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Menichelli D, Gazzaniga G, Del Sole F, Pani A, Pignatelli P, Pastori D. Acute upper and lower gastrointestinal bleeding management in older people taking or not taking anticoagulants: a literature review. Front Med (Lausanne) 2024; 11:1399429. [PMID: 38765253 PMCID: PMC11099229 DOI: 10.3389/fmed.2024.1399429] [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: 03/11/2024] [Accepted: 04/11/2024] [Indexed: 05/21/2024] Open
Abstract
Acute upper and lower gastrointestinal (GI) bleeding may be a potentially life-threatening event that requires prompt recognition and an early effective management, being responsible for a considerable number of hospital admissions. Methods. We perform a clinical review to summarize the recent international guidelines, helping the physician in clinical practice. Older people are a vulnerable subgroup of patients more prone to developing GI bleeding because of several comorbidities and polypharmacy, especially related to an increased use of antiplatelet and anticoagulant drugs. In addition, older patients may have higher peri-procedural risk that should be evaluated. The recent introduction of reversal strategies may help the management of GI bleeding in this subgroup of patients. In this review, we aimed to (1) summarize the epidemiology and risk factors for upper and lower GI bleeding, (2) describe treatment options with a focus on pharmacodynamics and pharmacokinetics of different proton pump inhibitors, and (3) provide an overview of the clinical management with flowcharts for risk stratification and treatment. In conclusion, GI is common in older patients and an early effective management may be helpful in the reduction of several complications.
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Affiliation(s)
- Danilo Menichelli
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
- Department of General Surgery and Surgical Specialty Paride Stefanini, Sapienza University of Rome, Rome, Italy
| | - Gianluca Gazzaniga
- Department of Medical Biotechnology and Translational Medicine, Postgraduate School of Clinical Pharmacology and Toxicology, Università degli Studi di Milano, Milan, Italy
| | - Francesco Del Sole
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Arianna Pani
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Pasquale Pignatelli
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Daniele Pastori
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Freitas RDS, de Souza Silva CM, Ferreira Fratelli C, Ramos de Lima L, Morato Stival M, Schwerz Funghetto S, Rodrigues da Silva IC, Vieira de Andrade R. IL-10 and IL-1β Serum Levels, Genetic Variants, and Metabolic Syndrome: Insights into Older Adults' Clinical Characteristics. Nutrients 2024; 16:1241. [PMID: 38674931 PMCID: PMC11053558 DOI: 10.3390/nu16081241] [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: 03/02/2024] [Revised: 04/04/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Populational aging is marked by chronic noncommunicable diseases, such as metabolic syndrome (MetS). IL-10 and IL-1β are pleiotropic cytokines with multiple biological effects linked to metabolic disorders. This cross-sectional study assessed 193 participants' IL-10 and IL-1β serum levels regarding their role in developing MetS, clinical characteristics, and their IL1B rs1143627 and IL10 rs1800890 variants' genotype frequencies in a population over 60. IL-10 levels correlated weakly with HDL levels and fat mass and inversely with triglycerides, glucose, glycated hemoglobin, and estimated average blood glucose levels. IL-10 levels were also indirectly influenced by the patient's T2DM duration, lean mass amount, and bone mineral content. Participants with altered HDL, elevated serum glucose, raised HbA1c levels, or those over 80 had reduced serum IL-10 levels compared to those with normal levels or other age groups, respectively. Women also had higher serum IL-10 levels than men. Dissimilarly, IL-1β levels correlated directly only with the number of total leukocytes and segmented neutrophils, showing only significant variations with self-reported alcohol consumption. Our study also found that those with the IL10 AA genotype (lower IL-10 levels) had a significantly higher risk of developing MetS. These findings may help direct future research and more targeted therapeutic approaches in older adults.
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Affiliation(s)
- Renata de Souza Freitas
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasilia, Federal District, Brasília 72220-900, Brazil (R.V.d.A.)
| | - Calliandra Maria de Souza Silva
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, University of Brasília, Federal District, Brasília 72220-900, Brazil
- Faculty of Ceilândia, University of Brasilia, Federal District, Brasília 72220-900, Brazil
| | - Caroline Ferreira Fratelli
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, University of Brasília, Federal District, Brasília 72220-900, Brazil
| | - Luciano Ramos de Lima
- Faculty of Ceilândia, University of Brasilia, Federal District, Brasília 72220-900, Brazil
| | - Marina Morato Stival
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, University of Brasília, Federal District, Brasília 72220-900, Brazil
- Faculty of Ceilândia, University of Brasilia, Federal District, Brasília 72220-900, Brazil
| | - Silvana Schwerz Funghetto
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, University of Brasília, Federal District, Brasília 72220-900, Brazil
- Faculty of Ceilândia, University of Brasilia, Federal District, Brasília 72220-900, Brazil
| | - Izabel Cristina Rodrigues da Silva
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, University of Brasília, Federal District, Brasília 72220-900, Brazil
- Faculty of Ceilândia, University of Brasilia, Federal District, Brasília 72220-900, Brazil
| | - Rosângela Vieira de Andrade
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasilia, Federal District, Brasília 72220-900, Brazil (R.V.d.A.)
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Wang Z, Wang S, Lin H, Wang C, Gao D. Prevalence of hypertension and related risk factors in older Chinese population: a meta-analysis. Front Public Health 2024; 12:1320295. [PMID: 38686031 PMCID: PMC11056525 DOI: 10.3389/fpubh.2024.1320295] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/12/2024] [Indexed: 05/02/2024] Open
Abstract
Objective Hypertension is the most challenging public health problem worldwide and seriously affects human health. To date, there are no epidemiological studies on the prevalence of and risk factors for hypertension among older people in mainland China. Methods We conducted a meta-analysis of the prevalence and risk factors of hypertension among the older population in mainland China. We searched Chinese and English databases for Chinese and English literature on hypertension epidemiology published between 2000 and 2022, and hypertension data among the older population were extracted from the included literature. A meta-analysis was performed using a random-effects model (I2 > 50%) with 95% confidence intervals for the forest plots. Data were processed using RevMan 5.3. Forty-nine publications (with data from 84,429 samples) met the evaluation criteria and were included in this study. Results We found that the total prevalence of hypertension was 47%. The total prevalence rate of the older population in China from 2000 to 2010 was 50%, and the prevalence rate from 2011 to 2021 was 45%, with no significant differences. The total prevalence in Central China was the highest (59%). There was no significant correlation between the prevalence rate of the older population, sex, and urban or rural areas. Conclusion Hypertension is common among the older population in China, and its control rate is low. Therefore, effective prevention and treatment measures, as well as education, should be formulated to improve the diagnosis and treatment of hypertension in the older population.
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Affiliation(s)
| | | | | | | | - Da Gao
- Department of Cardiovascular Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, China
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Wang C, Yang M, Zhu G, Hu Y, Shen L, Qiu J, Huang Y, Wang L. Vaccination Shortens the Negative Nucleic Acid Conversion Time of the Older Population: A Retrospective Cohort Study of 73,456 Asymptomatic and Mild Patients with COVID-19 in Shanghai. Int J Gen Med 2024; 17:763-773. [PMID: 38463436 PMCID: PMC10922007 DOI: 10.2147/ijgm.s451393] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/20/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose To explore the influencing factors to predict the negative nucleic acid conversion time and ORF1ab gene CT value changes in patients with asymptomatic and mild COVID-19. Patients and Methods A total of 73,456 patients with asymptomatic and mild COVID-19 admitted to the Mobile Cabin Hospital in Shanghai from April 3 to April 23, 2022 were selected as the research objects. Epidemiological, clinical, and laboratory data were collected. Correlation analysis was performed. Results In patients <18 years old and ≥65 years old, COVID-19 vaccine can shorten the negative nucleic acid conversion time, which is reflected in the lower median or 75% quantile (P<0.001, P<0.05). In patients with underlying diseases, the negative nucleic acid conversion time of booster vaccination and complete vaccination was lower than that of non-vaccinated group (P<0.001, P<0.05). In patients ≤18 years of age or >65 years of age, patients with comorbidity and patients with symptoms, compared with patients 18-65 years of age, patients without comorbidity and patients without symptoms, there was a greater difference in the rate of rise of CT values between vaccinated and unvaccinated patients (P<0.05). Conclusion The time of nucleic acid conversion to negative in patients with asymptomatic and mild COVID-19 is affected by age, comorbidity, and first nucleic acid CT value. Vaccination could shorten the negative nucleic acid conversion time of the older population, those with complications or symptoms. The vaccination of older patients does not increase the risk of symptoms.
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Affiliation(s)
- Chaoqun Wang
- Department of Endocrinology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Meng Yang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Guanglin Zhu
- Department of Respiratory and Critical Care Medicine, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, People’s Republic of China
| | - Yanyan Hu
- Department of Endocrinology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Le Shen
- Department of Endocrinology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Jiaona Qiu
- Department of Endocrinology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Yi Huang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Libing Wang
- Department of Hematology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
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Tran HTM, Roman C, Yip G, Dooley M, Salahudeen MS, Mitra B. Influence of Potentially Inappropriate Medication Use on Older Australians' Admission to Emergency Department Short Stay. Geriatrics (Basel) 2024; 9:6. [PMID: 38247981 PMCID: PMC10801464 DOI: 10.3390/geriatrics9010006] [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: 10/28/2023] [Revised: 12/26/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Older people in the emergency department (ED) often pose complex medical challenges, with a significant prevalence of polypharmacy and potentially inappropriate medicines (PIMs) in Australia. A retrospective analysis of 200 consecutive patients aged over 65 years admitted to the emergency short stay unit (ESSU) aimed to identify polypharmacy (five or more regular medications), assess PIM prevalence, and explore the link between pre-admission PIMs and ESSU admissions. STOPP/START version 2 criteria were used for the PIM assessment, with an expert panel categorizing associated risks. Polypharmacy was observed in 161 patients (80.5%), who were older (mean age 82 versus 76 years) and took more regular medications (median 9 versus 3). One hundred and eighty-five (92.5%) patients had at least one PIM, 81 patients (40.5%) had STOPP PIMs, and 177 patients (88.5%) had START omissions. Polypharmacy significantly correlated with STOPP PIM (OR 4.8; 95%CI: 1.90-12.1), and for each additional medication the adjusted odds of having a STOPP PIM increased by 1.20 (95%CI: 1.11-1.28). Nineteen admissions (9.5%) were attributed to one or more PIMs (total 21 PIMs). Of these PIMs, the expert panel rated eight (38%) as high risk, five (24%) as moderate risk, and eight (38%) as low risk for causing hospital admission. The most common PIMs were benzodiazepines, accounting for 14 cases (73.6%). Older ESSU-admitted patients commonly presented with polypharmacy and PIMs, potentially contributing to their admission.
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Affiliation(s)
- Hoa T. M. Tran
- Department of Pharmacy and Emergency and Trauma Centre, Alfred Hospital, Melbourne, VIC 3004, Australia;
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
| | - Cristina Roman
- Department of Pharmacy and Emergency and Trauma Centre, Alfred Hospital, Melbourne, VIC 3004, Australia;
| | - Gary Yip
- Department of General Medicine, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - Michael Dooley
- Department of Pharmacy, Alfred Hospital, Melbourne, VIC 3004, Australia;
| | - Mohammed S. Salahudeen
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
| | - Biswadev Mitra
- Emergency and Trauma Centre, Alfred Hospital, Melbourne, VIC 3004, Australia;
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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Xu C, Wongpakaran N, Wongpakaran T, Siriwittayakorn T, Wedding D, Varnado P. Syntactic Errors in Older Adults with Depression. Medicina (Kaunas) 2023; 59:2133. [PMID: 38138236 PMCID: PMC10744892 DOI: 10.3390/medicina59122133] [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] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: This study investigated the differences in syntactic errors in older individuals with and without major depressive disorder and cognitive function disparities between groups. We also explored the correlation between syntax scores and depression severity. Materials and Methods: Forty-four participants, assessed for dementia with the Mini-Cog, completed the 15-item Geriatric Depression Scale (TGDS-15) and specific language tests. Following a single-anonymized procedure, clinical psychologists rated the tests and syntax scores. Results: The results showed that the depressive disorders group had lower syntax scores than the non-depressed group, primarily on specific subtests. Additionally, cognitive test scores were generally lower among the depressed group. A significant relationship between depression severity and syntax scores was observed (r = -0.426, 95% CI = -0.639, -0.143). Conclusions: In conclusion, major depressive disorder is associated with reduced syntactic abilities, particularly in specific tests. However, the relatively modest sample size limited the sensitivity of this association. This study also considered the potential influence of cultural factors. Unique linguistic characteristics in the study's context were also addressed and considered as potential contributors to the observed findings.
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Affiliation(s)
- Chengjie Xu
- Master of Science Program in Mental Health, Multidisciplinary and Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand; (C.X.); (T.W.); (T.S.); (D.W.)
| | - Nahathai Wongpakaran
- Master of Science Program in Mental Health, Multidisciplinary and Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand; (C.X.); (T.W.); (T.S.); (D.W.)
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand;
| | - Tinakon Wongpakaran
- Master of Science Program in Mental Health, Multidisciplinary and Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand; (C.X.); (T.W.); (T.S.); (D.W.)
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand;
| | - Teeranoot Siriwittayakorn
- Master of Science Program in Mental Health, Multidisciplinary and Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand; (C.X.); (T.W.); (T.S.); (D.W.)
- Department of English, Faculty of Humanities, Chiang Mai University, 239, Huay Kaew Road, Muang District, Chiang Mai 50200, Thailand
| | - Danny Wedding
- Master of Science Program in Mental Health, Multidisciplinary and Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand; (C.X.); (T.W.); (T.S.); (D.W.)
- School of Humanistics and Clinical Psychology, Saybrook University, Oakland, CA 91103, USA
| | - Pairada Varnado
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand;
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Costache AD, Ignat BE, Grosu C, Mastaleru A, Abdulan I, Oancea A, Roca M, Leon MM, Badescu MC, Luca S, Jigoranu AR, Chetran A, Mitu O, Costache II, Mitu F. Inflammatory Pathways in Overweight and Obese Persons as a Potential Mechanism for Cognitive Impairment and Earlier Onset Alzeihmer's Dementia in the General Population: A Narrative Review. Biomedicines 2023; 11:3233. [PMID: 38137454 PMCID: PMC10741501 DOI: 10.3390/biomedicines11123233] [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: 10/23/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
The overweight status or obesity can be confirmed through classical methods such as the body mass index (BMI) and the waist-to-hip ratio (WHR). Apart from metabolic issues such as atherosclerosis, liver steatosis, or diabetes mellitus, long-term obesity or overweight status can pose a risk for cardiovascular and neurovascular complications. While some acute adverse events like coronary syndromes of strokes are well-documented to be linked to an increased body mass, there are also chronic processes that, due to their silent onset and evolution, are underdiagnosed and not as thoroughly studied. Through this review, we aimed to collect all relevant data with regard to the long-term impact of obesity on cognitive function in all ages and its correlation with an earlier onset of dementia such as Alzheimer's disease (AD). The exact mechanisms through which a decline in cognitive functions occurs in overweight or obese persons are still being discussed. A combination of factors has been acknowledged as potential triggers, such as a sedentary lifestyle and stress, as well as a genetic predisposition, for example, the apolipoprotein E (ApoE) alleles in AD. Most research highlights the impact of vascular dysfunction and systemic inflammation on the nervous system in patients with obesity and the subsequent neurological changes. Obesity during the early to mid-ages leads to an earlier onset of cognitive dysfunction in various forms. Also, lifestyle intervention can reverse cognitive dysfunction, especially dieting, to encourage weight loss.
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Affiliation(s)
- Alexandru Dan Costache
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Bogdan Emilian Ignat
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Cristina Grosu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Alexandra Mastaleru
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Irina Abdulan
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Andra Oancea
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Mihai Roca
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Maria Magdalena Leon
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Minerva Codruta Badescu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Stefana Luca
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Alexandru Raul Jigoranu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Adriana Chetran
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Ovidiu Mitu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Irina Iuliana Costache
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Florin Mitu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
- Romanian Academy of Scientists, 050044 Bucharest, Romania
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Shimizu A, Ohno T, Fujishima I, Kayashita J, Momosaki R, Nishioka S, Wakabayashi H. Impact of Poor Oral Health Status on Swallowing Function Improvement in Older Dysphagic Patients. Cureus 2023; 15:e51249. [PMID: 38288242 PMCID: PMC10823192 DOI: 10.7759/cureus.51249] [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] [Accepted: 12/28/2023] [Indexed: 01/31/2024] Open
Abstract
Background This study aimed to explore the relationship between poor oral health status and improvement in swallowing function in older patients with dysphagia across various clinical settings, including acute and post-acute care environments. Methods This retrospective cohort study encompassed patients aged 65 years and older with dysphagia. Oral health status was assessed using the oral health assessment tool (OHAT) or the revised oral assessment guide (ROAG). In this study, an OHAT score of ≥3 or an ROAG score of ≥13 indicated poor oral health status. The primary outcome measured was the change in the food intake level scale (FILS) score, which reflects swallowing function, during the observation period. The association between changes in FILS score and poor oral health status was analyzed using a multivariable linear regression model. Results The study included 361 older patients with dysphagia (mean age 82.7 ± 7.7 years; 47.3% male), of whom 82.5% had poor oral health. A negative association was found between poor oral health status and improvement in FILS score at the endpoint (partial regression coefficient: -0.523, 95% confidence interval: -0.99 to -0.06, P=0.026). Conclusions Our findings underscore the negative impact of poor oral health status on the improvement of swallowing function and emphasize the importance of oral health interventions for older patients. Further study on oral health interventions' effects on improving swallowing function in older patients with dysphagia is warranted.
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Affiliation(s)
- Akio Shimizu
- Department of Food and Health Science, Faculty of Health and Human Development, The University of Nagano, Nagano, JPN
| | - Tomohisa Ohno
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, JPN
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, JPN
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, JPN
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, JPN
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki, JPN
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Shinjuku-ku, JPN
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9
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Bilson J, Byrne CD. Fatty liver disease and risk of all cause and cause-specific mortality outcomes in the older population. Hepatobiliary Surg Nutr 2023; 12:949-952. [PMID: 38115939 PMCID: PMC10727805 DOI: 10.21037/hbsn-23-542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 12/21/2023]
Affiliation(s)
- Josh Bilson
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK
| | - Christopher D. Byrne
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK
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10
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Mao L, Mohan G, Normand C. Use of information communication technologies by older people and telemedicine adoption during COVID-19: a longitudinal study. J Am Med Inform Assoc 2023; 30:2012-2020. [PMID: 37572310 PMCID: PMC10654849 DOI: 10.1093/jamia/ocad165] [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: 01/14/2023] [Revised: 07/15/2023] [Accepted: 08/11/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVES To investigate how information communication technology (ICT) factors relate to the use of telemedicine by older people in Ireland during the pandemic in 2020. Furthermore, the paper tested whether the supply of primary care, measured by General Practitioner's (GP) accessibility, influenced people's telemedicine options. METHOD Based on 2 waves from The Irish Longitudinal Study on Ageing, a nationally representative sample, multivariate logistic models were applied to examine the association between pre-pandemic use of ICTs and telemedicine usage (GP, pharmacist, hospital doctor), controlling for a series of demographic, health, and socioeconomic characteristics. RESULTS Previously reported having Internet access was a statistically positive predictor for telemedicine usage. The availability of high-speed broadband Internet did not exhibit a statistical association. The association was more prominent among those under 70 years old and non-Dublin urban areas. People with more chronic conditions, poorer mental health, and private health insurance had higher odds of using telemedicine during the period of study. No clear pattern between telemedicine use and differential geographic access to GP was found. DISCUSSION The important role of ICT access and frequent engagement with the Internet in encouraging telemedicine usage among older adults was evidenced. CONCLUSION Internet access was a strong predictor for telemedicine usage. We found no evidence of a substitution or complementary relationship between telemedicine and in-person primary care access.
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Affiliation(s)
- Likun Mao
- Department of Economics, University of Aberdeen, King’s College, Aberdeen AB24 3FX, United Kingdom
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Trinity Central, Dublin D02 R590, Republic of Ireland
| | - Gretta Mohan
- Economic and Social Research Institute, Dublin 2 D02 K138, Republic of Ireland
| | - Charles Normand
- Centre for Health Policy and Management, Trinity College Dublin, Dublin 2, Republic of Ireland
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Kings College London, London SE5 9PJ, United Kingdom
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11
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Kocot E. Unmet Health Care Needs of the Older Population in European Countries Based on Indicators Available in the Eurostat Database. Healthcare (Basel) 2023; 11:2692. [PMID: 37830729 PMCID: PMC10572618 DOI: 10.3390/healthcare11192692] [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: 08/25/2023] [Revised: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023] Open
Abstract
Access to healthcare may affect the health of the population, especially older people. The aim of this study is to analyze the reasons and factors influencing the unmet healthcare needs (UHCN) of the older population in the context of differences between age groups for 28 European countries. A self-reported UHCN indicator obtained from Eurostat database was used. The share of people with healthcare needs reporting distance/transportation issues was significantly different in the younger and older groups, as well as in age groups within the older population. The differences in other reasons were not so considerable. Problems with UHCN were observed more often in the older population with lower rather than with higher income and with more severe activity limitations rather than with none/moderate limitations (differences statistically significant, except for income for 75+). In most countries, the UHCN dependence on income/activity limitation is higher in the age group of 15-64 than for the older population. To plan/introduce/monitor appropriate, tailored actions for improving healthcare access for the older population, a detailed analysis of the UHCN prevalence, reasons, and determinants in this age group is needed; it is insufficient to analyze only the population as a whole. Additionally, the group of older people is not homogeneous in terms of UHCN.
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Affiliation(s)
- Ewa Kocot
- Health Economics and Social Security Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawinska 8, 31-066 Krakow, Poland
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12
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Chhetri JK, Mei S, Wang C, Chan P. New horizons in Parkinson's disease in older populations. Age Ageing 2023; 52:afad186. [PMID: 37847793 DOI: 10.1093/ageing/afad186] [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: 08/15/2022] [Revised: 07/07/2023] [Indexed: 10/19/2023] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease. Ageing is considered to be the greatest risk factor for PD, with a complex interplay between genetics and the environment. With population ageing, the prevalence of PD is expected to escalate worldwide; thus, it is of utmost importance to reduce the burden of PD. To date, there are no therapies to cure the disease, and current treatment strategies focus on the management of symptoms. Older adults often have multiple chronic diseases and geriatric syndromes, which further complicates the management of PD. Healthcare systems and care models necessary to address the broad needs of older PD patients are largely unavailable. In this New Horizon article, we discuss various aspects of PD from an ageing perspective, including disease management. We highlight recent advancements in PD therapies and discuss new care models with the potential to improve patient's quality of life.
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Affiliation(s)
- Jagadish K Chhetri
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Shanshan Mei
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Chaodong Wang
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Piu Chan
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
- Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
- Clinical Center for Parkinson's Disease, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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13
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Yang D, Yang SH, Lee JM, Lee JM, Kim J. Effects of socioeconomic status on physical activity and cardiovascular diseases prior to and during the COVID-19 pandemic in the older adults. Front Public Health 2023; 11:1241027. [PMID: 37771823 PMCID: PMC10524274 DOI: 10.3389/fpubh.2023.1241027] [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] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/24/2023] [Indexed: 09/30/2023] Open
Abstract
Purpose This research seeks to evaluate the repercussions of socioeconomic status (SES) on physical activity (PA) among the older population, both pre and intra-COVID-19 pandemic. The study aims to scrutinize whether alteration in PA behaviors based on SES impacts cardiovascular diseases (CVDs). It is well established that PA has a significant association with CVDs and the pandemic has restricted PA in the older population. We endeavor to discern whether SES modulates PA levels and whether these levels of PA behavior subsequently influence the incidence of CVDs among older adults. Methods The analytical framework of this study relies on the data procured from the Fact-Finding on the Status of Senior Citizens (FSSSC) survey conducted in 2017 and 2020, involving 10,299 (75 ± 6 years) and 10,097 (74 ± 6 years) participants, respectively. We employ Structural Equation Modeling (SEM) to elucidate the ramification of the COVID-19 pandemic on CVDs while accommodating potential mediating and confounding variables, including socioeconomic status, PA levels, body mass index (BMI), and gender, in the context of the pandemic and CVDs. Results Our empirical models indicated a tendency for older adults of lower socioeconomic status (SES) to exhibit diminished levels of physical activity (PA) compared to their counterparts of higher SES, particularly considering the influence of the COVID-19 pandemic. Furthermore, prolonged engagement in PA is associated with a reduced risk of hypertension (p = 0.010), and congestive heart failure & arrhythmia (p < 0.001), when accounting for confounding factors. Conclusion The COVID-19 pandemic has generated an SES-based disparity in PA among older adults, despite PA time being greater in older individuals with higher SES. Interestingly, this did not result in a reduction in CVDs. Therefore, the study emphasizes the need for targeted exercise programs may be necessary to mitigate health inequality among the older population.
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Affiliation(s)
- Dongwoo Yang
- Center for Regional Development, Chonnam National University, Gwangju, Republic of Korea
| | - Seo-Hyung Yang
- School of Global Sports Studies, Korea University, Sejong, Republic of Korea
| | - Jae-Moo Lee
- College of Sport Science, Sungkyunkwan University, Suwon, Republic of Korea
| | - Jung-Min Lee
- Department of Physical Education, Kyung Hee University, Yongin, Republic of Korea
| | - Jahyun Kim
- Department of Kinesiology, California State University Bakersfield, Bakersfield, CA, United States
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14
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Lee CW, Lee TV, Galvan E, Chen VCW, Bui S, Crouse SF, Fluckey JD, Smith SB, Riechman SE. The Effect of Choline and Resistance Training on Strength and Lean Mass in Older Adults. Nutrients 2023; 15:3874. [PMID: 37764658 PMCID: PMC10534351 DOI: 10.3390/nu15183874] [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: 08/09/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Choline plays many important roles, including the synthesis of acetylcholine, and may affect muscle responses to exercise. We previously observed correlations between low choline intake and reduced gains in strength and lean mass following a 12-week resistance exercise training (RET) program for older adults. To further explore these findings, we conducted a randomized controlled trial. Three groups of 50-to-69-year-old healthy adults underwent a 12-week RET program (3x/week, 3 sets, 8-12 reps, 70% of maximum strength (1RM)) and submitted >48 diet logs (>4x/week for 12 weeks). Participants' diets were supplemented with 0.7 mg/kg lean/d (low, n = 13), 2.8 mg/kg lean/d (med, n = 11), or 7.5 mg/kg lean/d (high, n = 13) of choline from egg yolk and protein powder. The ANCOVA tests showed that low choline intake, compared with med or high choline intakes, resulted in significantly diminished gains in composite strength (leg press + chest press 1RM; low, 19.4 ± 8.2%; med, 46.8 ± 8.9%; high, 47.4 ± 8.1%; p = 0.034) and thigh-muscle quality (leg press 1RM/thigh lean mass; low, 12.3 ± 9.6%; med/high, 46.4 ± 7.0%; p = 0.010) after controlling for lean mass, protein, betaine, and vitamin B12. These data suggest that low choline intake may negatively affect strength gains with RET in older adults.
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Affiliation(s)
- Chang Woock Lee
- Department of Health and Human Performance, Nursing and Counseling, University of Houston-Victoria, Victoria, TX 77901, USA;
| | - Teak V. Lee
- Life Sciences Department, Pierce College, Woodland Hills, CA 91367, USA;
| | - Elfego Galvan
- School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ 85206, USA;
| | - Vincent C. W. Chen
- Department of Integrative Health and Exercise Science, Georgian Court University, Lakewood, NJ 08701, USA;
| | - Steve Bui
- Department of Health and Human Performance, Utah Tech University, St. George, UT 84770, USA;
| | - Stephen F. Crouse
- Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX 77843, USA; (S.F.C.); (J.D.F.)
| | - James D. Fluckey
- Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX 77843, USA; (S.F.C.); (J.D.F.)
| | - Stephen B. Smith
- Department of Animal Science, Texas A&M University, College Station, TX 77843, USA
| | - Steven E. Riechman
- Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX 77843, USA; (S.F.C.); (J.D.F.)
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15
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Yang S, Ye Z, Liu M, Zhang Y, Gan X, Wu Q, Zhou C, He P, Zhang Y, Qin X. Variety and Duration of Different Sedentary Behaviors, Inflammation, Genetic Susceptibility, and New-Onset Dementia in the Older Population. J Am Med Dir Assoc 2023; 24:1396-1404. [PMID: 37451311 DOI: 10.1016/j.jamda.2023.06.003] [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: 12/13/2022] [Revised: 05/13/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES We aimed to evaluate the relationship of the variety and duration of different sedentary behaviors (TV-watching, driving, and nonoccupational computer use) with the risk of dementia in older participants, and examine whether inflammation and genetic susceptibility may modify the relationship. DESIGN A prospective cohort study. SETTING AND PARTICIPANTS 173,829 older participants (≥60 years) without prior dementia in the UK Biobank were enrolled. METHODS A healthy sedentary behavior score was calculated as the number of the 3 major sedentary behaviors with a duration associated with the lowest risk of dementia. The primary outcome was new-onset all-cause dementia. RESULTS During a median follow-up of 12.4 years, 4965 (2.9%) participants developed new-onset dementia. There were U-shaped associations for TV-watching and driving time, and a reversed J-shaped association for nonoccupational computer use time with new-onset all-cause dementia, with the lowest dementia risk at >0-<2 hours/day for all the 3 sedentary behaviors. Moreover, a higher healthy sedentary behavior score was significantly associated with a lower risk of all-cause dementia (per 1 score increment: hazard ratio 0.78, 95% CI 0.75-0.81), with a stronger inverse association in those with higher levels of high-sensitivity C-reactive protein and monocytes (both P-interactions <.05). Genetic risks of dementia did not significantly modify the association. Similar trends were found for new-onset Alzheimer's disease and vascular dementia. CONCLUSIONS AND IMPLICATIONS The associations between the duration of different sedentary behaviors and new-onset dementia were different in the older population. Moreover, the variety of sedentary behavior was inversely associated with new-onset dementia, especially among those with higher levels of inflammation.
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Affiliation(s)
- Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China.
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16
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Zhou Z, Ryan J, Nelson MR, Woods RL, Orchard SG, Zhu C, Gilmartin-Thomas JFM, Fravel MA, Owen AJ, Murray AM, Espinoza SE, Ernst ME. The association of allopurinol with persistent physical disability and frailty in a large community based older cohort. J Am Geriatr Soc 2023; 71:2798-2809. [PMID: 37158186 PMCID: PMC10524392 DOI: 10.1111/jgs.18395] [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: 11/23/2022] [Revised: 03/12/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND The protective effects of allopurinol on physical function in older adults are not well understood, despite its potential to improve functional gains and reduce sarcopenia. This study aims to determine the association between allopurinol, persistent physical disability, and frailty in older gout patients. METHODS This analysis used data from a randomized trial in an older cohort, ASPirin in Reducing Events in the Elderly (ASPREE). ASPREE recruited 19,114 participants aged ≥65 years without prior cardiovascular events, dementia, or independence-limiting physical disability at trial enrolment. This analysis examined the association of baseline and time-varying allopurinol use with persistent physical disability and new-onset frailty in participants with gout at baseline (self-report or use of any anti-gout medications). Frailty was measured using the Fried frailty phenotype (score ≥3/5) and a deficit accumulation frailty index (FI) (score >0.21/1.0). Multivariable Cox proportional-hazards models were used for main analyses. RESULTS This analysis included 1155 gout participants, with 630 taking allopurinol at baseline and 525 not. During a median follow-up of 5.7 years, 113 new allopurinol users were identified. Compared with nonusers, baseline allopurinol use was associated with a significant risk reduction of persistent physical disability (Adjusted HR 0.46, 95% CI 0.23-0.92, p = 0.03). The strength of the association was modestly attenuated in the time-varying analysis (Adjusted HR 0.56, 0.29-1.08, p = 0.08). No significant associations with frailty measures were observed for either baseline allopurinol use (Fried frailty: Adjusted HR 0.83, 0.62-1.12; FI: Adjusted HR 0.96, 0.74-1.24) or time-varying allopurinol use (Fried frailty: Adjusted HR 0.92, 0.69-1.24; FI: Adjusted HR 1.02, 0.78-1.33). CONCLUSIONS Allopurinol use in older adults with gout is associated with a reduced risk of persistent physical disability but not associated with risk of frailty.
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Affiliation(s)
- Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mark R. Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Chao Zhu
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Julia F-M Gilmartin-Thomas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Institute for Health & Sport, Victoria University, VIC, Australia
- Australian Institute for Musculoskeletal Science, VIC, Australia
| | - Michelle A. Fravel
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa, IA, USA
| | - Alice J. Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne M. Murray
- Berman Center for Outcomes & Clinical Research, Hennepin HealthCare Research Institute, and Department of Medicine, Geriatrics Division, Hennepin Healthcare, Minneapolis, MN, USA
| | - Sara E. Espinoza
- University of Texas Health Science Center and Geriatric Research, Education & Clinical Center, San Antonio and South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Michael E. Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa, IA, USA
- Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa, IA, USA
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Tegegn MT, Assaye AK, Belete GT. Prevalence, causes and associated factors of visual impairment and blindness among older population in outreach site, Northwest Ethiopia. A dual center cross-sectional study. Afr Health Sci 2023; 23:683-695. [PMID: 38357156 PMCID: PMC10862582 DOI: 10.4314/ahs.v23i3.79] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Purpose The study aimed to determine the prevalence, causes, and associated factors of visual impairment and blindness among the older population in Outreach sites, Northwest Ethiopia. Methods A community-outreach-based cross-sectional study was conducted on 821 older population which were selected using a systematic random sampling technique. Face-to-face interviews and ocular examinations were performed to collect the data. A binary logistic regression was performed. Result A total of 821 participants were recruited for the study with a median age of 57 years, with a range of 40-91 years. Out of 821 participants, 41.8% had visual impairment, and 11.7% were blind. Sixty-four and fifty seven percent of visual impairment and blindness were caused by cataract. Age ≥70years (AOR=15.0; 95%CI: 8.4-26.9), rural residency (AOR=2.3; 95%CI: 1.5-3.6), non-formal education (AOR=3.0; 95%CI: 1.6-5.6), unemployed (AOR=1.5;95%CI:1.05-2.4) and history of eye examination (AOR=1.7;95%CI:1.1-2.8) were positively associated with visual impairment. Similarly, blindness was significantly associated with age ≥ 70years (AOR=7.2; 95%CI: 3.1-16.6), rural residency (AOR=2.2;95%CI:1.2-4.2), and history of eye examination (AOR=1.9; 95%CI: 1.1- 3.3). Conclusion the prevalence of visual impairment and blindness in this study was found to be high. Age, residency, educational status, occupational status, and history of eye examination were significantly associated with visual impairment and blindness.
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Affiliation(s)
- Melkamu Temeselew Tegegn
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aragaw Kegne Assaye
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gizachew Tilahun Belete
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Wang Z, Yang H, Sun C, Hong S. Estimating causal effects of physical disability and number of comorbid chronic diseases on risk of depressive symptoms in an elderly Chinese population: a machine learning analysis of cross-sectional baseline data from the China longitudinal ageing social survey. BMJ Open 2023; 13:e069298. [PMID: 37407052 DOI: 10.1136/bmjopen-2022-069298] [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] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE This study aimed to explore the causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms in an elderly Chinese population. DESIGN, SETTING AND ANALYSIS Cross-sectional, baseline data were obtained from the China Longitudinal Ageing Social Survey, a stratified, multistage, probabilistic sampling survey conducted in 2014 that covers 28 of 31 provincial areas in China. The causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms were analysed using the conditional average treatment effect method of machine learning. The causal effects model's adjustment was made for age, gender, residence, marital status, educational level, ethnicity, wealth quantile and other factors. OUTCOME Assessment of the causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms. PARTICIPANTS 7496 subjects who were 60 years of age or older and who answered the questions on depressive symptoms and other independent variables of interest in a survey conducted in 2014 were included in this study. RESULTS Physical disability and number of comorbid chronic diseases had causal effects on depressive symptoms. Among the subjects who had one or more functional limitations, the probability of depressive symptoms increased by 22% (95% CI 19% to 24%). For the subjects who had one chronic disease and those who had two or more chronic diseases, the possibility of depressive symptoms increased by 13% (95% CI 10% to 15%) and 20% (95% CI 18% to 22%), respectively. CONCLUSION This study provides evidence that the presence of one or more functional limitations affects the occurrence of depressive symptoms among elderly people. The findings of our study are of value in developing programmes that are designed to identify elderly individuals who have physical disabilities or comorbid chronic diseases to provide early intervention.
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Affiliation(s)
- Zhenjie Wang
- Institute of Population Research, Peking University, Beijing, People's Republic of China
| | - Hanmo Yang
- T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Chenxi Sun
- School of Intelligence Science and Technology and the Key Laboratory of Machine Perception (Ministry of Education), Peking University, Beijing, People's Republic of China
| | - Shenda Hong
- National Institute of Health Data Science, Peking University, Beijing, People's Republic of China
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Leal JC, Belo VS, Santos IM, Ferreira RV, de Melo SN, da Silva ES. Exergames in Older Adult Community Centers and Nursing Homes to Improve Balance and Minimize the Risk of Falls in Older Adults: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:1872. [PMID: 37444706 DOI: 10.3390/healthcare11131872] [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: 04/22/2023] [Revised: 06/02/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
There is a substantial gap in our knowledge regarding the efficacy of exergames on the reduction of fall risk in older adults. This systematic review analyzes the findings of clinical trials describing the efficacy of exergames to improve balance or reduce the risk of falls in individuals above 60 years of age who are residents in community centers or nursing homes. We searched Google Scholar, PubMed, and Embase up to January 2023. Initially, 52,294 records were screened. After applying the inclusion and exclusion criteria, 20 studies were included in this systematic review. Meta-analyses revealed statistically significant reductions in the risk of falls and improvements in balance. Exergaming tended to produce positive benefits according to the results obtained using different instruments (TUG, PPA, BBS, and others), control groups, and times of intervention. Nevertheless, a substantial proportion of studies exhibited a high risk of bias and only one had a long follow-up period. Although a large body of evidence supports the view that exergaming is suitable for reducing fall risk and improving balance in older adults, some gaps remain in our knowledge about such benefits.
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Affiliation(s)
- José Carlos Leal
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
- Physical Education Course, University Center of Formiga, Formiga 35574-530, Minas Gerais, Brazil
| | - Vinícius Silva Belo
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
| | - Ingrid Morselli Santos
- Medicine Course, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
| | - Rodrigo Vinícius Ferreira
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
- Physical Education Course, University Center of Formiga, Formiga 35574-530, Minas Gerais, Brazil
| | - Saulo Nascimento de Melo
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
| | - Eduardo Sérgio da Silva
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
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Zhang N, Zhou M, Li M, Ma G. Effects of Smartphone-Based Remote Interventions on Dietary Intake, Physical Activity, Weight Control, and Related Health Benefits Among the Older Population With Overweight and Obesity in China: Randomized Controlled Trial. J Med Internet Res 2023; 25:e41926. [PMID: 37115608 PMCID: PMC10182459 DOI: 10.2196/41926] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 02/20/2023] [Accepted: 03/23/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Traditional health management requires many human and material resources and cannot meet the growing needs. Remote medical technology provides an opportunity for health management; however, the research on it is insufficient. OBJECTIVE The objective of this study was to assess the effects of remote interventions on weight management. METHODS In this randomized controlled study, 750 participants were randomly assigned to a remote dietary and physical activity intervention group (group DPI), remote physical activity intervention group (group PI), or control group (group C). At baseline (time 1), day 45 (time 2), and day 90 (time 3), data were collected, including data on dietary intake, physical activity, indexes related to weight control, and health benefits. RESULTS A total of 85.6% (642/750) of participants completed the follow-up. Compared with group C, group DPI showed a significant decrease in energy intake (-581 vs -82 kcal; P<.05), protein intake (-17 vs -3 g; P<.05), fat intake (-8 vs 3 g; P<.05), and carbohydrate intake (-106.5 vs -4.7 g; P<.05) at time 3. Compared with time 1, groups DPI and PI showed a significant decrease in cereal and potato intake (P<.05). Compared with time 1, the physical activity levels related to transportation (group PI: 693 vs 597 metabolic equivalent [MET]-min/week, group C: 693 vs 594 MET-min/week; P<.05) and housework and gardening (group PI: 11 vs 0 MET-min/week, group C: 11 vs 4 MET-min/week; P<.05) in groups PI and C were improved at time 3. Compared with groups PI and C, group DPI showed a significant decrease in weight (-1.56 vs -0.86 kg and -1.56 vs -0.66 kg, respectively; P<.05) and BMI (-0.61 vs -0.33 kg/m2 and -0.61 vs -0.27 kg/m2, respectively; P<.05) at time 2. Compared with groups PI and C, group DPI showed a significant decrease in body weight (-4.11 vs -1.01 kg and -4.11 vs -0.83 kg, respectively; P<.05) and BMI (-1.61 vs -0.40 kg/m2 and -1.61 vs -0.33 kg/m2, respectively; P<.05) at time 3. Compared with group C, group DPI showed a significant decrease in triglyceride (-0.06 vs 0.32 mmol/L; P<.05) at time 2. Compared with groups PI and C, group DPI showed a significant decrease in systolic blood pressure (-8.15 vs -3.04 mmHg and -8.15 vs -3.80 mmHg, respectively; P<.05), triglyceride (-0.48 vs 0.11 mmol/L and -0.48 vs 0.18 mmol/L, respectively; P<.05), and fasting blood glucose (-0.77 vs 0.43 mmol/L and -0.77 vs 0.14 mmol/L, respectively; P<.05). There were significant differences in high-density lipoprotein cholesterol (-0.00 vs -0.07 mmol/L; P<.05) and hemoglobin A1c (-0.19% vs -0.07%; P<.05) between groups DPI and C. CONCLUSIONS Remote dietary and physical activity interventions can improve dietary intake among participants with overweight and obesity, are beneficial for weight control, and have potential health benefits. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900023355; https://www.chictr.org.cn/showproj.html?proj=38976.
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Affiliation(s)
- Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Mingzhu Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Muxia Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
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21
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De Santis KK, Mergenthal L, Christianson L, Busskamp A, Vonstein C, Zeeb H. Digital Technologies for Health Promotion and Disease Prevention in Older People: Scoping Review. J Med Internet Res 2023; 25:e43542. [PMID: 36951896 PMCID: PMC10131689 DOI: 10.2196/43542] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/30/2022] [Accepted: 01/31/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Digital technologies have the potential to contribute to health promotion and disease prevention in the aging world. OBJECTIVE This study aims to identify digital technologies for health promotion and disease prevention that could be used independently by older people in nonclinical settings using a scoping review. METHODS Through database (MEDLINE, PsycINFO, CINAHL, and SCOPUS; to March 3, 2022) and manual searches (to June 14, 2022), 90 primary studies and 8 systematic reviews were included in this scoping review. The eligibility was based on the PCC (Population, Concept, and Context) criteria: (1) people aged 50 years or older (population), (2) any digital (health) technology (eg, smartphone apps, websites, virtual reality; concept), and (3) health promotion and disease prevention in daily life in nonclinical and noninstitutional settings (context). Data items included study characteristics, PCC criteria, opportunities versus challenges, and evidence gaps. Data were synthesized using descriptive statistics or narratively described by identifying common themes. RESULTS The studies were published in 2005-2022 and originated predominantly from North America and Europe. Most primary studies were nonrandomized, reported quantitative data, and investigated effectiveness or feasibility (eg, acceptance or usability) of digital technologies in older people. The participants were aged 50 years to 99 years, predominantly female, affluent (ie, with high income, education, and digital competence), and intended to use or used digital technologies for a median of 3 months independently at home or in community settings. The digital technologies included mobile or nonmobile technologies or virtual reality. The studies used "modern devices" (eg, smartphones, wearables, or gaming consoles) or modern and "older devices" (eg, computers or mobile phones). The users interacted with digital technologies via websites, emails, text messages, apps, or virtual reality. Health targets of digital technologies were mobility, mental health, nutrition, or cognition. The opportunities versus challenges of digital technologies were (1) potential health benefits versus unclear or no benefits for some outcomes, (2) monitoring of health versus ethical issues with data collection and management, (3) implications for functioning in daily life (ie, potential to prolong independent living) versus unclear application for clinical management or care, (4) tailoring of technical properties and content toward older users versus general use, (5) importance of human support for feasibility versus other factors required to improve feasibility, (6) reduction of social isolation versus access to digital technologies, and (7) improvement in digital competence versus digital divide. CONCLUSIONS Various digital technologies were independently used by people aged 50 years or older for health promotion and disease prevention. Future studies should focus on (1) more diverse populations of older people, (2) new digital technologies, (3) other (clinical and care) settings, and (4) outcome evaluation to identify factors that could enhance any health benefits of digital technologies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/37729.
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Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
- Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany
| | - Lea Mergenthal
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Lara Christianson
- Department of Administration, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Annalena Busskamp
- Department Q6- Adults, Seniors, Women's and Men's Health, Health Equity, Federal Centre for Health Education, Cologne, Germany
| | - Claudia Vonstein
- Department Q6- Adults, Seniors, Women's and Men's Health, Health Equity, Federal Centre for Health Education, Cologne, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
- Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany
- Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
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22
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Tatoli R, Lampignano L, Donghia R, Niro A, Castellana F, Bortone I, Zupo R, Tirelli S, Lozupone M, Panza F, Alessio G, Boscia F, Sborgia G, Sardone R. Retinal Microvasculature and Neural Changes and Dietary Patterns in an Older Population in Southern Italy. Int J Environ Res Public Health 2023; 20:5108. [PMID: 36982016 PMCID: PMC10049576 DOI: 10.3390/ijerph20065108] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Like other parts of the body, the retina and its neurovascular system are also affected by age-related changes. The rising age of populations worldwide makes it important to study the pathologies related to age and their potential risk factors, such as diet and eating habits. The aim of this study was to investigate the predictive power of food groups versus retinal features among noninstitutionalized older adults from Southern Italy using a machine learning approach. METHODS We recruited 530 subjects, with a mean age of 74 years, who were drawn from the large population of the Salus in Apulia Study. In the present cross-sectional study, eating habits were assessed with a validated food frequency questionnaire. For the visual assessment, a complete ophthalmic examination and optical coherence tomography-angiography analyses were performed. RESULTS The analyses identified 13 out of the 28 food groups as predictors of all our retinal variables: grains, legumes, olives-vegetable oil, fruiting vegetables, other vegetables, fruits, sweets, fish, dairy, low-fat dairy, red meat, white meat, and processed meat. CONCLUSIONS Eating habits and food consumption may be important risk factors for age-related retinal changes. A diet that provides the optimal intake of specific nutrients with antioxidant and anti-inflammatory powers, including carotenoids and omega-3 fatty acids, could have beneficial effects.
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Affiliation(s)
- Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy
| | - Luisa Lampignano
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy
| | - Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy
| | - Alfredo Niro
- Eye Clinic, Hospital “SS. Annunziata”, ASL Taranto, 74100 Taranto, Italy
| | - Fabio Castellana
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy
| | - Ilaria Bortone
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Roberta Zupo
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy
| | - Sarah Tirelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Francesco Panza
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Giovanni Alessio
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Francesco Boscia
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Giancarlo Sborgia
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari Aldo Moro, 70121 Bari, Italy
| | | | - Rodolfo Sardone
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy
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Wu HHL, Chinnadurai R, Walker RJ, Tennankore KK. Is It Time to Integrate Frailty Assessment in Onconephrology? Cancers (Basel) 2023; 15:cancers15061674. [PMID: 36980558 PMCID: PMC10046649 DOI: 10.3390/cancers15061674] [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: 02/16/2023] [Revised: 03/04/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
Simple Summary There are an increasing number of older people living with kidney cancer and/or cancer and kidney disease worldwide, sparking a wider discussion on the impact of frailty and the clinical significance of conducting frailty assessments for this patient population. We provide an update on the current evidence related to frailty assessment in onconephrology and identify areas where further research efforts are anticipated to address knowledge gaps within this topic. Abstract Onconephrology has emerged as a novel sub-specialty of nephrology dedicated to the intersection between the kidney and cancer. This intersection is broad and includes a number of important areas of focus, including concurrent chronic kidney disease (CKD) and cancer, acute kidney complications of cancer, and cancer-treatment-induced nephrotoxicity. The importance of onconephrology is even more evident when considering the global growth in the population of older adults, many of whom are living with some degree of frailty. Furthermore, a considerable proportion of older adults have CKD (some of whom eventually progress to kidney failure) and are at high risk of developing solid tumour and hematologic malignancies. Specific to kidney disease, the association between frailty status and kidney disease has been explored in depth, and tools to capture frailty can be used to guide the management and prognostication of older adults living with kidney failure. Whilst there is emerging data regarding the assessment and impact of frailty in onconephrology, there remains a relative paucity of knowledge within this topic. In this article, we evaluate the definition and operationalization of frailty and discuss the significance of frailty within onconephrology. We review evidence on current approaches to assessing frailty in onconephrology and discuss potential developments and future directions regarding the utilization of frailty in this patient population. A greater awareness of the intersections and interactions between frailty and onconephrology and further efforts to integrate frailty assessment in onconephrology to optimize the delivery of realistic and goal-directed management strategies for patients is needed.
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Affiliation(s)
- Henry H. L. Wu
- Renal Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, The University of Sydney, Sydney, NSW 2065, Australia
- Correspondence: ; Tel.: +61-9926-4751
| | - Rajkumar Chinnadurai
- Department of Renal Medicine, Northern Care Alliance NHS Foundation Trust, Salford M6 8HD, UK
| | - Robert J. Walker
- Department of Medicine, Dunedin Campus, University of Otago, Dunedin 9016, New Zealand
| | - Karthik K. Tennankore
- Department of Medicine, Dalhousie University and Nova Scotia Health, Halifax, NS B3H 4R2, Canada
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Dankowski T, Kastner L, Suenkel U, von Thaler AK, Mychajliw C, Krawczak M, Maetzler W, Berg D, Brockmann K, Thiel A, Eschweiler GW, Heinzel S. Longitudinal dynamics of depression in risk groups of older individuals during the COVID-19 pandemic. Front Epidemiol 2023; 3:1093780. [PMID: 38455897 PMCID: PMC10911044 DOI: 10.3389/fepid.2023.1093780] [Citation(s) in RCA: 1] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/25/2023] [Indexed: 03/09/2024]
Abstract
Background Older individuals are most at risk of severe COVID-19 and particularly require protection causing (self)restriction of psychosocial interaction in daily living. So far, the impact of psychosocial withdrawal on mental health seems less pronounced in community-dwelling older individuals compared to younger individuals. However, dynamics and adverse long-term effects of the pandemic, such as increases in depression, are still mostly unclear, especially for vulnerable subgroups. Methods Pre-pandemic and 3-, 8-, 14-, 20-month peri-pandemic data were analyzed in 877 older participants (age at 3-month peri-pandemic: mean ± SD: 72.3 ± 6.3, range: 58-91 years) of the observational prospective TREND study in Germany. Severity of depression (Beck's Depression Inventory-II scores) and key factors of (mental) health were investigated for cross-sectional associations using path modeling. Risk groups defined by resilience, loneliness, history of depression, stress, health status and fear of COVID-19 were investigated for differences in depression between timepoints. Findings The early pandemic (3-month) severity of depression was most strongly associated with history of depression, stress and resilience. Overall increases in clinically relevant depression (mild-severe) from pre- to 3-month peri-pandemic were small (% with depression at pre-/3-month peri-pandemic: 8.3%/11.5%). Changes were most pronounced in risk groups with low resilience (27.2%/41.8%), loneliness (19.0%/28.9%), fear of COVID-19 (17.6%/31.4%), high stress (24.4%/34.2%), a history of depression (27.7%/36.9%), and low health status (21.8%/31.4%). Changes in depression were largely observed from pre- to 3-month and were sustained to the 20-month peri-pandemic timepoint, overall and in stratified risk groups defined by single and cumulative risk factors. Changes between timepoints were heterogenous as indicated by alluvial diagrams. Conclusion Only specific risk groups of older individuals showed a large increase in depression during the COVID-19 pandemic. Since these increases occurred early in the pandemic and were sustained over 20 months, these vulnerable risk groups need to be prioritized for counselling and risk mitigation of depression.
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Affiliation(s)
- Theresa Dankowski
- Department of Neurology, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
- Institute of Medical Informatics and Statistics, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Lydia Kastner
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Tübingen University Hospital, Tübingen, Germany
- Lead Graduate School and Research Network, University of Tübingen, Tübingen, Germany
| | - Ulrike Suenkel
- Department of Psychiatry and Psychotherapy, Tübingen University Hospital, Tübingen, Germany
| | - Anna-Katharina von Thaler
- Department of Neurology, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Christian Mychajliw
- Department of Psychiatry and Psychotherapy, Tübingen University Hospital, Tübingen, Germany
| | - Michael Krawczak
- Institute of Medical Informatics and Statistics, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Walter Maetzler
- Department of Neurology, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Daniela Berg
- Department of Neurology, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Gerhard W. Eschweiler
- Department of Psychiatry and Psychotherapy, Tübingen University Hospital, Tübingen, Germany
- Geriatric Center, Tübingen University Hospital, Tübingen, Germany
| | - Sebastian Heinzel
- Department of Neurology, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
- Institute of Medical Informatics and Statistics, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
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25
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Kim B, Kim G, Lee Y, Taniguchi K, Isobe T, Oh S. Triglyceride-Glucose Index as a Potential Indicator of Sarcopenic Obesity in Older People. Nutrients 2023; 15:nu15030555. [PMID: 36771263 PMCID: PMC9920571 DOI: 10.3390/nu15030555] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
PURPOSE This population-based cross-sectional study aimed to determine whether the triglyceride-glucose index (TyG index) is associated with sarcopenic obesity (SO) and whether it would be a helpful indicator of SO. METHODS A total of 3821 participants aged ≥ 60 years were selected for the study group, and 4919 participants aged 20-39 years were included as a reference group. The participants were allocated to sarcopenia, obesity, and SO groups depending on if their body mass index (BMI) was ≥25 kg/m2 and their sarcopenia index was ≤1 standard deviation (SD) lower than the mean of the reference group. The sex-specific differences and trends among the participants were analyzed by using the TyG index tertiles, and appropriate cut-off values of the TyG index for SO were calculated. RESULTS As the TyG index increased, BMI increased, but the sarcopenia index decreased in both sexes. Males and females in the middle and highest tertiles of the TyG index were 1.775 and 3.369, and they were 1.993 and 3.157 times more likely to have SO, respectively. The cut-off values of the TyG index for SO in males and females were ≥8.72 and 8.67, respectively. CONCLUSION A high TyG index is positively associated with SO, and the TyG index may be considered a potential indicator of SO.
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Affiliation(s)
- Bokun Kim
- Department of Anti-Ageing Health Care, Changwon National University, Changwon 51140, Republic of Korea
- Future Convergence Research Institute, Changwon National University, Changwon 51140, Republic of Korea
| | - Gwonmin Kim
- Medical Research Institute, Pusan National University, Busan 46241, Republic of Korea
| | - Yongkook Lee
- Department of Leisure Sports, Seoil University, Seoul 02192, Republic of Korea
| | - Keisuke Taniguchi
- Department of Physical Therapy, AHRU Medical Care and Welfare Professional Training College, Tsuchiura 300-0032, Japan
| | - Tomonori Isobe
- Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Sechang Oh
- Faculty of Rehabilitation, R Professional University of Rehabilitation, Tsuchiura 300-0032, Japan
- Correspondence: ; Tel.: +81-29-824-7611
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Li Y, Zhu R, Wang L, Tan J. Effect of vitamin K2 in the treatment of nocturnal leg cramps in the older population: Study protocol of a randomized, double-blind, controlled trial. Front Nutr 2023; 10:1119233. [PMID: 36908924 PMCID: PMC9996107 DOI: 10.3389/fnut.2023.1119233] [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: 12/08/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Nocturnal leg cramps (NLCs) are sudden contractions of the leg muscles, usually in the posterior calf muscles at night, affecting sleep quality. Because the precise pathophysiology of NCLs is unclear, different interventions have been proposed. There is conflicting evidence regarding the efficacy of conventional interventions in preventing cramps. Thus, the present study aims to investigate the effects of vitamin K2 for NLCs in a prospective randomized, double-blind, controlled trial. Methods and analysis This multicenter, randomized, double-blind, placebo-controlled clinical study will enroll older age (≥65-year-old) with two or more documented episodes of NLCs during 2 weeks of screening. Participants will be randomized to receive vitamin K2 or a similar-looking placebo for 8 weeks in a 1:1 ratio. Follow-up visits will be scheduled each week at the beginning of 4-week intervention, then participants will be visited semimonthly. The primary outcome is the difference in the mean number of NLCs per week in the vitamin K2 and placebo arms. The secondary outcomes include the severity and duration of NLCs in the vitamin K2 and placebo arms. Two hundred patients will be needed, for this two-treatment parallel design study, to achieve a probability is 90% that the study will detect a treatment difference at a two-sided 0.04 significance level, if the difference between treatments is 3.6 (difference in means between treatment arms) NLC events. Discussion Nocturnal Leg Cramps (NLCs) are a common musculoskeletal disorder in the general population, but effective and safe interventions have not been established. Our previous study has shown vitamin K2 was effective to reduce the frequency, severity, and duration of dialysis-related muscle cramps with a good safety profile. This randomized controlled trial (RCT) of rigorous methodological design will help to establish the effectiveness of vitamin K2 for the management of NLCs in older population. The findings of this RCT will encourage the studies of vitamin K2 in musculoskeletal disorders. Clinical Trial Registration www.ClinicalTrials.gov, identifier, NCT05547750.
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Affiliation(s)
- Ying Li
- Department of Hematology, Chengdu Third People's Hospital, Chengdu, Sichuan, China.,School of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Rui Zhu
- Department of Hematology, Chengdu Third People's Hospital, Chengdu, Sichuan, China.,School of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Li Wang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jing Tan
- Department of Hematology, Chengdu Third People's Hospital, Chengdu, Sichuan, China
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Kang MG, Jung HW. Association Between Oral Health and Frailty in Older Korean Population: A Cross-Sectional Study. Clin Interv Aging 2022; 17:1863-1872. [PMID: 36575660 PMCID: PMC9790170 DOI: 10.2147/cia.s384417] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose Frailty is closely associated with biological age, concurrent medical conditions, morbidity, and decreased survival. Poor oral health is common in older individuals and is associated with frailty. Considering its potential importance, a study on the association between oral health and frailty is meaningful. Therefore, we aimed to analyze the association between major oral health factors and frailty using nationally representative samples of older adults. Patients and Methods This cross-sectional study included 3018 older adults (age ≥ 65 years) from the seventh Korea National Health and Nutrition Examination Survey. Oral examination results, laboratory data, handgrip strength, life style factors derived from questionnaires, and food intake survey results were analyzed. This study used the deficit accumulation model among the main operational definitions of frailty. We constructed a frailty index based on 36 items and classified participants as non-frail, pre-frail, or frail. Oral health factors included chewing difficulty, number of teeth, periodontal disease, and number of carious teeth. Logistic regression analysis was performed to determine significant factors. Results A total of 1222 (40.5%), 1014 (33.6%), and 782 (25.9%) individuals were classified as non-frail, pre-frail, and frail, respectively. Chewing difficulty was associated with increased risk of frailty after adjusting for age, sex, socioeconomic factors, and comorbidities (odds ratio 2.68, 95% confidence interval 2.08-3.44). Periodontal disease was positively associated with chewing difficulty (odds ratio 1.29, 95% confidence interval 1.07-1.56), and chewing difficulty decreased as the number of teeth increased (odds ratio 0.97, 95% confidence interval 0.96-0.99). Conclusion Chewing difficulty was significantly associated with frailty in the older population. Considering the negative effect of chewing difficulty on frailty, more attention should be focused on oral health.
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Affiliation(s)
- Min-gu Kang
- Department of Internal Medicine, Chonnam National University Bitgoeul Hospital, Gwangju, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea,Correspondence: Hee-Won Jung, Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea, Tel +82 10 2318 3490, Email
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Lampignano L, Niro A, Castellana F, Bortone I, Zupo R, Tirelli S, Tatoli R, Griseta C, De Nucci S, Sila A, De Pergola G, Conte C, Alessio G, Boscia F, Sborgia G, Giannelli G, Sardone R. Liver fibrosis and retinal features in an older Mediterranean population: Results from the Salus in Apulia study. Front Neurosci 2022; 16:1048375. [PMID: 36590297 PMCID: PMC9798127 DOI: 10.3389/fnins.2022.1048375] [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: 09/23/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Background Age is a leading contributor to the liver fibrosis rate and a gradual deterioration of optical function, but this association in older populations is still under-explored. The present study aimed to explore the link between vascular and neural retinal characteristics and the risk of liver fibrosis in 731 older adults from the population-based Salus in Apulia study. Methods Retinal features were obtained using optical coherence tomography (OCT) and OCT-angiography (OCT-A). Liver fibrosis risk was taken as the fibrosis-4 (FIB-4) score. Generalized linear models (logistic regression) were used to estimate the association effect between each unit increase of OCT and OCT-A parameters as independent variables and a FIB-4 ≥ 2.67 score as an outcome. Generalized additive models were used to assess the non-linear association between OCT-A features and the linear FIB-4 score. Results Increased gangliar cell complex (GCC) thickness was inversely associated with a FIB-4 score above the cut-off in both the raw model (OR: 0.98; 95% CI: 0.96-0.99; SE: 0.01) and after adjustment for age, sex, education, hypertension, diabetes, total cholesterol, and triglycerides (OR: 0.98; 95% CI: 0.97-0.99; SE: 0.01). Conclusion Our findings add to the growing volume of scientific literature demonstrating that liver fibrosis is associated with retinal neurodegeneration. This study raises a number of new questions, including whether OCT-A may be used to track the progression of metabolic abnormalities and define exact thresholds for predicting and classifying liver disease.
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Affiliation(s)
- Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Alfredo Niro
- Eye Clinic, Hospital “SS. Annunziata”, Azienda Sanitaria Locale (ASL) Taranto, Taranto, Italy
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Sarah Tirelli
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Rossella Tatoli
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Chiara Griseta
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Sara De Nucci
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Annamaria Sila
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Bari, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy,Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Giovanni Alessio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Boscia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giancarlo Sborgia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | | | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy,*Correspondence: Rodolfo Sardone, ; orcid.org/0000-0003-1383-1850
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Toschi E, Slyne C, Weinger K, Sy S, Sifre K, Michals A, Davis D, Dewar R, Atakov-Castillo A, Haque S, Cummings S, Brown S, Munshi M. Use of Telecommunication and Diabetes-Related Technologies in Older Adults With Type 1 Diabetes During a Time of Sudden Isolation: Mixed Methods Study. JMIR Diabetes 2022; 7:e38869. [PMID: 36256804 PMCID: PMC9678329 DOI: 10.2196/38869] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/31/2022] [Accepted: 10/15/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The COVID-19 lockdown imposed a sudden change in lifestyle with self-isolation and a rapid shift to the use of technology to maintain clinical care and social connections. OBJECTIVE In this mixed methods study, we explored the impact of isolation during the lockdown on the use of technology in older adults with type 1 diabetes (T1D). METHODS Older adults (aged ≥65 years) with T1D using continuous glucose monitoring (CGM) participated in semistructured interviews during the COVID-19 lockdown. A multidisciplinary team coded the interviews. In addition, CGM metrics from a subgroup of participants were collected before and during the lockdown. RESULTS We evaluated 34 participants (mean age 71, SD 5 years). Three themes related to technology use emerged from the thematic analysis regarding the impact of isolation on (1) insulin pump and CGM use to manage diabetes, including timely access to supplies, and changing Medicare eligibility regulations; (2) technology use for social interaction; and (3) telehealth use to maintain medical care. The CGM data from a subgroup (19/34, 56%; mean age 74, SD 5 years) showed an increase in time in range (mean 57%, SD 17% vs mean 63%, SD 15%; P=.001), a decrease in hyperglycemia (>180 mg/dL; mean 41%, SD 19% vs mean 35%, SD 17%; P<.001), and no change in hypoglycemia (<70 mg/dL; median 0.7%, IQR 0%-2% vs median 1.1%, IQR 0%-4%; P=.40) during the lockdown compared to before the lockdown. CONCLUSIONS These findings show that our cohort of older adults successfully used technology during isolation. Participants provided the positive and negative perceptions of technology use. Clinicians can benefit from our findings by identifying barriers to technology use during times of isolation and developing strategies to overcome these barriers.
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Affiliation(s)
- Elena Toschi
- Joslin Diabetes Center, Boston, MA, United States
- Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | | | | | - Sarah Sy
- Joslin Diabetes Center, Boston, MA, United States
| | - Kayla Sifre
- Joslin Diabetes Center, Boston, MA, United States
| | - Amy Michals
- Joslin Diabetes Center, Boston, MA, United States
| | | | - Rachel Dewar
- Joslin Diabetes Center, Boston, MA, United States
| | | | - Saira Haque
- Research Triangle Institute International, Research Triangle Park, NC, United States
| | - Stirling Cummings
- Research Triangle Institute International, Research Triangle Park, NC, United States
| | - Stephen Brown
- Research Triangle Institute International, Research Triangle Park, NC, United States
| | - Medha Munshi
- Joslin Diabetes Center, Boston, MA, United States
- Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Cao Y, Xu X, Li M, Liu J, Shi Z. Both Short and Long Sleep Durations Are Associated with Poor Cognition and Memory in Chinese Adults Aged 55+ Years-Results from China Health and Nutrition Survey. Life (Basel) 2022; 12:1798. [PMID: 36362953 PMCID: PMC9696719 DOI: 10.3390/life12111798] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 08/29/2023] Open
Abstract
We aimed to examine the associations between sleep duration and cognitive functions and memory in older Chinese adults attending the China Health and Nutrition Survey. A total of 7924 participants 55 years and older who reported their sleep duration and had a cognitive screen test in 2004, 2006, and 2015 were included in the analysis. Mixed-effects logistic regression models were used to assess the associations. A short sleep duration (≤6 h/day) and long sleep duration (≥10 h/day) were positively associated with a low global cognitive score (odds ratio-OR: 1.23, 95% CI: 1.01-1.50; OR: 1.47, 95% CI: 1.17-1.79, respectively). Both short sleepers and long sleepers had an increased risk of self-reported poor memory (OR: 1.63, 95% CI: 1.39-1.91; OR: 1.48, 95% CI: 1.25-1.74, respectively). No differences in the above associations were found for income, education, and urbanity. In conclusion, both the short and long sleep duration were associated with declined cognition and memory. Maintaining a normal sleep duration may aid in the prevention of cognitive function decline in older adults.
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Affiliation(s)
- Yingting Cao
- Non-Communicable Diseases and Implementation Science Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Xiaoyue Xu
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Ming Li
- Centre for Population Health Research, Division of Health Sciences, University of South Australia, Adelaide, SA 5005, Australia
| | - Jianghong Liu
- Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
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Khairan P, Shirai K, Shobugawa Y, Cadar D, Saito T, Kondo K, Sobue T, Iso H. Pneumonia and subsequent risk of dementia: Evidence from the Japan Gerontological evaluation study. Int J Geriatr Psychiatry 2022; 37. [PMID: 36286595 DOI: 10.1002/gps.5825] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/29/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Recently, several studies reported that pneumonia might increase the risk of cognitive decline and dementia due to increased frailty. OBJECTIVES This study aims to examine the association between a history of pneumonia and subsequent dementia risk. METHODS Participants were 9952 aged 65 years or older Japanese men and women from the Japan Gerontological Evaluation Study prospective cohort study, followed up from 2013 to 2019. Dementia was identified by public long-term care insurance registration. A history of pneumonia contracted 1 year before the baseline questionnaire in 2013. A cox regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia risk, adjusted for potential confounding variables. We conducted competing risk analyses using a cause-specific hazard model. RESULTS During the follow-up period of 6 years, 939 persons developed dementia. There was no association between having a prior history of pneumonia with dementia risk (HR 1.20, 95% CI:0.81-1.78). However, we observed an increased risk of dementia in persons with pre-frailty and frailty; the multivariable HR (95% CI) was 1.75 (1.48-2.07) and 2.42 (2.00-2.93) for pre-frailty and frailty, respectively. When pneumonia and frailty were combined, the risk of dementia was the highest for the persons with a history of pneumonia and frailty; the multivariable HR (95% CI) was 2.30 (1.47-3.62). The multivariable HR (95% CI) for those without pneumonia with frailty was 1.95 (1.66-2.28). Meanwhile, the multivariable HR (95% CI) for those with pneumonia without frailty was 1.64 (0.68-3.99). CONCLUSION Our findings imply that a prior history of pre-frailty and frailty with or without pneumonia, but not a history of pneumonia per se, was associated with an increased risk of dementia among population-based-cohort of older Japanese people.
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Affiliation(s)
- Paramita Khairan
- Department of Social and Environmental Medicine, Environmental and Population Sciences, Osaka University Graduate School of Medicine, Suita Osaka, Japan.,Department of Internal Medicine, Faculty of Medicine, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
| | - Kokoro Shirai
- Department of Social Medicine, Public Health, Osaka University Graduate School of Medicine, Suita Osaka, Japan
| | - Yugo Shobugawa
- Department of Active Ageing, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Dorina Cadar
- Department of Neuroscience, Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK.,Department of Behavioural Science and Health, University College London, London, UK
| | - Tami Saito
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Katsunori Kondo
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.,Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Tomotaka Sobue
- Department of Social and Environmental Medicine, Environmental and Population Sciences, Osaka University Graduate School of Medicine, Suita Osaka, Japan
| | - Hiroyasu Iso
- Department of Social Medicine, Public Health, Osaka University Graduate School of Medicine, Suita Osaka, Japan
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Balki E, Hayes N, Holland C. The Impact of Social Isolation, Loneliness, and Technology Use During the COVID-19 Pandemic on Health-Related Quality of Life: Observational Cross-sectional Study. J Med Internet Res 2022; 24:e41536. [PMID: 36260401 PMCID: PMC9589397 DOI: 10.2196/41536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 10/08/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eric Balki
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Niall Hayes
- Directorate, Nottingham Trent University, Nottingham, United Kingdom
| | - Carol Holland
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
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De Santis KK, Mergenthal L, Christianson L, Zeeb H. Digital Technologies for Health Promotion and Disease Prevention in Older People: Protocol for a Scoping Review. JMIR Res Protoc 2022; 11:e37729. [PMID: 35862187 PMCID: PMC9353678 DOI: 10.2196/37729] [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: 03/04/2022] [Revised: 06/15/2022] [Accepted: 07/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Digital technologies could contribute to health promotion and disease prevention. It is unclear if and how such digital technologies address the health needs of older people in nonclinical settings (ie, daily life). OBJECTIVE This study aims to identify digital technologies for health promotion and disease prevention that target the needs of older people in nonclinical settings by performing a scoping review of the published literature. The scoping review is guided by the framework of Arksey and O'Malley. METHODS Our scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The information sources are bibliographic databases (MEDLINE, PsycINFO, CINAHL, and SCOPUS) and bibliographies of any included systematic reviews. Manual searches for additional studies will be performed in Google Scholar and most relevant journals. The electronic search strategy was developed in collaboration with a librarian who performed the search for studies on digital technologies for health promotion and disease prevention targeting the needs of older people. Study selection and data coding will be performed independently by 2 authors. Consensus will be reached by discussion. Eligibility is based on the PCC (Population, Concept, and Context) criteria as follows: (1) older people (population); (2) any digital (health) technology, such as websites, smartphone apps, or wearables (concept); and (3) health promotion and disease prevention in nonclinical (daily life, home, or community) settings (context). Primary studies with any design or reviews with a systematic methodology published in peer-reviewed academic journals will be included. Data items will address study designs, PCC criteria, benefits or barriers related to digital technology use by older people, and evidence gaps. Data will be synthesized using descriptive statistics or narratively described by identifying common themes. Quality appraisal will be performed for any included systematic reviews, using a validated instrument for this study type (A Measurement Tool to Assess Systematic Reviews, version 2 [AMSTAR2]). RESULTS Following preliminary literature searches to test and calibrate the search syntax, the electronic literature search was performed in March 2022 and manual searches were completed in June 2022. Study selection based on titles and abstracts was completed in July 2022, and the full-text screen was initiated in July 2022. CONCLUSIONS Our scoping review will identify the types of digital technologies, health targets in the context of health promotion and disease prevention, and health benefits or barriers associated with the use of such technologies for older people in nonclinical settings. This knowledge could guide further research on how digital technologies can support healthy aging. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/37729.
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Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany
| | - Lea Mergenthal
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Lara Christianson
- Department of Administration, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany.,Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
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Chai HH, Kiuchi S, Osaka K, Aida J, Chu CH, Gao S(S. Knowledge, Practices and Attitudes towards Silver Diamine Fluoride Therapy among Dentists in Japan: A Mixed Methods Study. Int J Environ Res Public Health 2022; 19:ijerph19148705. [PMID: 35886557 PMCID: PMC9319621 DOI: 10.3390/ijerph19148705] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/23/2022] [Accepted: 07/14/2022] [Indexed: 12/24/2022]
Abstract
In 2021, the World Health Organization included silver diamine fluoride (SDF) as an essential medicine to manage caries in adults and children. SDF was developed in the 1960s, but its use for children became unpopular in Japan because of the decline and low prevalence of early childhood caries. This mixed methods study explored the knowledge, practices and attitudes towards SDF therapy among dentists promoting fluoride use in Japan. It also investigated senior dentists’ perceptions of SDF therapy in Japan. The quantitative study invited all 173 members of the largest organisation promoting fluoride use in Japan to complete a web-based questionnaire survey. Sixty (60/173; 35%) dentists promoting fluoride use in Japan completed the questionnaire survey. All dentists knew of SDF treatment, and 50 (50/60; 83%) used SDF for dental care. Fifty-nine dentists (59/60; 98%) agreed that SDF therapy was simple and quick. All 60 dentists agreed that SDF was effective to arrest caries; 51 dentists (51/60; 85%) agreed that SDF was effective to prevent caries. Most dentists (51/60; 85%) were concerned about SDF’s unaesthetic staining. Fifty-seven dentists (57/60; 95%) used SDF to arrest primary posterior teeth, and 52 dentists (52/60; 87%) used SDF to arrest root caries. However, 25 dentists (25/60; 42%) did not use SDF to prevent caries in permanent teeth. The qualitative study interviewed 12 senior dentists using snowball sampling and achieved data saturation. The dentists opined that SDF therapy was effective, simple, painless, non-invasive and inexpensive. SDF is seldom used in Japan at present because of the unaesthetic black staining and the low prevalence of early childhood caries; however, it can regain popularity by arresting root caries in the aging population.
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Affiliation(s)
- Hollis Haotian Chai
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen 361005, China;
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
| | - Sakura Kiuchi
- Graduate School of Dentistry, Tohoku University, Sendai 980-8577, Japan; (S.K.); (K.O.); (J.A.)
| | - Ken Osaka
- Graduate School of Dentistry, Tohoku University, Sendai 980-8577, Japan; (S.K.); (K.O.); (J.A.)
| | - Jun Aida
- Graduate School of Dentistry, Tohoku University, Sendai 980-8577, Japan; (S.K.); (K.O.); (J.A.)
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
| | - Shiqian (Sherry) Gao
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen 361005, China;
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
- Correspondence:
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Liu H, Chen S, Li Z, Xing A, Liu Y, Yu J, Li D, Li Y, Zhou X, Yang Q, Wu S, Lei P. Long-term risks for cardiovascular disease and mortality across the glycaemic spectrum in a male-predominant Chinese cohort aged 75 years or older: the Kailuan study. Age Ageing 2022; 51:6596557. [PMID: 35647762 DOI: 10.1093/ageing/afac109] [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] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Ageing and diabetes are growing global health burdens. The current understanding of cardiovascular disease (CVD) and mortality risk across the glycaemic spectrum in older populations is limited. OBJECTIVES This study sought to characterise CVD and all-cause mortality risk across the glycaemic spectrum among Chinese adults aged 75 years or older in a community-based setting over10 years. METHODS The 3,989 adults in the Kailuan Study were aged over 75 years (median age was 79 years [interquartile range: 76-82]; 2,785 normoglycaemic, 691 prediabetic and 513 diabetic, determined by fasting blood glucose levels) at baseline, predominantly male (92.9% male) and followed until December 2019. Time-varying Cox regression and competing-risk models were used to examine the hazard ratio (HR) of incident CVD and mortality across the glycaemic exposures. RESULTS During median follow-up of 11.3 years, 433 first CVD and 2,222 deaths were recorded. Compared with normoglycaemia, multivariable-adjusted models revealed the following: (i) prediabetes was not associated with future risks for CVD (HR: 1.17; 95% CI 0.82-1.69) and all-cause mortality (HR 1.06; 95% CI 0.70-1.60); (ii) diabetes-associated enhanced risks for CVD and all-cause mortality were mainly confined to those exhibiting low-grade inflammation (high-sensitivity C-reactive protein ≥2.0 mg/L) levels. The results were consistent after multiple sensitivity analyses. CONCLUSIONS Among a male-predominant Chinese population aged 75 years or older, compared with normoglycaemic participants, prediabetes was not associated with an enhanced 10-year CVD and all-cause mortality risk, and diabetes-associated enhanced 10-year risk was mainly confined to individuals exhibiting low-grade inflammation.
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Affiliation(s)
- Hangkuan Liu
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin 300052, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital , Tangshan 063001, Hebei, China
| | - Ziping Li
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin 300052, China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital , Tangshan 063001, Hebei, China
| | - Yan Liu
- Department of Cardiology, Kailuan General Hospital , Tangshan 063001, Hebei, China
| | - Jiaxin Yu
- Department of Cardiology, Tangshan Worker’s Hospital , Tangshan 063003, Hebei, China
| | - Dai Li
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute , Tianjin 300052, China
| | - Yongle Li
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin 300052, China
| | - Xin Zhou
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin 300052, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin 300052, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital , Tangshan 063001, Hebei, China
| | - Ping Lei
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute , Tianjin 300052, China
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Beerepoot S, Luesken SWM, Huisman M, Deeg DJH. Enjoyment of Sexuality and Longevity in Late Midlife and Older Adults: The Longitudinal Ageing Study Amsterdam. J Appl Gerontol 2022; 41:1615-1624. [PMID: 35324364 PMCID: PMC9082964 DOI: 10.1177/07334648221078852] [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] [Indexed: 11/23/2022] Open
Abstract
Sexual well-being refers to the evaluation of one’s sexuality. We examined the association of enjoyment of sexuality with longevity and the moderating role of perceived importance of sexuality in this association. In the population-based Longitudinal Ageing Study Amsterdam, the survival of initially 55–84-year-olds was followed during 27 years. Complete data were available for 1042 participants (45.3%). Analyses were adjusted for health-related and psychosocial covariates. 60% of the participants experienced their sexuality as enjoyable and 44% as important. Enjoyment of sexuality was weakly, positively associated with longevity (B[CI] = 0.29[-0.004;0.58]). Perceived importance modified this association: only in those who perceived sexuality as important, the association between enjoyment and longevity was statistically significant (B[CI] = 0.78[0.29;1.27]). Positive affect, functional limitations, emotional loneliness, self-rated health, sense of mastery and alcohol consumption accounted for 35% of the latter association. Interventions may target older adults who perceive sexuality as important but not enjoyable.
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Affiliation(s)
- Shanice Beerepoot
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Suzanne W M Luesken
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Wu SH, Chen KL, Hsu C, Chen HC, Chen JY, Yu SY, Shiu YJ. Creatine Supplementation for Muscle Growth: A Scoping Review of Randomized Clinical Trials from 2012 to 2021. Nutrients 2022; 14:1255. [PMID: 35334912 DOI: 10.3390/nu14061255] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 03/01/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023] Open
Abstract
Creatine supplementation is the most popular ergonomic aid for athletes in recent years and is used for improving sport performance and muscle growth. However, creatine supplementation is not always effective in all populations. To address these discrepancies, numerous studies have examined the use of creatine supplementation for muscle growth. This scoping review aimed to investigate the effects of creatine supplementation for muscle growth in various populations, in which Arksey and O'Malley's scoping review framework is used to present the findings. For this study, we performed a systematic search of the PubMed, Embase, and Web of Science databases for theses and articles published between 2012 and 2021. A manual search of the reference lists of the uncovered studies was conducted and an expert panel was consulted. Two reviewers screened the articles for eligibility according to the inclusion criteria. Methodological quality was assessed using the National Heart, Lung and Blood Institute's (NHLBI's) quality assessment tool. A total of 16 randomized controlled trials (RCTs) were finally included. All the authors extracted key data and descriptively analyzed the data. Thematic analysis was used to categorize the results into themes. Three major themes related to muscle growth were generated: (i) subjects of creatine supplementation-muscle growth is more effective in healthy young subjects than others; (ii) training of subjects-sufficient training is important in all populations; (iii) future direction and recommendation of creatine supplementation for muscle growth-injury prevention and utilization in medical practice. Overall, creatine is an efficient form of supplementation for muscle growth in the healthy young population with adequate training in a variety of dosage strategies and athletic activities. However, more well-designed, long-term RCTs with larger sample sizes are needed in older and muscular disease-related populations to definitively determine the effects of creatine supplementation on muscle growth in these other populations.
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Cristiano A, Musteata S, De Silvestri S, Bellandi V, Ceravolo P, Cesari M, Azzolino D, Sanna A, Trojaniello D. Older Adults' and Clinicians' Perspectives on a Smart Health Platform for the Aging Population: Design and Evaluation Study. JMIR Aging 2022; 5:e29623. [PMID: 35225818 PMCID: PMC8922154 DOI: 10.2196/29623] [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] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/14/2022] Open
Abstract
Background Over recent years, interest in the development of smart health technologies aimed at supporting independent living for older populations has increased. The integration of innovative technologies, such as the Internet of Things, wearable technologies, artificial intelligence, and ambient-assisted living applications, represents a valuable solution for this scope. Designing such an integrated system requires addressing several aspects (eg, equipment selection, data management, analytics, costs, and users’ needs) and involving different areas of expertise (eg, medical science, service design, biomedical and computer engineering). Objective The objective of this study is 2-fold; we aimed to design the functionalities of a smart health platform addressing 5 chronic conditions prevalent in the older population (ie, hearing loss, cardiovascular diseases, cognitive impairments, mental health problems, and balance disorders) by considering both older adults’ and clinicians’ perspectives and to evaluate the identified smart health platform functionalities with a small group of older adults. Methods Overall, 24 older adults (aged >65 years) and 118 clinicians were interviewed through focus group activities and web-based questionnaires to elicit the smart health platform requirements. Considering the elicited requirements, the main functionalities of smart health platform were designed. Then, a focus group involving 6 older adults was conducted to evaluate the proposed solution in terms of usefulness, credibility, desirability, and learnability. Results Eight main functionalities were identified and assessed—cognitive training and hearing training (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 6/6, 100%; learnability: 6/6, 100%), monitoring of physiological parameters (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 6/6, 100%; learnability: 5/6, 83%), physical training (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 5/6, 83%; learnability: 2/6, 33%), psychoeducational intervention (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 4/6, 67%; learnability: 2/6, 33%), mood monitoring (usefulness: 4/6, 67%; credibility: 4/6, 67%; desirability: 3/6, 50%; learnability: 5/6, 50%), diet plan (usefulness: 5/6, 83%; credibility: 4/6, 67%; desirability: 1/6, 17%; learnability: 2/6, 33%), and environment monitoring and adjustment (usefulness: 1/6, 17%; credibility: 1/6, 17%; desirability: 0/6, 0%; learnability: 0/6, 0%). Most of them were highly appreciated by older participants, with the only exception being environment monitoring and adjustment. The results showed that the proposed functionalities met the needs and expectations of users (eg, improved self-management of patients’ disease and enhanced patient safety). However, some aspects need to be addressed (eg, technical and privacy issues). Conclusions The presented smart health platform functionalities seem to be able to meet older adults’ needs and desires to enhance their self-awareness and self-management of their medical condition, encourage healthy and independent living, and provide evidence-based support for clinicians’ decision-making. Further research with a larger and more heterogeneous pool of stakeholders in terms of demographics and clinical conditions is needed to assess system acceptability and overall user experience in free-living conditions.
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Affiliation(s)
- Alessia Cristiano
- Center for Advanced Technology in Health and Wellbeing, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy
| | - Stela Musteata
- Center for Advanced Technology in Health and Wellbeing, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy
| | - Sara De Silvestri
- Center for Advanced Technology in Health and Wellbeing, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy
| | - Valerio Bellandi
- Department of Computer Science, Università Degli Studi di Milano, Milan, Italy
| | - Paolo Ceravolo
- Department of Computer Science, Università Degli Studi di Milano, Milan, Italy
| | - Matteo Cesari
- Geriatric Unit, Istituto di Ricovero e Cura a Carattere Scientifico Istituti Clinici Scientifici Maugeri, Università Degli Studi di Milano, Milan, Italy
| | - Domenico Azzolino
- Geriatric Unit, Istituto di Ricovero e Cura a Carattere Scientifico Istituti Clinici Scientifici Maugeri, Università Degli Studi di Milano, Milan, Italy
| | - Alberto Sanna
- Center for Advanced Technology in Health and Wellbeing, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy
| | - Diana Trojaniello
- Center for Advanced Technology in Health and Wellbeing, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy
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Kutschar P, Osterbrink J, Weichbold M. Interviewer effects in a survey examining pain intensity and pain interference in nursing home residents. Age Ageing 2022; 51:6530460. [PMID: 35180286 PMCID: PMC8856601 DOI: 10.1093/ageing/afac008] [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] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Indexed: 02/03/2023] Open
Abstract
Introduction Face-to-face surveys are applied frequently when conducting research in older populations. Interviewers play a decisive role in data quality, may affect measurement and influence results. This study uses survey data about pain in nursing home residents and analyses, whether affiliation-of-interviewer (internal vs. external to nursing home) and gender-of-interviewer affect residents’ responses in terms of interviewer variance and systematically varying pain reports. Methods Overall, 258 nursing home residents with up to moderate cognitive impairment were examined by 61 interviewers about pain intensity and interference applying the Brief Pain Inventory. Interviewer variance was measured using intra-interviewer correlation coefficients (ρ). Two-factorial covariance analysis was applied to analyse whether pain intensity and interference scores differ by interviewer characteristics. Results Interviewer heterogeneity accounts for almost one quarter of total variance on average. Interviewer variance is higher for internal and male interviewers than for external and female interviewers. Covariance analyses show significant effects of interviewer characteristics on pain reports. Average pain intensity and interference scores vary considerably by interviewer gender and affiliation. Highest pain intensity was reported towards female internal and male external interviewers; highest pain interference was reported towards male external interviewers. Conclusion Residents’ answers substantially differ in relation to who is assessing pain. There is a risk of imprecise and biased survey estimates on sensitive topics like pain in nursing homes. Interviewer gender and affiliation seem to evoke gender-specific and status-related expectations and attributions which influence residents’ response process. Interviewer effects pose a considerable threat to survey data quality in institutionalised older populations.
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Affiliation(s)
- Patrick Kutschar
- Institute of Nursing Science and Practice, Paracelsus Medical University, A-5020 Salzburg, Austria
| | - Juergen Osterbrink
- Institute of Nursing Science and Practice, Paracelsus Medical University, A-5020 Salzburg, Austria
| | - Martin Weichbold
- Department of Sociology, Paris Lodron University Salzburg, A-5020 Salzburg, Austria
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Zheng PP, Guo ZL, Du XJ, Yang HM, Wang ZJ. Prevalence of Disability among the Chinese Older Population: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19:1656. [PMID: 35162679 PMCID: PMC8835133 DOI: 10.3390/ijerph19031656] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Disability is an important problem in aging societies globally. However, the research findings of the prevalence of disability have been inconsistent. This study aims to estimate the prevalence of disability and its influencing factors among the Chinese older population from 1979 to 31 July 2021. METHODS A systematic review and meta-analysis were conducted using both international (PubMed, Web of Science, CBMdisc, PsycINFO, the Cochrane Library, and EMBASE) and Chinese (CNKI, CQVIP, and WanFang) databases. Meta-analysis was performed using a random-effects model to account for heterogeneity. Subgroup analyses were also done. RESULTS The pooled prevalence of disability across all 97 studies was 26.2% (95% CI: 23.7-28.6%). The estimates varied according to the types of activities of daily living (ADL), gender, age, and region. Studies based on the identification of cases by using the complete ADL scale showed a higher prevalence than those using the basic ADL scale. The prevalence was slightly higher among female older individuals than among male older individuals. The highest rates were seen in older individuals aged 80 years or older. Elders in central China, southwest China, and northwest China were more likely to be BADL-disabled. CONCLUSION Prevalence of disability among the Chinese older population is high, around 26%. Using standardized diagnostic systems to correctly estimate the prevalence of disability would be helpful for public health professionals in China.
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Affiliation(s)
- Pian-Pian Zheng
- Institute of Population Research, Peking University, Beijing 100871, China; (P.-P.Z.); (Z.-L.G.)
| | - Zi-Le Guo
- Institute of Population Research, Peking University, Beijing 100871, China; (P.-P.Z.); (Z.-L.G.)
| | - Xiao-Jing Du
- School of Humanities and Social Sciences, Xi′an Jiaotong University, Xi′an 710049, China;
| | - Han-Mo Yang
- National School of Development, Peking University, Beijing 100871, China;
| | - Zhen-Jie Wang
- Institute of Population Research, Peking University, Beijing 100871, China; (P.-P.Z.); (Z.-L.G.)
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Qian XX, Chen Z, Fong DYT, Ho M, Chau PH. Post-hospital falls incidence and risk factors among older adults: a systematic review and meta-analysis. Age Ageing 2022; 51:6408804. [PMID: 34718373 DOI: 10.1093/ageing/afab209] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 06/03/2021] [Revised: 08/25/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Post-hospital falls constitute a significant health concern for older adults who have been recently discharged from the hospital. OBJECTIVES To systematically summarise existing evidence on the incidence and risk factors for post-hospital falls among older adults. METHODS A systematic review and meta-analysis was conducted. Six electronic databases were searched to identify cohort studies investigating the incidence and risk factors for post-hospital falls in older adults. The incidence and risk factors for post-hospital falls were extracted. The meta-analysis was used to calculate pooled incidences and 95% confidence intervals (CI). The meta-regression and subgroup meta-analysis were conducted to explore sources of heterogeneity in incidence proportions across the eligible studies. A qualitative synthesis was performed for the post-hospital falls risk factors. RESULTS Eighteen studies from eight countries (n = 9,080,568) were included. The pooled incidence proportion of any and recurrent post-hospital falls was 14% (95% CI: 13%-15%) and 10% (95% CI: 5%-14%), respectively. Follow-up period, study quality, study country, setting, percentage of female subjects, percentage of subjects with previous falls and the primary data collection method for falls significantly contributed to the 64.8% of the heterogeneity in incidence proportions. Twenty-six risk factors for post-hospital falls were identified in the eligible studies, where biological factors were the most commonly identified factors. The highest risks were reported for previous falls, previous fractures, delirium and neurological diseases. CONCLUSION The findings of this study suggested future post-hospital falls prevention should prioritise the needs of older adults with the dominant risk factors. Further investigations into the period-specific incidence and socioeconomic and environmental risk factors for post-hospital falls are also required.
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Affiliation(s)
- Xing Xing Qian
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Zi Chen
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Daniel Y T Fong
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
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Liu H, Liu J, Liu J, Xin S, Lyu Z, Fu X. Triglyceride to High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio, a Simple but Effective Indicator in Predicting Type 2 Diabetes Mellitus in Older Adults. Front Endocrinol (Lausanne) 2022; 13:828581. [PMID: 35282431 PMCID: PMC8907657 DOI: 10.3389/fendo.2022.828581] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/31/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A simple and readily available biomarker can provide an effective approach for the surveillance of type 2 diabetes mellitus (T2DM) in the elderly. In this research, we aim to evaluate the role of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as an indicator for new-onset T2DM in an elderly Chinese population aged over 75 years. METHODS This longitudinal retrospective cohort study was conducted using a free database from a health check screening project in China. Participants with baseline TG and HDL measurements were enrolled, and the data of T2DM development were collected. The cumulative incident T2DM rates in different quintile groups of TG/HDL-C ratio (Q1 to Q5) were calculated and plotted. The independent effect of baseline TG/HDL-C ratio on T2DM risk during the follow-up period was tested by the Cox proportional hazard model. Subgroup analysis was also conducted to clarify the role of TG/HDL-C ratio in specific populations. RESULTS A total of 231 individuals developed T2DM among 2,571 subjects aged over 75 years during follow-up. Regardless of adjustment for potential confounding variables, elevated TG/HDL-C ratio independently indicated a higher risk of incident T2DM [hazard ratio (HR) = 1.29; 95% confidence interval (CI), 1.14-1.47; P < 0.01. As compared with the lowest quintile (Q1), elevated TG/HDL-C ratio quintiles (Q2 to Q5) were associated with larger HR estimates of incident T2DM [HR (95% CI), 1.35 (0.85-2.17), 1.31 (0.83-2.06), 1.85 (1.20-2.85), and 2.10 (1.38-3.20), respectively]. In addition, a non-linear correlation was found between TG/HDL-C ratio and the risk of T2DM, and the slope of the curve decreased after the cutoff point of 2.54. Subgroup analysis revealed a stronger positive correlation among male individuals and those with body mass index <24 kg/m2. CONCLUSIONS Increased TG/HDL-C ratio indicates a greater risk of new-onset T2DM regardless of confounding variables. TG/HDL-C ratio is a simple but effective indicator in predicting T2DM in older adults. More future investigations are warranted to further promote the clinical application of TG/HDL-C ratio.
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Affiliation(s)
- Hongzhou Liu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Endocrinology, First Hospital of Handan City, Handan, China
| | - Jing Liu
- Clinics of Cadre, Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jixiang Liu
- Department of Cerebral Surgery, First Hospital of Handan City, Handan, China
| | - Shuanli Xin
- Department of Cardiology, First Hospital of Handan City, Handan, China
| | - Zhaohui Lyu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Xiaomin Fu, ; Zhaohui Lyu,
| | - Xiaomin Fu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Xiaomin Fu, ; Zhaohui Lyu,
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Chen Y, Zhu Z, Wang W, Shang X, He M, Li J. Association of Myopia With Risk of Incident Metabolic Syndrome: Findings From the UK Biobank Study Cohort of 91,591 Participants. Front Med (Lausanne) 2022; 9:872013. [PMID: 35652067 PMCID: PMC9150791 DOI: 10.3389/fmed.2022.872013] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 12/18/2022] Open
Abstract
Purpose To investigate the association between myopia and risk of metabolic syndrome (MetS) in a prospective cohort from the UK Biobank Study. Methods Volunteers (aged 40 years and above) free of baseline MetS and cataract included from the UK Biobank Study, a prospective follow-up cohort. Myopia was defined using uncycloplegic autorefraction, self-report-myopia, and medical records for refractive error at baseline. MetS as well as components of MetS were diagnosed based on health records, blood biochemistry, and questionnaires. Questionnaires determined the status of smoking, drinking, physical activity and dietary supplements, as well as ethnicity and education. Results A total of 91,591 participants were available in the analysis, with a mean age of 55.37 ± 8.07 years at baseline and a median follow-up years of 11.16 years. The proportion of myopia was 49.7%, and a total of 937 (1.0%) participants were identified as having incident MetS (0.09/100 person years). Subjects with myopia were more likely to have MetS compared with non-myopic subjects (0.82 vs. 0.21%, Log-rank test P < 0.001). Mopes had greater risk of incident MetS (Hazard ratio [HR] = 4.19, 95% confidence interval [CI] 3.57-4.93, P < 0.001) adjusting for baseline age, gender, education and ethnicity. After further controlling for lifestyle factors (smoking, drinking, physical activity, and fish oil supplement) or baseline metabolic disorders, the risk of incident MetS were 3.88- and 4.06-fold greater in myopic subjects than those without myopia, respectively (P < 0.001 for both models). The severity of myopia was not significantly correlated to incident MetS in multivariate-adjusted models. Conclusions An increased risk of incident MetS among the elderly is associated with myopia, but not the degree of myopia. These findings highlighted the need of prevention of MetS among older adults with myopia.
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Affiliation(s)
- Yanxian Chen
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Zhuoting Zhu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xianwen Shang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Mingguang He
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China.,Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Jinying Li
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
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Mehdipanah R, Martin J, Eisenberg AK, Schulz AJ, Morgenstern LB, Langa KM. Housing status, mortgage debt and financial burden as barriers to health among older adults in the U.S. Hous Soc 2022; 49:58-72. [PMID: 35280971 PMCID: PMC8916742 DOI: 10.1080/08882746.2021.1881373] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We examine relations between housing status, mortgage, financial burden, and healthy aging among older U.S. adults. We combine cross-sectional data from 2012 to 2014 Health and Retirement Study cohorts. Using regression models, we examined associations between owners and renters, mortgage and non-mortgage holders, financial strain, and difficulty paying bills, and poor self-rated health (SRH), heart condition (HC) and hospitalization (past two years). We find that compared to owners, renters had greater likelihood of poor SRH and hospitalization. Regardless of tenure, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Mortgage holders had lower likelihood of poor SRH. Accounting for mortgage status, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Associations between tenure or mortgage status and health were not modified by either financial burden factors. We conclude that there need to be more robust and inclusive programs that assist older populations with housing could improve self-rated health, with particular attention to renters, mortgage holders and those experiencing financial burden.
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Affiliation(s)
- Roshanak Mehdipanah
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Jaclyn Martin
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Alexa K. Eisenberg
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Amy J. Schulz
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Lewis B. Morgenstern
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Kenneth M. Langa
- Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States,Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, United States,Institute for Social Research, University of Michigan, Ann Arbor, MI, United States,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
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Lampignano L, Donghia R, Griseta C, Lagravinese G, Sciarra S, Zupo R, Castellana F, Bortone I, Guerra V, Tirelli S, De Nucci S, Tatoli R, Lozupone M, Sborgia G, Leo A, De Pergola G, Giannelli G, Panza F, Sardone R. Liver Health and Dementia in an Italian Older Population: Findings From the Salus in Apulia Study. Front Aging Neurosci 2021; 13:748888. [PMID: 34955810 PMCID: PMC8692772 DOI: 10.3389/fnagi.2021.748888] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/17/2021] [Indexed: 01/25/2023] Open
Abstract
Objectives: Non-alcoholic fatty liver disease (NAFLD) currently affects a quarter of the global population. Systemic inflammation, metabolic syndrome, and coronary artery disease, all conditions associated with NAFLD, have also been related to cognitive dysfunction in older age. The present study aimed to investigate the relationship between NAFLD risk and a dementia diagnosis in a large population-based sample aged > 65 years. Methods: We selected 1,542 participants (723 men) from the Salus in Apulia Study. To assess the risk of fat distribution in the liver, we used the Fatty Liver Index (FLI). Dementia was diagnosed according to the American Psychiatric Association criteria (DSM-5). Results: The overall prevalence of dementia was 8.5% [95% confidence interval (CI): 7–10%]. Subjects with dementia were older [effect size (ES): −0.89, 95% CI: −1.07 to −0.70], had a lower level of education (ES:0.88, 95% CI:0.69–1.06), higher levels of gamma-glutamyl transferase (ES: −0.21, 95% CI: −0.39 to −0.03), lower levels of total cholesterol (ES: −0.24, 95% CI: −0.42 to −0.06) and low-density lipoprotein cholesterol (ES: −0.20, 95% CI: −0.38 to 0.02), and a higher FLI (ES: −0.22, 95% CI: −0.39 to −0.04). In the logistic regression model adjusted for age, sex, education, hypertension, diabetes mellitus, alcohol consumption, smoking habits, stroke, cholesterol, and Apo-E, a dementia diagnosis was positively associated with FLI > 60 [odds ratio (OR):1.81; standard error (SE): 0.53; 95% CI: 1.02–3.21]. Conclusion: Our findings suggested that an increased NAFLD risk may be associated to dementia and cognitive decline in older age. Considering the high NAFLD prevalence, the possible adverse disease effects on cognitive performance pose a health problem with significant social and economic implications.
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Affiliation(s)
- Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Rossella Donghia
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Chiara Griseta
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | | | - Sabrina Sciarra
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Vito Guerra
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Sarah Tirelli
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Sara De Nucci
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Rossella Tatoli
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Madia Lozupone
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giancarlo Sborgia
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | | | - Giovanni De Pergola
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy.,Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Gianluigi Giannelli
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy
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Jani YH, Liu F, Orlu M, Desai N, du Chayla F, Ruiz F, Vallet T. Medicine acceptability for older people in hospital and care home: the influence of setting. Int J Pharm Pract 2021; 30:67-74. [PMID: 34908100 DOI: 10.1093/ijpp/riab077] [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: 11/13/2020] [Accepted: 11/23/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Medicines acceptability is likely to have a significant impact on older people's adherence and, consequently, treatment effectiveness. The objective was to explore the influence of setting on medicines acceptability in older people. METHODS A multi-centre, prospective, cross-sectional, observational study was conducted in one care home and one elderly care hospital ward in London, UK, involving individuals on ≥1 medicine(s) and aged ≥65 years. Data-driven approach was applied using multiple observer-reported outcomes analysis tool to distinguish between positively and negatively accepted medicines. KEY FINDINGS 263 observer reports from the care home (n = 97) and hospital ward (n = 166) involving 155 distinct medicinal products were assessed. Collectively, medicines appeared better accepted by patients at the hospital. Differences appeared to be driven by variations in solid oral dosage form (SODF) acceptability. Patients with dysphagia poorly accepted medicines in both settings, as expected. SODFs were unexpectedly better accepted in the hospital than in the care home in patients without dysphagia. CONCLUSIONS Medicines acceptability was affected by patient's characteristics, dosage form type and setting. Changes in care practices between care home and hospital may affect medicine administration and lead to variations in the ability and willingness of patients and carers to use the product as intended.
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Affiliation(s)
- Yogini H Jani
- Centre for Medicines Optimisation Research and Education, UCLH NHS Foundation Trust and UCL School of Pharmacy, London, UK
| | - Fang Liu
- Department of Clinical Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield, UK
| | - Mine Orlu
- UCL School of Pharmacy, University College London, London, UK
| | - Neel Desai
- UCL School of Pharmacy, University College London, London, UK
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Perego G, Ghidini A, Luciani A, Petrelli F. Antibody-drug conjugates in treating older patients suffering from cancer: what is the real value? Hum Vaccin Immunother 2021; 17:5575-5578. [PMID: 34856865 DOI: 10.1080/21645515.2021.1999711] [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] [Indexed: 10/19/2022] Open
Abstract
Immunotherapeutic drugs and target therapies have represented an epochal change in treating cancer patients. They represent an attractive option in oncologists' armamentarium, particularly if we consider the optimal balance between efficacy and toxicity. As a step forward, immuno- and target-therapies have merged intending to improve efficacy: antibody-drug conjugates ensure the perfect combination. They allow the delivery of large amounts of drugs to the target with a limited 'off-target' effect and a low rate of adverse events. These aspects could make immunoconjugates palatable as the first choice for fragile patients, but solid evidence does not exist on the use of these drugs in this population type, especially older people.
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48
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Deng L, Wang L, Zheng X, Shuai P, Liu Y. Women with Subclinical Hypothyroidism are at Higher Prevalence of Metabolic Syndrome and Its Components Compared to Men in an Older Chinese Population. Endocr Res 2021; 46:186-195. [PMID: 34028317 DOI: 10.1080/07435800.2021.1928177] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose: This study investigated the impact of sex differences on the relationship of subclinical hypothyroidism (SCH) with the prevalence of metabolic syndrome (MetS) and its components in an older Chinese population.Methods: The study included 1842 older Chinese individuals aged 65 years or older who received annual health checkups. The impact of sex differences on the relationship of SCH with the prevalence of MetS and its components was investigated by multivariate logistic regression analysis. Interaction effect between sex and SCH on the prevalence of MetS and its components were evaluated using a multivariate logistic regression model which includes interaction terms (sex-SCH).Results: The study comprised 1701 (92.3%) individuals with euthyroidism and 141 (7.7%) with SCH. In men, SCH was not associated with MetS or any components of the MetS. In women, the SCH group had higher prevalence of MetS [odds ratio (OR), 1.870; 95% confidence interval (CI), 1.136-3.079], abdominal obesity (OR, 1.693; 95% CI, 1.043-2.748), hypertriglyceridemia (OR, 1.711; 95% CI, 1.054-2.775) and low high-density lipoprotein cholesterol (HDL-C) (OR, 3.039; 95% CI, 1.576-5.861). There was an interaction between sex and SCH in terms of the effect on the prevalence of MetS and its components, including abdominal obesity and hypertriglyceridemia (P < .01 for all), and with a trend for low HDL-C (P = .098).Conclusion: There were sex differences in the correlation of SCH with the prevalence of MetS and its components in the older Chinese population. An interaction effect between sex and SCH on the prevalence of MetS and its components was found.
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Affiliation(s)
- Ling Deng
- Department of Health Management Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Lin Wang
- Department of Health Management Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Xiaoxia Zheng
- Department of Health Management Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Ping Shuai
- Department of Health Management Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Yuping Liu
- Department of Health Management Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
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Kominami K, Nishijima H, Imahashi K, Katsuragawa T, Murakami M, Akino M. Gas exchange threshold to guide exercise training intensity of older individuals during cardiac rehabilitation. Medicine (Baltimore) 2021; 100:e27540. [PMID: 34678888 PMCID: PMC8542148 DOI: 10.1097/md.0000000000027540] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 09/29/2021] [Indexed: 01/05/2023] Open
Abstract
The gas exchange threshold (GET), which is determined during incremental exercise (Inc-Ex) testing, is often considered a safe training intensity for cardiac rehabilitation. However, there are only a limited number of reports on the actual implementation of this method. We assessed the applicability of GET-guided exercise using a constant load exercise (CL-Ex) protocol.We recruited 20 healthy older individuals (healthy, age: 69.4 ± 6.8 years) and 10 patients with cardiovascular diseases or risk factors (patient, age: 73.0 ± 8.8 years). On day 1, we determined the GET during symptomatic maximal Inc-Ex. On day 2, CL-Ex at work rate (watt: W) where the GET manifested during Inc-Ex (therefore, not corrected for the known oxygen response delay) was maintained for 20 minute. Arterialized blood lactate (BLa) levels were also determined.Oxygen uptake reached a steady state in all participants, with a mean respiratory exchange ratio of < 1.0. The mean BLa at the GET during Inc-Ex was 1.51 ± .29 mmol·l-1 in the healthy group and 1.78 ± .42 mmol·L-1 in the patient group, which was about .5 mmol·L-1 above the resting level. During CL-Ex, BLa increased significantly over the value at the GET (Inc-Ex). However, it reached a steady-state level of 2.65 ± 1.56 (healthy) and 2.53 ± 0.95 (patient) mmol·L-1. The %peak oxygen uptake, %peak heart rate, and %heart rate reserve during CL-Ex were 58.8 ± 11.5, 71.8 ± 10.3, and 44.9 ± 17.4, respectively. All participants could complete CL-Ex with mean perceived exertion ratings (Borg/20) of 11.8 ± 1.3 (healthy) and 12.2 ± 1.3 (patient). These heart rate-related indices and exertion ratings were all within the recommended international guidelines for cardiac rehabilitation.CL-Ex at the GET appears to be the optimal exercise intensity for cardiac rehabilitation.
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Affiliation(s)
- Kazuyuki Kominami
- Cardiac Rehabilitation Center, Sapporo Ryokuai Hospital, Sapporo, Japan
| | - Hirotaka Nishijima
- Cardiac Rehabilitation Center, Sapporo Ryokuai Hospital, Sapporo, Japan
- Department of Cardiovascular Medicine, Sapporo Ryokuai Hospital, Sapporo, Japan
| | - Keiko Imahashi
- Cardiac Rehabilitation Center, Sapporo Ryokuai Hospital, Sapporo, Japan
| | - Toko Katsuragawa
- Cardiac Rehabilitation Center, Sapporo Ryokuai Hospital, Sapporo, Japan
| | - Mitsuyo Murakami
- Cardiac Rehabilitation Center, Sapporo Ryokuai Hospital, Sapporo, Japan
| | - Masatoshi Akino
- Cardiac Rehabilitation Center, Sapporo Ryokuai Hospital, Sapporo, Japan
- Department of Cardiovascular Medicine, Sapporo Ryokuai Hospital, Sapporo, Japan
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Doi S, Koyama Y, Tani Y, Murayama H, Inoue S, Fujiwara T, Shobugawa Y. Do Social Ties Moderate the Association between Childhood Maltreatment and Gratitude in Older Adults? Results from the NEIGE Study. Int J Environ Res Public Health 2021; 18:ijerph182111082. [PMID: 34769605 PMCID: PMC8582950 DOI: 10.3390/ijerph182111082] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 12/17/2022]
Abstract
Background: Childhood maltreatment can impede gratitude, yet little is known about the older population and its moderators. The aim of this study is to clarify the association between childhood maltreatment and levels of gratitude of the older population, and the moderating effect of social ties on the association. Methods: We analyzed the data of 524 community-dwelling older adults aged 65–84 years without functional disabilities in Tokamachi City, Niigata, Japan, collected for the Neuron to Environmental Impact across Generations (NEIGE) study in 2017. Using a questionnaire, the participants rated three types of childhood maltreatment before the age of 18 (physical abuse, emotional neglect, and psychological abuse), level of gratitude, and social ties. Results: We found an inverse association between emotional neglect and gratitude. Furthermore, emotional neglect was inversely associated with gratitude only for those with lower levels of social ties. Conclusions: Promoting social ties may mitigate the adverse impact of emotional neglect on the level of gratitude.
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Affiliation(s)
- Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan; (Y.K.); (Y.T.); (T.F.)
- Research Fellow of Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
- Correspondence: ; Tel.: +81-3-5803-5188
| | - Yuna Koyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan; (Y.K.); (Y.T.); (T.F.)
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan; (Y.K.); (Y.T.); (T.F.)
| | - Hiroshi Murayama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan;
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan;
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan; (Y.K.); (Y.T.); (T.F.)
| | - Yugo Shobugawa
- Division of International Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan;
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