Longitudinal effects of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in older women and men

Genetic variants in UMOD associate with kidney function and hypertension. These phenotypes are also linked to sex-related differences and impairment in cognitive and physical function in older age. Here we evaluate longitudinal associations between a common UMOD rs4293393-A>G variant and changes in estimated glomerular filtration rate (eGFR), blood pressure (BP), cognitive and physical function parameters in older participants in the BASE-II after long-term follow-up as part of the GendAge study. Overall, 1010 older participants (mean age 75.7 ± 3.7 years, 51.6% women) were analyzed after follow-up (mean 7.4 years) both in cross-sectional analysis and in longitudinal analysis as compared to baseline. In cross-sectional analysis, heterozygous G-allele carriers exhibited significantly higher eGFR values (AA, 71.3 ml/min/1.73 m2, 95% CI, 70.3-72.3 vs. AG, 73.5 ml/min/1.73 m2, 95% CI, 72.1-74.9, P = 0.033). Male heterozygous G-allele carriers had lower odds of eGFR < 60 mL/min/1.73 m2 (OR 0.51, 95% CI, 0.28-0.95, P = 0.032) and in Timed Up and Go-Test ≥ 10 s (OR 0.50, 95% CI, 0.29-0.85, P = 0.011) whereas women were less likely to have hypertension (OR 0.58, CI, 0.37-0.91, P = 0.018). UMOD genotypes were not significantly associated with longitudinal changes in any investigated phenotype. Thus, while the impact of UMOD rs4293393 on kidney function is maintained in aging individuals, this variant has overall no impact on longitudinal changes in BP, kidney, cognitive or functional phenotypes. However, our results suggest a possible sex-specific modifying effect of UMOD on eGFR and physical function in men and hypertension prevalence in women.

Effect of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in a community-based cohort of older adults

In genome-wide association studies, genetic variants in the UMOD gene associate with kidney function, blood pressure (BP), and hypertension. Elevated BP is linked to kidney function and impaired cognitive as well as physical performance in later life. We investigated the association between UMOD rs4293393-A > G and kidney function, BP, cognitive and physical function in the Berlin Aging Study II (BASE-II). Data of 1556 older BASE-II participants (mean age 68.2 ± 3.7 years) were analyzed. BP was determined by standardized automated measurements, estimated glomerular filtration rate (eGFR) by CKD Epidemiology Collaboration creatinine equation. Cognitive function was assessed by Mini-Mental State Examination and Digit Symbol Substitution Test, while physical function by Handgrip Strength and Timed Up and Go-Test. Association analyses were performed by covariance and logistic regression models adjusting for sex. G-allele carriers at UMOD rs4293393 exhibited significantly higher eGFR values compared to non-carriers (AA, 76.4 ml/min/1.73 m², CI: 75.7-77.2 vs. AG, 78.4 ml/min/1.73 m², CI: 77.3-79.5 vs. GG, 78.5 ml/min/1.73 m², CI: 75.4-81.7; P = 0.010), and a lower risk of eGFR < 60 mL/min/1.73 m² (AG, OR: 0.63, CI: 0.41-0.97, P = 0.033). However, UMOD rs4293393 genotypes were not associated with BP, diagnosis of hypertension or cognitive and physical function parameters. Our data corroborate previous findings on the association of UMOD rs4293393-G with better kidney function in older adults. However, no association between UMOD and BP or physical and cognitive parameters in these community-dwelling older adults was detected.

Sex Differences in Characteristics Associated with Potentially Inappropriate Medication Use and Associations with Functional Capacity in Older Participants of the Berlin Aging Study II

INTRODUCTION

Medication safety is a vital aim in older adults' pharmacotherapy. Increased morbidity and vulnerability require particularly careful prescribing. Beneath avoiding unnecessary polypharmacy and prescribing omissions, physicians have to be aware of potentially inappropriate medications (PIMs) and related outcomes to optimize older adults' drug therapy, and to reduce adverse drug events.

OBJECTIVE

The aim of this study was to identify participants characteristics associated with PIM use and associations of PIM use with functional capacity with a focus on sex differences.

METHODS

Multivariable logistic regression analyses of cross-sectional Berlin Aging Study II (BASE-II) data (N = 1,382, median age 69 years, interquartile range 67-71, 51.3% women) were performed with PIM classification according to the EU(7)-PIM list.

RESULTS

In the overall study population, higher education was associated with lower odds of PIM use (odds ratio [OR] 0.93, confidence interval [CI] 95% 0.87-0.99, p = 0.017). Falls (OR 1.53, CI 95% 1.08-2.17, p = 0.016), frailty/prefrailty (OR 1.68, 1.17-2.41, p = 0.005), and depression (OR 2.12, CI 95% 1.32-3.41, p = 0.002) were associated with increased odds of PIM use. A better nutritional status was associated with lower odds of PIM use (OR 0.88, CI 95% 0.81-0.97, p = 0.008). In the sex-stratified analysis, higher education was associated with lower odds of PIM use in men (OR 0.90, CI 95% 0.82-0.99, p = 0.032). Frailty/prefrailty was associated with increased odds of PIM use in men (OR 2.04, CI 95% 1.18-3.54, p = 0.011) and a better nutritional status was associated with lower odds of PIM use in men (OR 0.83, CI 95% 0.72-0.96, p = 0.011). Falls in the past 12 months were related to an increased prevalence of PIM use in women (OR 1.74, CI 95% 1.10-2.75, p = 0.019). Depression was associated with a higher prevalence of PIM use in both men (OR 2.74, CI 95% 1.20-6.24, p = 0.016) and women (OR 2.06, CI 95% 1.14-3.71, p = 0.017). We did not detect sex differences regarding the overall use of drugs with anticholinergic effects, but more men than women used PIMs referring to the cardiovascular system (p = 0.036), while more women than men used PIMs referring to the genitourinary system and sex hormones (p < 0.001).

CONCLUSION

We found similarities, but also differences between men and women as to the associations between PIM use and participants' characteristics and functional capacity assessments. The association of lower education with PIM use may suggest that physicians' prescribing behavior is modified by patient education, a relationship that could evolve from more critical attitudes of educated patients towards medication use. We conclude that sex differences in associations of PIM use with functional capacities might be partly attributable to sex differences in drug classes used, but not with regard to anticholinergics, as these are used to a similar extent in men and women in the cohort studied here.

Relationship between Lipoprotein (a) and cognitive function - Results from the Berlin Aging Study II

It has been suggested that an age-related loss of cognitive function might be driven by atherosclerotic effects associated with altered lipid patterns. However, the relationship between Lipoprotein (a) [Lp(a)] and healthy cognitive aging has not yet been sufficiently investigated. For the current analysis we used the cross-sectional data of 1,380 Berlin Aging Study II (BASE-II) participants aged 60 years and older (52.2% women, mean age 68 ± 4 years). We employed the Consortium to Establish a Registry for Alzheimer's Disease (CERAD)-Plus test battery to establish latent factors representing continuous measures of domain specific cognitive functions. Regression models adjusted for APOE genotypes, lipid parameters and other risk factors for cognitive impairment were applied to assess the association between Lp(a) and performance in specific cognitive domains. Men within the lowest Lp(a)-quintile showed better cognitive performance in the cognitive domain executive functions and processing speed (p = 0.027). No significant results were observed in women. The results of the current analysis of predominantly healthy BASE-II participants point towards an association between low Lp(a) concentrations and better cognitive performance. However, evidence for this relationship resulting from the current analysis and the employment of a differentiated cognitive assessment is rather weak.

Potentially inappropriate medication in older participants of the Berlin Aging Study II (BASE-II) - Sex differences and associations with morbidity and medication use

Introduction

Multimorbidity in advanced age and the need for drug treatment may lead to polypharmacy, while pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug events (ADEs).

Objective

The aim of this study was to determine the proportion of subjects using potentially inappropriate medication (PIM) in a cohort of older and predominantly healthy adults in relation to polypharmacy and morbidity.

Methods

Cross-sectional data were available from 1,382 study participants (median age 69 years, IQR 67–71, 51.3% females) of the Berlin Aging Study II (BASE-II). PIM was classified according to the EU(7)-PIM and German PRISCUS (representing a subset of the former) list. Polypharmacy was defined as the concomitant use of at least five drugs. A morbidity index (MI) largely based on the Charlson Index was applied to evaluate the morbidity burden.

Results

Overall, 24.1% of the participants were affected by polypharmacy. On average, men used 2 (IQR 1–4) and women 3 drugs (IQR 1–5). According to PRISCUS and EU(7)-PIM, 5.9% and 22.6% of participants received at least one PIM, while use was significantly more prevalent in females (25.5%) compared to males (19.6%) considering EU(7)-PIM (p = 0.01). In addition, morbidity in males receiving PIM according to EU(7)-PIM was higher (median MI 1, IQR 1–3) compared to males without PIM use (median MI 1, IQR 0–2, p<0.001).

Conclusion

PIM use occurred more frequently in women than in men, while it was associated with higher morbidity in males. As expected, EU(7)-PIM identifies more subjects as PIM users than the PRISCUS list but further studies are needed to investigate the differential impact of both lists on ADEs and outcome.

Key points

We found PIM use to be associated with a higher number of regular medications and with increased morbidity. Additionally, we detected a higher prevalence of PIM use in females compared to males, suggesting that women and people needing intensive drug treatment are patient groups, who are particularly affected by PIM use.

Phenotypic trait changes in laboratory--reared colonies of the maize herbivore, Diabrotica virgifera virgifera

The North American and European maize pest Diabrotica virgifera virgifera LeConte (Coleoptera: Chrysomelidae) was used to assess whether conditions of the natal field, subsequent laboratory rearing, or genetic population origin affect phenotypic traits of fitness, activity, or morphometrics. Standardized laboratory bioassays with large sample sizes revealed that none of the 16 tested traits, except crawling behaviours, appeared consistently stable across all seven tested colonies. Environmental conditions in the natal field of the F 0 generation affected trait averages of the subsequently reared F 1 generation in laboratory in ca. 47% of cases, and trait variability in 67% of cases. This was apparent for fitness and morphometrics, but less obvious for activity traits. Early generation laboratory rearing affected trait averages in ca. 56% of cases: morphometrics changed; fecundity and egg survival increased from F 1 to F 2. Trait variability increased or decreased in 38% of cases. Laboratory rearing for over more than 190 generations affected the trait averages in 60% of cases, reflected by decreases in flight activity and increases in body size, weight, and fecundity to some extent. It had little effect on trait variability, especially so for morphometric variability. The genetic population origin affected average levels of 55% and variability of 63% of phenotypic traits. A comparison among D. v. virgifera studies might be difficult if they use different populations or laboratory colonies. It is advised to consider possible effects of original field conditions, laboratory rearing, and population genetics when planning comparative studies targeting fitness, activity, or morphometric questions regarding Diabrotica species.

Stratified dispersal and increasing genetic variation during the invasion of Central Europe by the western corn rootworm, Diabrotica virgifera virgifera

Invasive species provide opportunities for investigating evolutionary aspects of colonization processes, including initial foundations of populations and geographic expansion. Using microsatellite markers and historical information, we characterized the genetic patterns of the invasion of the western corn rootworm (WCR), a pest of corn crops, in its largest area of expansion in Europe: Central and South-Eastern (CSE) Europe. We found that the invaded area probably corresponds to a single expanding population resulting from a single introduction of WCR and that gene flow is geographically limited within the population. In contrast to what is expected in classical colonization processes, an increase in genetic variation was observed from the center to the edge of the outbreak. Control measures against WCR at the center of the outbreak may have decreased effective population size in this area which could explain this observed pattern of genetic variation. We also found that small remote outbreaks in southern Germany and north-eastern Italy most likely originated from long-distance dispersal events from CSE Europe. We conclude that the large European outbreak is expanding by stratified dispersal, involving both continuous diffusion and discontinuous long-distance dispersal. This latter mode of dispersal may accelerate the expansion of WCR in Europe in the future.

Adult movements of newly introduced alien Diabrotica virgifera virgifera (Coleoptera: Chrysomelidae) from non-host habitats

Mark-release-recapture experiments were undertaken in order to investigate the movement of adult Diabrotica virgifera virgifera LeConte from accidental introduction points towards suitable habitats, such as its host plant, Zea mays L. In Hungary in 2003 and 2004, nine mark-release-recapture experiments were carried out in a grass steppe area and lucerne field, in which two small maize fields (10x10 m) had been planted 300 m distant from the central release point. After each release of 5500 to 6000 marked D. v. virgifera, beetle recaptures were recorded three times using non-baited yellow sticky traps placed on 30, 105, 205 and 305 m radii around the release point. In seven out of 15 recapture periods (47%), beetle populations showed no directional movements, and their movements towards any particular habitat cannot be predicted. During five recapture periods (33%), beetle populations showed a uni-directional movement, and in three cases (20%) a bi-directional movement was observed. In 10 out of 15 recapture periods (67%), the released populations moved in a direction that was comparable with the mean wind direction during these periods; thus, beetle movements were slightly correlated with wind direction. On average over sites and years, beetles were not preferentially moving towards the two small maize fields (located 300 m from the release point) compared to other directions. However, beetles moved significantly more frequently in the direction of naturally-occurring maize fields within a radius of 1500 m than towards other habitats. Beetles stayed more frequently within flowering lucerne fields out to a radius of 300 and 600 m than in non-flowering lucerne or other habitats. On average, 2.8% (SD 3.2) of all recaptured beetles arrived in one of the two small maize fields located 300 m from their release point indicating that there is a high risk of a founder population establishing. Habitat management cannot be suggested as a means of preventing the beetle's initial dispersal because movement was usually non-directional, and alternative food plants were used prior to reaching maize.

Screening of entomopathogenic nematodes for virulence against the invasive western corn rootworm, Diabrotica virgifera virgifera (Coleoptera: Chrysomelidae) in Europe

Entomopathogenic nematode species available in Europe were screened for their efficacy against both the root-feeding larvae and silk-feeding adults of the western corn rootworm, Diabrotica virgifera virgifera LeConte. Laboratory screening tests were aimed at the selection of candidate biological control agents for the management of this invasive alien pest in Europe. Steinernema glaseri, S. arenarium, S. abassi, S. bicornutum, S. feltiae, S. kraussei, S. carpocapsae and Heterorhabditis bacteriophora were studied to determine their virulence against third instar larvae and adults of D. v. virgifera in small-volume arenas (using nematode concentrations of 0.5, 0.8, 7.9 and 15.9 infective juveniles cm-2). All nematode species were able to invade and propagate in D. v. virgifera larvae, but adults were rarely infected. At concentrations of 7.9 and 15.9 cm-2, S. glaseri, S. arenarium, S. abassi and H. bacteriophora caused the highest larval mortality of up to 77%. Steinernema bicornutum, S. abassi, S. carpocapsae and H. bacteriophora appeared to have a high propagation level, producing 5970+/-779, 5595+/-811, 5341+/-1177 and 4039+/-1025 infective juveniles per larva, respectively. Steinernema glaseri, S. arenarium, S. feltiae, S. kraussei and H. bacteriophora were further screened at a concentration of 16.7 nematodes cm-2 against third instar larvae in medium-volume arenas (sand-filled trays with maize plants). Heterorhabditis bacteriophora, S. arenarium and S. feltiae caused the highest larval mortality with 77+/-16.6%, 67+/-3.5%, and 57+/-17.1%, respectively. In a next step, criteria for rating the entomopathogenic nematode species were applied based on results obtained for virulence and propagation, and for current production costs and availability in Europe. These criteria were then rated to determine the potential of the nematodes for further field testing. Results showed the highest potential in H. bacteriophora, followed by S. arenarium and S. feltiae, for further testing as candidate biological control agents.

Basic biology and small-scale rearing of Celatoria compressa(Diptera: Tachinidae), a parasitoid of Diabrotica virgifera virgifera (Coleoptera: Chrysomelidae)

The tachinid Celatoria compressa Wulp has been evaluated as a candidate biological control agent for the western corn rootworm, Diabrotica virgifera virgiferaLeConte, in Europe, where it is an invasive alien pest of maize. Special emphasis has been placed on understanding aspects of the parasitoid basic biology and on developing a rearing technique for a small-scale production of C. compressapuparia. The age of C. compressa adults was found to be the most crucial factor in achieving mating. Only newly emerged, 1-h-old females, mated successfully with 2- to 5-day-old males, achieving a success rate of 74%. After mating, a prelarviposition period of 4 days occurred. The 5-day-old C. compressa females inserted their eggs containing fully-developed first instars directly into adults of D. v. virgifera. Total larval and pupal developmental time, including a pre-larviposition period of 4 days, was 29 days under quarantine laboratory conditions (25 degrees C daytime, 15 degrees C at night, L:D 14:10, 50% +/- 10% r.h). Females of C. compressa were capable of producing on average 30 puparia throughout a female's mean larviposition period of 15 days. A large number of host attacks by C. compressa were unsuccessful, resulting in a mean larviposition success rate of 24% per female. Parasitoid females appear to have difficulties inserting the egg through the intersegmental sutures or membranes around leg openings of the host adults. Although the small-scale rearing technique of C. compressa presented is both time and labour intensive, C. compressa has been reared successfully for at least 20 successive generations without shifting the 1 male : 1 female sex ratio using a non-diapause strain of D. v. virgifera.

Clinical accuracy ratings of MMPI approaches for adolescents: adding ten years and the MMPI-A

Ehrenworth and Archer (1985) examined the relative merits of adolescent Minnesota Multiphasic Personality Inventory (MMPI) profiles utilizing either adult or adolescent scoring norms (Marks & Briggs, 1972). Eleven years later, the MMPI-A has been introduced into clinical use. It has been suggested that in these early years of the MMPI-A, clinicians plot both MMPI-A norms and Marks and Briggs (1972) norms to derive a clinical interpretation of a given profile, especially when code type interpretation is used (Archer, 1992). This study partially replicates the work of Ehrenworth and Archer (1985) by exploring the relation between code types generated with different norms (MMPI-A [Marks & Briggs, 1972] and adult K-corrected) in a sample of 134 adolescent psychiatric inpatients (77 female, 57 male). Code type narratives were blindly rated by members of the adolescent inpatient treatment staff. Although mean scores for the MMPI-A were significantly lower than those produced by the other two sets of norms, the use of the MMPI-A did not result in a clinical disadvantage. Both sets of adolescent norms (the Marks & Briggs and the MMPI-A) produced higher accuracy ratings than did the use of adult K-corrected norms but did not differ from each other. Gender differences were found on all three sets of norms, with female adolescent psychiatric inpatients scoring higher than male inpatients, particularly on Scales 1, 2, and 3.