scholarly journals Disparate effects of ankle-brachial index on mortality in the ‘very old’ and ‘younger old’ populations-the PolSenior survey

2021 ◽  
Author(s):  
Jarosław Królczyk ◽  
Anna Skalska ◽  
Karolina Piotrowicz ◽  
Małgorzata Mossakowska ◽  
Tomasz Grodzicki ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Oldest Old ◽  
Group Analysis ◽  
Ankle Brachial Index ◽  
Community Dwelling ◽  
Entire Group ◽  
Age Group ◽  
Risk Of Death ◽  
Multicenter Survey ◽  
Male Sex

AbstractTo assess the relationship between ankle-brachial index (ABI) and up to 10-year mortality in older individuals below and above the age of 80 years. In a multicenter survey of health status in the community dwelling subjects aged 55–59 and 65 + years in Poland, we assessed baseline medical history including risk-factors. We measured ABI, and serum creatinine, cholesterol, NT-proBNP, and interleukin-6 (IL-6) concentrations. We assessed mortality based on public registry. Between 2009 and 2019, 27.3% of 561 participants < 80 years, and 79.4% of 291 participants ≥ 80 years, died (p < 0.001); 67.8, 41.5, and 40.3% in the ABI groups < 0.9, 0.9–1.4, and > 1.4, respectively (p < 0.01). In the unadjusted Cox models, ABI was associated with mortality in the entire group, and < 80 years. In the entire group, analysis adjusted for age and sex showed mortality risk increased by 11% per year, and 50% with male sex. Mortality decreased by 37% per 1 unit ABI increase. In the group of people ≥ 80 years, only age was significantly associated with mortality (p < 0.001). In stepwise regression ABI < 0.9, male sex, active smoking, and NT-proBNP level were associated with risk of death < 80 years. In the ≥ 80 years old, mortality risk was associated with older age, and higher levels of IL-6, but not ABI. The ABI < 0.9 is associated with higher mortality in older people, but not among the oldest-old. In the oldest age group, age is the strongest predictor of death. In this age group, inflammageing is of importance.

scholarly journals Prevalence of falls and associated factors in community-dwelling older Brazilians: a systematic review and meta-analysis

2019 ◽  
Vol 35 (8) ◽  
Author(s):  
José Elias Filho ◽  
Wyngrid Porfirio Borel ◽  
Juliano Bergamaschine Mata Diz ◽  
Alexandre Wesley Carvalho Barbosa ◽  
Raquel Rodrigues Britto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Associated Factors ◽  
Meta Analysis ◽  
Oldest Old ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Age Group ◽  
Critical Appraisal Tool ◽  
Prevalence Ratios ◽  
Appraisal Tool

Falls determine huge epidemiological, clinical, and economic burden in the older population worldwide, presenting high odds of severe disability. The present study aimed to estimate the prevalence of falls and associated factors in older Brazilians using a systematic review with meta-analysis. Searches were performed in SciELO, PubMed, LILACS, Web of Science, Scopus and PsycINFO databases with no date or language restrictions. Studies on community-dwelling older persons aged ≥ 60 years from both sexes and with a sample size of ≥ 300 participants included. Exclusion criteria were studies conducted specifically for older adults diagnosed with chronic disabling diseases that predispose them to falls. Risk of bias of included studies was assessed using a critical appraisal tool focusing on prevalence designs. A random-effects meta-analysis was used to pool the prevalence of falls across studies. Exploratory analysis was conducted examining subgroup estimates, prevalence ratios and meta-regression. Thirty-seven studies involving 58,597 participants were included. Twelve-month prevalence of falls was 27% (95%CI: 24.3-30.0), with significantly higher estimates in female than male (PR = 1.57; 95%CI: 1.32-1.86), in age group ≥ 80 years than age group 60-69 years (PR = 1.46; 95%CI: 1.15-1.84), and in participants from the Central region than participants from the South region (PR = 1.36; 95%CI: 1.10-1.69) of Brazil. Risk of bias scores did not impact heterogeneity in the 12-month meta-analysis. These estimates strongly support evidence-based public interventions to prevent falls in older Brazilians, especially in women and the oldest-old population.

Mortality after proximal hip fracture in the Singapore population

2005 ◽  
Vol 15 (3) ◽  
pp. 166-170 ◽  
Author(s):  
K.H. Lin ◽  
Y.W. Lim ◽  
Y.J. Wu ◽  
K.S. Lam
Keyword(s):  
Hip Fracture ◽  
Mortality Risk ◽  
Cox Regression ◽  
Regional Hospital ◽  
Age Group ◽  
Risk Of Death ◽  
The Past ◽  
The Mean ◽  
One Year

The aims were to prospectively assess the mortality risk following proximal hip fractures, identify factors predictive of increased mortality and to investigate the time trends in mortality with comparison to previous studies. Prospectively collected data from 68 consecutive patients who had been admitted to a regional hospital from May 2001 to September 2001 were reviewed. The mean age of the patients was 79.3 years old (range, 55–98) and 72.1% females. Patients were followed prospectively to determine the mortality risk associated with hip fracture over a two-year follow-up period. The acute in-hospital mortality rate at six months, one year and two years was 5.9% (4/68), 14.7% (10/68), 20.6% (14/68) and 25% (17/68) respectively. One-year and two-year mortality for those patients who were 80 or older was significantly higher than for other patients and the number of co-morbid illnesses also had significant effect. Cox regression was performed to determine the significant predictors for survival time. It was noted that patients 80 years or older were at higher risk of death compared with those less than 80 years as well as those with higher number of co-morbid illnesses. Our mortality rates have not declined in the past 10 years when compared with previous local studies. We conclude that for this group of patients studied, their mortality at one year and two years could be predicted by their age group and their number of co-morbid illnesses.

scholarly journals Age group differences in association between IADL decline and depressive symptoms in community-dwelling elderly

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Eri Kiyoshige ◽  
Mai Kabayama ◽  
Yasuyuki Gondo ◽  
Yukie Masui ◽  
Hiroki Inagaki ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Group Analysis ◽  
Age Groups ◽  
Depression Scale ◽  
Information Criterion ◽  
Community Dwelling ◽  
Group Differences ◽  
Age Group ◽  
Multiple Group ◽  
Solitary Living

Abstract Background Instrumental Activities of Daily Living (IADL) is an indicator of whether a community-dwelling elderly can live independently. IADL decline was reported to be associated with aging and depression. The present study aimed to investigate whether the association between IADL decline and depressive symptoms differs with aging, using two age groups of community-dwelling Japanese elderly in their 70s and 80s. Methods We conducted longitudinal analysis among participants in their 70s and 80s at the baseline from Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. IADL was assessed by The Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence. As a main predictor, depressive symptoms were measured by the five-item version of the Geriatrics Depression Scale (GDS-5). As possible confounders, we considered cognitive function, body mass index, solitary living, education, economic status, medical history of stroke and heart disease, hypertension, dyslipidemia, diabetes, and sex. We obtained odds ratios (ORs) of IADL decline for having depressive symptoms in each age group (70s/80s) and tested interactions between depressive symptoms and age groups in relation to IADL decline in 3 years by logistic regression. Additionally, to confirm age group differences, we conducted multiple group analysis. Results There were 559 participants in their 70s and 519 in their 80s. Compared to participants without depressive symptoms, those with depressive symptoms had higher OR of IADL decline in 70s (OR [95% CI] = 2.33 [1.13, 4.78]), but not in 80s (OR [95% CI] = 0.85 [0.46, 1.53]). There were significant interactions between depressive symptoms and age groups in relation to IADL decline (p-value = 0.03). Multiple group analyses showed differences between the age groups by Akaike information criterion (AIC), and ORs (95%CI) decline for depressive symptoms was 2.33 (1.14, 4.77) in 70s and 0.85 (0.47, 1.54) in 80s. Conclusion The association of depressive symptoms and IADL decline during the 3 years was significantly different between the 70s and 80s age groups, and significant association was found only in people in their 70s. Detecting depressive symptoms may be a key for preventing IADL decline in people in their 70s and not for those in their 80s.

Abstract P017: Serum N-Carboxymethyl-Lysine and Risk of Mortality in Older Adults

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Mary Lou Biggs ◽  
David Benkeser ◽  
Joachim Ix ◽  
Jorge Kizer ◽  
Luc Djousse ◽  
...  
Keyword(s):  
Renal Failure ◽  
Mortality Risk ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Organ Systems ◽  
Increased Risk ◽  
Carboxymethyl Lysine ◽  
The Mean

Advanced glycation end products (AGEs) are compounds formed by the non-enzymatic glycation of proteins, lipids, and nucleic acids, and are thought to play a role in the pathogenesis of diseases across multiple organ systems. Carboxymethyl-lysine (CML) is a dominant AGE found in tissue proteins and in the circulation, and a commonly used AGE biomarker. Only a few epidemiological studies have evaluated the association between circulating CML and mortality risk, and none have evaluated the association between CML and cause-specific non-CVD mortality. We measured CML by ELISA on serum specimens collected from 3,373 Cardiovascular Health Study participants in 1996. Participants were followed for death through 2010, and cause of death was classified using death certificates, medical records, and proxy interview. We used Cox regression to estimate the relative risk of total and cause-specific mortality associated with circulating CML, adjusting for confounders (Models 1 & 2) and estimated glomerular filtration rate (eGFR) as a potential mediator (Model 3). We tested whether sex or diabetes modified the association between CML and mortality. The mean age among participants was 78 years and 60% were women. The mean CML level among participants was 629 ng/mL. Over median follow-up of 10 years, 2,322 deaths occurred (73.4 per 1,000 person-years). After adjustment for confounders (Models 1 & 2), CML was associated with an increased risk of death from CVD, dementia, infection, fracture/trauma, and renal failure (Table). Aside from renal failure, adjustment for eGFR attenuated the HR estimates modestly. There was no evidence for effect modification of the association of CML and all-cause mortality risk by sex or diabetes. In a cohort of community-dwelling older individuals, elevated circulating CML was associated with increased risk of mortality from cardiovascular causes, dementia, infection, fracture/trauma, and renal failure. A portion of the increased risk may be mediated through decreased renal function.

Abstract W P126: Allostatic Load Predicts Stroke Mortality Risk in Older Danes: Findings From the 1914 Glostrup Aging Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Christian R Salazar ◽  
Kirsten Avlund ◽  
Douglas E Morse
Keyword(s):  
Cardiovascular Disease ◽  
Birth Cohort ◽  
Mortality Risk ◽  
Allostatic Load ◽  
Cox Regression ◽  
Oldest Old ◽  
Stroke Mortality ◽  
Risk Of Death ◽  
Aging Study ◽  
Physiological Markers

Allostatic load (AL) is a composite measure of cumulative biological damage derived from physiological markers across multiple systems. While previous reports have shown that AL predicts cardiovascular events at early old age, the prognostic value of AL on stroke mortality among the oldest old remains largely unexplored. The objective of this study was to evaluate the association between AL and stroke mortality risk in a birth cohort of older Danish adults from the 1914 Glostrup Aging Study. In total, 330 Danish participants completed a structured questionnaire at baseline (age 80) and were assessed for 10 physiological markers that spanned the cardiovascular (systolic and diastolic blood pressure, heart rate), metabolic (HDL, ratio of total cholesterol/HDL, BMI, triglycerides, serum albumin, blood glucose), and inflammatory (IL6, TNF-alpha) systems. Composite summary scores of AL ranging from 0-10 were computed for each participant using a count-based approach, with high and low cut-points of AL defined at the median. Using the Danish National Civil Death Registry, we ascertained deaths from cardiovascular disease and stroke for all participants and examined survival probability over a 15-year period with Cox regression. Overall, there were 106 cardiovascular disease-related deaths, of which 25 were due to stroke. Older adults with high AL had a 2-fold higher hazard risk of death from stroke than those with low AL (hazard ratio [HR]=1.96, 95% confidence interval [CI]: 0.89 - 4.35), after adjustment for conventional risk factors of stroke. When stratified by sex, men with high AL had about a 6-fold higher risk of death from stroke than those with low AL (adjusted HR= 5.67, 95% CI= 1.66 - 19.4). No association between AL and stroke mortality risk was observed in women (adjusted HR=0.78, 95% CI: 0.23 - 2.63) among whom there were only 6 stroke deaths. In a birth cohort of older Danish adults, AL showed promise as a prognostic tool for stroke mortality risk. Larger studies in more diverse populations are necessary to confirm our findings.

scholarly journals Clinical Findings and Risk Factors of COVID-19 Infection and Death in Elderly patients Admitted to Medical Centers of Mazandaran University of Medical Sciences During 1 Year

Salmand ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 128-139
Author(s):  
Zoya Hadinejad ◽  
◽  
Yahya Saleh Tabari ◽  
Zeinab Sajadi ◽  
Hassan Talebi Ghadicolaei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Diseases ◽  
Oldest Old ◽  
The Elderly ◽  
Clinical Findings ◽  
Age Group ◽  
Medical Sciences ◽  
Risk Of Death ◽  
Descriptive Research ◽  
Medical Centers

Objectives: The elderly are at higher risks for developing Coronavirus Disease 2019 (COVID-19). Besides, when generating the illness, they have a higher risk of death. Recognizing clinical characteristics and risk factors associated with morbidity and mortality in the elderly is necessary to prevent mortality in similar infectious diseases. Methods & Materials: This descriptive research explored the data of all geriatrics admitted following COVID-19 in the medical centers affiliated with Mazandaran University of Medical Sciences. These data were collected from February 20, 2020, to February 20, 2021. Data analysis was performed by SPSS using logistic regression analysis. P<0.05 was considered significant. Results: Of the total 54523 patients admitted to the medical centers in the 12 months, 25218 patients were elderlies. In total, 51.05% and 12343 of the patients were female and male, respectively. In total, 3512 elderlies were expired. The death cases included 1814 (51.65%) males and the rest were females. Moreover, 16203 patients were in the age group of youngest-old, aged 60-75 years; 8270 patients were middle-old, 76-90 years; and the oldest-old category included 745 patients in the age group of ≥90 years. There was a significant relationship between age, gender, and COVID-19-induced death in the elderly (P<0.05). Older adults presented the highest death rate due to this disease Men were 10% more prone to die from COVID-19 than women. Major comorbidities recorded in this population were kidney diseases (92%), cancer (76%), diabetes (32%), and cardiovascular diseases (17%). Conclusion: Preventive measures to support the elderly are essential to combat the COVID-19 pandemic. Furthermore, it is essential to focus on the specific health needs of the elderly, such as proper nutrition, wellbeing, and mental health promotion.

scholarly journals Predictors of Cognitive Function in Community-Dwelling Older Adults by Age Group: Based on the 2017 National Survey of Older Korean Adults

2021 ◽  
Vol 18 (18) ◽  
pp. 9600
Author(s):  
Jinheum Kim ◽  
Eunjeong Cha
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
National Survey ◽  
Electronic Device ◽  
Oldest Old ◽  
Age Groups ◽  
Community Dwelling ◽  
Age Group ◽  
Community Dwelling Older Adults ◽  
Young Old

Owing to a growing older adult population, dementia is emerging as an important health issue. Given that maintaining cognitive functions is crucial for the prevention of dementia, this study aimed to identify the predictors of cognitive function in community-dwelling older adults, through a secondary data analysis of the 2017 National Survey of Older Koreans. A total of 9836 participants were classified into three age groups—young-old (65–74 years), old-old (75–84 years), and oldest-old (≥85 years)—and were separately analyzed using multiple linear regression models. The final model explained 28.0%, 35.0%, and 37.0% of variance in cognitive function in the three age groups, respectively. The most potent predictors of cognitive function in the young-old were electronic device-based activities, instrumental activities of daily living (IADL), and nutrition management; the predictors for the old-old group were electronic device-based activities, IADL, and dementia screening, and those for the oldest-old group were frequency of contact with acquaintances, traveling, and religion. Thus, age group-specific interventions are needed to effectively promote cognitive function among older adults. Digital literacy education, use of community-based elderly welfare programs, opportunities for social interactions, and physical activities can help older adults in maintaining a functional status and muscle strengthening.

scholarly journals COVID-19 Sex-Age Mortality Modeling - A Use Case of Risk-Based Vaccine Prioritization

2021 ◽  
Author(s):  
Vladimir Shapiro
Keyword(s):  
Regression Model ◽  
Mortality Risk ◽  
Polynomial Regression ◽  
Use Case ◽  
Age Group ◽  
Death Risk ◽  
Modeling Techniques ◽  
Male Sex ◽  
Male To Female ◽  
Polynomial Regression Model

This research builds upon the previous publications claiming that the male sex population and both sex individuals of advanced age are more susceptible to COVID-19’s risks. Relations between sex and age gradients are explored analytically based upon the proposed log-polynomial regression model of COVID-19 mortality. This model enables predicting mortality risk at any arbitrary age, as well as the derivation of several useful secondary metrics:•Sex differential: a ratio of male-to-female death risks for a given age group.•Age parity: age at which both sexes have an equal vulnerability.•Age lag: the number of years to subtract from a male’s age to match a female’s death risk.•Male equal risk age: male’s age at which male’s odds of dying from COVID-19 will equate female’s given the cutoff age. These metrics allow solving such practical problems as, e.g., prioritizing vaccine based on COVID-19 mortality risk associated with sex and age. Modeling techniques, refined in the paper, are by no means unique to COVID-19 and would apply to analyses of other diseases.

Antidepressant use and mortality in very old people

2016 ◽  
Vol 28 (7) ◽  
pp. 1201-1210 ◽  
Author(s):  
Gustaf Boström ◽  
Carl Hörnsten ◽  
Jon Brännström ◽  
Mia Conradsson ◽  
Peter Nordström ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Antidepressant Treatment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Old People ◽  
Very Old ◽  
Risk Of Death ◽  
Antidepressant Use ◽  
Cox Proportional Hazard Regression

ABSTRACTBackground:Antidepressant treatment may increase the risk of death. The association between antidepressants and mortality has been evaluated in community-dwelling older people, but not in representative samples of very old people, among whom dementia, multimorbidity, and disability are common.Methods:Umeå 85+/GERDA study participants (n = 992) aged 85, 90, and ≥95 years were followed for up to five years. Cox proportional hazard regression models were used to analyze mortality risk associated with baseline antidepressant treatment, adjusted for potential confounders.Results:Mean age was 89 years; 27% of participants had dementia, 20% had stroke histories, 29% had heart failure, and 16% used antidepressants. In age- and sex-adjusted analyses, antidepressant use was associated with a 76% increased mortality risk (hazard ratio [HR] = 1.76; 95% confidence interval [CI], 1.41–2.19). Adding adjustment for Geriatric Depression Scale score, HR was 1.62 (95% CI, 1.29–2.03). The association was not significant when adjusting for additional confounding factors (HR = 1.08; 95% CI, 0.85–1.38). Interaction analyses in the fully adjusted model revealed a significant interaction between sex and antidepressant use (HR: 1.76; 95% CI, 1.05–2.94). Among male and female antidepressant users, the HRs for death were 0.76 (95% CI, 0.47–1.24) and 1.28 (95% CI, 0.97–1.70), respectively.Conclusion:Among very old people, baseline antidepressant treatment does not seem to be independently associated with increased mortality risk. However, the risk may be different in men and women. This difference and the potential risk of initial treatment require further investigation in future cohort studies of very old people.

Mortality rates and predictors in community-dwelling elderly individuals with cognitive impairment: an eight-year follow-up after initial assessment

2014 ◽  
Vol 26 (8) ◽  
pp. 1295-1304 ◽  
Author(s):  
Jee Eun Park ◽  
Jun-Young Lee ◽  
Guk-Hee Suh ◽  
Byung-Soo Kim ◽  
Maeng Je Cho
Keyword(s):  
Cognitive Impairment ◽  
Mortality Risk ◽  
Mortality Rates ◽  
Community Dwelling ◽  
Behavioral Changes ◽  
Initial Assessment ◽  
Mortality Data ◽  
Elderly Individuals ◽  
Risk Of Death

ABSTRACTBackground:We assessed eight-year mortality rates and predictors in a rural cohort of elderly individuals with cognitive impairment.Methods:A total of 1,035 individuals, including 155 (15.0%) individuals with cognitive impairment, no dementia (CIND), and 69 (6.7%) individuals with clinically diagnosed dementia were followed for eight years from 1997. The initial assessment involved a two-step diagnostic procedure performed during a door-to-door survey, and mortality data were obtained from the Korean National Statistical Office (KNSO). The relationship between clinical diagnosis and risk of death was examined using the Cox proportional hazards model after adjusting for age, sex, and education.Results:During follow-up, 392 individuals died (37.9%). Compared to persons without cognitive impairment, mortality risk was nearly double among those with CIND (hazard ratio [95% confidence interval], 1.92 [1.46–2.54]), and this increased more than three-fold among those with dementia (3.20 [2.30–4.44]). Old age and high scores on the behavioral changes scale at diagnosis were two common predictors of mortality among those with CIND and dementia. Among the items on the behavioral changes scale, low sociability, less spontaneity, and poor hygiene were associated with increased mortality in individuals with CIND. Conversely, low sociability, excessive emotionality, and irritability were associated with increased mortality in patients with dementia.Conclusions:Both dementia and CIND increased mortality risk compared with normal cognition in this community cohort. It is important to identify and manage early behavioral changes to reduce mortality in individuals with CIND and dementia.

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