scholarly journals Dynapenic Abdominal Obesity Increases Mortality Risk Among English and Brazilian Older Adults: A 10-Year Follow-Up of the ELSA and SABE Studies

2018 ◽  
Vol 22 (1) ◽  
pp. 138-144 ◽  
Author(s):  
Tiago da Silva Alexandre ◽  
S. Scholes ◽  
J. L. Ferreira Santos ◽  
Y. A. de Oliveira Duarte ◽  
C. de Oliveira
Keyword(s):  
Older Adults ◽  
Abdominal Obesity ◽  
Mortality Risk

scholarly journals Physical Functioning Decline and Mortality in Older Adults With Multimorbidity: Joint Modeling of Longitudinal and Survival Data

2018 ◽  
Vol 74 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Melissa Y Wei ◽  
Mohammed U Kabeto ◽  
Andrzej T Galecki ◽  
Kenneth M Langa
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Physical Functioning ◽  
Survival Data ◽  
Short Form ◽  
Joint Modeling ◽  
Full Spectrum ◽  
Increased Risk ◽  
The Impact

Abstract Background Multimorbidity is common among older adults and strongly associated with physical functioning decline and increased mortality. However, the full spectrum of direct and indirect effects of multimorbidity on physical functioning and survival has not been quantified. We aimed to determine the longitudinal relationship of multimorbidity on physical functioning and quantify the impact of multimorbidity and multimorbidity-attributed changes in physical functioning on mortality risk. Methods The Health and Retirement Study (HRS) is a nationally representative population-based prospective cohort of adults aged 51 or older. In 2000, participants were interviewed about physician-diagnosed chronic conditions, from which their multimorbidity-weighted index (MWI) was computed. Between 2000 and 2011, participants reported their current physical functioning using a modified Short Form-36. With MWI as a time-varying exposure, we jointly modeled its associations with physical functioning and survival. Results The final sample included 74,037 observations from 18,174 participants. At baseline, participants had a weighted mean MWI of 4.6 ± 4.2 (range 0–36.8). During follow-up, physical functioning declined: −1.72 (95% confidence interval [CI] −1.77, −1.67, p < .001) HRS physical functioning units per point MWI in adjusted models. Over follow-up, 6,362 (34%) participants died. Mortality risk increased 8% (hazard ratio 1.08, 95% CI 1.07–1.08, p < .001) per point MWI in adjusted models. Across all population subgroups, MWI was associated with greater physical functioning decline and mortality risk. Conclusions Multimorbidity and its associated decline in physical functioning were significantly associated with increased mortality. These associations can be predicted with an easily interpreted and applied multimorbidity index that can better identify and target adults at increased risk for disability and death.

Abdominal Obesity and Mobility Disability in Older Adults: A 4-Year Follow-Up of the International Mobility in Aging Study

2018 ◽  
Vol 22 (10) ◽  
pp. 1228-1237 ◽  
Author(s):  
Juliana Fernandes de Souza Barbosa ◽  
C. dos Santos Gomes ◽  
J. Vilton Costa ◽  
T. Ahmed ◽  
M. V. Zunzunegui ◽  
...  
Keyword(s):  
Older Adults ◽  
Abdominal Obesity ◽  
International Mobility ◽  
Mobility Disability ◽  
Aging Study

scholarly journals Degree of cognitive impairment and mortality: a 17-year follow-up in a community study

2014 ◽  
Vol 24 (6) ◽  
pp. 503-511 ◽  
Author(s):  
J. Santabárbara ◽  
R. Lopez-Anton ◽  
G. Marcos ◽  
C. De-la-Cámara ◽  
E. Lobo ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mortality Risk ◽  
Community Sample ◽  
Population Attributable Fraction ◽  
Moderate Degree ◽  
Mild Degree ◽  
Mini Mental Status Examination ◽  
Severe Degree

Background.To test the hypothesis that cognitive impairment in older adults is associated with all-cause mortality risk and the risk increases when the degree of cognitive impairment augments; and then, if this association is confirmed, to report the population-attributable fraction (PAF) of mortality due to cognitive impairment.Method.A representative random community sample of individuals aged over 55 was interviewed, and 4557 subjects remaining alive at the end of the first year of follow-up were included in the analysis. Instruments used in the assessment included the Mini-Mental Status Examination (MMSE), the History and Aetiology Schedule (HAS) and the Geriatric Mental State (GMS)-AGECAT. For the standardised degree of cognitive impairment Perneczky et al's MMSE criteria were applied. Mortality information was obtained from the official population registry. Multivariate Cox proportional hazard models were used to test the association between MMSE degrees of cognitive impairment and mortality risk. We also estimated the PAF of mortality due to specific MMSE stages.Results.Cognitive impairment was associated with mortality risk, the risk increasing in parallel with the degree of cognitive impairment (Hazard ratio, HR: 1.18 in the ‘mild’ degree of impairment; HR: 1.29 in the ‘moderate’ degree; and HR: 2.08 in the ‘severe’ degree). The PAF of mortality due to severe cognitive impairment was 3.49%.Conclusions.A gradient of increased mortality-risk associated with severity of cognitive impairment was observed. The results support the claim that routine assessment of cognitive function in older adults should be considered in clinical practice.

Frailty, depression risk, and 10-year mortality in older adults: the FRADEA study

2020 ◽  
pp. 1-10
Author(s):  
Marta Carolina Ruiz-Grao ◽  
Pedro Manuel Sánchez-Jurado ◽  
Milagros Molina-Alarcón ◽  
Antonio Hernández-Martínez ◽  
Almudena Avendaño Céspedes ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Continuous Variable ◽  
Survival Times ◽  
Frailty Phenotype ◽  
Depression Risk ◽  
The Relationship

Abstract Objectives: To investigate if depression risk modifies the association between frailty and mortality in older adults. Design: Ongoing cohort study. Setting: Albacete city, Spain Participants: Eight hundred subjects, 58.8% women, over 70 years of age from the Frailty and Dependence in Albacete (FRADEA) study. Measurements: Frailty phenotype, Geriatric Depression Scale (GDS), comorbidity, disability, and drug use were collected at baseline. Six groups were categorized: (G1: non-frail/no depression risk; G2: non-frail/depression risk; G3: prefrail/no depression risk; G4: prefrail/depression risk; G5: frail/no depression risk; and G6: frail/depression risk). Mean follow-up was 2542 days (SD 1006). GDS was also analyzed as a continuous variable. The association between frailty and depression risk with 10-year mortality was analyzed. Results: Mean age was 78.5 years. Non-frail was 24.5%, prefrail 56.3%, frail 19.3%, and 33.5% at depression risk. Mean GDS score was 3.7 (SD 3.2), increasing with the number of frailty criteria (p < 0.001). Ten-year mortality rate was 44.9%. Mortality was 21.4% for the non-frail, 45.6% for the prefrail, and 72.7% for the frail participants, 56% for those with depression risk, and 39.3% for those without depression risk. Mean survival times for groups G1 to G6 were, respectively, 3390, 3437, 2897, 2554, 1887, and 1931 days. Adjusted mortality risk was higher for groups G3 (HR 2.1; 95% confidence interval (CI) 1.4–3.1), G4 (HR 2.5; 95% CI 1.7–3.8), G5 (HR 3.8; 95% CI 2.4–6.1), and G6 (HR 4.0; 95% CI 2.6–6.2), compared with G1 (p < 0.001). Interaction was found between frailty and depression risk, although they were independently associated with mortality. Conclusions: Depression risk increases mortality risk in prefrail older adults but not in non-frail and frail ones. Depression should be monitored in these older adults to optimize health outcomes. Factors modulating the relationship between frailty and depression should be explored in future studies.

scholarly journals PREDICTORS OF MORTALITY RISK AMONG MEDICARE ADVANTAGE ENROLLEES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S724-S724
Author(s):  
Soyoung Choun ◽  
Lan Doan ◽  
Diana J Govier ◽  
Karen Hooker ◽  
Carolyn Mendez-Luck ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Medicare Advantage ◽  
Predictors Of Mortality ◽  
Self Rated Health ◽  
Risk Of Mortality ◽  
All Cause Mortality

Abstract Overall all-cause mortality rates have declined significantly in past decades among individuals aged 65 and above in every racial and ethnic group. We explored demographic, overall health, and disability development as predictors of mortality in Medicare beneficiaries enrolled in Medicare Advantage plans. We used data from the 2014-2018 Medicare Health Outcomes Survey, a nationally representative panel survey with a two-year follow-up, administered by the Centers for Medicare and Medicaid Services. Our sample consisted of 1,273,494 community-dwelling adults aged 65 and older (Mage = 74.5 years, age range: 65-109 years) enrolled in Medicare Advantage plans. Mortality was assessed over a 2-year follow-up period. We used Cox proportional hazards regression analysis to predict risk of all-cause mortality by demographics, self-rated health, chronic health conditions, smoking status, and activities of daily living (ADLs). Among all participants, the mortality rate was 7.0% (n = 88,058) at 2-year follow-up. Advanced age and being male were significantly associated with greater risk of mortality, while higher levels of education and income were inversely associated with mortality. Controlling for other factors, white adults had higher mortality risk than black or African American, Hispanic, and Asian older adults. Individuals who were unmarried, had lower self-rated health, had more chronic health conditions, smoked, and had more ADL limitations had higher mortality risk. Our findings suggest that sustained health and better functional capacity are important elements in decreasing the risk of mortality in older adults.

scholarly journals Associations of Cytomegalovirus Infection With All-Cause and Cardiovascular Mortality in Multiple Observational Cohort Studies of Older Adults

2020 ◽  
Author(s):  
Sijia Chen ◽  
Graham Pawelec ◽  
Stella Trompet ◽  
David Goldeck ◽  
Laust H Mortensen ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Cmv Infection ◽  
Igg Antibody ◽  
White Community

Abstract Background Whether latent cytomegalovirus (CMV) infection in older adults has any substantial health consequences is unclear. Here, we sought associations between CMV-seropositivity and IgG titer with all-cause and cardiovascular mortality in 5 longitudinal cohorts. Methods Leiden Longevity Study, Prospective Study of Pravastatin in the Elderly at Risk, Longitudinal Study of Aging Danish Twins, and Leiden 85-plus Study were assessed at median (2.8–11.4 years) follow-up . Cox regression and random effects meta-analysis were used to estimate mortality risk dependent on CMV serostatus and/or IgG antibody titer, in quartiles after adjusting for confounders. Results CMV-seropositivity was seen in 47%–79% of 10 122 white community-dwelling adults aged 59–93 years. Of these, 3519 had died on follow-up (579 from cardiovascular disease). CMV seropositivity was not associated with all-cause (hazard ratio [HR], 1.05; 95% confidence interval [CI], .97–1.14) or cardiovascular mortality (HR, 0.97; 95% CI, .83–1.13). Subjects in the highest CMV IgG quartile group had increased all-cause mortality relative to CMV-seronegatives (HR, 1.16; 95% CI, 1.04–1.29) but this association lost significance after adjustment for confounders (HR, 1.13; 95% CI, .99–1.29). The lack of increased mortality risk was confirmed in subanalyses. Conclusions CMV infection is not associated with all-cause or cardiovascular mortality in white community-dwelling older adults.

scholarly journals Does dynapenic abdominal obesity accelerate the decline in physical performance in older adults?

2020 ◽  
Author(s):  
Roberta de Oliveira Máximo ◽  
Dayane Capra de Oliveira ◽  
Paula Camila Ramirez ◽  
Mariane Marques Luiz ◽  
Aline Fernanda de Souza ◽  
...  
Keyword(s):  
Older Adults ◽  
Sex Differences ◽  
Longitudinal Study ◽  
Physical Performance ◽  
Abdominal Obesity ◽  
Mixed Models ◽  
Clinical Characteristics ◽  
Generalized Linear Mixed Models ◽  
English Longitudinal Study

Abstract Background There are few epidemiological evidences of sex differences in the association between dynapenic abdominal obesity and the decline in physical performance among older adults. Objectives To investigate whether the decline in physical performance is worse in individuals with dynapenic abdominal obesity and whether there are sexes differences in this association. Methods A longitudinal analysis was conducted with 3,881 participants of the English Longitudinal Study of Ageing aged 60 years or older in an eight-year follow-up period. The outcome was physical performance evaluated using the Short Physical Performance Battery (SPPB). Abdominal obesity was determined based on waist circumference (> 102 cm for men and > 88 cm for women). Dynapenia was determined based on grip strength (< 26 kg for men < 16 kg for women). The sample was divided into four different groups: non-dynapenic/non-abdominal obese (ND/NAO); non-dynapenic/abdominal obese (ND/AO); dynapenic/non-abdominal obese (D/NAO); and dynapenic/abdominal obese (D/AO). Changes in SPPB performance levels in these groups, stratified by sex, were analyzed using generalized linear mixed models adjusted by sociodemographic, behavioral and clinical characteristics. Results At baseline, women with D/AO had the worst performance on the SPPB among the groups analyzed (-1.557 points; 95% CI: -1.915 to -1.199; p < 0.001), and men with D/AO had a worse performance on the SPPB compared to those in the ND/NAO and ND/AO groups (-1.179 points; 95% CI: -1.639 to -0.717; p < 0.001). Over the eight-year follow-up, men with D/AO had a faster decline in performance on the SPPB compared to those in the ND/NAO group (-0.106 points per year; 95% CI: -0.208 to -0.004; p < 0.05). Conclusion Dynapenic abdominal obesity accelerates the decline in physical performance in men but not women.

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