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Mori K, Igarashi T, Noguchi A, Ito M, Nagaoka Y, Takeshita C, Takeda N, Watanabe T, Yoshioka I, Hirabayashi K, Fujii T. Giant retroperitoneal myolipoma mimicking liposarcoma: report of a resected case and review of the literature. Int Cancer Conf J 2024; 13:144-152. [PMID: 38524654 PMCID: PMC10957821 DOI: 10.1007/s13691-024-00655-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/01/2024] [Indexed: 03/26/2024] Open
Abstract
Myolipomas are rare tumors that are often difficult to differentiate from liposarcoma. Herein, we report a case of resected giant myolipoma preoperatively diagnosed as liposarcoma. A 63-year-old woman was suspected of having a large retroperitoneal liposarcoma on October 202X. The patient was referred to our department for tumor resection and a histological diagnosis. After consultation with the urology, obstetric and gynecology, and vascular surgery departments, tumor resection was planned, including the potential resection of other organs. Intraoperative findings revealed a large, elastic, soft tumor with a smooth surface and a capsule occupying the entire abdominal cavity. The tumor was adherent to the stomach, left colon, and uterine adnexa, and no invasion was observed. The tumor was completely resected, and organ resection was not necessary. The tumor was 40 cm in diameter and 4.0 kg in weight. Pathological examination and immunostaining confirmed a diagnosis of myolipoma. The patient's postoperative course was uneventful, and she was discharged on postoperative day 10 with no complications. Twelve months after surgery, the patient was doing well. To the best of our knowledge, we report a complete resection of the largest retroperitoneal myolipoma reported to date. Physicians should consider surgery, even for suspected large sarcomas that may be difficult to resect completely.
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Affiliation(s)
- Kosuke Mori
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Takamichi Igarashi
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Akira Noguchi
- Department of Diagnostic Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Toyama 930-0194 Japan
| | - Miki Ito
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Yasuhiro Nagaoka
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Chitaru Takeshita
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Naoya Takeda
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Toru Watanabe
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Isaku Yoshioka
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Kenichi Hirabayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Toyama 930-0194 Japan
| | - Tsutomu Fujii
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
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Yao K, Su H, Cui K, Gao Y, Xu D, Wang Q, Ha Z, Zhang T, Chen S, Liu T. Effectiveness of an intermittent fasting diet versus regular diet on fat loss in overweight and obese middle-aged and elderly people without metabolic disease: a systematic review and meta-analysis of randomized controlled trials. J Nutr Health Aging 2024; 28:100165. [PMID: 38308923 DOI: 10.1016/j.jnha.2024.100165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/31/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVE As the number of adults aged over 40 with obesity increases dramatically, intermittent fasting interventions (IF) may help them to lose fat and weight. This systematic review investigated the most recent research on the effects of intermittent fasting and a regular diet on body composition and lipids in adults aged over 40 with obesity without the metabolic disease. DATA SOURCES Randomized controlled trials (RCTs) on IF on adults aged over 40 with obesity were retrieved from PubMed, Web of Science, EBSCO, China Knowledge Network (CNKI), VIP database, Wanfang database with the experimental group using IF and the control group using a regular diet. Revman was used for meta-analysis. Effect sizes are expressed as weighted mean differences (WMD) and 95% confidence intervals (CI). STUDY SELECTION A total of 9 articles of randomised controlled trials that met the requirements were screened for inclusion. Studies typically lasted 2-6 weeks. The experimental population was aged 42-66 years, with a BMI range of 25.7-35 kg/m2. SYNTHESIS A total of 9 RCTs were included. meta-analysis showed that body weight (MD: -2.05 kg; 95% CI (-3.84, -0.27); p = 0.02), BMI (MD: -0.73 kg/m2; 95% CI (-1.05, -0.41); p < 0.001), fat mass (MD: -2.14 kg; 95% CI (-3.81, 0.47); p = 0.01), and TG (MD = -0.32 mmol/L, 95% CI (-0.50, -0.15, p < 0.001) were significantly lower in the experimental group than in the control group. No significant reduction in lean body mass (MD: -0.31 kg; 95% CI (-0.96, 0.34); p = 0.35). CONCLUSION IF had a reduction in body weight, BMI, fat mass, and TG in adults aged over 40 with obesity without metabolic disease compared to RD, and IF did not cause a significant decrease in lean body mass, which suggests healthy and effective fat loss. However, more long-term and high-quality trials are needed to reach definitive conclusions.
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Affiliation(s)
- Ke Yao
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Hao Su
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China.
| | - Kaiyin Cui
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Ye Gao
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Dengyun Xu
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Qian Wang
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Zhitong Ha
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Teng Zhang
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Shuning Chen
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Tao Liu
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
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Miyata J, Muraki I, Iso H, Yamagishi K, Yasuda N, Sawada N, Inoue M, Tsugane S. Sleep duration, its change, and risk of dementia among Japanese: The Japan Public Health Center-based Prospective Study. Prev Med 2024; 180:107884. [PMID: 38309314 DOI: 10.1016/j.ypmed.2024.107884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE Previous findings on the association between sleep duration, changes in sleep duration, and long-term dementia risk were mixed. Thus, we aimed to investigate the association between midlife sleep duration, its change, and dementia. METHODS We recruited 41,731 Japanese (40-71 years) and documented their habitual sleep duration at baseline (1990-1994) and a 5-year follow-up survey. Changes in sleep duration were calculated as differences between baseline and 5-year measurements. We identified dementia using the Long-Term Care Insurance system (2007-2016). Hazard ratios (HRs) and 95% confidence intervals (CIs) of dementia were calculated using the area-stratified Cox model. RESULTS During 360,389 person-years, 4621 participants exhibited dementia. The multivariable HRs of dementia compared with 7 h of sleep were 1.13 (95% CI: 0.98-1.30) for 3-5 h, 0.93 (0.85-1.02) for 6 h, 1.06 (0.99-1.14) for 8 h, 1.13 (1.01-1.27) for 9 h, and 1.40 (1.21-1.63) for 10-12 h with a J-shaped fashion (p for linear < 0.001 and quadratic < 0.001). For its change, the HRs compared with no change were 1.02 (0.90-1.16) for decreased ≥2 h, 0.95 (0.88-1.03) for decreased 1 h, 1.00 (0.91-1.09) for increased 1 h, and 1.37 (1.20-1.58) for increased ≥2 h. The positive association for decreased sleep duration was observed in individuals with an initial sleep duration of ≤7 h, but not in those with ≥8 h (p for interaction = 0.007). CONCLUSIONS Long and increased sleep duration was associated with a higher risk of dementia.
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Affiliation(s)
- Jun Miyata
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, 205 Yoshikugicho, Goto, Nagasaki 853-8691, Japan; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Institute for Global Health Policy Research, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan; Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Nobufumi Yasuda
- Department of Public Health, Kochi University Medical School, Kohasu, Okoh-cho, Nankoku, Kochi 783-8505, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institution for Cancer Control, 5-1-1 Tsukiji, Chuo, Tokyo 104-0045, Japan
| | - Manami Inoue
- Division of Cohort Research, National Cancer Center Institution for Cancer Control, 5-1-1 Tsukiji, Chuo, Tokyo 104-0045, Japan; Division of Prevention, National Cancer Center Institution for Cancer Control, 5-1-1 Tsukiji, Chuo, Tokyo 104-0045, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institution for Cancer Control, 5-1-1 Tsukiji, Chuo, Tokyo 104-0045, Japan; International University of Health and Welfare Graduate School of Public Health, 4-1-26 Akasaka, Minato, Tokyo 107-8402, Japan
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de Lemos Muller CH, Schroeder HT, Farinha JB, Lopez P, Reischak-Oliveira Á, Pinto RS, de Bittencourt Júnior PIH, Krause M. Effects of resistance training on heat shock response (HSR), HSP70 expression, oxidative stress, inflammation, and metabolism in middle-aged people. J Physiol Biochem 2024; 80:161-173. [PMID: 37930617 DOI: 10.1007/s13105-023-00994-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
Resistance training (RT) can increase the heat shock response (HSR) in the elderly. As middle-aged subjects already suffer physiological declines related to aging, it is hypothesized that RT may increase the HSR in these people. To assess the effects of resistance training on heat shock response, intra and extracellular HSP70, oxidative stress, inflammation, body composition, and metabolism in middle-aged subjects. Sixteen volunteers (40 - 59 years) were allocated to two groups: the trained group (n = 7), which performed 12 weeks of RT; and the physically inactive-control group (n = 9), which did not perform any type of exercise. The RT program consisted of 9 whole-body exercises (using standard gym equipment) and functional exercises, carried out 3 times/week. Before and after the intervention, body composition, muscle mass, strength, functional capacity, and blood sample measurements (lipid profile, glucose, insulin, oxidative damage, TNF-α, the HSR, HSP70 expression in leukocytes, and HSP72 in plasma) were performed. The HSR analysis demonstrated that this response is maintained at normal levels in middle-aged people and that RT did not cause any improvement. Also, RT increases muscle mass, strength, and functional capacity. Despite no additional changes of RT on the antioxidant defenses (catalase, glutathione peroxidase, and reductase) or inflammation, lipid peroxidation was diminished by RT (group x time interaction, p = 0.009), indicating that other antioxidant defenses may be improved after RT. HSR is preserved in middle-aged subjects without metabolic complications. In addition, RT reduces lipid peroxidation and can retard muscle mass and strength loss related to the aging process.
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Affiliation(s)
- Carlos Henrique de Lemos Muller
- Laboratório de Inflamação, Metabolismo e Exercício (LAPIMEX) e Laboratório de Fisiologia Celular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
| | - Helena Trevisan Schroeder
- Laboratório de Inflamação, Metabolismo e Exercício (LAPIMEX) e Laboratório de Fisiologia Celular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
| | - Juliano Boufleur Farinha
- Programa de Pós-Graduação Em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança (ESEFID), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90690-200, Brazil
| | - Pedro Lopez
- Programa de Pós-Graduação Em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança (ESEFID), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90690-200, Brazil
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Álvaro Reischak-Oliveira
- Programa de Pós-Graduação Em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança (ESEFID), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90690-200, Brazil
| | - Ronei Silveira Pinto
- Programa de Pós-Graduação Em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança (ESEFID), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90690-200, Brazil
| | - Paulo Ivo Homem de Bittencourt Júnior
- Laboratório de Inflamação, Metabolismo e Exercício (LAPIMEX) e Laboratório de Fisiologia Celular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
| | - Mauricio Krause
- Laboratório de Inflamação, Metabolismo e Exercício (LAPIMEX) e Laboratório de Fisiologia Celular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil.
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Yang L, Chen W, Chen D, He J, Wang J, Qu Y, Yang Y, Tang Y, Zeng H, Deng W, Liu H, Huang L, Li X, Du L, Liu J, Li Q, Song H. Cohort profile: the China surgery and anesthesia cohort (CSAC). Eur J Epidemiol 2024; 39:207-218. [PMID: 38198037 PMCID: PMC10904502 DOI: 10.1007/s10654-023-01083-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 11/12/2023] [Indexed: 01/11/2024]
Abstract
The China Surgery and Anaesthesia Cohort (CSAC) study was launched in July 2020 and is an ongoing prospective cohort study recruiting patients aged 40-65 years who underwent elective surgeries with general anaesthesia across four medical centres in China. The general objective of the CSAC study is to improve our understanding of the complex interaction between environmental and genetic components as well as to determine their effects on a wide range of interested surgery/anaesthesia-related outcomes. To achieve this goal, we collected enriched phenotypic data, e.g., sociodemographic characteristics, lifestyle factors, perioperative neuropsychological changes, anaesthesia- and surgery-related complications, and medical conditions, at recruitment, as well as through both active (at 1, 3, 7 days and 1, 3, 6, 12 months after surgery) and passive (for more than 1 year after surgery) follow-up assessments. We also obtained omics data from blood samples. In addition, COVID-19-related information was collected from all participants since January 2023, immediately after COVID-19 restrictions were eased in China. As of July 18, 2023, 12,766 participants (mean age = 52.40 years, 57.93% were female) completed baseline data collection (response rate = 94.68%), among which approximately 70% donated blood and hair samples. The follow-up rates within 12 months after surgery were > 92%. Our initial analyses have demonstrated the incidence of and risk factors for chronic postsurgical pain (CPSP) and postoperative cognitive dysfunction (POCD) among middle-aged Chinese individuals, which may prompt further mechanistic exploration and facilitate the development of effective interventions for preventing those conditions. Additional studies, such as genome-wide association analyses for identifying the genetic determinants of CPSP and POCD, are ongoing, and their findings will be released in the future.
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Affiliation(s)
- Lei Yang
- Department of Anesthesiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
| | - Wenwen Chen
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Dongxu Chen
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Junhui He
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Junren Wang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Yang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuling Tang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Huolin Zeng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wanxin Deng
- Surgical Anesthesia Center, The First People's Hospital of Longquanyi District, Chengdu, China
| | - Hongxin Liu
- Surgical Anesthesia Center, The First People's Hospital of Longquanyi District, Chengdu, China
| | - Lining Huang
- Department of Anesthesiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuze Li
- Department of Anesthesiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lei Du
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Liu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Li
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, China.
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
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Sunayama M, Nishiyama T, Otani T, Nakagawa-Senda H, Shibata K, Yamada T, Suzuki S. Positive association between blood glucose in physical examinations and self-reported fractures among middle-aged and elderly Japanese men: a prospective cohort study. Arch Osteoporos 2024; 19:11. [PMID: 38265505 DOI: 10.1007/s11657-024-01369-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
The association between blood glucose and fractures is not consistent across populations. Blood glucose was associated with fractures five years later in middle-aged and elderly men who underwent health examinations in Japan, respectively. Blood glucose-targeted fracture alerts are crucial for middle-aged and elderly individuals. OBJECTIVES The evidence on blood glucose as a fracture risk marker has not been adequately examined in various populations, and there are no studies in middle-aged Japanese. We aimed to determine the association between blood glucose status and self-report fractures among middle-aged and elderly Japanese men. METHODS The data from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Okazaki Study were used. Hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) measured at baseline physical examinations were examined for association with fractures questioned five years later. Analyses were performed for the middle-aged and elderly respondents. RESULTS The HbA1c was dichotomized into 290 (11.8%) with HbA1c ≥ 6.5% and 2165 (88.2%) with HbA1c < 6.5%. Compared to the group with an HbA1c < 6.5, the odds ratio for the risks of fracture among the group with an HbA1c ≥ 6.5% were 3.46 (95% confidence interval (CI), 1.75-6.84) in Model 1 (adjusted for age) and 3.60 (95% CI, 1.77-7.34) in Model 2 (adjusted for various confounding factors). These associations were also observed in both middle-aged and elderly generations, whereas no association was observed for FPG. CONCLUSIONS Among Japanese men who have undergone physical examinations, those with an HbA1c of 6.5% or higher are at higher risk for fractures, and HbA1c-targeted fracture alerts are crucial for middle-aged and elderly individuals.
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Affiliation(s)
- Makoto Sunayama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Takahiro Otani
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Hiroko Nakagawa-Senda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Kiyoshi Shibata
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
- Department of Health and Nutritional Sciences, Nagoya Keizai University, Aichi, Japan
| | - Tamaki Yamada
- Okazaki Public Health Center, Okazaki Medical Association, Aichi, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan.
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Pengpid S, Peltzer K. Rural-urban health differences among aging adults in India. Heliyon 2024; 10:e23397. [PMID: 38173538 PMCID: PMC10761573 DOI: 10.1016/j.heliyon.2023.e23397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/08/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Background The aim of this study was to determine the rural-urban health differences among aging adults in India. Methods The national cross-sectional data of 67,489 individuals (≥45 years) in 2017-2018 from 35 states and union territories of India (excluding Sikkim) in 2017-2018 were analysed. Various sociodemographic data, well-being indicators, lifestyle factors and physical conditions were assessed by face-to-face interviews and physical measurement. Univariable and multivariable logistic regression was utilized to assess the predictors between residence status (rural dweller, urban migrant, and urban dweller) and various health indicator outcomes. Results Majority (70.4 %) of the participants lived in rural areas, 10.3 % were urban migrants and 19.3 % urban dwellers. In the multivariable logistic regression analysis, urban migrants and urban dwellers had a higher self-rated health status, cognitive functioning, physical inactivity, overweight or obesity and abdominal obesity than rural dwellers, while urban migrants and/or urban dwellers had lower functional disability, insomnia symptoms, current smokeless tobacco use, current smoking, heavy episodic drinking and underweight than rural dwellers. Furthermore, urban migrants and/or urban dwellers had higher odds of diabetes, hypertension, heart disease, cancer, high cholesterol than rural dwellers, while urban migrants and/or urban dwellers had lower odds of persistent headaches, major injury, recurrent fall, physical pain, periodontal disease, vision impairment, and gastrointestinal problems than rural dwellers. Conclusion Among 30 health indicators assessed, 16 had an urban migrant and/or urban dweller advantage, 8 had urban migrant and/or urban dweller penalty, and 6 did not differ between rural-urban groups. Public health promotion and health care should address differing health care needs of rural and urban middle-aged and older adults.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Kim J, Jeong K, Lee S, Baek Y. Machine-learning model predicting quality of life using multifaceted lifestyles in middle-aged South Korean adults: a cross-sectional study. BMC Public Health 2024; 24:159. [PMID: 38212741 PMCID: PMC10785386 DOI: 10.1186/s12889-023-17457-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND In the context of population aging, advances in healthcare technology, and growing interest in healthy aging and higher quality of life (QOL), have gained central focus in public health, particularly among middle-aged adults. METHODS This study presented an optimal prediction model for QOL among middle-aged South Korean adults (N = 4,048; aged 30-55 years) using a machine-learning technique. Community-based South Korean population data were sampled through multistage stratified cluster sampling. Twenty-one variables related to individual factors and various lifestyle patterns were surveyed. QOL was assessed using the Short Form Health Survey (SF-12) and categorized into total QOL, physical component score (PCS), and mental component score (MCS). Seven machine-learning algorithms were used to predict QOL: decision tree, Gaussian Naïve Bayes, k-nearest neighbor, logistic regression, extreme gradient boosting, random forest, and support vector machine. Data imbalance was resolved with the synthetic minority oversampling technique (SMOTE). Random forest was used to compare feature importance and visualize the importance of each variable. RESULTS For predicting QOL deterioration, the random forest method showed the highest performance. The random forest algorithm using SMOTE showed the highest area under the receiver operating characteristic (AUC) for total QOL (0.822), PCS (0.770), and MCS (0.786). Applying the data, SMOTE enhanced model performance by up to 0.111 AUC. Although feature importance differed across the three QOL indices, stress and sleep quality were identified as the most potent predictors of QOL. Random forest generated the most accurate prediction of QOL among middle-aged adults; the model showed that stress and sleep quality management were essential for improving QOL. CONCLUSION The results highlighted the need to develop a health management program for middle-aged adults that enables multidisciplinary management of QOL.
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Affiliation(s)
- Junho Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kyoungsik Jeong
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Siwoo Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Younghwa Baek
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
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Bao Y, Lu P, Wang M, Zhang X, Song A, Gu X, Ma T, Su S, Wang L, Shang X, Zhu Z, Zhai Y, He M, Li Z, Liu H, Fairley CK, Yang J, Zhang L. Exploring multimorbidity profiles in middle-aged inpatients: a network-based comparative study of China and the United Kingdom. BMC Med 2023; 21:495. [PMID: 38093264 PMCID: PMC10720230 DOI: 10.1186/s12916-023-03204-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Multimorbidity is better prevented in younger ages than in older ages. This study aims to identify the differences in comorbidity patterns in middle-aged inpatients from China and the United Kingdom (UK). METHODS We utilized 184,133 and 180,497 baseline hospitalization records in middle-aged populations (40-59 years) from Shaanxi, China, and UK Biobank. Logistic regression was used to calculate odds ratios and P values for 43,110 unique comorbidity patterns in Chinese inpatients and 21,026 unique comorbidity patterns in UK inpatients. We included the statistically significant (P values adjusted by Bonferroni correction) and common comorbidity patterns (the pattern with prevalence > 1/10,000 in each dataset) and employed network analysis to construct multimorbidity networks and compare feature differences in multimorbidity networks for Chinese and UK inpatients, respectively. We defined hub diseases as diseases having the top 10 highest number of unique comorbidity patterns in the multimorbidity network. RESULTS We reported that 57.12% of Chinese inpatients had multimorbidity, substantially higher than 30.39% of UK inpatients. The complete multimorbidity network for Chinese inpatients consisted of 1367 comorbidities of 341 diseases and was 2.93 × more complex than that of 467 comorbidities of 215 diseases in the UK. In males, the complexity of the multimorbidity network in China was 2.69 × more than their UK counterparts, while the ratio was 2.63 × in females. Comorbidities associated with hub diseases represented 68.26% of comorbidity frequencies in the complete multimorbidity network in Chinese inpatients and 55.61% in UK inpatients. Essential hypertension, dyslipidemia, type 2 diabetes mellitus, and gastritis and duodenitis were the hub diseases in both populations. The Chinese inpatients consistently demonstrated a higher frequency of comorbidities related to circulatory and endocrine/nutritional/metabolic diseases. In the UK, aside from these comorbidities, comorbidities related to digestive and genitourinary diseases were also prevalent, particularly the latter among female inpatients. CONCLUSIONS Chinese inpatients exhibit higher multimorbidity prevalence and more complex networks compared to their UK counterparts. Multimorbidity with circulatory and endocrine/nutritional/metabolic diseases among both Chinese and UK inpatients necessitates tailored surveillance, prevention, and intervention approaches. Targeted interventions for digestive and genitourinary diseases are warranted for the UK.
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Affiliation(s)
- Yining Bao
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Pengyi Lu
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Mengjie Wang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Xueli Zhang
- Medical Research Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Aowei Song
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, 256 Youyi West Road, Xi'an, 710068, China
| | - Xiaoyun Gu
- Department of Information Technological, Shaanxi Health Information Center, Xi'an, China
| | - Ting Ma
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, 256 Youyi West Road, Xi'an, 710068, China
| | - Shu Su
- Clinical Research Management Office, The Second Affiliated Hospital of ChongQing Medical University, Chongqing, China
| | - Lin Wang
- AIM Lab, Faculty of IT, Monash University, Melbourne, VIC, Australia
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, 150001, China
| | - Xianwen Shang
- Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Division of Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Yuhang Zhai
- Gies College of Business, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Division of Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Zengbin Li
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Hanting Liu
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jiangcun Yang
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, 256 Youyi West Road, Xi'an, 710068, China.
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China.
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
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Wang P, Li K, Xu C, Fan Z, Wang Z. Spatial analysis of overweight prevalence in China: exploring the association with air pollution. BMC Public Health 2023; 23:1595. [PMID: 37608324 PMCID: PMC10463435 DOI: 10.1186/s12889-023-16518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/13/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Overweight is a known risk factor for various chronic diseases and poses a significant threat to middle-aged and elderly adults. Previous studies have reported a strong association between overweight and air pollution. However, the spatial relationship between the two remains unclear due to the confounding effects of spatial heterogeneity. METHODS We gathered height and weight data from the 2015 China Health and Retirement Long-term Survey (CHARLS), comprising 16,171 middle-aged and elderly individuals. We also collected regional air pollution data. We then analyzed the spatial pattern of overweight prevalence using Moran's I and Getis-Ord Gi* statistics. To quantify the explanatory power of distinct air pollutants for spatial differences in overweight prevalence across Southern and Northern China, as well as across different age groups, we utilized Geodetector's q-statistic. RESULTS The average prevalence of overweight among middle-aged and elderly individuals in each city was 67.27% and 57.39%, respectively. In general, the q-statistic in southern China was higher than that in northern China. In the north, the prevalence was significantly higher at 54.86% compared to the prevalence of 38.75% in the south. SO2 exhibited a relatively higher q-statistic in middle-aged individuals in both the north and south, while for the elderly in the south, NO2 was the most crucial factor (q = 0.24, p < 0.01). Moreover, fine particulate matter (PM2.5 and PM10) also demonstrated an important effect on overweight. Furthermore, we found that the pairwise interaction between various risk factors improved the explanatory power of the prevalence of overweight, with different effects for different age groups and regions. In northern China, the strongest interaction was found between NO2 and SO2 (q = 0.55) for middle-aged individuals and PM2.5 and SO2 (q = 0.27) for the elderly. Conversely, in southern China, middle-aged individuals demonstrated the strongest interaction between SO2 and PM10 (q = 0.60), while the elderly showed the highest interaction between NO2 and O3 (q = 0.42). CONCLUSION Significant spatial heterogeneity was observed in the effects of air pollution on overweight. Specifically, air pollution in southern China was found to have a greater impact on overweight than that in northern China. And, the impact of air pollution on middle-aged individuals was more pronounced than on the elderly, with distinct pollutants demonstrating significant variation in their impact. Moreover, we found that SO2 had a greater impact on overweight prevalence among middle-aged individuals, while NO2 had a greater impact on the elderly. Additionally, we identified significant statistically interactions between O3 and other pollutants.
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Affiliation(s)
- Peihan Wang
- Key Laboratory of Regional Sustainable Development Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, P.R. China
| | - Kexin Li
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, P.R. China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, P.R. China.
- University of Chinese Academy of Sciences, Beijing, 100049, P.R. China.
| | - Zixuan Fan
- Key Laboratory of Regional Sustainable Development Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, P.R. China.
- School of Health Policy and Management, Peking Union Medical College, Beijing, 100730, P.R. China.
| | - Zhenbo Wang
- Key Laboratory of Regional Sustainable Development Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, P.R. China
- University of Chinese Academy of Sciences, Beijing, 100049, P.R. China
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Chen HY, Chen HY, Chen BH, Lou SZ, Chen LY, Lin CL. Effect of age on postural performance and control strategies during changes in visual input and dual-tasking stances. Heliyon 2023; 9:e18472. [PMID: 37520946 PMCID: PMC10374924 DOI: 10.1016/j.heliyon.2023.e18472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/16/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023] Open
Abstract
Background With age, people begin to experience deterioration in standing balance, especially when sensory input is suddenly removed or added. Here, we sought to explore the effects of age on postural performance and postural control strategies. Methods The convenience sample consisted of 15 young, 10 middle-aged, and 14 elderly healthy adults. They were instructed to stand with their feet together in four randomly administered conditions involving visual input removal/addition and single-/dual-tasking. Dual-tasking involved continuous subtraction by 3s. Results Postural sway displacement in the two older groups seemed larger than that in the younger group; however, neither the main effect of group (F2, 36 = 1.152, p = .327) nor the group × time interaction effect (F4, 27 = 0.229, p = .922) was significant. Greater stiffness of the lower leg muscles was observed in the vision-addition condition than in the vision-removal condition in only the elderly group (t13 = -2.755, p = .016). The dual-tasking condition resulted in smaller sway displacement (F1, 36 = 7.690, p = .009) and greater muscle stiffness (F1, 36 = 5.495, p = .025). In the vision-removal condition, the increase in muscle stiffness due to dual-tasking was significantly larger in the middle-aged (t9 = -3.736, p = .005) and elderly groups (t13 = -2.512, p = .026). Conclusions In healthy older individuals, age-related changes were observed in control strategies used to maintain standing balance upon changes in visual input. The dual-task paradigm induced the use of an ankle-stiffening strategy in middle-aged and elderly adults.
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Affiliation(s)
- Hui-Ya Chen
- Department of Adapted Physical Education, National Taiwan Sport University, Taoyuan, Taiwan
| | - Han-Yu Chen
- Department of Physical Therapy, Hung Kuang University, Taichung, Taiwan
| | - Bing-Hong Chen
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Shu-Zon Lou
- Department of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Li-Yuan Chen
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Ling Lin
- Department of Electrical Engineering, Ming Chi University of Technology, New Taipei City, Taiwan
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Patterson JT, Wier J, Kumaran P, Adamczyk A. Rising incidence of acute total hip arthroplasty for primary and adjunctive treatment of acetabular fracture in older and middle-aged adults. Eur J Orthop Surg Traumatol 2023:10.1007/s00590-023-03653-4. [PMID: 37480486 DOI: 10.1007/s00590-023-03653-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/15/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Acute total hip arthroplasty (THA) may be an alternative or an adjuvant to internal fixation for surgical treatment of acetabular fractures. We investigate recent trends in the operative management of acetabular fractures. We hypothesize that the incidence of acute THA for acetabular fractures has increased over time. METHODS 4569 middle-aged (45-64 years) and older adults (≥ 65 years) who received acute operative management of an acetabular fracture within 3 weeks of admission between 2010 and 2020 were identified from the United States Nationwide Inpatient Sample database. Treatment was classified as open reduction internal fixation (ORIF), THA, or combined ORIF and THA (ORIF + THA). Patients were stratified by age ≥ 65 years old. Associations between demographic factors and the incidence of each procedure over the study period were modeled using linear regression. RESULTS The relative incidence of treatments was 80.9% ORIF, 12.1% THA, and 7.0% ORIF + THA. Among patients aged 45-64 years old, THA increased 4.8% [R2 = 0.62; β1 = 0.6% (95% Confidence Interval (CI) 0.2-0.9%)] and ORIF + THA increased 2.6% [R2 = 0.73; β1 = 0.3% (95% CI 0.2-0.4%)], while the use of ORIF decreased 7.4% [R2 = 0.75; β1 = -0.9% (95% CI -1.2 to -0.5%)]. Among patients ≥ 65 years old, THA increased 16.5% [R2 = 0.87; β1 = 1.7% (95% CI 1.2-2.2%)] and ORIF + THA increased 5.0% [R2 = 0.38, β1 = 0.6% (95% CI 0.0-1.3%)], while ORIF decreased 21.5% [R2 = 0.75; β1 = -2.4% (95% CI -3.45 to -1.3%)]. CONCLUSION The treatment of acetabular fractures with acute THA has increased in the last decade, particularly among older adults.
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Affiliation(s)
- Joseph T Patterson
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA, 90033-5322, USA.
| | - Julian Wier
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA, 90033-5322, USA
| | - Pranit Kumaran
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA, 90033-5322, USA
| | - Andrew Adamczyk
- Department of Orthopaedic Surgery, University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA
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Adams M, Gordt-Oesterwind K, Bongartz M, Zimmermann S, Seide S, Braun V, Schwenk M. Effects of Physical Activity Interventions on Strength, Balance and Falls in Middle-Aged Adults: A Systematic Review and Meta-Analysis. Sports Med Open 2023; 9:61. [PMID: 37466877 DOI: 10.1186/s40798-023-00606-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Weak lower body strength and balance impairments are fundamental risk factors for mobility impairments and falls that can be improved by physical activity (PA). Previous meta-analyses have focused on these risk factors in adults aged ≥ 65 years. Yet, the potential of PA for improving these risk factors in middle-aged populations has not been systematically investigated. This systematic review and meta-analysis aim to examine the effect of general and structured PA on lower limb strength, postural balance and falls in middle-aged adults. METHODS A computerized systematic literature search was conducted in the electronic databases MEDLINE, CINAHL, Web of Science and Cochrane Library. PA intervention types were classified according to the ProFaNE taxonomy. Randomized controlled trials exploring the effects of PA on strength (e.g., leg press one-repetition-maximum), balance (e.g., single limb stance) and falls (e.g., fall rates) in adults aged 40-60 years were systematically searched and included in a network analysis. Moderator analyses were performed for specific subgroups (age, sex, low PA). The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. RESULTS Out of 7170 articles screened, 66 studies (median PEDro score 5) with 3387 participants were included. Strong, significant effects on muscle strength were found for strength (SMD = 1.02), strength-aerobic (SMD = 1.41), strength-endurance (SMD = 0.92) and water-based (SMD = 1.08) training (52 studies, I2 = 79.3%). Strength training (SMD = 1.16), strength-aerobic (SMD = 0.98) and 3D training (SMD = 1.31) improved postural balance (30 studies, I2 = 88.1%). Moderator analyses revealed significant effects of specific intervention types on certain subgroups and subdomains of strength and balance. No studies were found measuring falls. CONCLUSIONS Structured PA interventions in middle-aged adults improve strength and balance outcomes related to functional impairments and falls. Strength training increases both strength and balance and can be recommended to prevent age-related functional decline. However, the interpretability of the results is limited due to considerable heterogeneity and the overall low methodological quality of the included studies. Long-term trials are needed to determine the preventive potential of PA on strength, balance and falls. This meta-analysis may inform guidelines for tailored training during middle age to promote healthy aging. Prospero registration: CRD42020218643.
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Affiliation(s)
- Michael Adams
- Network Aging Research, Heidelberg University, 69115, Heidelberg, Germany.
- Institute of Sports and Sports Sciences, Heidelberg University, 69117, Heidelberg, Germany.
| | - Katharina Gordt-Oesterwind
- Network Aging Research, Heidelberg University, 69115, Heidelberg, Germany
- Institute of Sports and Sports Sciences, Heidelberg University, 69117, Heidelberg, Germany
- Unit Digitale Geriatrie, Geriatric Center of Heidelberg University Hospital, Medical Faculty of Heidelberg University, 69120, Heidelberg, Germany
| | - Martin Bongartz
- Geriatric Center, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, 69126, Heidelberg, Germany
| | - Samuel Zimmermann
- Institute of Medical Biometry, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Svenja Seide
- Institute of Medical Biometry, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Volker Braun
- Medical Faculty Mannheim, Heidelberg University, 68167, Mannheim, Germany
| | - Michael Schwenk
- Network Aging Research, Heidelberg University, 69115, Heidelberg, Germany
- Institute of Sports and Sports Sciences, Heidelberg University, 69117, Heidelberg, Germany
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, 78464, Constance, Germany
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Bian LL, Lan AC, Zheng YK, Xue HY, Ye Q. Association between calf circumference and cardiac metabolic risk factors in middle-aged and elderly women. Heliyon 2023; 9:e17456. [PMID: 37408906 PMCID: PMC10319178 DOI: 10.1016/j.heliyon.2023.e17456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 06/08/2023] [Accepted: 06/18/2023] [Indexed: 07/07/2023] Open
Abstract
Aims To assess the correlation between calf circumference and cardiac metabolic risk factors such as hypertension, abnormal blood glucose and dyslipidaemia among middle-aged and elderly women. Methods The cross-sectional study population consisted of 476 female participants aged 40-80 years, including 304 perimenopausal and 172 postmenopausal women. Calf circumference, body mass index (BMI), blood pressure, blood glucose and blood lipids were measured. Logistic regression analysis was used to evaluate the study aims. Results Calf circumference was lower in postmenopausal than perimenopausal women, and postmenopausal women had the highest rates of hypertension, abnormal blood glucose and abnormal blood lipids. Pearson correlation coefficients showed that calf circumference was positively correlated with triglycerides (TGs), BMI, fasting plasma glucose (FPG),2-h plasma glucose, glycated haemoglobin (HbA1C), systolic blood pressure and diastolic blood pressure; and negatively correlated with high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC). The group with the lowest quantile of calf circumference had higher rates of hypertension (odds ratio (OR)2.14,95% confidence interval (CI)1.67-2.74),dysglycaemia (OR1.40,95%CI1.03-1.90) and dyslipidaemia (OR2.14,95%CI 1.86-2.46). Conclusion In perimenopausal women, measurements of calf circumference can be used to predict the presence of cardiac metabolic risk factors, which can be detected by observing blood pressure, blood glucose, and blood lipids.
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Affiliation(s)
- Le-Le Bian
- Geriatric, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang, China
| | - Ai-Chun Lan
- Geriatric, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang, China
| | - Yong-Ke Zheng
- Geriatric, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang, China
| | - Hai-Yan Xue
- Obstetrics and Gynaecology, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang, China
| | - Qiao Ye
- Physical Examination Centre, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang, China
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Jaffee SR, Widom CS. Resilience to Maltreatment in Early Adulthood Does Not Predict Low Allostatic Load at Midlife. Ann Behav Med 2023; 57:489-498. [PMID: 37040622 PMCID: PMC10413319 DOI: 10.1093/abm/kaac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Although childhood maltreatment is associated with a host of poor health and social outcomes in adulthood, many individuals manifest resilience. PURPOSE We tested competing predictions about whether achieving positive psychosocial outcomes in young adulthood would be differentially predictive of allostatic load at midlife for those with and without a childhood history of maltreatment. METHODS The sample included 808 individuals, 57% of whom had court-documented records of childhood abuse or neglect between 1967 and 1971, and demographically matched controls without those histories. Participants provided information on socioeconomic, mental health, and behavioral outcomes in interviews conducted between 1989 and 1995 (mean age = 29.2 years). Indicators of allostatic load were measured between 2003 and 2005 (mean age = 41.2 years). RESULTS The relationship between positive life outcomes in young adulthood and allostatic load in middle adulthood varied depending on childhood maltreatment status (b = .16, 95% CI: .03; .28); for adults who did not experience childhood maltreatment, more positive life outcomes predicted lower allostatic load (b = -.12, 95% CI: -.23; -.01), whereas the relationship was not significant for adults with a childhood history of maltreatment (b = .04, 95% CI: -.06; .13). There were no differences in the results predicting allostatic load for African-American and White respondents. CONCLUSIONS Childhood maltreatment may have enduring effects on physiological functioning that are manifest in elevated allostatic load scores in middle age. Alternatively, resilience to maltreatment-as manifest in positive functioning in socioeconomic and behavioral domains-may not be sufficiently stable over adulthood to buffer individuals from the physiological consequences of stressful environments.
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Affiliation(s)
- Sara R Jaffee
- Department of Psychology, University of Pennsylvania, 425 South University Ave., Philadelphia, PA 19104, USA
| | - Cathy Spatz Widom
- Department of Psychology, John Jay College of Criminal Justice, New York, New York, USA
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Sin S, Lee EJ, Won S, Kim WJ. Longitudinal mortality of preserved ratio impaired spirometry in a middle-aged Asian cohort. BMC Pulm Med 2023; 23:155. [PMID: 37138264 PMCID: PMC10157957 DOI: 10.1186/s12890-023-02451-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/24/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Although preserved ratio impaired spirometry (PRISm) has been determined to have poor prognosis, it is a heterogeneous state, and studies regarding its prognosis in Asians are limited. This study investigated the long-term all-cause and cardiovascular mortality of patients with PRISm compared with those of patients with chronic obstructive pulmonary disease (COPD) and normal individuals in the Korean middle-aged general population. METHODS Participants were recruited between 2001 and 2002 from a community-based prospective cohort in South Korea. Mortality data were collected over a 16.5-year mean follow-up period. The all-cause and cardiovascular mortality risks of PRISm were compared between patients with COPD and healthy controls. RESULTS The PRISm group had a mean age of 53.4 years and mean body mass index of 24.9 kg/m2; furthermore, 55.2% of the PRISm patients had never smoked, and the prevalence of comorbidities was not higher than that in the other groups. Compared with normal individuals, PRISm patients did not show increased all-cause mortality, whereas COPD patients showed increased all-cause mortality (PRISm: adjusted hazard ratio [aHR], 1.19; 95% confidence interval [CI], 0.85-1.65; COPD: aHR, 1.34, 95% CI, 1.07-1.69). Furthermore, the PRISm patients did not show increased cardiovascular mortality compared with normal individuals (PRISm: aHR, 1.65; 95% CI, 0.92-2.95; COPD: aHR, 1.83; 95% CI, 1.09-3.07). CONCLUSION In our population-based cohort, all-cause and cardiovascular mortality risk did not increase in individuals with PRISm compared with normal individuals. Further studies are needed to distinguish a lower-risk subgroup of PRISm with certain characteristics, such as middle-aged, light-smoking Asians without additional cardiovascular risk.
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Affiliation(s)
- Sooim Sin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Eun Ju Lee
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Sungho Won
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Republic of Korea.
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
- Department of Internal Medicine, School of Medicine, Kangwon National University, Kangwon National University Hospital, Chuncheon, 24341, Republic of Korea.
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Wang D, Kou PQ, Liao YY, Wang KK, Yan Y, Chen C, Chu C, Wang Y, Niu ZJ, Ma Q, Sun Y, Mu JJ. Sex differences in impact of cumulative systolic blood pressure from childhood to adulthood on albuminuria in midlife: a 30-year prospective cohort study. BMC Public Health 2023; 23:666. [PMID: 37041564 PMCID: PMC10088136 DOI: 10.1186/s12889-023-15613-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/05/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Albuminuria is recognized as being a predictor of cardiovascular and renal disease. We aimed to identify the impact of the long-term burden and trends of systolic blood pressure on albuminuria in midlife, as well as to explore sex differences concerning this relationship. METHODS This longitudinal study consisted of 1,683 adults who had been examined 4 or more times for blood pressure starting in childhood, with a follow-up time period of 30 years. The cumulative effect and longitudinal trend of blood pressure were identified by using the area under the curve (AUC) of individual systolic blood pressure measurement with a growth curve random effects model. RESULTS Over 30 years of follow-up, 190 people developed albuminuria, including 53.2% males and 46.8% females (aged 43.39 ± 3.13 years in the latest follow-up). The urine albumin-to-creatinine ratio (uACR) values increased as the total and incremental AUC values increased. Additionally, women had a higher albuminuria incidence in the higher SBP AUC groups than men do (13.3% for men vs. 33.7% for women). Logistic regression showed that the ORs of albuminuria for males and females in the high total AUC group were 1.34 (0.70-2.60) and 2.94 (1.50-5.74), respectively. Similar associations were found in the incremental AUC groups. CONCLUSIONS Higher cumulative SBP was correlated with higher uACR levels and a risk of albuminuria in middle age, especially in women. The identification and control of cumulative SBP levels from an early age may assist in reducing the incidences of renal and cardiovascular disease for individuals in later life.
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Affiliation(s)
- Dan Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Pu-Qing Kou
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Yue-Yuan Liao
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Ke-Ke Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Yu Yan
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Chen Chen
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Chao Chu
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Yang Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Ze-Jiaxin Niu
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Qiong Ma
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Yue Sun
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China
| | - Jian-Jun Mu
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China.
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China.
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, China.
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Chang HC, Wu YS, Tzeng WC, Wu HY, Lee PC, Wang WY. Sex differences in risk factors for metabolic syndrome in middle-aged and senior hospital employees: a population-based cohort study. BMC Public Health 2023; 23:587. [PMID: 36991367 PMCID: PMC10053111 DOI: 10.1186/s12889-023-15491-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Several cross-sectional studies have reported risk factors for metabolic syndrome (MetS). However, these studies did not focus on sex differences in middle-aged and senior populations or employ a longitudinal design. These study design differences are important, as there are sex differences in lifestyle habits associated with MetS, and middle-aged and senior individuals have increased MetS susceptibility. Therefore, the purpose of this study was to examine whether sex differences influenced MetS risk over a ten-year follow-up period among middle-aged and senior hospital employees. METHODS This population-based and prospective cohort study enrolled 565 participants who did not have MetS in 2012 for a ten-year repeated-measurement analysis. Data were retrieved from the hospital's Health Management Information System. Analyses included Student's t tests, χ2 tests and Cox regression. P < 0.05 indicated statistical significance. RESULTS Male middle-aged and senior hospital employees had an elevated MetS risk (hazard ratio (HR) = 1.936, p < 0.001). Men with more than four family history risk factors had an increased risk of MetS (HR = 1.969, p = 0.010). Women who worked shift duty (HR = 1.326, p = 0.020), had more than two chronic diseases (HR = 1.513, p = 0.012), had three family history risk factors (HR = 1.623, p = 0.010), or chewed betel nuts (HR = 9.710, p = 0.002) had an increased risk of MetS. CONCLUSIONS The longitudinal design of our study improves the understanding of sex differences in MetS risk factors in middle-aged and senior adults. A significantly elevated risk of MetS over the ten-year follow-up period was associated with male sex, shift work, the number of chronic diseases, the number of family history risk factors, and betel nut chewing. Women who chewed betel nuts had an especially increased risk of MetS. Our study indicates that population-specific studies are important for the identification of subgroups susceptible to MetS and for the implementation of hospital-based strategies.
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Affiliation(s)
- Hsu-Chieh Chang
- Department of Nursing, Tri-Service General Hospital and School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yi-Syuan Wu
- Trauma and Critical Care Service, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chii Tzeng
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Hao-Yi Wu
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Pai-Ching Lee
- Department of Nursing, Tri-Service General Hospital and Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Wei-Yun Wang
- Department of Nursing, Tri-Service General Hospital Songshan Branch and School of Nursing, National Defense Medical Center, Taipei, Taiwan.
- Department of Nursing, Tri-Service General Hospital Songshan Branch, 4F, No. 131, Jiankang Rd., Songshan District, Taipei, 105309, Taiwan, ROC.
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19
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Liu S, Lin K, Zhang Y, Gao Y, Wang W, Du M, Jiang T, Zhou M, Zhang X. Prevalence and risk factors of psychotic symptoms in middle-aged patients with first-episode drug-naïve major depressive disorder: A large-scale cross-sectional study. J Affect Disord 2023; 325:102-109. [PMID: 36623569 DOI: 10.1016/j.jad.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Psychotic symptoms are common in patients with major depressive disorder (MDD). However, few studies have assessed the incidence of comorbid psychotic symptoms in first-episode drug naïve (FEDN) MDD patients. The present study aimed to evaluate the prevalence and risk factors of psychotic symptoms in a large sample of middle-aged Chinese patients with FEDN MDD. METHODS 813 middle-aged (age range 35 to 65 years) outpatients with FEDN MDD were recruited. The 17-item Hamilton Rating Scale for Depression (HAMD), the 14-item Hamilton Anxiety Rating Scale (HAMA), and the positive subscales of the Positive and Negative Syndrome Scale (PANSS) were used to assess patient anxiety, depression and psychotic symptoms, respectively. RESULTS The prevalence of psychotic symptoms in middle-aged patients with FEND MDD was 10.95 %. Multivariate logistic regression analysis showed that HAMA score, HAMD score, TSH, TC and BMI levels were significant predictors of psychotic symptoms in MDD middle-aged patients. The HAMA score and HAMD score predicted psychotic symptoms for both male and female middle-aged patients with MDD, while higher TSH, TC and BMI levels were correlated with psychotic symptoms only in female MDD patients. Furthermore, combining the HAMA score, HAMD score, and TSH could differentiate between psychotic major depression (PMD) and nonpsychotic major depression (NPMD) in middle-aged patients. CONCLUSIONS Psychotic symptoms among middle-aged patients with MDD can be identified by integrating clinical and biological variables as early as possible during the first time see a doctor.
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Affiliation(s)
- Shilin Liu
- Department of Neurocritical Care Unit, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Keyi Lin
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China; Anhui Public Health Clinical Center, Hefei, Anhui, 230001, China
| | - Yang Zhang
- Department of Neurosurgery, The second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China
| | - Yaotian Gao
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China; Anhui Public Health Clinical Center, Hefei, Anhui, 230001, China
| | - Wei Wang
- Department of Neurosurgery, The second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China
| | - Mengcheng Du
- Department of Neurosurgery, The second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China
| | - Tao Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China; Anhui Public Health Clinical Center, Hefei, Anhui, 230001, China; Department of Neurosurgery, The second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230001, China; Anhui Provincial Institute of Translational Medicine, Hefei, Anhui, 230001, China.
| | - Min Zhou
- Department of Neurocritical Care Unit, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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20
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Oh JW, Kim SM, Lee D, Yon DK, Lee SW, Smith L, Kostev K, Koyanagi A, Solmi M, Carvalho AF, Shin JI, Son NH, Lee S. Reduced grip strength potentially indicates depression: Investigating multicontinental databases. J Affect Disord 2023; 323:426-434. [PMID: 36481227 DOI: 10.1016/j.jad.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Multi-national studies in the association between handgrip strength and depression in middle and older aged adults are limited. Hence, Brazil, China, Europe, Korea, United Kingdom (UK) and United States (US) datasets were utilized to investigate this association. METHODS A cross-sectional study was conducted with 51,285 participants aged >45 years. Handgrip strength scores were divided into quartiles, groups 1 (highest) to 4 (lowest) in each database, and depression measures converted to binary scores. RESULTS Males in China and UK reported higher adjusted odds ratios (aORs) of depression for groups 2, 3, and 4 than for group 1. Brazil, US, and Korea reported greater aORs in groups 3 and 4 whereas Europe demonstrated increased aORs for group 4 only. Among females, China, Brazil, US, and Korea showed high aORs across all groups, while UK and Europe reported increased aORs for group 4 only. Highest ORs were reported from Korea in group 4 for males (aOR: 3·09; 95 % CI: 2·15-4·43; p < 0·001) and females (aOR: 3·74; 95 % CI: 2·78-5·03; p < 0·001). When removing the regional factor, aORs were higher in lower groups, with the highest reported from group 4 for males (aOR: 2·32; 95 % CI: 2·09-2·58; p < 0·001) and females (aOR: 2·11; 95 % CI: 1·95-2·29; p < 0·001). LIMITATIONS Being a cross-sectional study, the results were not able to establish the causal direction between handgrip strength and depression. CONCLUSION Lower handgrip strength was associated with an increased likelihood of depression. Early assessment of handgrip strength may identify populations at-risk for depression among middle and older aged adults.
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Affiliation(s)
- Jae Won Oh
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Sun Mi Kim
- Department of Nursing, Sorabol University, Gyeongju, Republic of Korea
| | - Deokjong Lee
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea; Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | | | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Cibersam, ISCIII, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ontario, Canada; Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program University of Ottawa, Ottawa, Ontario; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Nak-Hoon Son
- Department of Statistics, Keimyung University, Daegu, Republic of Korea.
| | - San Lee
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea; Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Oyoshi T, Maekawa K, Mitsuta Y, Hirata N. Predictors of early postoperative cognitive dysfunction in middle-aged patients undergoing cardiac surgery: retrospective observational study. J Anesth 2023; 37:357-363. [PMID: 36658371 DOI: 10.1007/s00540-023-03164-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE This study aimed to identify the incidence and risk factors of early post-operative cognitive dysfunction (POCD) in middle-aged patients undergoing cardiac surgery. METHODS Data were examined retrospectively from 71 patients aged 46-64 years who underwent elective cardiac surgery. Magnetic resonance imaging (MRI) and MR angiography were obtained preoperatively to assess prior cerebral infarctions, carotid artery stenosis, and intracranial arterial stenosis. Patients also completed six neuropsychological tests of memory, attention, and executive function before and after surgery. Mild cognitive impairment (MCI) was defined as performance 1.5 standard deviations (SD) below the population means on any neurocognitive battery, whereas POCD was defined as a decrease of 1 SD population means on at least two in the test battery. Patient characteristics were analyzed using univariate analysis, and independent predictors were analyzed using multivariate logistic regression analysis. RESULTS After surgery, 25 patients (35%) were assessed with POCD. Patients with POCD had significantly higher rates of preoperative MCI and cerebral infarcts on MRI. Multivariate logistic regression analysis identified preoperative MCI and cerebral infarctions detected by MRI as a predictor of POCD. CONCLUSION More than one-third of middle-aged patients undergoing cardiac surgery developed POCD. Our findings suggested preoperative MCI and infarcts detected by MRI were risk factors for POCD in these middle-aged patients.
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Affiliation(s)
- Takafumi Oyoshi
- Departments of Anesthesiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965, Japan.,Department of Anesthesiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kengo Maekawa
- Departments of Anesthesiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965, Japan
| | - Yuki Mitsuta
- Departments of Anesthesiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965, Japan.,Department of Anesthesiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Naoyuki Hirata
- Department of Anesthesiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
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Akhtar S, Mohanty SK, Singh RR, Sen S. Chronic diseases and productivity loss among middle-aged and elderly in India. BMC Public Health 2022; 22:2356. [PMID: 36522623 PMCID: PMC9756765 DOI: 10.1186/s12889-022-14813-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
CONTEXT Chronic diseases are growing in India and largely affecting the middle-aged and elderly population; many of them are in working age. Though a large number of studies estimated the out-of-pocket payment and financial catastrophe due to this condition, there are no nationally representative studies on productivity loss due to health problems. This paper examined the pattern and prevalence of productivity loss, due to chronic diseases among middle-aged and elderly in India. METHODS We have used a total of 72,250 respondents from the first wave of Longitudinal Ageing Study in India (LASI), conducted in 2017-18. We have used two dependent variables, limiting paid work and ever stopped work due to ill health. We have estimated the age-sex adjusted prevalence of ever stopped working due to ill health and limiting paid work across MPCE quintile and socio- demographic characteristics. Propensity Score Matching (PSM) and logistic regression was used to examine the effect of chronic diseases on both these variables. FINDINGS We estimated that among middle aged adults in 45-64 years, 3,213 individuals accounting to 6.9% (95%CI:6.46-7.24) had ever-stopped work and 6,300 individuals accounting to 22.7% (95% CI: 21.49-23.95) had limiting paid work in India. The proportion of ever-stopped and limiting work due to health problem increased significantly with age and the number of chronic diseases. Limiting paid work is higher among females (25.1%), and in urban areas (24%) whereas ever-stopped is lower among female (5.7%) (95% CI:5.16-6.25 ) and in urban areas (4.9%) (95% CI: 4.20-5.69). The study also found that stroke (21.1%) and neurological or psychiatric problems (18%) were significantly associated with both ever stopped work and limiting paid work. PSM model shows that, those with chronic diseases are 4% and 11% more likely to stop and limit their work respectively. Regression model reveals that more than one chronic conditions had a consistent and significant positive impact on stopping work for over a year (increasing productivity loss) across all three models. CONCLUSION Individuals having any chronic disease has higher likelihood of ever stopped work and limiting paid work. Promoting awareness, screening and treatment at workplace is recommended to reduce adverse consequences of chronic disease in India.
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Affiliation(s)
- Shamrin Akhtar
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Sanjay K. Mohanty
- grid.419349.20000 0001 0613 2600Department of Population and Development, International Institute for Population Sciences, Mumbai, 400088 India
| | - Rajeev Ranjan Singh
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Soumendu Sen
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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23
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Freeman LK, Miller MB, Simenson A, Sparrow E, Costa AN, Musich M, McCrae CS, Curtis AF. Sex differences in associations between alcohol use and sleep in mid-to-late life. Sleep Med 2022; 100:298-303. [PMID: 36152525 DOI: 10.1016/j.sleep.2022.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To examine associations between alcohol use and sleep in middled-aged/older adults and to test sex as a moderator of this relationship. METHODS Participants were 183 adults (46% female) ages 50 and above who consumed alcohol in the past year. Linear regressions tested sex as a moderator of associations between alcohol use and sleep parameters. Alcohol use was measured using the Alcohol Use Disorders Identification Test (AUDIT). Overall sleep health and sleep quality were assessed using the Pittsburgh Sleep Quality Index (PSQI), and pre-sleep arousal was assessed using the Pre-Sleep Arousal Scale. RESULTS Overall, 11% of participants screened positive for hazardous drinking (AUDIT scores of 7+/8+ for women/men), and 59% reported poor overall sleep health (scores >5 on the PSQI). Alcohol use was not associated with overall sleep health (B = -0.25, p = .08) or pre-sleep arousal (B = 0.15, p = .64). However, contrary to hypotheses, more hazardous drinking was associated with better subjective sleep quality, only among women (B = -0.08, p = .009). Alcohol use was not associated with sleep quality among men (B = 0.01, p = .58). Associations remained significant when controlling for age, symptoms of anxiety and depression, body mass index, use of sleep medication, number of medical conditions, and chronic pain. CONCLUSIONS Among middle-aged and older adults, alcohol use is more strongly associated with sleep patterns among women than men, when assessed concurrently (i.e., at the same time point). Findings support the need for further consideration of sex differences in associations between alcohol use and sleep.
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Affiliation(s)
- Lindsey K Freeman
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO, 65211, USA
| | - Mary Beth Miller
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO, 65211, USA; Department of Psychiatry, University of Missouri, 1 Hospital Dr, Columbia, MO, 65212, USA
| | - Angelynn Simenson
- Department of Psychiatry, University of Missouri, 1 Hospital Dr, Columbia, MO, 65212, USA
| | - Emilie Sparrow
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO, 65211, USA
| | - Amy N Costa
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO, 65211, USA
| | - Madison Musich
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO, 65211, USA
| | - Christina S McCrae
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO, 65211, USA; Department of Psychiatry, University of Missouri, 1 Hospital Dr, Columbia, MO, 65212, USA
| | - Ashley F Curtis
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO, 65211, USA; Department of Psychiatry, University of Missouri, 1 Hospital Dr, Columbia, MO, 65212, USA.
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Wang Y, Liu Y, Hu J, Guan H, Wang Y, Liu M, He L, Sun N, Yang W, Ma Y. Association of handgrip strength with all-cause mortality: a nationally longitudinal cohort study in China. J Sci Med Sport 2022; 25:878-883. [PMID: 36064503 DOI: 10.1016/j.jsams.2022.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Handgrip strength is considered a vital and reliable measure of comprehensive physical assessments, whereas the association of handgrip strength with overall mortality risk among Chinese adults was less studied. We prospectively investigated the association between handgrip strength and all-cause mortality among Chinese middle-aged and older people based on data from the China Health and Retirement Longitudinal Study (CHARLS).3 DESIGN: Longitudinal cohort study. METHODS Grip strength was assessed for both hands by a dynamometer. Odds ratios (ORs)4 and 95 % confidence intervals (CIs)5 were estimated applying logistic regression models with adjustments for age, body mass index, ethnicity, education level, annual household income, marital status, drinking, smoking, physical activity, and medical insurance among men and women. Deaths were ascertained by each follow-up survey in which the household member who lived with the participants were inquired. RESULTS Over an average follow-up period of approximately 8 years among the screened 11,618 participants ≥45 years old, 1290 deaths were documented. The age range was 45-93 for men and 45-96 for women. Greater handgrip strength was associated with a lower overall mortality risk, with adjusted ORs (comparing with extreme tertiles) of 0.47 (95 % CI: 0.35-0.64; P-trend<0.001) in men and 0.51 (95 % CI: 0.24-1.08; P-trend = 0.059) in women. Such inverse association seemed stronger among younger men (OR = 0.29, 95 % CI: 0.18-0.45), compared with the older men (OR = 0.49, 95 % CI: 0.33-0.73; P-interaction = 0.023). CONCLUSIONS Handgrip strength was inversely associated with all-cause mortality risk, especially among the younger men. Further investigations are warranted to elucidate the underlying mechanism.
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Affiliation(s)
- Yuhan Wang
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, China
| | - Yang Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, China
| | - Jiajin Hu
- Health Sciences Institute, China Medical University, China
| | - Hongcai Guan
- School of Public Health, Peking University, China
| | - Yewei Wang
- Department of Environmental Health Sciences, Yale School of Public Health, USA
| | - Ming Liu
- Bioinformatics and Computational Biology Program, Worcester Polytechnic Institute, USA
| | - Lixia He
- Division of Molecular and Cellular Oncology, Harvard Medical School, USA
| | - Naihui Sun
- The First Affiliated Hospital, China Medical University, China
| | - Wanshui Yang
- Department of Nutrition, School of Public Health, Anhui Medical University, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, China.
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Ramírez-Moreno JM, Rebollo B, Macías-Sedas P, Valverde N, Parejo A, Felix-Redondo FJ, Roa Montero AM, Constantino AB, Gómez Baquero MJ, Ceberino-Muñoz D, Fernández-Bergés D. Strength of association of classical vascular risk factors in young patients with ischaemic stroke: a case-control study. Neurologia 2022:S2173-5808(22)00142-0. [PMID: 36309160 DOI: 10.1016/j.nrleng.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/24/2022] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Recent studies have reported an increasing incidence of ischaemic stroke among young adults. However, the strength of the association between traditional vascular risk factors has not been fully established. METHODS We compared 120 patients with a first ischaemic stroke before the age of 55 years admitted to the stroke unit of our centre with 600 healthy non-stroke controls from a population-based cohort study (HERMEX), matched for sex. Risk factors assessed included: hypertension, obesity, auricular fibrillation, current smoking, estimated glomerular filtration rate (eGFR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus. We used logistic regression analysis and calculated population attributable risk. We performed an overall analysis, by sex and aetiological subgroup. RESULTS Using logistic regression analysis, we found that overall, the significant risk factors were: hypertension (OR: 1.58; 95%CI: 1.01-2.50), atrial fibrillation (OR: 4.77; 95%CI: 1.20-19.00), low eGFR (OR: 4.74; 95%CI: 1.3-21.94) and low HDL-C (OR: 5.20; 95%CI: 3.29-8.21), as well as smoking for males (OR: 1.86; 95%CI: 1.14-3.03). LDL-C showed an inverse association with stroke. The population attributable risk for HDL-C was 37.8% and for hypertension 21.1%. In terms of aetiological subgroups, only low HDL-C was associated with stroke of undetermined aetiology. CONCLUSIONS Hypertension, auricular fibrillation, low eGFR, and low HDL-C, plus tobacco use in men, are the main risk factors among patients under 55 years of age with a first ischaemic stroke. We believe that it would be of particular interest to further explore the management of low HDL-C levels as part of preventive strategies in young stroke patients.
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Affiliation(s)
- J M Ramírez-Moreno
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain; Departamento de Ciencias Biomédicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, Badajoz, Spain; Grupo de Investigación Multidisciplinar de Extremadura (GRIMEX), Spain; Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE).
| | - B Rebollo
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain
| | - P Macías-Sedas
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain
| | - N Valverde
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain
| | - A Parejo
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain
| | - F J Felix-Redondo
- Grupo de Investigación Multidisciplinar de Extremadura (GRIMEX), Spain; Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE); Servicio Extremeño de Salud, Spain
| | - A M Roa Montero
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain
| | - A B Constantino
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain
| | - M J Gómez Baquero
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain
| | - D Ceberino-Muñoz
- Servicio de Neurología, Centro de Ictus, Hospital Universitario de Badajoz, Badajoz, Spain
| | - D Fernández-Bergés
- Grupo de Investigación Multidisciplinar de Extremadura (GRIMEX), Spain; Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE); Servicio Extremeño de Salud, Spain
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Dillon K, Morava A, Prapavessis H, Grigsby-Duffy L, Novic A, Gardiner PA. Total Sedentary Time and Cognitive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-analysis. Sports Med Open 2022; 8:127. [PMID: 36224459 PMCID: PMC9556686 DOI: 10.1186/s40798-022-00507-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/14/2022] [Indexed: 11/06/2022]
Abstract
Background An estimated 47 million people have dementia globally, and around 10 million new cases are diagnosed each year. Many lifestyle factors have been linked to cognitive impairment; one emerging modifiable lifestyle factor is sedentary time. Objective To conduct a systematic review and meta-analysis of peer-reviewed literature examining the association between total sedentary time with cognitive function in middle-aged and older adults under the moderating conditions of (a) type of sedentary time measurement; (b) the cognitive domain being assessed; (c) looking at sedentary time using categorical variables (i.e., high versus low sedentary time); and (d) the pattern of sedentary time accumulation (e.g., longer versus shorter bouts). We also aimed to examine the prevalence of sedentary time in healthy versus cognitively impaired populations and to explore how experimental studies reducing or breaking up sedentary time affect cognitive function. Lastly, we aimed to conduct a quantitative pooled analysis of all individual studies through meta-analysis procedures to derive conclusions about these relationships. Methods Eight electronic databases (EMBASE; Web of Science; PsycINFO; CINAHL; SciELO; SPORTDiscus; PubMed; and Scopus) were searched from inception to February 2021. Our search included terms related to the exposure (i.e., sedentary time), the population (i.e., middle-aged and older adults), and the outcome of interest (i.e., cognitive function). PICOS framework used middle-aged and older adults where there was an intervention or exposure of any sedentary time compared to any or no comparison, where cognitive function and/or cognitive impairment was measured, and all types of quantitative, empirical, observational data published in any year were included that were published in English. Risk of bias was assessed using QualSyst. Results Fifty-three studies including 83,137 participants met the inclusion criteria of which 23 studies had appropriate data for inclusion in the main meta-analysis. The overall meta-analysis suggested that total sedentary time has no association with cognitive function (r = −0.012 [95% CI − 0.035, 0.011], p = 0.296) with marked heterogeneity (I2 = 89%). Subgroup analyses demonstrated a significant negative association for studies using a device to capture sedentary time r = −0.035 [95% CI − 0.063, − 0.008], p = 0.012). Specifically, the domains of global cognitive function (r = −0.061 [95% CI − 0.100, − 0.022], p = 0.002) and processing speed (r = −0.067, [95% CI − 0.103, − 0.030], p < 0.001). A significant positive association was found for studies using self-report (r = 0.037 [95% CI − 0.019, 0.054], p < 0.001). Specifically, the domain of processing speed showed a significant positive association (r = 0.057 [95% CI 0.045, 0.069], p < 0.001). For prevalence, populations diagnosed with cognitive impairment spent significantly more time sedentary compared to populations with no known cognitive impairments (standard difference in mean = −0.219 [95% CI − 0.310, − 0.128], p < 0.001). Conclusions The association of total sedentary time with cognitive function is weak and varies based on measurement of sedentary time and domain being assessed. Future research is needed to better categorize domains of sedentary behaviour with both a validated self-report and device-based measure in order to improve the strength of this relationship. PROSPERO registration number: CRD42018082384. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00507-x.
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Affiliation(s)
- Kirsten Dillon
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Anisa Morava
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Harry Prapavessis
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Lily Grigsby-Duffy
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1021.20000 0001 0526 7079Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220 Australia
| | - Adam Novic
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1022.10000 0004 0437 5432School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Paul A. Gardiner
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1048.d0000 0004 0473 0844Faculty of Health, Engineering and Sciences, The University of Southern Queensland, Brisbane, Australia
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Kim J, Ahn S. A menopausal transition model based on transition theory. Korean J Women Health Nurs 2022; 28:210-21. [PMID: 36403573 DOI: 10.4069/kjwhn.2022.08.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/16/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The purpose of this study was to construct a hypothetical model based on Meleis and colleagues' Transition Theory and a literature review to explain women's menopausal transition, constructing a modified model considering previous studies and model fit and testing the effects between variables. METHODS With a correlational survey design, middle-aged Korean women aged 40 to 64 years who had experienced menopausal symptoms were recruited and filled out a self-administered study questionnaire. Measures included menopausal symptoms, resilience, social support, menopause management, menopause adaptation, and quality of life. The data were analyzed using SPSS 24.0 and AMOS 24.0. RESULTS The model fit indices were considered acceptable: χ2 /degree of freedom=2.93, standardized root mean residual=.07, comparative fit index=.90, and parsimonious normed fit index=.73. All eight direct-effect paths-from menopausal symptoms to support and adaptation, from support to adaptation and resilience, from resilience to adaptation and management, from management to quality of life, and from adaptation to quality of life-were significant. The explanatory power of the menopause transition model was 63.6%. CONCLUSION Women who experience menopausal symptoms may be able to maintain and improve their quality of life if menopause management and menopause adaptation are successful through resilience and social support. Future research is needed to confirm whether strengthening facilitation as a nursing intervention strategy may promote healthy response patterns.
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Tey YY, Ching SM, Maharajan MK, Lee KW, Chow ZY, Chua PW, Tan CX, Lim SN, Tan CH, Thew HZ, Ramachandran V, Hoo FK. Prevalence and factors associated with sexual dysfunction among middle-aged women in a multi-ethnic country: A cross sectional study in Malaysia. Malays Fam Physician 2022; 17:56-63. [PMID: 35949996 PMCID: PMC9357414 DOI: 10.51866/oa.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia. METHODS The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis. RESULTS A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents' ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (0R=16.60, 95% CI=2.54-108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (0R=0.13, 95% CI=0.08-0.24). CONCLUSION Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.
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Affiliation(s)
- Yin Yee Tey
- MD, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Siew Mooi Ching
- MMedFamMed, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Malaysian Research Institute of Ageing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia,
| | - Mari Kannan Maharajan
- PhD (Pharmacy), Department of Pharmacy Practice, School of Pharmacy, International, Medical Universiti, Kuala Lumpur, Malaysia
| | - Kai Wei Lee
- PhD (Medical Sciences), Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul, Rahman, Kajang, Selangor, Malaysia
| | - Zhen Yee Chow
- MD, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Pei Wen Chua
- MD, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Chin Xuan Tan
- MD, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Shi Nie Lim
- MD, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Chun Han Tan
- MD, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hui Zhu Thew
- MMedFamMed, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Vasudevan Ramachandran
- PhD (Genetics), Centre for Materials Engineering and Regenerative Medicine, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Fan Kee Hoo
- MRCP, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Mohtar S, Jomhari N, Omar NA, Mustafa MBP, Yusoff ZM. The usability evaluation on mobile learning apps with gamification for middle-aged women. Educ Inf Technol (Dordr) 2022; 28:1189-1210. [PMID: 35912038 PMCID: PMC9307217 DOI: 10.1007/s10639-022-11232-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
Mobile learning and gamification are becoming increasingly popular, especially in education. Numerous researches suggest that mobile learning apps with gamification can improve student learning. However, there are fewer studies that analyze the gamification effects and usability of mobile apps for middle-aged women. The aim of this study is to propose a new mobile learning app with gamification aspects for the use of middle-aged women in memorizing Arabic words. In the preliminary study, pre and post-tests were conducted to determine the effect of the use of the gamification application on 61 middle-aged women using Kahoot! game. The results from the Kahoot! game shows that participants enjoy learning and can memorize Arabic words effectively, indicating that gamification can motivate learning among middle-aged women. Then the usability of a new mobile app prototype containing learning notes and quizzes for user self-learning purposes was evaluated using three (3) criteria namely effectiveness, efficiency, and satisfaction. The considered indicators to measure the application's effectiveness are (a) tapping behaviour (number of taps used to perform a specific task), (b) number of attempts (how many times users tried to complete the task successfully), and (c) quiz score (score obtained by user after self-learning using the mobile app). Two variables were used to measure the efficiency of the application: the duration of task completion and the number of requests for help. In order to evaluate the satisfaction, a questionnaire was used to determine how respondents rated the mobile app's usability. The usability evaluation results show that the proposed mobile app was effective as users could utilize all the modules provided and successfully answer the quiz questions.
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Affiliation(s)
- Syahida Mohtar
- Department of Software Engineering, Faculty of Information & Communication Technology, Universiti Teknikal Malaysia Melaka Hang Tuah Jaya, Durian Tunggal, 76100 Melaka, Malaysia
| | - Nazean Jomhari
- Department of Software Engineering, Faculty of Computer Science and Information Technology, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nor Azyra Omar
- Department of Software Engineering, Faculty of Computer Science and Information Technology, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mumtaz Begum Peer Mustafa
- Department of Software Engineering, Faculty of Computer Science and Information Technology, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zulkifli Mohd Yusoff
- Department of Al-Quran and Al-Hadith, Academy of Islamic Studies, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
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Shiao C, Tang PF, Wei YC, Tseng WYI, Lin TT. Brain white matter correlates of learning ankle tracking using a wearable device: importance of the superior longitudinal fasciculus II. J Neuroeng Rehabil 2022; 19:64. [PMID: 35761285 PMCID: PMC9237986 DOI: 10.1186/s12984-022-01042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background Wearable devices have been found effective in training ankle control in patients with neurological diseases. However, the neural mechanisms associated with using wearable devices for ankle training remain largely unexplored. This study aimed to investigate the ankle tracking performance and brain white matter changes associated with ankle tracking learning using a wearable-device system and the behavior–brain structure relationships in middle-aged and older adults. Methods Twenty-six middle-aged and older adults (48–75 years) participated in this study. Participants underwent 5-day ankle tracking learning with their non-dominant foot using a custom-built ankle tracking system equipped with a wearable sensor and a sensor-computer interface for real-time visual feedback and data acquisition. Repeated and random sequences of target tracking trajectories were both used for learning and testing. Ankle tracking performance, calculated as the root-mean-squared-error (RMSE) between the target and actual ankle trajectories, and brain diffusion spectrum MR images were acquired at baseline and retention tests. The general fractional anisotropy (GFA) values of eight brain white matter tracts of interest were calculated to indicate their integrity. Two-way (Sex × Time) mixed repeated measures ANOVA procedures were used to investigate Sex and Time effects on RMSE and GFA. Correlations between changes in RMSE and those in GFA were analyzed, controlling for age and sex. Results After learning, both male and female participants reduced the RMSE of tracking repeated and random sequences (both p < 0.001). Among the eight fiber tracts, the right superior longitudinal fasciculus II (R SLF II) was the only one which showed both increased GFA (p = 0.039) after learning and predictive power of reductions in RMSE for random sequence tracking with its changes in GFA [β = 0.514, R2 change = 0.259, p = 0.008]. Conclusions Our findings implied that interactive tracking movement learning using wearable sensors may place high demands on the attention, sensory feedback integration, and sensorimotor transformation functions of the brain. Therefore, the SLF II, which is known to perform these brain functions, showed corresponding neural plasticity after such learning, and its plasticity also predicted the behavioral gains. The SLF II appears to be a very important anatomical neural correlate involved in such learning paradigms. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-01042-2.
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Affiliation(s)
- Chishan Shiao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Fang Tang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan. .,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan. .,Center for Artificial Intelligence and Robotics, National Taiwan University, Taipei, Taiwan. .,Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan. .,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
| | - Yu-Chen Wei
- Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Yih Isaac Tseng
- Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ta-Te Lin
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Biomechatronics Engineering, College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan
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Zhu C, Yu H, Lian Z, Wang J. Prospective association between depressive symptoms and hip fracture and fall among middle-aged and older Chinese individuals. BMC Psychiatry 2022; 22:258. [PMID: 35413849 PMCID: PMC9004028 DOI: 10.1186/s12888-022-03906-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/01/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The effect of depressive symptoms on hip fracture (HF) and falls among the Chinese population is unclear. This study aims to examine the prospective association between depressive symptoms and HF as well as fall accidents in a nationally representative Chinese population. METHODS We used data from 10,596 participants in the Chinese Health and Retirement Longitudinal Study (from 2011 to 2018) who were aged ≥45 years and had no HFs at baseline. Depressive symptoms were assessed using the 10-item version of the Center for Epidemiological Studied Depression scale (cutoff for distinguishing high versus low at ≥12). Logistic regression analyses adjusted for demographic characteristics, lifestyle factors and physical comorbidities were performed. RESULTS For the analysis of baseline depressive symptoms and HF, 399 (3.8%) participants reported HF accidents in the following 7-year period. Individuals with elevated depressive symptoms at baseline experienced a markedly higher HF risk (odds ratio [OR] = 1.33, 95% confidence interval [CI] = 1.06-1.67) than those without elevated depressive symptoms, after adjusting for a wide range of potential confounders. For the analysis of baseline depressive symptoms and falls, 3974 (37.5%) experienced fall accidents during the follow-up. The presence of elevated depressive symptoms was independently associated with an increased risk of fall events (OR = 1.21, 95% CI = 1.10-1.33). These associations were consistent across multiple characteristics. CONCLUSIONS In conclusion, elevated depressive symptoms were associated with an increased risk of HF and falls, which may have considerable clinical and preventive implications.
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Affiliation(s)
- Chunsu Zhu
- grid.415110.00000 0004 0605 1140Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014 China
| | - Hongyu Yu
- grid.415110.00000 0004 0605 1140Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014 China
| | - Zhiwei Lian
- Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China.
| | - Jianmin Wang
- grid.415110.00000 0004 0605 1140Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014 China
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Kantele A, Rombo L, Vene S, Kundi M, Lindquist L, Erra EO. Three-dose versus four-dose primary schedules for tick-borne encephalitis (TBE) vaccine FSME-immun for those aged 50 years or older: A single-centre, open-label, randomized controlled trial. Vaccine 2022; 40:1299-1305. [PMID: 35101266 DOI: 10.1016/j.vaccine.2022.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/26/2021] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND TBE vaccination failures among those past middle age have raised concern about immune response declining with age. We investigated immunogenicity of the TBE-vaccine FSME-Immun among those aged 50+ years using the standard three-dose primary series and alternative four-dose schedules. METHODS In this single-centre, open-label, randomized controlled trial, 200 TBE-naive Swedish adults were given primary TBE vaccination with FSME-Immun. Those aged 50+ years (n = 150) were randomized to receive the standard three-dose (days 0-30-360) or one of two four-dose series (0-7-21-360; 0-30-90-360). For participants < 50 years (n = 50) the standard three-dose schedule was used. Titres of neutralizing antibodies were determined on days 0, 60, 120, 360, and 400. The main outcome was the log titre of TBE virus-specific neutralizing antibodies on day 400. RESULTS The three-dose schedule yielded lower antibody titres among those aged 50+ years than the younger participants on day 400 (geometric mean titre 41 versus 74, p < 0.05). The older group showed higher titres for the four-dose 0-7-21-360 than the standard three-dose schedule both on day 400 (103 versus 41, p < 0.01; primary end point) and at the other testing points (days 60, 120, 360). Using the other four-dose schedule (0-30-90-360), no such difference was observed on day 400 (63 versus 41, NS). CONCLUSION Immune response to the TBE vaccine declined with age. A four-dose schedule (0-7-21-360) may benefit those aged 50 years or older. This study is registered at ClinicalTrials.gov, NCT01361776.
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Affiliation(s)
- Anu Kantele
- Meilahti Vaccine Research Center, MeVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Human Microbiome Research Program, Faculty of Medicine, University, University of Helsinki, Helsinki, Finland.
| | - Lars Rombo
- Clinical Research Centre, Sormland County Council Eskilstuna, and University of Uppsala, Uppsala, Sweden; Department of Medical Biochemistry and Microbiology, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Sirkka Vene
- Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden
| | - Michael Kundi
- Medical University of Vienna, Center for Public Health, Vienna, Austria
| | - Lars Lindquist
- Division of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Elina O Erra
- Meilahti Vaccine Research Center, MeVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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Abstract
BACKGROUND Preparing for aging is investing resources in preparing to cope with the challenges that are expected to happen in older age. This will lead to an increase in the quality and well-being in aging. The present study was conducted to elucidate the preparation of the middle-aged people for healthy older age in Tehran, Iran. METHODS The present study was performed with a qualitative approach and using semi-structured interviews with 23 Iranian middle-aged people (45 to 59 years old), selected by purposive sampling, and the interviews continued until theoretical saturation. Data were analyzed using the content analysis technique with MAXQDA 10 software. RESULTS The preparation of the middle-aged people was examined in four main categories including staying healthy, financial perspective for the future, outlook on aging, and planning for use time productively. The middle-aged people paid more attention to Staying healthy than other dimensions and the saw their future financially as very dark. Outlook on aging and planning for use time productively dimensions were less considered by the subjects. DISCUSSION Preparing for healthy aging is a multidimensional concept. The results of the study showed that the middle-aged studied in Iranian society rarely had the necessary preparation and planning to have healthy aging, also preparation is outside the individual behavioral factors and is more affected by the economic situation of the society. So, interventions and the country's macro-policy are needed to plan for healthy aging these people.
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Affiliation(s)
- Mahnaz Solhi
- Department of Education and Health Promotion, School of health, Iran University of Medical Sciences, Tehran, Iran
| | - Razieh Pirouzeh
- Health Education and Health Promotion, School of health, Iran University of Medical Sciences, Tehran, Iran.
| | - Nasibeh Zanjari
- Department of Health and Social welfare, Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Choi EY, Um S, Shin H, Kim YS. Attitudes toward aging, active coping, and depressive symptoms among middle-aged and older Korean adults: How do they differ by age group? J Affect Disord 2022; 296:380-387. [PMID: 34606797 DOI: 10.1016/j.jad.2021.09.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/09/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Despite the adverse health outcomes of holding negative attitudes toward aging, little attention has been paid to these attitudes' role in mental health among the aging population. OBJECTIVES Drawing on the stress coping theory, this study examines whether negative attitudes toward aging and low levels of active coping are associated with greater depressive symptoms, and whether active coping attenuates the increased risk of depression caused by negative aging attitudes. We also investigate how these associations differ in middle-aged and older adults. METHODS A nationwide sample of 500 Koreans aged 55 or above was analyzed. Multivariate linear regression analyses were performed separately by age groups to investigate the independent effects of attitudes toward aging and active coping as well as their interactive effects on depressive symptoms. RESULTS Our findings showed that more negative attitudes toward aging were related to higher levels of depressive symptoms. There were age group differences in the independent and moderating effects of active coping. For the middle-aged, those with higher levels of active coping had fewer depressive symptoms, while no such significant association was found among older adults. On the contrary, active coping buffered the adverse effects of endorsing negative aging attitudes on depressive symptoms only for the older adult group. LIMITATIONS A causality cannot be inferred by our findings due to the cross-sectional design. CONCLUSIONS The findings provide some of the first insights into how one's aging attitudes and coping style may protect against the risk of depression and how it differs by age group.
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Affiliation(s)
- Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, USA
| | - Sarang Um
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medicine Science, Kyunghee University Suwon, South Korea
| | - Hyeri Shin
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medicine Science, Kyunghee University Suwon, South Korea
| | - Young Sun Kim
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medicine Science, Kyunghee University Suwon, South Korea.
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Thuyen TQ, Duong DH, Nga BTT, Ngoc NA, Linh DT, Phuong PT, Nhung BT, Binh TQ. Incidence and prediction nomogram for metabolic syndrome in a middle-aged Vietnamese population: a 5-year follow-up study. Endocrine 2022; 75:108-118. [PMID: 34341864 DOI: 10.1007/s12020-021-02836-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/20/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE We aimed to determine the incidence and prediction nomogram for new-onset metabolic syndrome (MetS) in a middle-aged Vietnamese population. METHODS A population-based prospective study was conducted in 1150 participants aged 40-64 years without MetS at baseline and followed-up for 5 years. Data on lifestyle factors, socioeconomic status, family diabetes history, and anthropometric measures were collected. MetS incidence was estimated in general population and subgroup of age, gender, and MetS components. A Cox proportional hazards regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for MetS. A prediction nomogram was developed and checked for discrimination and calibration. RESULTS During median follow-up of 5.14 years, the accumulate MetS incidence rate was 23.4% (95% CI: 22.2-24.7). The annual incidence rate (95% CI) was 52.9 (46.7-60.1) per 1000 person-years in general population and higher in women [56.6 (48.7-65.9)] than men [46.5 (36.9-59.3)]. The HRs (95% CI) for developing MetS were gender [females vs males: 2.04 (1.26-3.29)], advanced age [1.02 (1.01-1.04) per one year], waist circumference [1.08 (1.06-1.10) per one cm] and other obesity-related traits, and systolic blood pressure [1.02 (1.01-1.03) per one mmHg]. The prediction nomogram for MetS had a good discrimination (C-statistics = 0.742) and fit calibration (mean absolute error = 0.009) with a positive net benefit in the predicted probability thresholds between 0.13 and 0.70. CONCLUSIONS The study is the first to indicate an alarmingly high incidence of MetS in a middle-aged population in Vietnam. The nomogram with simply applicable variables would be useful to qualify individual risk of developing MetS.
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Affiliation(s)
- Tran Quang Thuyen
- Department of Epidemiology, Vietnam Military Medical University, 104 Phung Hung, Ha Dong, Hanoi, Vietnam
- Military Institute of Preventive Medicine, 21 Trung Liet, Dong Da, Hanoi, Vietnam
| | - Dinh Hong Duong
- Department of Epidemiology, Vietnam Military Medical University, 104 Phung Hung, Ha Dong, Hanoi, Vietnam
| | - Bui Thi Thuy Nga
- Department of Nutrition & Non-communication Disease, National Institute of Nutrition, 48B Tang Bat Ho, Hanoi, Vietnam
| | - Nguyen Anh Ngoc
- Department of Nutrition & Non-communication Disease, National Institute of Nutrition, 48B Tang Bat Ho, Hanoi, Vietnam
| | - Duong Tuan Linh
- Department of Nutrition & Non-communication Disease, National Institute of Nutrition, 48B Tang Bat Ho, Hanoi, Vietnam
| | - Pham Tran Phuong
- Department of Nutrition & Non-communication Disease, National Institute of Nutrition, 48B Tang Bat Ho, Hanoi, Vietnam
| | - Bui Thi Nhung
- Department of Nutrition & Non-communication Disease, National Institute of Nutrition, 48B Tang Bat Ho, Hanoi, Vietnam
| | - Tran Quang Binh
- Department of Nutrition & Non-communication Disease, National Institute of Nutrition, 48B Tang Bat Ho, Hanoi, Vietnam.
- Dinh Tien Hoang Institute of Medicine, 20 Cat Linh, Dong Da, Hanoi, Vietnam.
- National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi, Vietnam.
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Phillips KC, Noh B, Gage M, Yoon T. Neural and muscular alterations of the plantar flexors in middle-aged women. Exp Gerontol 2021; 159:111674. [PMID: 34954012 DOI: 10.1016/j.exger.2021.111674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Considering the large population of middle-aged adults, it is important to understand the age-related change in lower limb muscles and the possible mechanisms before old age (> 65 years old). The purpose of this study was to investigate age-related neural and muscular alterations of the plantar flexors in young and middle-aged women. METHODS Twenty two middle-aged (54.0 ± 5.8 yrs) and 17 young (21.8 ± 1.4 yrs) recreationally active women performed rapid maximal voluntary isometric contractions (MVIC) of the plantar flexors. Absolute and normalized rate of torque development (RTD) and electromyography (EMG) were examined. Electrical stimulation was used to examine voluntary activation and contractile properties of the muscle. Ultrasonography was used to examine medial and lateral gastrocnemius muscle thickness and pennation angle. A 6-minute walk and sit to stand task were also performed by all participants. RESULTS The middle-aged women had significantly lower MVIC torque (141 ± 49 vs. 109 ± 30 Nm, P = 0.031), absolute RTD (753.0 ± 313.6 vs. 423.0 ± 156.1 Nm/s, P = 0.001), and normalized peak RTD (554.0 ± 191.0 vs. 388.0 ± 91.9% MVIC/s, P = 0.001). Normalized early RTD0-50 and late RTD100-200, voluntary activation, and EMG were similar between groups. Resting twitch data showed that time to peak (124.0 ± 20.4 vs. 143.0 ± 16.7 ms, P = 0.002) and half relaxation time (73.1 ± 15.2 vs. 107.0 ± 28.2 ms, P < 0.001) was significantly faster for the young women. Thickness was greater in the lateral gastrocnemius (1.6 ± 0.2 vs. 1.4 ± 0.2 cm, P = 0.006) for the young women. Pennation angle of both muscles were greater for the young women (15.8 ± 3.9 vs. 13.1 ± 2.7 degrees, P < 0.05). Performance of the 6-minute walk was similar between groups, however, the young women performed more repetitions during the sit to stand task (25.6 ± 6.7 vs. 18.3 ± 4.7 reps, P < 0.001). CONCLUSION Compared to young women, middle-age women were shown to have lower MVIC torque, peak RTD, and functional performance. Muscle architecture and contractile properties are affected by aging.
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Affiliation(s)
- Kevin C Phillips
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton 49931, USA; Exercise Science Program, Brevard College, Brevard 28712, USA
| | - Byungjoo Noh
- Department of Kinesiology, Jeju National University, Jeju-si 63243, Republic of Korea
| | - Matthew Gage
- Career Program, Gogebic Community College, Houghton 49931, USA
| | - Tejin Yoon
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton 49931, USA; Department of Physical Education, Kangwon National University, Chuncheon 24341, Republic of Korea; Interdisciplinary Program in Biohealth-machinery Convergence Engineering, Kangwon National University, Chuncheon 24341, Republic of Korea.
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Wang L, Zhang R, Yang Y, Sun X, Zhang B, Zhu H, Luo X, Ma X, Zhang X. Severity and factors of menopausal symptoms in middle-aged women in Gansu Province of China: a cross-sectional study. BMC Womens Health 2021; 21:405. [PMID: 34879847 PMCID: PMC8653527 DOI: 10.1186/s12905-021-01531-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
Objective To investigate the severity and risk factors of menopausal symptoms in the middle-aged women in Gansu Province of China. Methods In this cross-sectional study, a total of 7319 women (aged 40–55 years) attended the health survey in Gansu Province in China were enrolled. Information on demographics, menopausal status, reproductive history, and history of chronic diseases was collected via a structured questionnaire. Severity of menopausal symptom was evaluated by the Modified Kupperman Menopausal Index. Ordinal logistic regression model was applied to explore its risk factors. Results A total of 7319 participants were included in present study, among them, 3606 (49.27%) had moderate or severe menopausal symptom. Compared with premenopausal women, perimenopausal and postmenopausal women have a higher mKMI score. We observed that older age, higher BMI, non-married status, longer duration of menstruation (≥ 7 days), number of pregnancy (> 3 times), longer duration of breastfeeding (> 12 months), peri- or post-menopausal status, and menopause hormone therapy was positively associated with menopausal symptom score, while higher level of family income, educational and physical activity, and history of gynecological, breast or chronic disease were negatively associated with the score. Conclusions Numerous factors were associated with the severity of menopausal symptom among the Chinese women. Because it was gradually increased with aging, more attention is warranted to manage the menopausal symptom. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01531-x.
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Affiliation(s)
- LiRong Wang
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - Rui Zhang
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - Ye Yang
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - XiaoYan Sun
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - BaoLi Zhang
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - HaiYing Zhu
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - XiaoRong Luo
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - XiaoLing Ma
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - XueHong Zhang
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China. .,The First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo of Gansu Province, No. 1, Donggangxi Rd, Chengguan District, Lanzhou City, 730000, Gansu Province, China.
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Pengpid S, Peltzer K. Physical activity, health and well-being among a nationally representative population-based sample of middle-aged and older adults in India, 2017-2018. Heliyon 2021; 7:e08635. [PMID: 34988323 PMCID: PMC8695286 DOI: 10.1016/j.heliyon.2021.e08635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/03/2021] [Accepted: 12/15/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This study aimed to determine the association between physical activity (PA) and health and well-being in middle-aged and older community-dwelling adults in India. METHODS The cross-sectional sample consisted of 72,262 individuals (≥45 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017-2018. Logistic regression, adjusted for relevant confounders, was used to predict associations between PA levels and 23 health indicators. RESULTS In all 23.8% of participants were inactive, 12.9% had low, 7.6% moderate, and 55.7% high PA. In the final adjusted logistic regression analyses, higher PA levels were associated with better mental health (less insomnia symptoms, less depressive symptoms, less loneliness, and better cognitive functioning), and better well-being (self-rated health status, life satisfaction, happiness, functional ability, and hand grip strength). Moreover, moderate and/or high PA were negatively associated with diabetes, heart disease, stroke, hypertension, chronic lung disease, vision impairment, cataract, chronic renal failure, and Alzheimer's disease/dementia. While in unadjusted analysis, moderate and/or high PA were protective against major depressive disorder and bone or joint diseases, this became non-significant in the adjusted model. PA was not significantly associated with abdominal obesity and cancer. CONCLUSION Overall, higher PA levels were positively associated with 10 of 11 mental health and well-being indicators as well as being protective against 9 of 12 chronic conditions.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa.,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Cui Y, Zhu C, Lian Z, Han X, Xiang Q, Liu Z, Zhou Y. Prospective association between depressive symptoms and stroke risk among middle-aged and older Chinese. BMC Psychiatry 2021; 21:532. [PMID: 34706692 PMCID: PMC8555147 DOI: 10.1186/s12888-021-03492-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to assess the association between baseline symptoms and changes in depressive symptoms and stroke incidents. METHODS We used data from the Chinese Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. In total, 10,100 individuals aged ≥45 years and without a history of stroke in 2013 were included. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (elevated depressive symptoms cutoff ≥10). Changes of depressive symptoms were assessed by two successive surveys (stable low/no, recent onset, recently remitted, and stable high depressive symptoms). We assessed whether baseline depressive symptoms and changes of them were associated with stroke incidents reported through 2018. Logistic regression analyses adjusted for age, gender, education, marital status and other potential confounders were performed. RESULTS For the analysis of baseline depressive symptoms and stroke (n = 10,100), 545 (5.4%) reported stroke incidents in the following 5-year period. Individuals with elevated depressive symptoms in 2013 experienced a markedly higher stroke risk (odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.28-1.84) compared with those without elevated depressive symptoms. In the analysis of changes in depressive symptoms (n = 8491, 430 (5.1%) stroke events), participants with stable high (OR = 2.01, 95% CI = 1.58-2.56) and recent-onset (OR = 1.39, 95% CI = 1.04-1.85) depressive symptoms presented higher stroke risk compared to those with stable low/no depressive symptoms, while recently remitted symptoms (OR = 1.12, 95% CI = 0.80-1.57) were not associated with stroke risk. CONCLUSIONS In conclusion, stable high and newly started depressive symptoms were associated with increased stroke risk, whereas the improvement of depressive symptoms was not related to increase in stroke risk, suggesting that stroke risk may be decreased by effective management of depressive symptoms.
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Affiliation(s)
- Yimin Cui
- Department of Pharmacy, Peking University First Hospital, No. 6, Dahongluochang Street, Xicheng District, Beijing, 100034, China.
- School of Pharmaceutical Sciences, Peking University, Beijing, China.
| | - Chunsu Zhu
- Department of Pharmacy, Peking University First Hospital, No. 6, Dahongluochang Street, Xicheng District, Beijing, 100034, China
- School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Zhiwei Lian
- Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
| | - Xueyan Han
- Department of Medical Statistics, Peking University First Hospital, Beijing, China
| | - Qian Xiang
- Department of Pharmacy, Peking University First Hospital, No. 6, Dahongluochang Street, Xicheng District, Beijing, 100034, China
| | - Zhenming Liu
- School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Ying Zhou
- Department of Pharmacy, Peking University First Hospital, No. 6, Dahongluochang Street, Xicheng District, Beijing, 100034, China
- School of Pharmaceutical Sciences, Peking University, Beijing, China
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Cuevas AG, Greatorex-Voith S, Assari S, Slopen N, Economos CD. Longitudinal Analysis of Psychosocial Stressors and Body Mass Index in Middle-Aged and Older Adults in the United States. J Gerontol B Psychol Sci Soc Sci 2021; 76:1580-1589. [PMID: 32857165 DOI: 10.1093/geronb/gbaa142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Psychosocial stress may be a risk factor for obesity and overweight in middle-aged and older adults. However, research on psychosocial stress and excess body weight has typically been cross-sectional and focused on single stressors. METHODS Using 3 waves of data from the Health and Retirement Study, we conducted longitudinal analyses to assess associations between 5 psychosocial stressors-individually and in combination-and body mass index (BMI), adjusting for sociodemographic factors, alcohol use, and smoking history. We tested interaction effects between race and gender with stressors on BMI. RESULTS A total of 3,956 participants were included in the main analyses. Most participants were White (88.04%) and more than half were female (60.39%). Perceived discrimination, financial stress, and relationship stress were positively associated with BMI. A greater cumulative stress burden was associated with higher BMI. In stratified analyses, greater financial stress was associated with higher BMI among White participants, whereas greater neighborhood stress was associated with lower BMI among Black participants. Greater relationship stress, financial stress, cumulative high stress, and overall cumulative stress burden were associated with higher BMI for women, but not men. DISCUSSION Different sources of stress may be risk factors to weight gain and affect BMI in adults. White and female adults may be more susceptible to the obesogenic effects of stressors. Reducing exposure to stress may help reduce the burden of high BMI among middle-aged and older adults.
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Affiliation(s)
- Adolfo G Cuevas
- Department of Community Health, Tufts University, Medford, Massachusetts
| | | | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, California
| | - Natalie Slopen
- Department of Epidemiology and Biostatistics, University of Maryland, College Park
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
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Hunter ML, Knuiman MW, Musk BAW, Hui J, Murray K, Beilby JP, Hillman DR, Hung J, Newton RU, Bucks RS, Straker L, Walsh JP, Zhu K, Bruce DG, Eikelboom RH, Davis TME, Mackey DA, James AL. Prevalence and patterns of multimorbidity in Australian baby boomers: the Busselton healthy ageing study. BMC Public Health 2021; 21:1539. [PMID: 34380465 PMCID: PMC8359115 DOI: 10.1186/s12889-021-11578-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/30/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Chronic medical conditions accumulate within individuals with age. However, knowledge concerning the trends, patterns and determinants of multimorbidity remains limited. This study assessed the prevalence and patterns of multimorbidity using extensive individual phenotyping in a general population of Australian middle-aged adults. METHODS Participants (n = 5029, 55% female), born between 1946 and 1964 and attending the cross-sectional phase of the Busselton Healthy Ageing Study (BHAS) between 2010 and 2015, were studied. Prevalence of 21 chronic conditions was estimated using clinical measurement, validated instrument scores and/or self-reported doctor-diagnosis. Non-random patterns of multimorbidity were explored using observed/expected (O/E) prevalence ratios and latent class analysis (LCA). Variables associated with numbers of conditions and class of multimorbidity were investigated. RESULTS The individual prevalence of 21 chronic conditions ranged from 2 to 54% and multimorbidity was common with 73% of the cohort having 2 or more chronic conditions. (mean ± SD 2.75 ± 1.84, median = 2.00, range 0-13). The prevalence of multimorbidity increased with age, obesity, physical inactivity, tobacco smoking and family history of asthma, diabetes, myocardial infarct or cancer. There were 13 pairs and 27 triplets of conditions identified with a prevalence > 1.5% and O/E > 1.5. Of the triplets, arthritis (> 50%), bowel disease (> 33%) and depression-anxiety (> 33%) were observed most commonly. LCA modelling identified 4 statistically and clinically distinct classes of multimorbidity labelled as: 1) "Healthy" (70%) with average of 1.95 conditions; 2) "Respiratory and Atopy" (11%, 3.65 conditions); 3) "Non-cardiometabolic" (14%, 4.77 conditions), and 4) "Cardiometabolic" (5%, 6.32 conditions). Predictors of multimorbidity class membership differed between classes and differed from predictors of number of co-occurring conditions. CONCLUSION Multimorbidity is common among middle-aged adults from a general population. Some conditions associated with ageing such as arthritis, bowel disease and depression-anxiety co-occur in clinically distinct patterns and at higher prevalence than expected by chance. These findings may inform further studies into shared biological and environmental causes of co-occurring conditions of ageing. Recognition of distinct patterns of multimorbidity may aid in a holistic approach to care management in individuals presenting with multiple chronic conditions, while also guiding health resource allocation in ageing populations.
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Affiliation(s)
- Michael L Hunter
- Busselton Population Medical Research Institute Inc, Nedlands, WA, 6009, Australia.
- School of Population and Global Health, The University of Western Australia, Crawley, WA, 6009, Australia.
- BPMRI Busselton Health Study Centre, PO Box 659, Busselton, Western Australia, 6280.
| | - Matthew W Knuiman
- School of Population and Global Health, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Bill A W Musk
- Busselton Population Medical Research Institute Inc, Nedlands, WA, 6009, Australia
- School of Population and Global Health, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Jennie Hui
- Busselton Population Medical Research Institute Inc, Nedlands, WA, 6009, Australia
- School of Population and Global Health, The University of Western Australia, Crawley, WA, 6009, Australia
- PathWest Laboratory Medicine of WA, QEII Medical Centre, Nedlands, WA, 6009, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, WA, 6009, Australia
| | - John P Beilby
- Busselton Population Medical Research Institute Inc, Nedlands, WA, 6009, Australia
- PathWest Laboratory Medicine of WA, QEII Medical Centre, Nedlands, WA, 6009, Australia
| | - David R Hillman
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
| | - Joseph Hung
- Busselton Population Medical Research Institute Inc, Nedlands, WA, 6009, Australia
- Faculty of Health and Medical Sciences, Medical School, University of Western Australia, Crawley, 6009, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, 6027, Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Perth, WA, 6083, Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, WA, 6845, Australia
| | - John P Walsh
- Faculty of Health and Medical Sciences, Medical School, University of Western Australia, Crawley, 6009, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
| | - Kun Zhu
- Faculty of Health and Medical Sciences, Medical School, University of Western Australia, Crawley, 6009, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
| | - David G Bruce
- Faculty of Health and Medical Sciences, Medical School, University of Western Australia, Crawley, 6009, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, WA, 6008, Australia
- Ear Sciences Centre, The University of Western Australia, Crawley, WA, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Timothy M E Davis
- Medical School, University of Western Australia, Fremantle Hospital, Fremantle, WA, 6959, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Australia
| | - Alan L James
- Busselton Population Medical Research Institute Inc, Nedlands, WA, 6009, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
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Choi JH, Lee JY, Lim YC, Kim JK, Do Han K, Cho JH. Association between obstructive sleep apnea and thyroid cancer incidence: a national health insurance data study. Eur Arch Otorhinolaryngol 2021; 278:4569-4574. [PMID: 34032908 DOI: 10.1007/s00405-021-06896-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Little is known about the incidence of thyroid cancer in patients with obstructive sleep apnea (OSA). This study aimed to evaluate whether OSA is associated with the incidence of thyroid cancer based on the Korea National Health Insurance Service (KNHIS) database. METHODS This study was designed as a retrospective cohort data analysis of the KNHIS dataset. A total of 198,574 patients who were over 20 years of age and had been newly diagnosed with OSA between 2007 and 2014 were enrolled. A control group of 992,870 individuals was selected based on propensity score matching by age and sex. The mean follow-up duration was 4.5 ± 2.3 years. The primary endpoint was the incidence of newly diagnosed thyroid cancer. RESULTS The hazard ratio (HR) for thyroid cancer incidence among OSA patients compared to the control was 1.72 (95% confidence interval [CI] 1.60-1.84) based on Model 1 (not adjusted by any covariate) and 1.64 (95% CI 1.53-1.76) based on Model 2 (adjusted by income level, diabetes, hypertension, and dyslipidemia). Thyroid cancer incidence was significantly higher in male patients (HR = 1.93, 95% CI 1.74-2.12) than female ones (HR = 1.39, 95% CI 1.26-1.54). When compared by age, the HR of thyroid cancer was higher in middle-aged (40 ≤ age < 65 years) patients (HR = 1.68, 95% CI 1.55-1.83) than in young (20 ≤ age < 40 years, HR = 1.53, 95% CI 1.32-1.77) or old (65 ≤ age, HR = 1.28, 95% CI 0.94-1.74) patients. CONCLUSION OSA may increase the risk of developing thyroid cancer, especially in middle-aged men.
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Affiliation(s)
- Ji Ho Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea
| | - Jae Yong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea
| | - Young Chang Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University College of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea
| | - Jin Kook Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University College of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Jae Hoon Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University College of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea.
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Miyashita T, Kudo S, Maekawa Y. Assessment of walking disorder in community-dwelling Japanese middle-aged and elderly women using an inertial sensor. PeerJ 2021; 9:e11269. [PMID: 33954059 PMCID: PMC8052961 DOI: 10.7717/peerj.11269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 03/23/2021] [Indexed: 11/20/2022] Open
Abstract
Background Decreased walking speed has been revealed to be related to many negative events. Several researchers support the importance of triceps surae function as a cause of decreased walking speed. The purpose of this study was to investigate the relationship between walking speed and plantar flexor power during the terminal stance of gait in community-dwelling middle-aged and elderly women using an inertial sensor. Methods One hundred thirty-six healthy female middle-aged to elderly community-dwelling women were included in this study. We measured two-step score, grip strength, walking speed and accelerometer data from which we estimated ankle power (estimated ankle power) during walking using an inertial sensor. All participants were classified into the four different age strata, fifties (50-59), sixties (60-69), seventies (70-79) and eighties (80-89). The differences in each parameter between the four age groups were compared using repeated analysis of variance and post-hoc Bonferroni corrections for multiple comparisons to establish significance. Multiple regression analysis was carried out using a stepwise method to determine the correlations with comfortable walking speed. Comfortable walking speed was considered a dependent variable. Results The normalized estimated ankle power of the eighties group was significantly decreased in comparison with seventies age groups and fifties age groups (P < 0.05), but there were no significant differences in normalized estimated ankle power between the sixties and eighties age-groups. The results of stepwise multiple regression analysis revealed that the normalized estimated ankle power, two-step value and body weight were highly-significant partial regression coefficients (adjusted R 2 = 0.57).
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Affiliation(s)
- Toshinori Miyashita
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka City, Japan.,Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka City, Japan
| | - Shintarou Kudo
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka City, Japan.,Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka City, Japan.,Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka City, Japan
| | - Yoshihiro Maekawa
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka City, Japan.,Department of Clinical Laboratory, Morinomiya University of Medical Sciences, Osaka City, Japan.,Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka City, Japan
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Clarke RB, Amini H, James P, von Euler-Chelpin M, Jørgensen JT, Mehta A, Cole-Hunter T, Westendorp R, Mortensen LH, Loft S, Brandt J, Hertel O, Ketzel M, Backalarz C, Andersen ZJ, Lim YH. Outdoor light at night and breast cancer incidence in the Danish Nurse Cohort. Environ Res 2021; 194:110631. [PMID: 33345898 DOI: 10.1016/j.envres.2020.110631] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Knowledge of the role of melatonin, xenograft experiments, and epidemiological studies suggests that exposure to light at night (LAN) may disturb circadian rhythms, possibly increasing the risk of developing breast cancer. OBJECTIVES We examined the association between residential outdoor LAN and the incidence of breast cancer: overall and subtypes classified by estrogen (ER) and progesterone (PR) receptor status. METHODS We used data on 16,941 nurses from the Danish Nurse Cohort who were followed-up from the cohort baseline in 1993 or 1999 through 2012 in the Danish Cancer Registry for breast cancer incidence and the Danish Breast Cancer Cooperative Group for breast cancer ER and PR status. LAN exposure data were obtained from the U.S. Defense Meteorological Satellite Program (DMSP) available for 1996, 1999, 2000, 2003, 2004, 2006, and 2010 in nW/cm2/sr unit, and assigned to the study participants' residence addresses during the follow-up. Time-varying Cox regression models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between LAN and breast cancer, adjusting for individual characteristics, road traffic noise, and air pollution. RESULTS Of 16,941 nurses, 745 developed breast cancer in total during 320,289 person-years of follow-up. We found no association between exposure to LAN and overall breast cancer. In the fully adjusted models, HRs for the highest (65.8-446.4 nW/cm2/sr) and medium (22.0-65.7 nW/cm2/sr) LAN tertiles were 0.97 (95% CI: 0.77, 1.23) and 1.09 (95% CI: 0.90, 1.31), respectively, compared to the lowest tertile of LAN exposure (0-21.9 nW/cm2/sr). We found a suggestive association between LAN and ER-breast cancer. CONCLUSION This large cohort study of Danish female nurses suggests weak evidence of the association between LAN and breast cancer incidence.
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Affiliation(s)
- Rebecca B Clarke
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Heresh Amini
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, United States.
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - My von Euler-Chelpin
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette T Jørgensen
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Amar Mehta
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Statistics Denmark, Copenhagen, Denmark
| | - Tom Cole-Hunter
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Centre for Air pollution, energy and health Research, University of Sydney, Sydney, Australia; International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Rudi Westendorp
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Laust H Mortensen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Statistics Denmark, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | | | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Seoul National University Medical Research Center, Seoul, Republic of Korea.
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He D, Li ZC, Zhang TY, Cheng XG, Tian W. Prevalence of Lumbar Spondylolisthesis in Middle-Aged People in Beijing Community. Orthop Surg 2021; 13:202-206. [PMID: 33438343 PMCID: PMC7862163 DOI: 10.1111/os.12871] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/12/2020] [Accepted: 10/25/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Lumbar spondylolisthesis (LS) is a common lumbar disease, and the prevalence of LS in different countries or regions was not consistent in the past. This study intends to make statistics on the prevalence of lumbar spondylolisthesis in middle-aged people in Beijing community. METHODS This is an epidemiological study. 4548 people in Beijing community aged 50 to 64 years were recruited from the local communities by advertisements placed in housing estates and community centres for people to take part in a prospective cohort study from August from September 2013 to March 2014. There is no intervention on the subjects. RadiAnt DICOM Viewer is adopted to read the lateral CT positioning images of all the studied objects, adjust the image as bone window, observe and evaluate the slide of L1 to L5 vertebra in the lateral CT positioning image. RESULTS Among the 4,548 subjects included in the study, 2,490 (54.75%) were male and 2,058 (45.25%) were female. A total of 785 subjects had lumbar spondylolisthesis, with a total incidence of 17.26%. There was no significant difference between prevalence of males and females in the subgroup 50-54 years old (13.55% males / 12.53% females) and 55-59 years old (14.77% males / 14.93% females). But the prevalence of LS in 60-64 years old females (28.57%) increased significantly, compared with 55-59 years old females (14.93%) and 60-64 years old males (18.76%). There were 847 levels that had slipped, L5S1 > L4/5 > L3/4 > L2/3 > L1/2. The retrolisthesis was the most, accounting for 61.51% (521/847), and the anterolisthesis was 38.49% (326/847), including anterolisthesis gradeI for 95.71% (312/326), anterolisthesis gradeII for 4.29% (14/326). Neither of anterolisthesis and retrolisthesis presented more than grade III. Among all the subjects, 318 had anterolisthesis, with a total incidence of 6.99%, and 467 subjects only had retrolisthesis. CONCLUSION The total prevalence of LS in the middle-aged people in Beijing community was 17.26%, 15.98% in males and 18.80% in females, and women are more likely to suffer from LS after 60 years old.
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Affiliation(s)
- Da He
- Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing, China
| | - Zu-Chang Li
- Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing, China
| | - Tian-Yu Zhang
- Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing, China
| | - Xiao-Guang Cheng
- Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing, China
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Bellard AM, Cornelissen PL, Mian E, Cazzato V. The ageing body: contributing attitudinal factors towards perceptual body size estimates in younger and middle-aged women. Arch Womens Ment Health 2021; 24:93-105. [PMID: 32562005 PMCID: PMC7929965 DOI: 10.1007/s00737-020-01046-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023]
Abstract
Over-estimation of body size, a core feature of eating disorders (EDs), has been well-documented both in young healthy and ED individuals. Yet, evidence that altered body perception might also affect older women is limited. Here, we examined whether attitudinal components of body image (i.e. the feelings an individual has about their body size and shape) might affect perceived actual and ideal body shape self-estimates in midlife, similarly to younger women. Thirty-two younger (mean age, 24.22 years) and 33 middle-aged (mean age, 53.79 years) women took part to a computerized body perception assessment of perceived, actual and ideal aspects of body image. Body mass index (BMI), societal and interpersonal aspects of appearance ideals, measured by means of Sociocultural Attitudes towards Appearance Questionnaire (SATAQ-4), and assessment of body uneasiness and concerns for specific body parts, measured by Body Uneasiness Test (BUT-A/B) scales, were also investigated. Younger and middle-aged women with larger BMI showed greater discrepancy in perceptual distortions from their perceived actual body size. However, middle-aged women with greater body part concerns overestimated their perceived body size, as opposed to younger women who were almost accurate. Unlike middle-aged women, younger women with higher body part concerns desired slimmer ideal body image than their perceived actual. Results suggest that distortions in the perceived actual and ideal body size self-estimates of younger and middle-aged women are best explained by a combination of BMI, body part concerns and the particular age group to which a participant belonged. In the future, a personalized approach for the assessment of women's perceptions and concerns of specific body areas during lifespan should be adopted.
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Affiliation(s)
- Ashleigh M. Bellard
- grid.4425.70000 0004 0368 0654School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Piers L. Cornelissen
- grid.42629.3b0000000121965555Department of Psychology, Northumbria University, Newcastle, UK
| | - Emanuel Mian
- Emotifood Body Image & Eating Disorders Unit, 20900 Monza, Italy
| | - Valentina Cazzato
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK.
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Wang P, Sha J, Meng M, Wang C, Yao Q, Zhang Z, Sun W, Wang X, Qie G, Bai X, Liu K, Chu Y. Risk factors for severe COVID-19 in middle-aged patients without comorbidities: a multicentre retrospective study. J Transl Med 2020; 18:461. [PMID: 33287826 PMCID: PMC7719726 DOI: 10.1186/s12967-020-02655-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023] Open
Abstract
Background Information regarding characteristics and risk factors of COVID-19 amongst middle-aged (40–59 years) patients without comorbidities is scarce. Methods We therefore conducted this multicentre retrospective study and collected data of middle-aged COVID-19 patients without comorbidities at admission from three designated hospitals in China. Results Among 119 middle-aged patients without comorbidities, 18 (15.1%) developed into severe illness and 5 (3.9%) died in hospital. ARDS (26, 21.8%) and elevated D-dimer (36, 31.3%) were the most common complications, while other organ complications were relatively rare. Multivariable regression showed increasing odds of severe illness associated with neutrophil to lymphocyte ratio (NLR, OR, 11.238; 95% CI 1.110–1.382; p < 0.001) and D-dimer greater than 1 µg/ml (OR, 16.079; 95% CI 3.162–81.775; p = 0.001) on admission. The AUCs for the NLR, D-dimer greater than 1 µg/ml and combined NLR and D-dimer index were 0.862 (95% CI, 0.751–0.973), 0.800 (95% CI 0.684–0.915) and 0.916 (95% CI, 0.855–0.977), respectively. SOFA yielded an AUC of 0.750 (95% CI 0.602–0.987). There was significant difference in the AUC between SOFA and combined index (z = 2.574, p = 0.010). Conclusions More attention should be paid to the monitoring and early treatment of respiratory and coagulation abnormalities in middle-aged COVID-19 patients without comorbidities. In addition, the combined NLR and D-dimer higher than 1 μg/ml index might be a potential and reliable predictor for the incidence of severe illness in this specific patient with COVID-19, which could guide clinicians on early classification and management of patients, thereby relieving the shortage of medical resource. However, it is warranted to validate the reliability of the predictor in larger sample COVID-19 patients.
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Affiliation(s)
- Peng Wang
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China
| | - Jing Sha
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China
| | - Mei Meng
- Department of Critical Care Medicine, Ruijin Hospital, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Cuiyan Wang
- Shandong Medical Imaging Research Institute Affiliated To Shandong University, Jinan, P.R. China
| | - Qingchun Yao
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China
| | - Zhongfa Zhang
- Jinan Infectious Diseases Hospital, Shandong University, Jinan, P. R. China
| | - Wenqing Sun
- Department of Intensive Care Unit, Shandong Provincial Chest Hospital, Jinan, P. R. China
| | - Xingguang Wang
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, P. R. China
| | - Guoqiang Qie
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China
| | - Xue Bai
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China
| | - Keke Liu
- Shandong Academy of Clinical Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, P. R. China
| | - Yufeng Chu
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, P. R. China.
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Mailey EL, Gasper R, Dlugonski D, Besenyi GM. Promoting Strength Training Among Baby Boomers: Message Framing Effects on Motivation and Behavior. Int J Behav Med 2020; 28:499-510. [PMID: 33200382 DOI: 10.1007/s12529-020-09939-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Regular participation in strength training significantly enhances older adults' physical and functional health, yet only 14% of adults over age 50 report engaging in strength training at least twice per week. Exercise messages about why and how older adults should engage in strength training could influence their perceptions of and participation in the behavior. This study was designed to promote strength training among adults aged 50-70 and to determine whether the message frame accompanying a brief workout would have an impact on participants' motivation, self-efficacy, and/or physical activity behavior. METHODS Participants (N = 308) were randomly assigned to one of four message conditions: Easy Intrinsic, Hard Intrinsic, Easy Extrinsic, or Hard Extrinsic. Immediately after completing baseline measures of motivation and physical activity, participants received the recommended strength training workout and corresponding motivational message. They completed follow-up measures of motivation and physical activity 2 weeks later. RESULTS Controlled regulation was higher at follow-up among participants exposed to an extrinsic message relative to an intrinsic message (F(3,208) = 3.08, p = .03). Strength training (Z = - 5.95, p < .001) and moderate physical activity (Z = - 3.23, p = .001) increased among participants not engaging in regular strength training at baseline. CONCLUSIONS These results suggest message framing may have a short-term impact on Baby Boomers' physical activity motivation, such that emphasizing extrinsic goals (i.e., weight loss and appearance) may contribute to controlled motivation. However, repeated measurements are needed to determine the longer-term maintenance and influence of these effects.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology, Kansas State University, KS, Manhattan, USA.
| | - Rebecca Gasper
- Department of Kinesiology, Kansas State University, KS, Manhattan, USA
| | - Deirdre Dlugonski
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, KY, Lexington, USA
| | - Gina M Besenyi
- Department of Kinesiology, Kansas State University, KS, Manhattan, USA
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Yu X, Zhang W. Neighborhood's locality, road types, and residents' multimorbidity: evidence from China's middle-aged and older adults. BMC Public Health 2020; 20:1728. [PMID: 33198728 PMCID: PMC7670703 DOI: 10.1186/s12889-020-09876-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/11/2020] [Indexed: 02/08/2023] Open
Abstract
Background Neighborhood factors have gained increasing attention, while the association between the neighborhood’s characteristics and multimorbidity has not been clarified. In this study, we aim to depict variations in the number of non-communicable chronic diseases (NCDs) as a function of urban vs. rural settings and road types. Methods The present cross-sectional study derived data from the China Health and Retirement Longitudinal Study 2011 National Baseline Survey. Negative binomial regression with clustered robust standard errors was performed to analyze variations in the number of NCDs among 13,414 Chinese middle-aged and older adults. Logistic regression models were employed to investigate the association between neighborhood-level characteristics and each NCD, respectively. Results First, over 65% of subjects had at least one NCDs, and over 35% had multimorbidity. Arthritis (33.08%), hypertension (24.54%), and digestive disease (21.98%) were the most prevalent NCDs. Urban vs. rural differences in multimorbidity were fully explained by neighborhood clustering variations (IRR = 1.02, 95% CI, 0.95–1.10). Living with paved roads was associated with a smaller number of NCDs relative to living with unpaved roads (IRR = 0.86, 95% CI, 0.78–0.95). Results from subgroup analyses suggested that in comparison with those living with unpaved roads, individuals living with paved roads respectively had lower odds of chronic lung disease (OR = 0.76, 95% CI, 0.63–0.93), chronic liver disease (OR = 0.74, 95% CI, 0.55–0.99), chronic kidney disease (OR = 0.68, 95% CI, 0.51–0.89), digestive disease (OR = 0.82, 95% CI, 0.69–0.97), arthritis or rheumatism (OR = 0.69, 95% CI, 0.55–0.87), and asthma (OR = 0.67, 95% CI, 0.51–0.88). Conclusions Urban vs. rural disparities in multimorbidity appeared to result from within-neighborhoods characteristics. The improvement in neighborhood-level characteristics, such as road pavement, holds promise to alleviate the increasing disease burden of chronic diseases.
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Affiliation(s)
- Xuexin Yu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610040, Sichuan, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610040, Sichuan, China.
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Ward-Ritacco CL, Meyer A, Walker G, Riebe D, Sabik NJ. Percent body fat, but not lean mass, is associated with objectively measured physical function in middle-aged women. Maturitas 2020; 142:11-6. [PMID: 33158482 DOI: 10.1016/j.maturitas.2020.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 06/02/2020] [Accepted: 06/09/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The relationship between components of body composition and physical function is not well characterized among middle-aged women. This cross-sectional study examined the strength of the associations between lean mass and percent fat and physical function in middle-aged women. STUDY DESIGN Body composition, physical function and physical activity were objectively measured in 80 women (mean age 52.58 ± 6.10 years; range = 40-63 years). MAIN OUTCOME MEASURES Adiposity (%Fat) and lean mass were measured via dual-energy x-ray absorptiometry. Steps/day and minutes of low-, moderate- and vigorous-intensity physical activity were assessed via accelerometer. Physical function was measured via a seated transfer task, 30-second chair stand, a six-minute walk task, 8-foot timed up and go, and a lift and carry task. RESULTS When controlling for steps/day, measures of lean mass were related to performance on the seated transfer task (r = .25) and 30-second chair stand (-.26) (both p > 0.05), while %Fat was related to performance on the seated transfer task (r = .53), 8-foot timed up and go (r = .32), 30-second chair stand (r = -.35), and six-minute walk (r = -.48; all p ≤ 0.05). Linear regression analyses revealed: (1) age, steps/day, and %Fat were independently related to performance on the seated transfer task and 30-second chair stand (both p ≤ 0.05), (2) %Fat was associated with six-minute walk and 8-foot up-and-go performance (p ≤ 0.01); none of the variables included were associated with lift and carry. CONCLUSIONS Adiposity but not lean mass was associated with objectively measured physical function in middle-aged women. Interventions that focus on reducing body fat may be an effective method for improving functional performance among women in this age group.
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