scholarly journals Interplay Between Socioeconomic Markers and Genetic Predisposition to the Time to Dementia Onset

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 642-642
Author(s):  
Olesya Ajnakina ◽  
Dorina Cadar ◽  
Andrew Steptoe

Abstract Identifying interplay between socio-economic markers (education and financial resources) and genetic factors influencing time of dementia and Alzheimer’s disease (AD) diagnosis is of central relevance for the development of preventative strategies. Using 7039 individuals aged >50 years from the English Longitudinal Study of Ageing, 320 (4.6%) of whom developed dementia over the 10-year follow-up, we investigated interactions between polygenic score for AD (AD-PGS) and socioeconomic markers on the timing of dementia or AD diagnosis. One standard deviation increase in AD-PGS was associated with an accelerated time to dementia onset by 4.8 months. Interactions between AD-PGS and lower wealth accelerated time to AD diagnosis by 24 months; an interaction between AD-PGS and years of schooling in decelerating time to AD by 3.0 months suggests education serves as protective mechanisms against AD diagnosis. Socio-economic markers are important factors influencing time to dementia and AD, particularly in those with polygenetic predisposition to AD.

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.


EP Europace ◽  
2019 ◽  
Vol 22 (3) ◽  
pp. 352-360 ◽  
Author(s):  
Ruben R De With ◽  
Ernaldo G Marcos ◽  
Elton A M P Dudink ◽  
Henri M Spronk ◽  
Harry J G M Crijns ◽  
...  

Abstract Aims Atrial fibrillation (AF) is a progressive disease, but identifying patients at risk for AF progression is challenging. We aimed to identify factors associated with AF progression. Methods and results Atrial fibrillation progression was assessed in 392 patients with recent-onset paroxysmal or persistent AF included in the prospective, observational, multicentre identification of a risk profile to guide atrial fibrillation (AF-RISK) study. Progression of AF was assessed by Holter monitoring and 2-week event recorder at baseline and 1-year follow-up. AF progression was defined as: (i) doubling in AF burden at 1 year compared to baseline with a minimum AF burden of 10% in paroxysmal AF; or (ii) transition from paroxysmal to persistent or permanent AF; or (iii) persistent to permanent AF. Age was 60 ± 11 years, 62% were men, and 83% had paroxysmal AF. At 1 year, 52 (13%) had AF progression (11% in paroxysmal; 26% in persistent AF). Multivariable logistic regression showed that left atrial volume [odds ratio (OR) per 10 mL 1.251, 95% confidence interval (CI) 1.078–1.450; P < 0.001], N-terminal pro-B-type natriuretic peptide (NT-proBNP; OR per standard deviation increase 1.583, 95% CI 1.099–2.281; P = 0.014), and plasminogen activator inhibitor-1 (PAI-1; OR per standard deviation increase 0.660, 95% CI 0.472–0.921; P = 0.015) were associated with AF progression. In an additional follow-up of 1.9 (0.9–3.3) years patients with AF progression developed more cardiovascular events and all-cause mortality (12.4%/year vs. 2.3%/year, P < 0.001). Conclusion Atrial fibrillation progression occurred in 13% of patients with recent-onset AF during 1-year follow-up. Left atrial volume, NT-proBNP, and PAI-1 were associated with AF progression. Patients with AF progression had a higher event rate. Trial registration number Clinicaltrials.gov NCT01510210.


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):  
Giorgi Beridze ◽  
Alba Ayala ◽  
Oscar Ribeiro ◽  
Gloria Fernández-Mayoralas ◽  
Carmen Rodríguez-Blázquez ◽  
...  

Purpose: Loneliness and social isolation have detrimental effects on health in old age; however, the prospective associations with quality of life (QoL) remain unclear. Furthermore, despite the existence of a European north-south gradient in the distribution of loneliness and social isolation, little is known whether the associations are context-specific. We investigated the relationships between loneliness, social isolation and QoL of older adults residing in the North (Sweden) and South (Spain) of Europe. Methods: Study sample consisted of 2995 Swedish and 4154 Spanish older adults who participated in waves six and seven of the Study on Health, Aging and Retirement in Europe (SHARE). Loneliness and social isolation were measured at the baseline, and QoL was measured at the baseline and follow-up using CASP-12. Prospective associations were assessed via multivariate linear regression. Results: In Sweden, subjects with higher vs. lower loneliness had 1.01 (95% CI: −1.55, −0.40) units lower QoL, while every standard deviation increase in social isolation was associated with a 0.27 (95% CI: −0.42, −0.09)-unit decrease in QoL. In Spain, every standard deviation increase in social isolation was associated with a 0.66 (95% CI: −1.11, −0.22)-unit decrease in QoL. The association was stronger in subjects aged ≤65 years old and those with no chronic diseases. The association with loneliness was not statistically significant in Spain. Conclusion: Loneliness and social isolation are prospectively associated with decreased QoL among older adults, yet the associations are contextually bound. Future interventions should target both exposures, among others, in order to increase QoL in this group.


BMJ ◽  
2019 ◽  
pp. l6377 ◽  
Author(s):  
Daisy Fancourt ◽  
Andrew Steptoe

AbstractObjectiveTo explore associations between different frequencies of arts engagement and mortality over a 14 year follow-up period.DesignProspective cohort study.ParticipantsEnglish Longitudinal Study of Ageing cohort of 6710 community dwelling adults aged 50 years and older (53.6% women, average age 65.9 years, standard deviation 9.4) who provided baseline data in 2004-05.InterventionSelf reported receptive arts engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera).MeasurementMortality measured through data linkage to the National Health Service central register.ResultsPeople who engaged with receptive arts activities on an infrequent basis (once or twice a year) had a 14% lower risk of dying at any point during the follow-up (809/3042 deaths, hazard ratio 0.86, 95% confidence interval 0.77 to 0.96) compared with those who never engaged (837/1762 deaths). People who engaged with receptive arts activities on a frequent basis (every few months or more) had a 31% lower risk of dying (355/1906 deaths, 0.69, 0.59 to 0.80), independent of demographic, socioeconomic, health related, behavioural, and social factors. Results were robust to a range of sensitivity analyses with no evidence of moderation by sex, socioeconomic status, or social factors. This study was observational and so causality cannot be assumed.ConclusionsReceptive arts engagement could have a protective association with longevity in older adults. This association might be partly explained by differences in cognition, mental health, and physical activity among those who do and do not engage in the arts, but remains even when the model is adjusted for these factors.


2018 ◽  
Vol 73 (1) ◽  
pp. 86-88 ◽  
Author(s):  
Lin Yang ◽  
Lee Smith ◽  
Mark Hamer

BackgroundThe aetiology of age-related sarcopenia is not known.ObjectivesTo investigate if risk of developing sarcopenia differs by gender and to identify gender-specific risk factors of incident sarcopenia in a large population-based cohort of older English adults.MethodsThe sample (n=3404; age 63.4 (SD 7.7) years; 54.1% women) comprised older community-dwelling adults recruited from the English Longitudinal Study of Ageing. Sarcopenia was defined as handgrip <26 kg in men and <16 kg in women. Handgrip strength was assessed at baseline (2004/2005) and repeated at follow-up (2012/2013). Analysed risk factors included baseline anthropometric measures, smoking, vigorous and moderate physical activity, depressive symptoms, chronic illnesses and wealth. After excluding participants with sarcopenia at baseline, multivariable logistic regressions were used to explore baseline risk factors for incident sarcopenia.ResultsDuring 8-year follow-up, 208 and 287 cases of sarcopenia were identified in men (n=1564) and women (n=1840), respectively. Women were at 20% (age adjusted OR=1.20, 95% CI 0.98 to 1.47) higher risk of developing sarcopenia than men. The inverse association between physical activity and sarcopenia risk was observed at moderate (OR=0.44, 95% CI 0.27 to 0.67) and vigorous (0.53, 95% CI 0.31 to 0.82) intensities in men and only vigorous (OR=0.44, 95% CI 0.28 to 0.68) intensity in women. Social factors, such as wealth, and chronic health conditions appeared to be more strongly associated with sarcopenia in men.ConclusionWomen are at higher risk of developing incident sarcopenia than men, and this is likely explained by a range of gender-specific risk factors.


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