Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B6 and B12, with advancing older age: a systematic review

2020 ◽  
pp. 1-11 ◽  
Author(s):  
N. Gillies ◽  
D. Cameron-Smith ◽  
S. Pundir ◽  
C. R. Wall ◽  
A. M. Milan

Abstract Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 89
Author(s):  
Gotaro Kojima ◽  
Reijiro Aoyama ◽  
Yu Taniguchi

Frailty is defined as a state of increased vulnerability due to age-related decline in reserve and function across multiple physiological systems. Increasing physical activity level is considered to be a measure to counteract frailty. Some studies have indicated that pet owners are more engaged in physical activity than non-owners. We conducted a systematic review regarding associations between pet ownerships and frailty among community-dwelling older adults and critically assessed the findings. PubMed was searched in April 2020 according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for cross-sectional or prospective studies examining associations between pet ownership and frailty in community-dwelling older adults with a mean age of 60 or above. A supplementary search was done using Google Scholar. Identified articles were reviewed by two investigators independently and assessed for methodological quality. The search identified 48 studies, among which three studies (two cross-sectional and one prospective) were included in this review. These studies suggested that pet ownership may be associated with a lower risk of frailty. This systematic review found only a limited amount of relevant research. More research is needed to establish the link between pet ownership and frailty as well as healthy aging and well-being.


Author(s):  
Miji Kim ◽  
Jeremy D Walston ◽  
Chang Won Won

Abstract Background Growth differentiation factor 15 (GDF-15) is associated with disease progression, mitochondrial dysfunction, and mortality. Elevated GDF-15 level was recently reported to be associated with poorer physical performance in healthy adults. However, the association between serum GDF-15 level and sarcopenia in community-dwelling older adults has not been well characterized. Methods We conducted cross-sectional (n = 929) and two-year prospective analyses (n = 788) among participants aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study. Participants with an estimated glomerular filtration rate of <60 mL/min/1.73 m 2 were excluded. Appendicular lean mass was measured using dual-energy X-ray absorptiometry. Sarcopenia status was determined according to the Asian Working Group for Sarcopenia-2019 algorithm. Results At baseline, 16.6% of the participants had sarcopenia. Median GDF-15 concentration was higher in the sarcopenic group than in the non-sarcopenic group (1221 pg/mL vs. 1019 pg/mL, p<0.001). In the multivariate analysis adjusted for cardiometabolic risk and biological factors, the highest GDF-15 tertile (≥1245 pg/mL) had an increased likelihood of sarcopenia (odds ratio, 1.96; 95% confidence interval, 1.16–3.33) than the lowest tertile (<885 pg/mL). During the two-year follow-up period, 67 (10.1%) individuals without sarcopenia at baseline developed sarcopenia. There were no significant associations between baseline serum GDF-15 levels and incident sarcopenia or its components (all p>0.05). Conclusions Elevated GDF-15 was associated with prevalent sarcopenia but not able to predict incident sarcopenia in the 2-year follow-up. Further studies are needed to explore the pathophysiological roles of GDF-15 in the development of sarcopenia.


Author(s):  
Sansano-Nadal ◽  
Giné-Garriga ◽  
Brach ◽  
Wert ◽  
Jerez-Roig ◽  
...  

Exercise is a form of physical activity (PA). PA is an important marker of health and quality of life in older adults. The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure, and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65+ year-old adults. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42017070892) of randomized clinical trials (RCT). We searched three electronic databases during January 2018 to identify RCT assessing any type of exercise-based intervention. Studies had to report a pre-, post-, and at least 6-month post-intervention follow-up. To be included, at least one PA outcome had to be assessed. The effect of exercise-based interventions was assessed compared to active (e.g., a low-intensity type of exercise, such as stretching or toning activities) and non-active (e.g., usual care) control interventions at several time points. Secondary analyses were conducted, restricted to studies that reported specific strategies to enhance the sustainability of PA. The intervention effect was measured on self-reported and objective measures of time spent in PA, by means of standardized mean differences. Standardized mean differences of PA level were pooled. Pooled estimates of effect were computed with the DerSimonian–Laird method, applying a random effects model. The risk of bias was also assessed. We included 12 studies, comparing 18 exercise intervention groups to four active and nine non-active control groups. Nine studies reported specific strategies to enhance the long-term sustainability of PA. The strategies were mostly related to the self-efficacy, self-control, and behavior capability principles based on the social cognitive theory. Exercise interventions compared to active control showed inconclusive and heterogeneous results. When compared to non-active control, exercise interventions improved PA time at the six-months follow up (standardized mean difference (SMD) 0.30; 95%CI 0.15 to 0.44; four studies; 724 participants; I2 0%), but not at the one- or two-years follow-ups. No data were available on the mid- and long-term effect of adding strategies to enhance the sustainability of PA. Exercise interventions have small clinical benefits on PA levels in community-dwelling older adults, with a decline in the observed improvement after six months of the intervention cessation.


Author(s):  
Christopher Neville ◽  
Hung Nguyen ◽  
Kim Ross ◽  
Mariana Wingood ◽  
Elizabeth Walker Peterson ◽  
...  

Background Despite sufficient evidence to suggest that lower-limb–related factors may contribute to fall risk in older adults, lower-limb and footwear influences on fall risk have not been systematically summarized for readers and clinicians. The purpose of this study was to systematically review and synethesize the literature related to lower-limb, foot, and footwear factors that may increase the risk of falling among community-dwelling older adults. Methods We searched PubMed, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and AgeLine. To describe the trajectory toward increasing risk of falls, we examined those articles that linked age-related changes in the lower limb or footwear to prospective falls or linked them to evidenced-based fall risk factors, such as gait and balance impairment. Results This systematic review consisted of 81 articles that met the review criteria, and the results reflect a narrative review of the appraised literature for eight pathways of lower-limb–related influences on fall risk in older adults. Six of the eight pathways support a direct link to fall risk. Two other pathways link to the intermediate factors but lack studies that provide evidence of a direct link. Conclusions This review provides strong guidance to advance understanding and assist with managing the link between lower-limb factors and falls in older adults. Due to the lack of literature in specific areas, some recommendations were based on observational studies and should be applied with caution until further research can be completed.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026667 ◽  
Author(s):  
Tengku Amatullah Madeehah Tengku Mohd ◽  
Raudah Mohd Yunus ◽  
Farizah Hairi ◽  
Noran N Hairi ◽  
Wan Yuen Choo

ObjectivesThis review aims to: (1) explore the social support measures in studies examining the association between social support and depression among community-dwelling older adults in Asia and (2) the evidence of association.DesignA systematic review was conducted using electronic databases of CINAHL, PubMed, PsychINFO, Psychology and Behavioural Sciences Collection, SocINDEX and Web of Science for articles published until the 11th of January 2018.Eligibility criteriaAll observational studies investigating the association between social support and depression among community-dwelling older adults in Asia were included.ParticipantsOlder adults aged 60 years and more who are living in the community.Exposure measuresSocial support.Outcome measuresDepression.ResultsWe retrieved16 356 records and screened 66 full-text articles. Twenty-four observational studies were included in the review. They consisted of five cohort studies and 19 cross-sectional studies. Social support was found to be measured by multiple components, most commonly through a combination of structural and functional constructs. Perceived social support is more commonly measured compared with received social support. Good overall social support, having a spouse or partner, living with family, having a large social network, having more contact with family and friends, having emotional and instrumental support, good support from family and satisfaction with social support are associated with less depressive symptoms among community-dwelling older adults in Asia.ConclusionsThere were 20 different social support measures and we applied a framework to allow for better comparability. Our findings emphasised the association between good social support and decrease depression among older adults. Compared with western populations, family support has a greater influence on depression among community-dwelling older adults in Asia. This indicates that the family institution needs to be incorporated into designed programmes and interventions when addressing depression in the Asian context.Trialregistration numberCRD42017074897.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027728 ◽  
Author(s):  
Siobhan Leahy ◽  
Marica Cassarino ◽  
Matthew DL O' Connell ◽  
Liam Glynn ◽  
Rose Galvin

IntroductionTwo major global health challenges are the rapidly ageing population and the high prevalence of obesity in all age groups. Older adults are also susceptible to age-related loss of muscle strength, termed dynapaenia. The co-occurrence of both obesity and dynapaenia, termed dynapaenic obesity (DO), has been associated with poorer health outcomes and increased healthcare usage compared with either state alone. The purpose of this systematic review is to quantify the prevalence and incidence of DO in older adult populations, and to explore the association between DO and health outcomes, specifically chronic disease and multimorbidity, functional disability and healthcare usage.Methods and analysisUsing the Meta-analyses Of Observational Studies in Epidemiology guidelines, we will conduct a systematic review of cross-sectional and longitudinal observational studies of older adults, which include measures of DO and specified outcomes. Detailed literature searches of will be conducted using six electronic databases: Excerpta Medica dataBASE (EMBASE), PubMed, MEDLINE, SCOPUS, ScienceDirect and Cumulative Index of Nursing and Allied Health Complete (CINAHL), including articles published from database inception until Febuary 2019. The reference lists of included articles will also be searched. Two independent reviewers will undertake a three-step screening and review process using the Population, Risk Factor, Outcome framework to define eligibility. The Newcastle Ottawa Scale for non-randomised studies will be used to assess risk of bias and to rate study quality. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval is not required for this systematic review. Findings from this research will be submitted for peer-reviewed publication in academic journals, and presented at relevant academic conferences.PROSPERO registration numberCRD42018112471.


2018 ◽  
Vol 125 (5) ◽  
pp. 1468-1474 ◽  
Author(s):  
Yoshihiro Fukumoto ◽  
Yosuke Yamada ◽  
Tome Ikezoe ◽  
Yuya Watanabe ◽  
Masashi Taniguchi ◽  
...  

Ultrasonic echo intensity (EI), an easy-to-use measure of intramuscular fat and fibrous tissues, is known to increase with aging. However, age-related changes in EI have not been examined in a longitudinal design. The objective of this study was to investigate 4-yr longitudinal changes in the EI of the quadriceps femoris in older adults, based on difference in physical activity (PA). This study included 131 community-dwelling older adults with a mean age of 72.9 ± 5.2 yr. Subcutaneous fat thickness (FT), muscle thickness (MT), and EI of the quadriceps femoris were measured by ultrasound. Isometric knee extensor strength was also measured. PA was assessed using a questionnaire at baseline, and participants were classified into the high or low PA groups. In 4 yr, a significant decrease in FT, MT, and strength was observed in both groups ( P < 0.05), whereas a significant decrease in EI was observed only in the high PA group ( P < 0.05). Multiple linear regression analyses revealed that the difference in PA was a significant predictor of 4-yr changes in MT (β = 0.189, P = 0.031) and EI (β = −3.145, P = 0.045) but not in the body mass index, FT, or strength adjusted for potential confounders. The present findings suggest that greater PA has a positive effect on longitudinal changes in the MT and EI of the quadriceps femoris in older adults. In addition, greater PA may contribute to a future decrease in EI, and an increase in EI may not occur in 4 yr, even in older adults with lesser PA. NEW & NOTEWORTHY Our results suggest that greater physical activity (PA) may mitigate future changes in muscle thickness and echo intensity (EI). A decrease in EI over 4 yr was observed in older adults with greater PA, and an increase in EI was not observed, even in older adults with smaller PA. Several cross-sectional studies demonstrated an increase in EI with aging. Additionally, the results of our longitudinal study suggest that an age-related increase in EI may be moderated after the old-age period.


2004 ◽  
Vol 97 (2) ◽  
pp. 781-789 ◽  
Author(s):  
Liza Stathokostas ◽  
Shanthi Jacob-Johnson ◽  
Robert J. Petrella ◽  
Donald H. Paterson

The purpose of this study was to describe the longitudinal (10 yr) decline in aerobic power [maximal O2 uptake (V̇o2 max)] and anaerobic threshold [ventilatory threshold (TV̇e)] of older adults living independently in the community. Ten years after initial testing, 62 subjects (34 men, mean age 73.5 ± 6.4 yr; 28 women, 72.1 ± 5.3 yr) achieved V̇o2 max criteria during treadmill walking tests to the limit of tolerance, with TV̇e determined in a subset of 45. V̇o2 max in men showed a rate of decline of −0.43 ml·kg−1·min−1·yr−1, and the decline in V̇o2 max was consequent to a lowered maximal heart rate with no change in the maximum O2 pulse. The women showed a slower rate of decline of V̇o2 max of −0.19·ml·kg−1·min−1·yr−1 ( P < 0.05), again with a lowered HRmax and unchanged O2 pulse. In this sample, lean body mass was not changed over the 10-yr period. Changes in V̇o2 max were not significantly related to physical activity scores. TV̇e showed a nonsignificant decline in both men and women. Groupings of young-old (65–72 yr at follow-up) vs. old-old (73–90 yr at follow-up) were examined. In men, there were no differences in the rate of V̇o2 max decline. The young-old women showed a significant decline in V̇o2 max, whereas old-old women, initially at a V̇o2 max of 19.4 ± 3.1 ml·kg−1·min−1, showed no loss in V̇o2 max. The longitudinal data, vs. cross-sectional analysis, showed a greater decline for men but similar estimates of the rates of change in women. Thus the 10-yr longitudinal study of the cohort of community-dwelling older adults who remained healthy, ambulatory, and independent showed a 14% decline in V̇o2 max in men, and a smaller decline of 7% in women, with the oldest women showing little change over the 10-yr period.


2010 ◽  
Vol 22 (5) ◽  
pp. 819-829 ◽  
Author(s):  
Diana E. Clarke ◽  
Jean Y. Ko ◽  
Constantine Lyketsos ◽  
George W. Rebok ◽  
William W. Eaton

ABSTRACTBackground: Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer's disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and/or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults.Methods: Data on 1,136 community-dwelling adults aged 50 years and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Logistic regression, t-tests, χ2 and Generalized Estimating Equations were used to accomplish the study's objectives.Results: The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower Mini-mental State Examination (MMSE) scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR = 2.74; 95%CI = 1.35, 5.57) function at 1-year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were twice as likely to have functional decline. Incidence of apathy at 1-year follow up and 13-year follow-up was 22.6% and 29.4%, respectively.Conclusions: These results underline the public health importance of apathy and the need for further population-based studies in this area.


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