due to lower and higher mortality, respectively, from CVD and cancer.
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Affiliation(s)
- Yutaka Takata
- Division of General Internal Medicine, Department of Health Promotion, Kyushu Dental College, Kitakyushu, Japan.
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