Initial level and rate of change in grip strength predict all-cause mortality in very old adults

Advanced old age has been characterized as a biologically highly vulnerable life phase. Biological, morbidity-, and cognitive impairment-related factors play an important role as mortality predictors among very old adults. However, it is largely unknown whether previous findings confirming the role of different wellbeing domains for mortality translate to survival among the oldest-old individuals. Moreover, the distinction established in the wellbeing literature between hedonic and eudaimonic wellbeing as well as the consideration of within-person variability of potentially relevant mortality predictors has not sufficiently been addressed in prior mortality research. In this study, we examined a broad set of hedonic and eudaimonic wellbeing indicators, including their levels, their changes, as well as their within-person variability, as predictors of all-cause mortality in a sample of very old individuals. We used data from the LateLine study, a 7-year longitudinal study based on a sample of n = 124 individuals who were living alone and who were aged 87–97 years (M = 90.6, SD = 2.9) at baseline. Study participants provided up to 16 measurement occasions (mean number of measurement occasions per individual = 5.50, SD = 4.79) between 2009 and 2016. Dates of death were available for 118 individuals (95.2%) who had deceased between 2009 and 2021. We ran longitudinal multilevel structural equation models and specified between-person level differences, within-person long-term linear change trends, as well as the “detrended” within-person variability in three indicators of hedonic (i.e., life satisfaction and positive and negative affect) and four indicators of eudaimonic wellbeing (i.e., purpose in life, autonomy, environmental mastery, and self-acceptance) as all-cause mortality predictors. Controlling for age, gender, education, and physical condition and testing our sets of hedonic and eudaimonic indictors separately in terms of their mortality impact, solely one eudaimonic wellbeing indicator, namely, autonomy, showed significant effects on survival. Surprisingly, autonomy appeared “paradoxically” related with mortality, with high individual levels and intraindividual highly stable perceptions of autonomy being associated with a shorter residual lifetime. Thus, it seems plausible that accepting dependency and changing perceptions of autonomy over time in accordance with objectively remaining capabilities might become adaptive for survival in very old age.

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Relationship Between Perceived Physical and Mental Fatigability and Physical Performance in Very Old Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.576 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 178-178

Author(s):

Yixin Hu ◽

Zhuangzhuang Zhang ◽

Woei-Nan Bair ◽

Anying Bai ◽

Li Fan

Keyword(s):

Grip Strength ◽

Physical Performance ◽

Performance Measures ◽

Gait Speed ◽

Clinical Importance ◽

Community Dwelling ◽

Very Old ◽

Chair Stand ◽

Old Adults ◽

Usual Gait Speed

Abstract To investigate the relationship between perceived physical and mental fatigability and physical performance in community-dwelling very old adults (≥80 years). We examined the association in one retired community in Beijing including 404 very old adults. Pittsburgh Fatigability Scale (PFS), Chinese version, was used to assess perceived fatigability in physical domain (PFS-P) and mental domain (PFS-M). High fatigability is defined as PFS-P ≥ 15, and PFS-M ≥ 13. Physical performance measures include grip strength, usual gait speed, chair stand and Short Physical Performance Battery (SPPB) test. Women have higher PFS scores (both PFS-P & PFS-M) and higher prevalence of high fatigability than men. After adjusting for sex, usual gait speed and SPPB scores were significantly associated with PFS-P & PFS-M, while grip strength and chair stand performance were significantly associated with PFS-P only. After multivariable adjustment, usual gait speed (B=-3.745, P=0.021) and chair stand performance (B=0.335, P=0.005) were significantly associated with PFS-P, while usual gait speed (B=-2.656, P=0.006) and SPPB scores (B=-0.214, P=0.029) were significantly associated with PFS-M. Perceived physical and mental fatigability is highly prevalent in very older adults and they differ by sex. The significant associations between PFS scores and performance measures suggest that PFS is of potential clinical importance, especially when testing performance measures are not feasible. Utilization of PFS score can assist in identifying target populations who are at risk of reduced physical functions, such as older with depression, older women. Interventions to improve usual gait speed are likely to reduce both perceived physical and mental fatigability.

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Dietary selenium intakes and their association with muscle strength and function in ≥ 85 year old adults: the Newcastle 85 + Study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120005601 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Giorgia Perri ◽

Tom Hill ◽

John Mathers ◽

Nuno Mendonça ◽

Rachel Duncan ◽

...

Keyword(s):

Antioxidant Properties ◽

Selenium Deficiency ◽

Rate Of Change ◽

Food Sources ◽

Cross Sectional ◽

Very Old ◽

Dietary Selenium ◽

Old Adults ◽

Selenium Intake ◽

Males And Females

AbstractSelenium is an essential micronutrient with biochemical and cellular effects through activities of 25 selenocysteine-containing selenoproteins. Selenoproteins are anti-inflammatory and have antioxidant properties. Severe selenium deficiency causes muscle weakness and atrophy in humans however the effects of moderate selenium deficiency are unclear. The aims of this study are twofold: 1) to determine dietary selenium intakes and contributing food sources in very old adults and; 2) to determine whether dietary selenium intakes are associated with 5-year trajectories of muscle function: hand-grip strength (HGS) and Timed-Up-and-Go (TUG).Cross-sectional (baseline) and prospective (1.5, 3 and 5-year follow-up) analyses of 845 participants aged 85 years from the Newcastle 85 + study were assessed for HGS and TUG performance using standardized protocols (Antoneta et al. 2016). Baseline dietary intakes were assessed using 24-hour multiple pass recall methods on two separate days (Mendonça et al. 2016). The top selenium food contributors (~90%) and the adequacy of intakes were determined i.e. those with intakes < LRNI, between the LRNI and RNI and > RNI. Linear mixed models explored the associations between selenium intake categories and time on the prospective, 5-year change in HGS and TUG in all participants, males and females.Median intakes of selenium were 39, 48 and 35μg for all participants, males and females, respectively. Selenium intakes were below the LRNI in 51% of participants (median 27μg) whilst 15% had intakes ≥ the RNI (median 85μg). Only 13.3% of females and 16.9 % of males met the RNI. The top selenium contributors were cereals (46%), meat (22%), fish (10%), milk (6%), eggs (4%) and potatoes (3%) making up 91% of selenium intakes. Those with the lowest intakes had 2.72 kg lower HGS and 2.36s slower TUG compared to those with higher intakes (P < 0.005). There was no association between selenium intake in HGS or TUG, but time had a significant effect on the rate of change over 5-years in both parameters (P < 0.001).Overall these results show that poor dietary selenium intakes are common in very old adults and that cereal and cereal products are major sources of selenium in this population. Whilst low selenium intakes are associated with worse HGS and TUG performance in the cross-sectional analysis, no significant associations were observed in the prospective analyses.

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Circulating Interleukin-6 (but Not Other Immune Mediators) Associates with Criteria for Fried’s Frailty among Very Old Adults

Journal of Aging Research ◽

10.1155/2020/6831791 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Gilberto Santos Morais Junior ◽

Diego Ignacio Valenzuela Perez ◽

Audrey Cecília Tonet-Furioso ◽

Lucy Gomes ◽

Karla Helena Coelho Vilaça ◽

...

Keyword(s):

Grip Strength ◽

Serum Levels ◽

Total Serum ◽

Strong Negative Correlation ◽

Old Patients ◽

Walk Speed ◽

Very Old ◽

Old Adults ◽

Immune Mediators ◽

Inflammatory State

Background and Aim. Frailty is a geriatric condition resulting from physiological changes covering the musculoskeletal, immune, and neuroendocrine systems, leading to a greater inflammatory state. The present research aimed to investigate the association of components of Fried’s frailty (as well as of the phenotype as a whole) with total serum levels of a panel of inflammatory mediators. Methods. One hundred and sixty-one very old patients (aged ≥80 years) devoid of cognitive decline were eligible for analyses. Clinical and biochemical data along with physical and cognitive assessments encompassing dual-energy X-ray scans and hand dynamometry were adopted to investigate frailty criteria, while circulating immune mediators (IFNγ, IL-2, IL-4, IL-6, IL-10, and TNFα) were assessed using high-throughput flow cytometry. Results. Preliminarily, IL-6 correlated positively with waist-to-hip ratio and C-reactive protein and negatively with glycemia. In analyses controlled for these factors, serum levels of IL-6 were comparatively augmented among the very old participants with reduced grip strength (OR = 3.299; 95% CI 1.08–6.09; p = 0.032 ) and among those with slow walk speed (OR = 2.460; 95% CI 1.16–7.05; p = 0.022 ). Conclusions. Our study shows a strong negative correlation of IL-6 levels with Fried’s frailty components of grip strength and walk speed in very old adults, regardless of confounding factors.

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Airflow limitation by the Global Lungs Initiative equations in a cohort of very old adults

European Respiratory Journal ◽

10.1183/09031936.00217214 ◽

2015 ◽

Vol 46 (1) ◽

pp. 123-132 ◽

Cited By ~ 13

Author(s):

Eralda Turkeshi ◽

Bert Vaes ◽

Elena Andreeva ◽

Catharina Matheï ◽

Wim Adriaensen ◽

...

Keyword(s):

Cox Regression ◽

Multivariable Analysis ◽

Predictive Ability ◽

Population Based ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Very Old ◽

Old Adults ◽

All Cause Mortality

The cut-off for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) defining airflow limitation for chronic obstructive pulmonary disease (COPD) is still contested. We assessed airflow limitation prevalence by the lower limit of normal (LLN) of Global Lungs Initiative (GLI) 2012 reference values and its predictive ability for all-cause mortality and hospitalisation in very old adults (aged ≥80 years) compared with the fixed cut-off.In a Belgian population-based prospective cohort of 411 very old adults, airflow limitation prevalence by the 5th percentile of GLI 2012 z-scores (GLI-LLN) and fixed cut-off (0.70) were compared with COPD reported by general practitioners (GPs). Survival and Cox regression multivariable analysis assessed the association of airflow limitation by both cut-offs with 5-year all-cause mortality and first hospitalisation at 3 years.9.2% had airflow limitation by GLI-LLN and 27% by fixed cut-off, without good agreement (kappa coefficient ≤0.40) with GP-reported COPD (9%). Only airflow limitation by GLI-LLN was independently associated with mortality (adjusted hazard ratio 2.10, 95% CI 1.30–3.38). FEV1/FVC <0.70 but ≥GLI-LLN (17.8%) had no significantly higher risk for mortality or hospitalisation.In a cohort of very old adults, airflow limitation by GLI-LLN has lower prevalence than by fixed cut-off, independently predicts all-cause mortality and does not miss individuals with significantly higher all-cause mortality and hospitalisation.

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Between-person and within-person associations of sleep and working-memory in the everyday lives of old and very old adults: initial level, learning, and variability

SLEEP ◽

10.1093/sleep/zsab279 ◽

2021 ◽

Author(s):

Anna J Lücke ◽

Cornelia Wrzus ◽

Denis Gerstorf ◽

Ute Kunzmann ◽

Martin Katzorreck ◽

...

Keyword(s):

Working Memory ◽

Sleep Duration ◽

Initial Level ◽

Memory Performance ◽

Very Old ◽

Old Adults ◽

Sample Average ◽

Very Old Age ◽

Working Memory Updating ◽

Young Old

Abstract Study Objectives Sleep duration affects various aspects of cognitive performance, such as working-memory and learning, among children and adults. However, it remains open, whether similar or even stronger associations exist in old and very old age when changes in sleep and cognitive decrements are common. Methods Using repeated daily-life assessments from a sample of 121 young-old (66–69 years old) and 39 old-old adults (84–90 years old), we assessed links between sleep duration and different aspects of working-memory (initial level, practice-related learning, and residualized variability) between and within persons. Participants reported their sleep durations every morning and performed a numerical working-memory updating task six times a day for seven consecutive days. Results Both people who slept longer and those who slept shorter than the sample average showed lower initial performance levels, but a stronger increase of WM over time (i.e. larger learning effects), relative to people with average sleep. Sleep duration did not predict performance variability. Within-person associations were found for people sleeping relatively little on average: For them, working-memory performance was lower on days with shorter than average sleep, yet higher on days with longer than average sleep. Except for lower initial levels of working-memory in old-old adults, no differences between young-old and old-old adults were observed. Conclusion We conclude that sufficient sleep remains important for working-memory performance in older adults and that it is relevant to include different aspects of working-memory performance, because effects differed for initial performance and learning.

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Physical activity and all-cause mortality and mediators of the association in the very old

Experimental Gerontology ◽

10.1016/j.exger.2021.111374 ◽

2021 ◽

Vol 150 ◽

pp. 111374

Author(s):

Yusuke Osawa ◽

Yukiko Abe ◽

Michiyo Takayama ◽

Yuko Oguma ◽

Yasumichi Arai

Keyword(s):

Physical Activity ◽

Very Old ◽

All Cause Mortality

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