scholarly journals Catechol-O-Methyltransferase Genotype, Frailty, and Gait Speed: The Cardiovascular Health Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 757-757
Author(s):  
Shannon Mance ◽  
Andrea Rosso ◽  
Joshua Bis ◽  
Stephanie Studenski ◽  
Nico Bohnen ◽  
...  
Keyword(s):  
Gait Speed ◽  
Chronic Conditions ◽  
Regression Models ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Full Cohort ◽  
Cross Sectional ◽  
Multivariable Regression ◽  
Multivariable Regression Models

Abstract The association of COMT with gait speed varies across studies; frailty, a condition increasing vulnerability to stressors, may influence this association. Cross-sectional data was obtained in 3,744 participants (71 years, 82% white, 39% male) for gait speed, frailty (Fried definition), and COMT. Multivariable regression models of COMT predicting gait were adjusted for demographics, chronic conditions, and locomotor factors. Interactions of COMT by frailty and by race predicting gait speed were p=0.03 and p=0.02, respectively. Compared to Met/Met, the Val/Val group walked marginally more slowly in the full cohort (0.87 vs 0.89 m/sec, p=0.2); differences were significant for those with frailty (n=220, 0.55 vs 0.63m/sec, p=0.03), but not for those with moderate (n=1691, 0.81 vs 0.81m/sec, p=0.9), or no frailty (n=1833, 0.98 vs 0.97 m/sec, p=0.7). Associations were similar by race, but significant for whites only. Studies should assess the influence of dopaminergic signaling on gait slowing due to frailty.

scholarly journals GAIT SLOWING AMONG FRAIL OLDER ADULTS: IS HIGHER DOPAMINERGIC SIGNALING PROTECTIVE?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S89-S89
Author(s):  
Caterina Rosano ◽  
Stephanie Studenski ◽  
Nicolaas Bohnen ◽  
Andrea Rosso
Keyword(s):  
Older Adults ◽  
Racial Differences ◽  
Gait Speed ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Linear Regression Models ◽  
Full Cohort ◽  
Frail Older Adults ◽  
Age Related

Abstract Strategies to reduce gait slowing in frail older adults are urgently needed. Higher dopaminergic (DA) signaling is emerging as a protecting factor against age-related gait slowing, in the absence of Parkinson’s Disease (PD). DA signaling is potentially modifiable, thereby offering promising novel strategies to reduce gait slowing. In 3,752 PD-free participants of the Cardiovascular Health Study (72.3 years, 81% white, 39% male), we measured gait speed (usual pace, 15 feet), frailty (Fried definition), and genetic polymorphism of Catechol-O-methyltransferase (COMT, rs4680), an enzyme regulating tonic brain DA levels. Multivariable linear regression models of COMT predicting gait speed were adjusted for age, gender, BMI, ankle-arm index, vision, and arthritis. Strength, education, medications, pulmonary, cardio- and cerebro-vascular diseases, diabetes, mood, and cognition were considered as additional covariates. We examined the full cohort and the subgroup with frailty (n=222), without and with race-stratification to address racial differences in allele frequencies. Average (SE) gait speed was 0.88 (0.003) and 0.58 (0.01) m/sec in the full cohort and the frail subgroup, respectively. COMT was linearly associated with gait speed; gait was faster for met/met (higher DA signaling) and slower for val/val (lower DA signaling) participants. In adjusted models, differences between these two groups were: 0.02 (0.01) m/sec in the full cohort (p=0.4); 0.07(0.02) m/sec in the frail subgroup (p=0.02); 0.10 (0.02) m/sec in white with frailty (p=0.01). COMT genotyping may help identify frail adults who are less vulnerable to gait impairments. Studies of frailty should examine whether higher DA signaling offers resilience against age-related gait slowing.

scholarly journals Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults

2021 ◽  
Vol 18 (6) ◽  
pp. 2931
Author(s):  
Ryo Komatsu ◽  
Koutatsu Nagai ◽  
Yoko Hasegawa ◽  
Kazuki Okuda ◽  
Yuto Okinaka ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Cross Sectional ◽  
Important Indicator ◽  
Community Dwelling Older Adults ◽  
Oral Frailty

This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22–4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73–0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.

scholarly journals Are soluble ST2 levels influenced by vitamin D and/or the seasons?

2019 ◽  
Vol 8 (6) ◽  
pp. 691-700
Author(s):  
Vito Francic ◽  
Martin Keppel ◽  
Verena Schwetz ◽  
Christian Trummer ◽  
Marlene Pandis ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cardiovascular Risk ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Disease Manifestation ◽  
Cross Sectional ◽  
Soluble St2 ◽  
Vitamin D Levels ◽  
Cardiovascular Biomarker

Objective Cardiovascular disease manifestation and several associated surrogate markers, such as vitamin D, have shown substantial seasonal variation. A promising cardiovascular biomarker, soluble ST2 (sST2), has not been investigated in this regard – we therefore determined if systemic levels of sST2 are affected by seasonality and/or vitamin D in order to investigate their clinical interrelation and usability. Design sST2 levels were measured in two cohorts involving hypertensive patients at cardiovascular risk, the Styrian Vitamin D Hypertension Trial (study A; RCT design, 8 weeks 2800 IU cholecalciferol daily) and the Ludwigshafen Risk and Cardiovascular Health Study (LURIC; study B; cross-sectional design). Methods The effects of a vitamin D intervention on sST2 levels were determined in study A using ANCOVA, while seasonality of sST2 levels was determined in study B using ANOVA. Results The concentrations of sST2 remained unchanged by a vitamin D intervention in study A, with a mean treatment effect (95% confidence interval) of 0.1 (−0.6 to 0.8) ng/mL; P = 0.761), despite a rise in 25(OH)D (11.3 (9.2–13.5) ng/mL; P < 0.001) compared to placebo. In study B, seasonal variations were present in 25(OH)D levels in men and women with or without heart failure (P < 0.001 for all subgroups), while sST2 levels remained unaffected by the seasons in all subgroups. Conclusions Our study provides the first evidence that systemic sST2 levels are not interrelated with vitamin D levels or influenced by the seasons in subjects at cardiovascular risk.

Association Between Erythrocyte Levels of n-3 Polyunsaturated Fatty Acids and Risk of Frailty in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study

2020 ◽  
Author(s):  
Doyeon Kim ◽  
Chang Won Won ◽  
Yongsoon Park
Keyword(s):  
Fatty Acids ◽  
Cohort Study ◽  
Polyunsaturated Fatty Acids ◽  
Cardiovascular Health ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Cross Sectional ◽  
Frailty Criterion ◽  
Long Chain

Abstract Background Inflammation is a major risk factor for frailty, but n-3 polyunsaturated fatty acids (PUFA) has been suggested as an anti-inflammatory agent. The present study aimed to investigate the hypothesis that the higher erythrocyte levels of long-chain n-3 PUFA were associated with lower odds of frailty and frailty criterion. Methods Cross-sectional analysis from the Korean Frailty and Aging Cohort Study, a total of 1,435 people aged 70–84 years were included. Sex- and age-stratified community residents, drawn in urban and rural regions nationwide, were eligible for participation in the study. All participants were categorized as frail and nonfrail according to the Cardiovascular Health Study index. Results The likelihood of frailty was inversely associated with the erythrocyte levels of eicosapentaenoic acid (EPA; odds ratio [OR] per unit 0.33; 95% confidence interval [CI] 0.14–0.77; p for trend = .002) and docosahexaenoic acid (DHA; OR per unit 0.42; 95% CI 0.20–0.87; p for trend = .018). Among each frailty criterion, the likelihood of slow walking speed was associated with erythrocyte levels of EPA and DHA, and the likelihood of exhaustion was inversely associated with the erythrocyte levels of DHA. Conclusions The present study showed that the frailty and frailty criterion were significantly associated with lower erythrocyte levels of long-chain n-3 PUFA, suggesting that lower n-3 PUFA could be a marker for the risk of frailty.

scholarly journals Hospitalization Rates in Older Adults With Albuminuria: The Cardiovascular Health Study

2020 ◽  
Vol 75 (12) ◽  
pp. 2426-2433 ◽  
Author(s):  
Joshua I Barzilay ◽  
Petra Buzkova ◽  
Michael G Shlipak ◽  
Nisha Bansal ◽  
Pranav Garimella ◽  
...  
Keyword(s):  
Older Adults ◽  
Rate Ratio ◽  
Regression Models ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Hospitalization Rates ◽  
Incident Rate Ratio ◽  
Increased Risk ◽  
Incident Rate

Abstract Background Albuminuria is highly prevalent among older adults, especially those with diabetes. It is associated with several chronic diseases, but its overall impact on the health of older adults, as measured by hospitalization, has not been quantified. Method We followed up 3,110 adults, mean age 78 years, for a median 9.75 years, of whom 654 (21%) had albuminuria (≥30 mg albumin/gram creatinine) at baseline. Poisson regression models, adjusted for cardiovascular, renal, and demographic factors, were used to evaluate the association of albuminuria with all-cause and cause-specific hospitalizations, as defined by ICD, version 9, categories. Results The rates of hospitalization per 100 patient-years were 65.85 for participants with albuminuria and 37.55 for participants without albuminuria. After adjustment for covariates, participants with albuminuria were more likely to be hospitalized for any cause than participants without albuminuria (incident rate ratio, 1.39 [95% confidence intervals, 1.27. 1.53]) and to experience more days in hospital (incident rate ratio 1.56 [1.37, 1.76]). The association of albuminuria with hospitalization was similar among participants with and without diabetes (adjusted incident rate ratio for albuminuria versus no albuminuria: diabetes 1.37 [1.11, 1.70], no diabetes 1.40 [1.26, 1.55]; p interaction nonsignificant). Albuminuria was significantly associated with hospitalization for circulatory, endocrine, genitourinary, respiratory, and injury categories. Conclusions Albuminuria in older adults is associated with an increased risk of hospitalization for a broad range of illnesses. Albuminuria in the presence or absence of diabetes appears to mark a generalized vulnerability to diseases of aging among older adults.

scholarly journals The Association Between Myocardial Strain and Frailty in the Cardiovascular Health Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 524-525
Author(s):  
Annabel Tan ◽  
Sanjiv J Shah ◽  
Jason Sanders ◽  
Bruce Psaty ◽  
Anne Newman ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Longitudinal Strain ◽  
Cardiovascular Health ◽  
Myocardial Strain ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Cross Sectional ◽  
Lv Ejection Fraction

Abstract Myocardial strain, measured by speckle tracking echocardiography (STE), is a novel measure of subclinical cardiovascular disease and may reflect myocardial aging. We aimed to explore the association between myocardial strain and frailty, a clinical syndrome of impaired resilience and lack of physiologic reserve. Frailty was defined in 4,042 participants of the Cardiovascular Health Study (CHS) as having 3 or more of the following clinical criteria: weakness, slowness, shrinking, exhaustion, and inactivity. We examined the cross-sectional and longitudinal associations of left ventricular (LV) longitudinal strain, LV early diastolic strain rate and left atrial reservoir strain with frailty in participants with no history of cardiovascular disease or heart failure at the time of echocardiography. In cross-sectional analyses, LV longitudinal strain, LV early diastolic strain, left atrial reservoir strain and LV ejection fraction (measured by conventional echocardiography) levels were lower (worse) among frail participants than among those who were not frail and pre-frail (p&lt;0.01). This association of LV longitudinal strain and frailty was robust to adjustment by LV ejection fraction (adjusted OR: 1.34, 95% CI: 1.20, 2.09). Conversely, LV ejection fraction was not associated with frailty after adjustment for LV longitudinal strain. In longitudinal analyses, LV longitudinal strain and LV early diastolic strain were associated with incident frailty (adjusted OR: 1.49, 95% CI: 1.07, 2.08) and 1.65, 95% CI: 1.15, 2.25, respectively). In community-dwelling older adults without prevalent cardiovascular disease, worse LV longitudinal strain, reflective of subclinical myocardial dysfunction, was associated with frailty independent of LV ejection fraction and other risk factors.

scholarly journals Association Between Activity Diversity and Frailty in Community-Dwelling Older Japanese: A Cross-Sectional Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 185-185
Author(s):  
Junta Takahashi ◽  
Shuichi Obuchi ◽  
Hisashi Kawai ◽  
Kaori Ishii ◽  
Koichiro Oka ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Cardiovascular Health ◽  
Economic Status ◽  
Japanese Version ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Cross Sectional ◽  
Indirect Contact

Abstract In addition to intensity and quality, diversity of activity will be an important factor to explain health outcomes among older adults. Few studies, though, examined an association between activity diversity and health outcomes. This study aimed to examine the association between activity diversity and frailty among community-dwelling older Japanese. Participants were community-dwelling older adults who participated in a cohort study, the “Otassya-Kenshin” in 2018 . The participants were asked frequency of 20 daily activities, inside/outside chores, leisure activities with/without physically, direct/indirect contact with friends and so on, in a week and activity diversity score were calculated using the formula of Shannon’s entropy. Frailty was defined by the Japanese version of the Cardiovascular Health Study criteria. The difference in diversity score between frail and non frail were examined by t-test. Logistic regression analysis with covariates, age, sex, economic status, living alone, BMI, Mini-Mental State Examination, and IADL was adopted to find association between activity diversity score and presence of frailty. Of 652 participants (age: 72.8±6.3, women: 60.6%) analyzed, 27 (4.1%) were defined as frail. Frailty group revealed significantly lower activity diversity score than non-frailty group (0.66±0.11 vs 0.75±0.08, P&lt;0.01). 0.2 point of decrease in diversity score increase 5 times chance of frailty after controlling covariates. We found significant relationship between activity diversity and health outcome among older subjects. The activity diversity may provide additional information to number or intensity of activity.

scholarly journals Variations in breast cancer surgical treatment and timing: determinants and disparities

2021 ◽  
Author(s):  
Irene Dankwa-Mullan ◽  
Judy George ◽  
M. Christopher Roebuck ◽  
Joseph Tkacz ◽  
Van C Willis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Models ◽  
Surgical Intervention ◽  
Breast Conserving Surgery ◽  
Clinical Factors ◽  
Cross Sectional ◽  
Icd 10 ◽  
Multivariable Regression ◽  
Multivariable Regression Models ◽  
Area Health

Abstract Purpose To describe clinical and non-clinical factors associated with receipt of breast conserving surgery (BCS) versus mastectomy and time to surgical intervention. Methods Cross-sectional retrospective study of January 1, 2012 through March 31, 2018 data from the IBM MarketScan Commercial Claims and Encounter and Medicare Supplemental Databases. Area Health Resource Files provided non-clinical characteristics and sociodemographic data. Eligibility: Female sex, claim(s) with ICD-9-CM or ICD-10-CM diagnosis of non-metastatic invasive breast cancer, > 6 months of continuous insurance pre- and post-diagnosis, evidence of BCS or mastectomy following initial ICD9/10 code diagnosis. Logistic and quantile multivariable regression models assessed the association between clinical and non-clinical factors and the outcome of BCS and time to surgery, respectively. Results A total of 53,060 women were included in the study. Compared to mastectomy, BCS was significantly associated with older age (ORs: 1.54 to 2.99, 95% CIs 1.45 to 3.38; ps < .0001) and higher community density of medical genetics (OR: 5.88, 95% CIs 1.38 to 25.00; p = 0.02) or obstetrics and gynecology (OR: 1.13, 95% CI 1.02 to 1.25; p = .02) physicians. Shorter time-to-BCS was associated with living in the South (−2.96, 95% CI −4.39 to −1.33; p < .0001). Longer time-to-BCS was associated with residence in more urban (4.18, 95% CI 0.08 to 8.29; p = 0. 05), educated (9.02, 95% CI 0.13 to 17.91; p = 0.05), or plastic-surgeon-dense (4.62, 95% CI 0.50 to 8.73; p = 0.03) communities. Conclusions Clinical and non-clinical factors are associated with adoption of BCS and time to treatment, suggesting opportunities to ensure equitable and timely care.

scholarly journals Coagulation factor VIII, white matter hyperintensities and cognitive function: Results from the Cardiovascular Health Study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242062
Author(s):  
Jessica L. Rohmann ◽  
W. T. Longstreth ◽  
Mary Cushman ◽  
Annette L. Fitzpatrick ◽  
Susan R. Heckbert ◽  
...  
Keyword(s):  
Cognitive Function ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Cardiovascular Health ◽  
Coagulation Factor ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Digit Symbol Substitution Test ◽  
Cross Sectional ◽  
Over Time

Objective To investigate the relationship between high FVIII clotting activity (FVIII:C), MRI-defined white matter hyperintensities (WMH) and cognitive function over time. Methods Data from the population-based Cardiovascular Health Study (n = 5,888, aged ≥65) were used. FVIII:C was measured in blood samples taken at baseline. WMH burden was assessed on two cranial MRI scans taken roughly 5 years apart. Cognitive function was assessed annually using the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST). We used ordinal logistic regression models adjusted for demographic and cardiovascular factors in cross-sectional and longitudinal WMH analyses, and adjusted linear regression and linear mixed models in the analyses of cognitive function. Results After adjustment for confounding, higher levels of FVIII:C were not strongly associated with the burden of WMH on the initial MRI scan (OR>p75 = 1.20, 95% CI 0.99–1.45; N = 2,735) nor with WMH burden worsening over time (OR>p75 = 1.18, 95% CI 0.87–1.59; N = 1,527). High FVIII:C showed no strong association with cognitive scores cross-sectionally (3MSE>p75 β = -0.06, 95%CI -0.45 to 0.32, N = 4,005; DSST>p75 β = -0.69, 95%CI -1.52 to 0.13, N = 3,954) or over time (3MSE>p75 β = -0.07,95% CI -0.58 to 0.44, N = 2,764; DSST>p75 β = -0.22, 95% CI -0.97 to 0.53, N = 2,306) after confounding adjustment. Interpretation The results from this cohort study of older adult participants indicate no strong relationships between higher FVIII:C levels and WMH burden or cognitive function in cross-sectional and longitudinal analyses.

TEA FOR ALZHEIMER PREVENTION

2015 ◽  
pp. 1-6
Author(s):  
L. Feng ◽  
M.-S. Chong ◽  
W.-S. Lim ◽  
T.-S. Lee ◽  
E.-H. Kua ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cardiovascular Health ◽  
Preventive Measure ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Future Research ◽  
Tea Consumption ◽  
Cross Sectional ◽  
Tea Drinking

The availability of empirical data from human studies in recent years have lend credence to the old axiomatic wisdom that health benefits of tea drinking extend to the area of cognition. Specifically, there is increasing interest as to whether tea drinking can delay or even prevent the onset of Alzheimer’s disease (AD). Data from several cross-sectional studies have consistently shown that tea drinking is associated with better performance on cognitive tests. This association is supported by longitudinal data from the Singapore Longitudinal Aging Study, the Chinese Longitudinal Healthy Longevity Survey and the Cardiovascular Health Study. The only two published longitudinal analyses on clinical outcome reported conflicting results: one study reported that mid-life tea drinking was not associated with risk reduction of Alzheimer’s disease in late life while the other one found that green tea consumption reduced the incidence of dementia or mild cognitive impairment. Two small trials from Korea and Japan reported encouraging but preliminary results. While the existing evidence precludes a definite conclusion as to whether tea drinking can be an effective and simple lifestyle preventive measure for AD, further research involving longer-term longitudinal studies and randomized controlled trials is clearly warranted to shed light on this topic of immense public health interest. Biological markers of tea consumption and Alzheimer diseases should be employed in future research to better delineate the underlying mechanisms of tea drinking’s protective effect on cognition.

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