scholarly journals Peak Expiratory Flow Predicts Incident Dementia in a U.S. Sample of Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 984-985
Author(s):  
Patrick Donahue ◽  
Qian-Li Xue ◽  
Michelle Carlson
Keyword(s):  
Older Adults ◽  
Peak Expiratory Flow ◽  
Respiratory Function ◽  
Public Health Problem ◽  
Future Research ◽  
Causal Pathways ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Expiratory Flow ◽  
Incident Cases

Abstract Dementia is an increasingly important public health problem with known vascular contributors. Respiratory function, measured by peak expiratory flow (PEF), may be a novel modifiable risk factor in reducing the risk of dementia along the vascular pathway. We investigated the association between PEF and incident dementia in older adults from the National Health and Aging Trends Study (NHATS). Using NHATS criteria, participants were categorized as having or not having probable incident dementia during NHATS Rounds 2-4, spanning three years. Of 3,622 participants with available PEF and covariate data, 543 (15.0%) had incident cases of dementia. Quartile of baseline PEF was analyzed as a predictor of incident dementia using logistic regression models, while controlling for several health and sociodemographic covariates. The fourth quartile of PEF had statistically significantly decreased odds of incident dementia when compared to the first PEF quartile (OR = 0.27; 95% CI [0.19, 0.40]). Significantly reduced odds of incident dementia were found when comparing the third and second PEF quartiles to the first PEF quartile, as well (OR = 0.35; 95% CI [0.26, 0.47] and OR = 0.62; 95% CI [0.48, 0.80], respectively). These relationships were dose-dependent so that increasing PEF quartile levels were more protective against incident dementia. PEF may be considered as an easily administered, low-cost measure of respiratory function and a possible screening tool for dementia risk. Improving PEF may reduce dementia risk through vascular mechanisms (e.g., increased blood circulation and brain oxygenation). Future research should explore these potential causal pathways between PEF and dementia.

Physical Performance Predictors for Incident Dementia Among Japanese Community-Dwelling Older Adults

2019 ◽  
Vol 99 (9) ◽  
pp. 1132-1140
Author(s):  
Takehiko Doi ◽  
Kota Tsutsumimoto ◽  
Sho Nakakubo ◽  
Min-Ji Kim ◽  
Satoshi Kurita ◽  
...  
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Grip Strength ◽  
Physical Performance ◽  
Performance Level ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Community Dwelling Older Adults

Abstract Background Evaluating physical performance could facilitate dementia risk assessment. However, findings differ regarding which type of physical performance best predicts dementia. Objective The objective of this study was to examine the association between physical performance and incidence of dementia in Japanese community-dwelling older adults. Design This was a prospective study of community-dwelling older adults. Methods Of 14,313 invited individuals who were ≥ 65 years old, 5104 agreed to participate from 2011 to 2012, and 4086 (52% women; mean age = 72.0 years) met the criteria. Baseline assessments of the following physical performance indicators were obtained: grip strength, the Five-Times Sit-to-Stand Test, and the Timed “Up & Go” Test. The physical performance level in each test was categorized as C1 (highest), C2 (middle–high), C3 (middle–low), or C4 (lowest) on the basis of sex-stratified quartile values. Incident dementia status was obtained from medical records that were updated monthly. Results During follow-up (mean duration = 42.9 months), there were 243 incident cases of dementia (5.9%). Log-rank test results indicated that a lower physical performance level constituted a significant risk factor for dementia. After adjustment for covariates, Cox proportional hazards models (reference: highest physical performance level [C1]) demonstrated that the Five-Times Sit-to-Stand Test in the group with the lowest physical performance level (hazard ratio = 1.69; 95% CI = 1.10–2.59) was significantly associated with a risk of dementia. Likewise, the Timed “Up & Go” Test in the group with the lowest physical performance level (hazard ratio = 1.54; 95% CI = 1.01–2.35) was significantly associated with a risk of dementia. However, grip strength was not significantly associated with a risk of dementia. Limitations This study was limited by the use of medical record data. Conclusions A lower mobility-related physical performance level was associated with dementia risk. Dementia risk assessment should include an adequate evaluation of physical function.

scholarly journals Illiteracy, dementia risk, and cognitive trajectories among older adults with low education

Neurology ◽  
2019 ◽  
Vol 93 (24) ◽  
pp. e2247-e2256 ◽  
Author(s):  
Miguel Arce Rentería ◽  
Jet M.J. Vonk ◽  
Gloria Felix ◽  
Justina F. Avila ◽  
Laura B. Zahodne ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Independent Effect ◽  
Growth Curve Models ◽  
Cox Proportional Hazards Models ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Low Education

ObjectiveTo investigate whether illiteracy was associated with greater risk of prevalent and incident dementia and more rapid cognitive decline among older adults with low education.MethodsAnalyses included 983 adults (≥65 years old, ≤4 years of schooling) who participated in a longitudinal community aging study. Literacy was self-reported (“Did you ever learn to read or write?”). Neuropsychological measures of memory, language, and visuospatial abilities were administered at baseline and at follow-ups (median [range] 3.49 years [0–23]). At each visit, functional, cognitive, and medical data were reviewed and a dementia diagnosis was made using standard criteria. Logistic regression and Cox proportional hazards models evaluated the association of literacy with prevalent and incident dementia, respectively, while latent growth curve models evaluated the effect of literacy on cognitive trajectories, adjusting for relevant demographic and medical covariates.ResultsIlliterate participants were almost 3 times as likely to have dementia at baseline compared to literate participants. Among those who did not have dementia at baseline, illiterate participants were twice as likely to develop dementia. While illiterate participants showed worse memory, language, and visuospatial functioning at baseline than literate participants, literacy was not associated with rate of cognitive decline.ConclusionWe found that illiteracy was independently associated with higher risk of prevalent and incident dementia, but not with a more rapid rate of cognitive decline. The independent effect of illiteracy on dementia risk may be through a lower range of cognitive function, which is closer to diagnostic thresholds for dementia than the range of literate participants.

scholarly journals Places of living and places of dying: the case for preventing suicide in residential long-term care

2020 ◽  
pp. 1-16
Author(s):  
Briony Jain ◽  
Viktoryia Kalesnikava ◽  
Joseph E. Ibrahim ◽  
Briana Mezuk
Keyword(s):  
Older Adults ◽  
Suicide Prevention ◽  
Residential Care ◽  
Long Term Care ◽  
Public Health Problem ◽  
Future Research ◽  
Term Care ◽  
The Impact ◽  
Residential Long Term Care

Abstract This commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders – societal, organisational and individual – considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.

scholarly journals Relationship between respiratory muscle strength and grip strength in institutionalized and community-dwelling older adults

2021 ◽  
Vol 15 ◽  
Author(s):  
Liliane de Faria Marcon ◽  
Ruth Caldeira de Melo ◽  
Francisco Luciano Pontes
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Peak Expiratory Flow ◽  
Respiratory Muscle ◽  
Community Dwelling ◽  
Inspiratory Pressure ◽  
Maximal Inspiratory Pressure ◽  
Maximal Expiratory Pressure ◽  
Expiratory Flow ◽  
Community Dwelling Older Adults

OBJECTIVE: To evaluate the relationship between respiratory muscle strength and grip strength in institutionalized and community-dwelling older adults. METHODS: This cross-sectional study had 64 voluntary participants, and 33 were institutionalized and 31 lived in the community. Maximal inspiratory pressure, maximal expiratory pressure, peak expiratory flow, grip strength, anthropometric data, and physical activity level were assessed. RESULTS: In the institutionalized group, there was no correlation between respiratory variables and grip strength, but maximal expiratory pressure was the respiratory predictor most strongly associated with grip strength (p = 0.04). In the community-dwelling group, there was a correlation between maximal inspiratory pressure and grip strength (r = 0.54), maximal expiratory pressure and grip strength (r = 0.62), and peak expiratory flow and grip strength (r = 0.64); peak expiratory flow and maximal expiratory pressure were the respiratory predictors most strongly associated with grip strength (p < 0.05). In a joint group analysis, there was an association between maximal inspiratory pressure and grip strength (r = 0.40), maximal expiratory pressure and grip strength (r = 0.57), and peak expiratory flow and grip strength (r = 0.57); peak expiratory flow and maximal expiratory pressure were the respiratory predictors most strongly associated with grip strength (p < 0.05). CONCLUSIONS: Peak expiratory flow and maximal expiratory pressure seem to be good predictors of grip strength in community-dwelling older adults, but this relationship does not seem to be maintained in institutionalized patients, possibly because of a greater loss of respiratory function.

scholarly journals Longitudinal Engagement in Modifiable Lifestyle Behaviors and Dementia Risk

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Roger Wong
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Proportional Hazards Model ◽  
Community Dwelling ◽  
Cox Proportional Hazards Model ◽  
Future Research ◽  
Lifestyle Behaviors ◽  
Sampling Weights ◽  
Social Contacts ◽  
Dementia Risk

Abstract Dementia is a major public health threat as there are currently no definitive methods to prevent, treat, and cure the disorder. Recent efforts have focused on modifiable lifestyle behaviors to reduce dementia risk. Yet, the majority of these studies have utilized cross-sectional data or are limited to specific geographic areas. The purpose of this study was to explore how longitudinal engagement in modifiable lifestyle behaviors (physical activity, smoking, and social contacts) influence dementia risk. This study analyzed eight annual waves (2011-2018) of prospective data from the National Health and Aging Trends Study, a large nationally representative U.S. sample of older adults. Each wave, physical activity was measured as engagement in vigorous physical activities; smoking was measured as current engagement in cigarette smoking; and social contacts was measured as visiting friends/family outside of their home. The dependent variable was number of years to a new dementia diagnosis. Multivariate analyses were conducted using the Cox proportional hazards model with survey sampling weights applied for a national sample of 6,800 community-dwelling older adults dementia-free at baseline. After controlling for sociodemographics (age, sex, race, etc.) and health (physical health, chronic disease, etc.), longitudinal engagement in physical activity significantly decreased dementia risk (Hazard Ratio [HR]=0.60, p&lt;.05), however, there was no significant relationship with smoking (HR=1.12, p=.58) and social contacts (1.06, p=.83). Our findings indicate physical activity is a promising modifiable lifestyle behavior for prevention. Future research should explore physical activity interventions that are most effective in reducing dementia risk, such as strength-based or aerobic-based activities.

scholarly journals GAMBARAN EFIKASI DIRI DAN PEAK EXPIRATORY FLOW RATE PASIEN PENYAKIT PARU OBSTRUKSI KRONIS (PPOK)

2019 ◽  
Vol 6 (1) ◽  
pp. 38-45
Author(s):  
Emdat Suprayitno ◽  
Azizah Khoiriyati ◽  
Titiek Hidayati
Keyword(s):  
Peak Expiratory Flow ◽  
Flow Rate ◽  
Self Efficacy ◽  
Peak Expiratory Flow Rate ◽  
Univariate Analysis ◽  
Public Health Problem ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Expiratory Flow

Background: Chronic obstructive pulmonary disease (COPD) has become a huge public health problem in the world. In Asy-Syaafi Hospital, COPD is the most commonly found disease after bcronchitis among the patients in out patient unit of lung desease. Self efficacy showed patients’ confidence in independently managing chronic desease. Wheter they want or not to start the treatment is determined by their self efficacy. Peak expiratory flow rate showed condition and problems of lung function and the narrowing or blockage of the airway. Objective: Identify conditions and problems on self efficacy and Peak expiratory flow rate of COPD patients in Asy-Syaafi Hospital Pamekasan, East Java. Method: This research was descriptive study used non analytic cross sectional design, with total sampling, involving 30 respondents. Data were collected with a questionnaire of the COPD self efficacy (CSES) and peak flow meter. Data analysis was performed with a univariate analysis. Results: Self efficacy was in low category with score less than 99 (86.7%) and peak expiratory flow rate was less than <50% of the PEF (90%). Conclusion: Most of COPD self efficacy in Asy-Syaafi Hospital Pamekasan were in not good category and peak expiratory flow rate contained in red zone or the occurrence of major constriction of the airways. Keywords: COPD, Self Eficacy, Peak Expiratory Flow Rate

scholarly journals Effect of Cigarette Smoking on Peak Expiratory Flow Rate

2020 ◽  
Vol 15 (2) ◽  
pp. 165-167
Author(s):  
Rubait Naznin ◽  
Akhtarun Nessa ◽  
Sayeda Nazrina
Keyword(s):  
Cigarette Smoking ◽  
Peak Expiratory Flow ◽  
Flow Rate ◽  
Peak Expiratory Flow Rate ◽  
Demographic Data ◽  
Public Health Problem ◽  
Chronic Obstructive ◽  
Cigarette Smokers ◽  
Group I ◽  
Expiratory Flow

Introduction: Cigarette smoking is an intractable public health problem that carries a threat to the health of the entire population. Smoking is a known risk factor for chronic obstructive pulmonary diseases, cardiovascular diseases, certain cancers especially lung cancer. Objectives:To assess the effect of cigarette smoking on peak expiratory flow rate (PEFR) among cigarette smokers and examine whether PEFR differs between cigarette smokers and non-smokers. Materials and Methods: This is cross-sectional comparative study was done for one year from July 2014 to June 2015. A total of 150 subjects were recruited from the medicine and allied outpatient departments of Mymensingh Medical College Hospital and Mymensingh locality. They are divided into 50 non-smokers (Group I) and 100 smokers (group II) with a duration of smoking 5-10 years (group IIA) and more than 10 years (Group IIB). PEFR was recorded by using Wright’s mini Peak flow meter. A questionnaire including demographic data was completed in all cases. The data were collected and analyzed using SPSS version 11.5. Results: Mean PEFR among non-smokers was 449.20±6.83 L/min whereas among smokers of 5-10 years duration(Group IIA) and above 10 years duration (Group IIB),  it was 301.20±2.17 L/min and 297.80±2.54 L/min respectively. Mean PEFR values were significantly lower in smokers than non-smokers of both groups. Conclusion: Cigarette smoking has deleterious effects on lung function causing a significant reduction of PEFR in smokers compared to nonsmokers. Coordinated national strategies for tobacco prevention, cessation, and control are essential for the establishment of a smoke-free environment. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 165-167

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