scholarly journals Multimorbidity patterns and memory trajectories in older adults: Evidence from the English Longitudinal Study of Ageing

Author(s):  
Rebecca Bendayan ◽  
Yajing Zhu ◽  
A D Federman ◽  
R J B Dobson

Abstract Background We aimed to examine the multimorbidity patterns within a representative sample of UK older adults and their association with concurrent and subsequent memory. Methods Our sample consisted of 11,449 respondents (mean age at baseline was 65.02) from the English Longitudinal Study of Ageing (ELSA). We used fourteen health conditions and immediate and delayed recall scores (IMRC and DLRC) over 7 waves (14 years of follow up). Latent class analyses were performed to identify the multimorbidity patterns and linear mixed models were estimated to explore their association with their memory trajectories. Models were adjusted by socio-demographics, BMI and health behaviors. Results Results showed 8 classes: Class 1:Heart Disease/Stroke (26%), Class 2:Asthma/Lung Disease (16%), Class 3:Arthritis/Hypertension (13%), Class 4:Depression/Arthritis (12%), Class 5:Hypertension/Cataracts/Diabetes (10%), Class 6:Psychiatric Problems/Depression (10%), Class 7:Cancer (7%) and Class 8:Arthritis/Cataracts (6%). At baseline, Class 4 was found to have lower IMRC and DLRC scores and Class 5 in DLRC, compared to the no multimorbidity group (n=6380, 55.72% of total cohort). For both tasks, in unadjusted models, we found an accelerated decline in Classes 1, 3 and 8; and, for DLRC, also in Classes 2 and 5. However, it was fully attenuated after adjustments. Conclusions These findings suggest that individuals with certain combinations of health conditions are more likely to have lower levels of memory compared those with no multimorbidity and their memory scores tend to differ between combinations. Socio-demographics and health behaviours have a key role to understand who is more likely to be at risk of an accelerated decline.

2019 ◽  
Vol 32 (9) ◽  
pp. 1120-1132 ◽  
Author(s):  
Hai Nguyen ◽  
Kia-Chong Chua ◽  
Alexandru Dregan ◽  
Silia Vitoratou ◽  
Ivet Bayes-Marin ◽  
...  

Objective: We aimed to identify the patterns of multimorbidity in older adults and explored their association with sociodemographic and lifestyle risk factors. Method: The sample included 9,171 people aged 50+ from Wave 2 of the English Longitudinal Study of Aging (ELSA). Latent Class Analysis (LCA) was performed on 26 chronic diseases to determine clusters of common diseases within individuals and their association with sociodemographic and lifestyle risk factors. Result: Three latent classes were identified: (a) a cardiorespiratory/arthritis/cataracts class, (b) a metabolic class, and (c) a relatively healthy class. People aged 70 to 79 were 9.91 times (95% Confidence Interval [CI] = [5.13, 19.13]) more likely to be assigned to the cardiorespiratory/arthritis/cataracts class, while regular drinkers and physically inactive people were 0.33 times (95% CI = [0.24, 0.47]) less likely to be assigned to this class. Conclusion: Future research should investigate these patterns further to gain more insights into the needs of people with multimorbidity.


2020 ◽  
Author(s):  
Roberta de Oliveira Máximo ◽  
Dayane Capra de Oliveira ◽  
Paula Camila Ramirez ◽  
Mariane Marques Luiz ◽  
Aline Fernanda de Souza ◽  
...  

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.


2019 ◽  
Author(s):  
Chloe Fawns-Ritchie ◽  
Jackie Price ◽  
Ian J Deary

AbstractObjectiveTo examine the association of health literacy and cognitive ability with risk of diabetes.Research Design and Methods: Participants were 8,669 English Longitudinal Study of Ageing participants (mean age 66.7 years, SD 9.7) who completed health literacy and cognitive ability tests at wave 2 (2004-2005), and who answered a self-reported question on whether a doctor had ever diagnosed them with diabetes. Logistic regression was used to examine the cross-sectional associations of health literacy and cognitive ability with diabetes status. In those without diabetes at wave 2, Cox regression was used to test the associations of health literacy and cognitive ability with risk of diabetes over a median of 9.5 years follow-up (n=6,961).ResultsAdequate (compared to limited) health literacy (OR 0.72, 95% CI 0.61-0.84) and higher cognitive ability (OR per 1 SD 0.73, CI 0.67-0.80) were both associated with lower odds of self-reported diabetes. Adequate health literacy (HR 0.64; CI 0.53-0.77) and higher cognitive ability (HR 0.77, CI 0.69-0.85) were also associated with lower risk of self-reporting diabetes during follow-up. When both health literacy and cognitive ability were added to the same model, these associations were slightly attenuated. Additional adjustment for health behaviours, education and social class attenuated associations further, and neither health literacy nor cognitive ability were significantly associated with diabetes.ConclusionsAdequate health literacy and better cognitive ability were associated with reduced risk of diabetes. These associations were independent of each other, but not of other health- and socioeconomic-related variables.


2011 ◽  
Vol 41 (9) ◽  
pp. 1889-1896 ◽  
Author(s):  
M. Hamer ◽  
G. D. Batty ◽  
M. Kivimaki

BackgroundThe cross-sectional association between impaired glucose/diabetes and depression is inconsistent. We examined the longitudinal associations between diabetes, indicators of glucose metabolism and depressive symptoms over 2 years of follow-up.MethodParticipants were 4338 men and women from the English Longitudinal Study of Ageing, a prospective study of community-dwelling older adults [aged 62.9 (s.d.=9.0) years, 45.2% men]. Depressive symptoms were assessed at baseline and after 2 years of follow-up using the eight-item Centre of Epidemiological Studies – Depression (CES-D) scale. Glycated haemoglobin (HbA1c) levels, fasting glucose and other biological and behavioural risk factors were also assessed at baseline.ResultsApproximately 11.5% of the sample were categorized with elevated depressive symptoms at follow-up (a score ⩾4 on the CES-D). There was an association between HbA1c and depressive symptoms at follow-up [per unit increase, odds ratio (OR) 1.17, 95% confidence interval (CI) 1.03–1.33] after adjustment for age and baseline CES-D. Cross-sectionally, the probability of depressive symptoms increased with increasing HbA1c levels until the value of 8.0% after which there was a plateau [p(curve)=0.03]. Compared with those with normal fasting glucose, participants with diabetes (confirmed through self-report or elevated fasting blood glucose) at baseline had an elevated risk of depressive symptoms at follow-up (OR 1.52, 95% CI 1.01–2.30) after adjusting for depressive symptoms at baseline, behavioural and sociodemographic variables, adiposity and inflammation.ConclusionsThese data suggest that poor glucose metabolism and diabetes are risk factors for future depression in older adults. There was no evidence of a U-shaped association.


2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016358 ◽  
Author(s):  
Nafeesa N Dhalwani ◽  
Radia Fahami ◽  
Harini Sathanapally ◽  
Sam Seidu ◽  
Melanie J Davies ◽  
...  

ObjectivesAssess the longitudinal association between polypharmacy and falls and examine the differences in this association by different thresholds for polypharmacy definitions in a nationally representative sample of adults aged over 60 years from England.DesignLongitudinal cohort study.SettingThe English Longitudinal Study of Ageing waves 6 and 7.Participants5213 adults aged 60 or older.Main outcome measuresRates, incidence rate ratio (IRR) and 95% CI for falls in people with and without polypharmacy.ResultsA total of 5213 participants contributed 10 502 person-years of follow-up, with a median follow-up of 2.02 years (IQR 1.9–2.1 years). Of the 1611 participants with polypharmacy, 569 reported at least one fall within the past 2 years (rate: 175 per 1000 person-years, 95% CI 161 to 190), and of the 3602 participants without polypharmacy 875 reported at least one fall (rate: 121 per 1000 person-years, 95% CI 113 to 129). The rate of falls was 21% higher in people with polypharmacy compared with people without polypharmacy (adjusted IRR 1.21, 95% CI 1.11 to 1.31). Using ≥4 drugs threshold the rate of falls was 18% higher in people with polypharmacy compared with people without (adjusted IRR 1.18, 95% CI 1.08 to 1.28), whereas using ≥10 drugs threshold polypharmacy was associated with a 50% higher rate of falls (adjusted IRR 1.50, 95% CI 1.34 to 1.67).ConclusionsWe found almost one-third of the total population using five or more drugs, which was significantly associated with 21% increased rate of falls over a 2-year period. Further exploration of the effects of these complex drug combinations in the real world with a detailed standardised assessment of polypharmacy is greatly required along with pragmatic studies in primary care, which will help inform whether the threshold for a detailed medication review should be lowered.


Author(s):  
Mary McCarron ◽  
Marie O'Dwyer ◽  
Eilish Burke ◽  
Eimear McGlinchey ◽  
Philip McCallion

Abstract There are limited studies on the prevalence of epilepsy and co-morbid conditions in older adults with an ID. To begin to address this prevalence of epilepsy was estimated for participants in the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing. Associations with demographic variables and co morbid health conditions were examined. It was found that prevalence was high (30.7%); but declined as people aged. Those with epilepsy were less likely to live with family, independently or in community settings, rates of refractory epilepsy were high and, despite medication over half of those with epilepsy still reported experiencing seizures. Given these findings, people with ID and their careers have considerable needs for information about epilepsy management, and for support from specialist ID and epilepsy services.


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