scholarly journals Loneliness, Social Isolation and All-Cause Mortality in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 925-925
Author(s):  
Timothy Barnes ◽  
Rifky Tkatch ◽  
Manik Ahuja ◽  
Laurie Albright ◽  
James Schaeffer ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Regression Models ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Risk Of Mortality ◽  
The Social ◽  
All Cause Mortality ◽  
Using Data

Abstract As distinct constructs, loneliness and social isolation have both been associated with mortality in older adults. Many studies have examined each construct separately; however, few have examined their impact together, especially within the U.S. Using data from a large sample of U.S. adults age 65+ (N=7,982), the effect of loneliness and social isolation on all-cause mortality was examined considering their separate and joint effects. Measures were based on the UCLA-3 Loneliness Scale and the Social Network Index (SNI). Loneliness was categorized as: Severe, moderate, or no loneliness. Social isolation (defined by the SNI) was categorized as: Limited, medium, or diverse social networks (SN). Cox proportional hazards regression models were performed. Among participants, there were 328 deaths after data collection (4.1%). In separate, adjusted models, loneliness (severe, HR=1.86, 95% CI: 1.43-2.41 and moderate, HR=1.51, 95% CI: 1.16-1.98) and social isolation (limited SN, HR=2.37, 95% CI: 1.72-3.27 and moderate SN, HR=1.55, 95% CI: 1.12-2.14) were both associated with mortality. Modeled together, loneliness (severe, HR=1.55, 95% CI: 1.18-2.04 and moderate, HR=1.40, 95% CI: 1.07-1.83) and social isolation (limited SN, HR=2.08, 95% CI: 1.49-2.89 and moderate SN, HR=1.46, 95% CI: 1.05-2.02) both remained significantly associated with all-cause mortality with limited SN as the stronger indicator. Results demonstrate that both loneliness and social isolation contribute to greater risk of mortality among older adults. Furthermore, individuals with limited SN are at greatest risk. As the COVID-19 pandemic continues, loneliness and social isolation should be targeted safely in efforts to reduce mortality risk among older adults.

scholarly journals Impact of the Changes in the Frequency of Social Participation on All-Cause Mortality in Japanese Older Adults: A Nationwide Longitudinal Study

2021 ◽  
Vol 19 (1) ◽  
pp. 270
Author(s):  
Keiichi Shimatani ◽  
Mayuko T. Komada ◽  
Jun Sato
Keyword(s):  
Older Adults ◽  
Social Participation ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Japanese Older Adults ◽  
The Impact

Previous studies have shown that more frequent social participation was associated with a reduced risk of mortality. However, limited studies have explored the changes in the frequency of social participation in older adults. We investigated the impact of the changes in the frequency of social participation on all-cause mortality in Japanese older adults aged 60 years and older. The current study, conducted as a secondary analysis, was a retrospective cohort study using open available data. The participants were 2240 older adults (45.4% male and 54.6% female) sampled nationwide from Japan who responded to the interview survey. Changes in the frequency of social participation were categorized into four groups (none, initiated, decreased, and continued pattern) based on the responses in the baseline and last surveys. The Cox proportional-hazards model showed a decreased risk of all-cause mortality in decreased and continued patterns of social participation. Stratified analysis by sex showed a decreased risk of mortality in the continued pattern only among males. The results of the current study suggest that the initiation of social participation at an earlier phase of life transition, such as retirement, may be beneficial for individuals.

scholarly journals The Association between Noise Exposure and Metabolic Syndrome: A Longitudinal Cohort Study in Taiwan

2020 ◽  
Vol 17 (12) ◽  
pp. 4236 ◽  
Author(s):  
Tao Huang ◽  
Ta-Chien Chan ◽  
Ying-Jhen Huang ◽  
Wen-Chi Pan
Keyword(s):  
Metabolic Syndrome ◽  
Regression Models ◽  
Noise Exposure ◽  
Proportional Hazards ◽  
Traffic Noise ◽  
Noise Pollution ◽  
Cox Proportional Hazards ◽  
High Noise ◽  
Proportional Hazards Regression ◽  
Using Data

Metabolic syndrome is becoming more common worldwide. Studies suggest environmental pollution, including traffic noise, might be linked with metabolic syndrome. This study sought to evaluate how noise exposure is linked to the development of metabolic syndrome and its components in Taiwan. Using data from a cohort of 42,509 participants and Cox proportional hazards regression models, the effects of noise exposure on metabolic syndrome and its components were quantified. After adjustment for covariates (age, gender, body mass index, and physical activity), the hazard ratio for metabolic syndrome was 1.13 (95% CI: 1.04–1.22) for medium noise exposure and 1.24 (95% CI: 1.13–1.36) for high noise exposure. Noise exposure was also positively associated with all of metabolic syndrome’s components. This finding suggests noise exposure might contribute to metabolic syndrome and its components. Policies aiming to reduce noise pollution might reduce the risks of metabolic syndrome and its components.

scholarly journals Cardiorespiratory Fitness without Exercise Testing Can Predict All-Cause Mortality Risk in a Representative Sample of Korean Older Adults

2019 ◽  
Vol 16 (9) ◽  
pp. 1633 ◽  
Author(s):  
Moongu Song ◽  
Inhwan Lee ◽  
Hyunsik Kang
Keyword(s):  
Older Adults ◽  
Cardiorespiratory Fitness ◽  
Exercise Testing ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Geriatric Population ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Using Data

This study examined the association between cardiorespiratory fitness (CRF) without exercise testing and all-cause mortality in Korean older adults. The present study was carried out using data from the 2008 and 2011 Living Profiles of Older People Survey. A total of 14,122 participants aged 60 years and older (57% women) completed the 2008 baseline and 2011 follow-up assessments (i.e., socioeconomic status, health behaviors and conditions, and prevalence of chronic diseases), and they were included for the final analyses. CRF was estimated (eCRF) with sex-specific algorithms and classified as lower (lowest 25%), middle (middle 50%), and upper (highest 25%). Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) across eCRF categories. In total, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.059 (0.814~1.378) for the middle eCRF group, and 1.714 (1.304~2.253) for the lower eCRF group. In men, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.011 (0.716~1.427) for the middle eCRF group, and 1.566 (1.098~2.234) for the lower eCRF group. In women, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.064 (0.707~1.602) for the middle eCRF group, and 1.599 (1.032~2.478) for the lower eCRF group. The current findings suggest that eCRF may have an independent predictor of all-cause mortality, underscoring the importance of promoting physical activity to maintain a healthful level of CRF in Korean geriatric population.

scholarly journals The Association Between Triglyceride-Glucose Index, Cardio-Cerebrovascular Diseases, and Death in Korean Adults: A Longitudinal Study Based on the NHIS-HEALS Cohort

2021 ◽  
Author(s):  
Joungyoun Kim ◽  
Sang-jun Shin ◽  
Hee-Taik Kang
Keyword(s):  
Regression Models ◽  
Proportional Hazards ◽  
Cerebrovascular Diseases ◽  
Cox Proportional Hazards ◽  
Men And Women ◽  
Tyg Index ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Triglyceride Glucose Index ◽  
All Cause Mortality

Abstract Background: The triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance. We aimed to investigate the TyG index in relation to cardio-cerebrovascular diseases (CCVDs) and mortality.Methods: This retrospective study included 114,603 subjects. The TyG index was categorized into four quartile groups by sex: Q1, <8.249 and <8.063; Q2, 8.249 ‒ <8.614 and 8.063 ‒ <8.403; Q3, 8.614 ‒ < 8.998 and 8.403 ‒ <8.752; and Q4, ≥8.998 and ≥8.752, in men and women, respectively. To calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the primary outcomes (CCVDs and all-cause mortality), Cox proportional hazards regression models were adopted.Results: Compared to Q1, fully adjusted HRs (95% CIs) for the primary outcomes of Q2, Q3, and Q4 were 1.063 (0.982‒1.152), 1.112 (1.026‒1.206), and 1.153 (1.060‒1.254) in men and 1.099 (0.986‒1.226), 1.049 (0.941‒1.169), and 1.069 (0.960‒1.190) in women, respectively. HRs (95% CIs) for cardiovascular diseases (CVDs) of Q2, Q3, and Q4 were 1.117 (0.971‒1.285), 1.191 (1.036‒1.369), and 1.237 (1.071‒1.427) in men and 1.239 (1.018‒1.509), 1.188 (0.976‒1.446), and 1.248 (1.027‒1.517) in women, respectively. Conclusions: The elevated TyG index were was positively associated with CCVDs and all-cause mortality in men and predicted the higher risk of CVDs in both sexes.

Co-existence of social isolation and homebound status increase the risk of all-cause mortality

2018 ◽  
Vol 31 (5) ◽  
pp. 703-711 ◽  
Author(s):  
Ryota Sakurai ◽  
Masashi Yasunaga ◽  
Mariko Nishi ◽  
Taro Fukaya ◽  
Masami Hasebe ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Proportional Hazards ◽  
Later Life ◽  
Cox Proportional Hazards ◽  
Face To Face ◽  
All Cause Mortality ◽  
Socially Isolated ◽  
The Impact

ABSTRACTBackground:Social isolation and homebound statuses are possible risk factors for increased mortality among older adults. However, no study has addressed the impact of accumulation of these two factors on mortality. The aim of this study was to examine whether such accumulation increased the risk of all-cause mortality.Methods:The analyzed sample was drawn from a mail survey of 1,023 older adults without instrumental activities of daily living disability. Participants were classified into four groups according to the frequency of both face-to-face and non-face-to-face interactions with others (social isolation and non-social isolation) and the frequency of going outdoors (homebound and non-homebound). Social isolation and homebound statuses were defined as having a social interaction less than once a week and going outdoors either every few days or less, respectively. All-cause mortality information during a six-year follow-up was obtained.Results:In total, 78 (7.6%) participants were both socially isolated and homebound. During the follow-up period, 65 participants died, with an overall mortality rate of 10.6 per 1000 person-years. Cox proportional hazards regression analyses demonstrated that older adults who were socially isolated and homebound showed a significantly higher risk of subsequent all-cause mortality compared with healthy adults who were neither socially isolated nor homebound, independent of potential covariates (aHR, 2.19; 95% CI: 1.04–4.63).Conclusion:Our results suggest that the co-existence of social isolation and homebound statuses may synergistically increase risk of mortality. Both active and socially integrated lifestyle in later life might play a major role in maintaining a healthy status.

scholarly journals Low hemoglobin levels and an increased risk of psoriasis in patients with chronic kidney disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Si-Hyung Lee ◽  
Miri Kim ◽  
Kyung-Do Han ◽  
Ji Hyun Lee
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Regression Models ◽  
Proportional Hazards ◽  
Surrogate Marker ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Increased Risk ◽  
Using Data

AbstractChronic diseases, such as chronic kidney disease (CKD), are frequently accompanied by various comorbidities, including anemia, which is considered a surrogate marker of systemic inflammation. Psoriasis is a chronic inflammatory skin disease prevalent in patients with chronic disease. Psoriasis risk in patients with CKD, however, especially in patients with low hemoglobin levels, has never been investigated. In this study, we investigated associations between low hemoglobin levels and psoriasis in patients with CKD using data from the National Health Insurance Service of Korea. During a mean follow-up period of 6.16 ± 1.02 years, psoriasis was recorded in 13,803 patients with CKD (2.39% of CKD patients). The cumulative incidence of psoriasis was significantly higher in CKD patients with anemia (hemoglobin levels < 13 g/dL in men and < 12 g/dL in women) than those without. In multivariate-adjusted Cox proportional hazards regression models, the risk of psoriasis was significantly higher in anemic CKD patients than nonanemic CKD patients (hazard ratio [HR] 1.136, 95% CI 1.089–1.185, p < 0.001). Additionally, we noted that the incidence of psoriasis decreased with increasing hemoglobin levels in CKD patients (HR 0.953, 95% CI 0.942–0.965, p < 0.001). Altogether, our findings indicate that low hemoglobin levels are significantly related to psoriasis risk in patients with CKD. Further study is required to elucidate whether low hemoglobin levels have an impact on the development of psoriasis or are merely a surrogate marker of psoriasis risk in patients with CKD.

scholarly journals Quantitative assessment of erector spinae muscles and prognosis in elderly patients with pneumonia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroki Yoshikawa ◽  
Kosaku Komiya ◽  
Takashi Yamamoto ◽  
Naoko Fujita ◽  
Hiroaki Oka ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hospital Mortality ◽  
Regression Models ◽  
Proportional Hazards ◽  
Community Acquired Pneumonia ◽  
Cox Proportional Hazards ◽  
Erector Spinae ◽  
Cross Sectional ◽  
Proportional Hazards Regression ◽  
Survivor Group

AbstractErector spinae muscle (ESM) size has been reported as a predictor of prognosis in patients with some respiratory diseases. This study aimed to assess the association of ESM size on all-cause in-hospital mortality among elderly patients with pneumonia. We retrospectively included patients (age: ≥ 65 years) admitted to hospital from January 2015 to December 2017 for community-acquired pneumonia who underwent chest computed tomography (CT) on admission. The cross-sectional area of the ESM (ESMcsa) was measured on a single-slice CT image at the end of the 12th thoracic vertebra and adjusted by body surface area (BSA). Cox proportional hazards regression models were used to assess the influence of ESMcsa/BSA on in-hospital mortality. Among 736 patients who were admitted for pneumonia, 702 patients (95%) underwent chest CT. Of those, 689 patients (98%) for whom height and weight were measured to calculate BSA were included in this study. Patients in the non-survivor group were significantly older, had a greater frequency of respiratory failure, loss of consciousness, lower body mass index, hemoglobin, albumin, and ESMcsa/BSA. Multivariate analysis showed that a lower ESMcsa/BSA independently predicted in-hospital mortality after adjusting for these variables. In elderly patients with pneumonia, quantification of ESMcsa/BSA may be associated with in-hospital mortality.

scholarly journals Nonfatal Stroke and All-Cause Mortality among Community-Dwelling Older Adults Living in Rural Ecuador: A Population-Based, Prospective Study

2018 ◽  
Vol 09 (04) ◽  
pp. 551-555
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Victor J. Del Brutto
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Rural Setting ◽  
Nonfatal Stroke ◽  
All Cause Mortality ◽  
History Of ◽  
Univariate Analyses

ABSTRACT Background: Stroke is a leading cause of disability in developing countries. However, there are no studies assessing the impact of nonfatal strokes on mortality in rural areas of Latin America. Using a population-based, prospective cohort study, we aimed to assess the influence of nonfatal strokes on all-cause mortality in older adults living in an underserved rural setting. Methods: Deaths occurring during a 5-year period in Atahualpa residents aged ≥60 years were identified from overlapping sources. Tests for equality of survivor functions were used to estimate differences between observed and expected deaths for each covariate investigated. Cox proportional hazards models were used to estimate Kaplan–Meier survival curves of variables reaching significance in univariate analyses. Results: Of 437 individuals enrolled over 5 years, follow-up was achieved in 417 (95%), contributing 1776 years of follow-up (average 4.3 ± 1.3 years). Fifty-one deaths were detected, for an overall cumulative 5-year mortality rate of 12.2% (8.9%–15.6%). Being older than 70 years of age, having poor physical activity, edentulism, and history of a nonfatal stroke were related to mortality in univariate analyses. A fully adjusted Cox proportional hazards model showed that having history of a nonfatal stroke (P = 0.024) and being older than 70 years of age (P = 0.031) independently predicted mortality. In contrast, obesity was inversely correlated with mortality (P = 0.047). Conclusions: A nonfatal stroke and increasing age increase the risk of all-cause mortality in inhabitants of a remote rural village. The body mass index is inversely related to death (obesity paradox).

scholarly journals Kidney Clearance of Secretory Solutes Is Associated with Progression of CKD: The CRIC Study

2020 ◽  
Vol 31 (4) ◽  
pp. 817-827 ◽  
Author(s):  
Yan Chen ◽  
Leila R. Zelnick ◽  
Ke Wang ◽  
Andrew N. Hoofnagle ◽  
Jessica O. Becker ◽  
...  
Keyword(s):  
Kynurenic Acid ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Ckd Progression ◽  
Glomerular Function ◽  
Additional Information ◽  
Proportional Hazards Regression ◽  
All Cause Mortality ◽  
Liquid Chromatography Tandem Mass ◽  
Urine Concentrations

BackgroundThe secretion of organic solutes by the proximal tubules is an essential intrinsic kidney function. However, the clinical significance of the kidney’s clearance of tubular secretory solutes is uncertain.MethodsIn this prospective cohort study, we evaluated 3416 participants with CKD from the Chronic Renal Insufficiency Cohort (CRIC) study. We measured plasma and 24-hour urine concentrations of endogenous candidate secretory solutes at baseline, using targeted liquid chromatography–tandem mass spectrometry. The study defined CKD progression by a ≥50% decline in the eGFR, initiation of maintenance dialysis, or kidney transplantation. We used Cox proportional hazards regression to test associations of secretory-solute clearances with CKD progression and mortality, adjusting for eGFR, albuminuria, and other confounding characteristics.ResultsParticipants in this ancillary study had a mean age of 58 years and 41% were black; the median eGFR was 43 ml/min per 1.73 m2. After adjustment, lower kidney clearances of six solutes—kynurenic acid, pyridoxic acid, indoxyl sulfate, xanthosine, isovalerylglycine, and cinnamoylglycine—were associated with significantly greater risks of CKD progression, with clearance of kynurenic acid, a highly protein-bound solute, having the strongest association. Lower clearances of isovalerylglycine, tiglylglycine, hippurate, and trimethyluric acid were significantly associated with all-cause mortality after adjustment.ConclusionsWe found lower kidney clearances of endogenous secretory solutes to be associated with CKD progression and all-cause mortality, independent of eGFR and albuminuria. This suggests that tubular clearance of secretory solutes provides additional information about kidney health beyond measurements of glomerular function alone.

Effect of HPV Status on Survival of Oropharynx Cancer with Distant Metastasis

2020 ◽  
Vol 163 (2) ◽  
pp. 372-374 ◽  
Author(s):  
Adam W. Kaplon ◽  
Thomas J. Galloway ◽  
Mihir K. Bhayani ◽  
Jeffrey C. Liu
Keyword(s):  
Distant Metastasis ◽  
Survival Data ◽  
Regression Models ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
National Cancer Database ◽  
Proportional Hazards Regression ◽  
Kaplan Meier ◽  
Hpv Status ◽  
Oropharynx Squamous Cell Carcinoma

Human papillomavirus (HPV)–positive oropharynx squamous cell carcinoma (OPSCC) is known to have improved survival over HPV-negative disease. However, it is largely unknown whether HPV status similarly affects survival in patients presenting with distant metastatic disease. We queried the National Cancer Database for OPSCC with distant metastasis. Kaplan-Meier curves and Cox proportional hazards regression models controlling for relevant demographics were used to evaluate overall survival. In total, 768 OPSCC cases were available for analysis with HPV and survival data: 50% of cases were HPV negative and 50% were HPV positive. The 1- and 2-year survival for HPV-negative disease was 49% and 27%, respectively, as compared with 67% and 42% in the HPV-positive cohort. HPV positivity was associated with improved median survival in treated and untreated patients. Age, comorbidities, and HPV status were predictive of improved survival on multivariate analysis. HPV-positive OPSCC has improved survival in the setting of distant metastatic presentation as compared with HPV-negative disease and shows greater responsiveness to treatment.

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