scholarly journals NIA HEALTH DISPARITIES RESEARCH NETWORK: APPROACHES AND FINDINGS FROM GERIATRICS AND CLINICAL GERONTOLOGY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S13-S13
Author(s):  
Lyndon Joseph ◽  
CarlV Hill
Keyword(s):  
Health Disparities ◽  
Life Expectancy ◽  
Research Network ◽  
Imaging Biomarkers ◽  
Sociocultural Factors ◽  
Multiple Chronic Conditions ◽  
Structural Level ◽  
Biological Mechanisms ◽  
Age Related ◽  
Reduce Life Expectancy

Abstract Health disparities are differences in the incidence, prevalence and burden of diseases, mortality rates and causes of death that exist among population groups. Health disparities are associated with a broad, complex, and interrelated array of factors that influence health, accelerate aging and reduce life expectancy. NIA’s health disparities research goals are to understand environmental and sociocultural factors and related behavioral and biological mechanisms that diminish health and reduce life expectancy for vulnerable populations, explore the biological mechanisms through which disparities influence age-related change, and identify where disparities emerge in diagnosis, prognosis or treatment in geriatric conditions. Presentations will focus on whether structural-level discrimination may be a key factor in potentiating well known race-related health disparities especially those with an accelerated onset and may be associated with MRI-indicators of subclinical brain pathology; identifying biomarkers for early detection of cognitive and functional decline in high risk subpopulations and how ethnicity influences cerebral spinal fluid and imaging biomarkers link to early identification of cognitive and functional impairment ; effects of medication management and deprescribing among African American and Hispanic older adults with Alzheimer’s disease and related dementias and multiple chronic conditions; examine the use of multi-level factors and technology to overcome the barriers to urban-rural health disparities in managing many chronic diseases such as hepatitis C virus infection and delivery of appropriate medical services; and understanding the racial and ethnic differences in the link between environmental exposures and auto-immune comorbid asthma.

Disparities in Health Between Black and White Americans: Current Knowledge and Directions for Future Research

2018 ◽  
pp. 456-478
Author(s):  
Thomas E. Fuller-Rowell ◽  
David S. Curtis ◽  
Adrienne M. Duke
Keyword(s):  
Health Disparities ◽  
Current Knowledge ◽  
Public Investment ◽  
The United States ◽  
Future Research ◽  
Sociocultural Factors ◽  
White Americans ◽  
Biological Mechanisms ◽  
Black And White ◽  
Racial Ethnic

Conceptual frameworks for racial/ethnic health disparities are abundant, but many have received insufficient empirical attention. As a result, there are substantial gaps in scientific knowledge and a range of untested hypotheses. Particularly lacking is specificity in behavioral and biological mechanisms for such disparities and their underlying social determinants. Alongside lack of political will and public investment, insufficient clarity in mechanisms has stymied efforts to address racial health disparities. Capitalizing on emergent findings from the Midlife in the United States (MIDUS) study and other longitudinal studies of aging, this chapter evaluates research on health disparities between black and white US adults. Attention is given to candidate behavioral and biological mechanisms as precursors to group differences in morbidity and mortality and to environmental and sociocultural factors that may underlie these mechanisms. Future research topics are discussed, emphasizing those that offer promise with respect to illuminating practical solutions to racial/ethnic health disparities.

scholarly journals Health Disparities Scientific Research in the Division of Geriatrics and Clinical Gerontology

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 363-364
Author(s):  
Lyndon Joseph
Keyword(s):  
Health Disparities ◽  
Large Data ◽  
Research Area ◽  
Population Diversity ◽  
Future Research ◽  
Multiple Chronic Conditions ◽  
Research Areas ◽  
Area Of Interest ◽  
Age Related ◽  
Clinical Gerontology

Abstract The Division of Geriatrics and Clinical Gerontology (DGCG) supports clinical and translational research on health and disease in the aged, and research on aging over the human lifespan, including its relationships to health outcomes. Key areas include development of new interventions for age-related conditions and pathologies, prevention and treatment of multiple chronic conditions, geriatric palliative care, factors influencing the progression of chronic diseases over the life span, and predictive markers of aging that may inform potential interventions for extension of health span. Population diversity and health disparities are critical aspects of science that cut across DGCG research areas. This presentation will highlight several examples of DGCG-supported studies related to health disparities and discuss potential future research directions. One potential upcoming research area of interest involves leveraging large data sets to examine disparities in risks and benefits of long-term osteoporosis drug therapy and drug holidays according to racial and ethnic groupings

Endokrinológiai tényezők és metabolikus folyamatok szerepe az élettartam szabályozásában

2021 ◽  
Vol 162 (33) ◽  
pp. 1318-1327
Author(s):  
Tamás Halmos ◽  
Ilona Suba
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Life Expectancy ◽  
Significant Risk ◽  
Low Grade ◽  
Aging Effects ◽  
Protective Function ◽  
Beneficial Effects ◽  
Age Related

Összefoglaló. Az emberek a lehető leghosszabb ideig akarnak élni, jó egészségben. Ha kiküszöbölnénk a kedvezőtlen külső körülményeket, a várható élettartam meghaladhatná a 100 évet. A 20. és 21. században a jóléti társadalmakban a várható élettartam jelentősen megnőtt, így Magyarországon is. Az áttekintett irodalom alapján megvizsgáltuk, hogy a genetika és az öröklődés mellett milyen endokrinológiai és metabolikus tényezők játszanak szerepet az élet meghosszabbításában. Megvizsgáltunk minden endogén tényezőt, amely pozitívan vagy negatívan befolyásolhatja az életkorral összefüggő betegségeket (Alzheimer-kór, szív- és érrendszeri betegségek, rák) és az élettartamot. Kiemeltük a hyperinsulinaemia, az inzulinrezisztencia, a metabolikus szindróma öregedést gyorsító hatását, az inzulinszerű növekedési hormon-1 ellentmondásos szerepét, valamint az élet meghosszabbításában részt vevő, újabban felfedezett peptideket, mint a klotho és a humanin. Ismertettük a mitochondriumok szerepét az élettartam meghatározásában, bemutattuk a mitohormesis folyamatát és annak stresszvédő funkcióját. Bemutattuk a rapamicin célszervét, az mTOR-t, amelynek gátlása meghosszabbítja az élettartamot, valamint a szirtuinokat. Kitértünk az autophagia folyamatára, és ismertettük a szenolitikumok szerepét az öregedésben. Az időskori autoimmunitás csökkenése hozzájárul az élettartam rövidüléséhez, utaltunk a thymus koordináló szerepére. Kiemeltük a bélmikrobiom fontos szerepét az élettartam szabályozásában. Hivatkoztunk a „centenáriusok” megfigyeléséből nyert humánadatokra. Megvizsgáltuk, milyen beavatkozási lehetőségek állnak rendelkezésre az egészségben tölthető élettartam meghosszabbításához. Az életmódbeli lehetőségek közül kiemeltük a kalóriabevitel-csökkentés és a testmozgás jótékony szerepét. Megvizsgáltuk egyes gyógyszerek feltételezett hatásait. Ezek közé tartozik a metformin, az akarbóz, a rezveratrol. E gyógyszerek mindegyikének hatása hasonló a kalóriamegszorításéhoz. Nincs olyan „csodaszer”, amely igazoltan meghosszabbítja az élettartamot emberben. Egyes géneknek és génmutációknak jótékony hatásuk van, de ezt környezeti tényezők, betegségek, balesetek és más külső ártalmak módosíthatják. Kiemeljük az elhízás, az alacsony fokozatú gyulladás és az inzulinrezisztencia öregedésre gyakorolt gyorsító hatását. A metabolikus szindróma elterjedtsége miatt ez jelentős népegészségügyi kockázatot jelent. Az inzulin, a növekedési hormon és az inzulinszerű növekedési faktorok hatásainak értékelése továbbra is ellentmondásos. Az egészséges, szellemileg és fizikailag aktív életmód, a kalóriacsökkentés mindenképpen előnyös. Az életet meghosszabbító szerek értékelése még vitatott. Orv Hetil. 2021; 162(33): 1318–1327. Summary. People want to live as long as possible in good health. If we eliminate the unfavorable external conditions, the life expectancy could exceed 100 years. In the 20th and 21th centuries, life expectancy in welfare societies increased significantly, including in Hungary. Based on the reviewed literature, we examined what endocrinological and metabolic factors play a role in prolonging life in addition to genetics and inheritance. We examined all endogenous factors that can positively or negatively affect age-related diseases (Alzheimer’s disease, cardiovascular disease, cancer) and longevity. We highlighted the aging effects of hyperinsulinemia, insulin resistance, metabolic syndrome, the controversial role of insulin-like growth factor-1, and more recently discovered peptides involved in prolonging lifespan, such as klotho and humanin. We described the role of mitochondria in determining longevity, we demonstrated the process of mitohormesis and its stress-protective function. We presented the target organ of rapamycin, mTOR, the inhibition of which prolongs lifespan, as well as sirtuins. We covered the process of autophagy and described the role of senolytics in aging. The decrease in autoimmunity in old age contributes to the shortening of life expectancy, we referred to the coordinating role of the thymus. We highlighted the important role of intestinal microbiome in the regulation of longevity. We referred to human data obtained from observations on “centenarians”. We examined what intervention options are available to prolong healthy life expectancy. Among the lifestyle options, we highlighted the beneficial role of calorie reduction and exercise. We examined the putative beneficial effects of some drugs. These include metformin, acarbose, resveratrol. The effect of each of these drugs is similar to calorie restriction. There is no “miracle cure” that has been shown to prolong life-span in humans. Some genes and gene mutations have beneficial effects, but this can be modified by environmental factors, diseases, accidents, and other external harms. We highlight the accelerating effects of obesity, low-grade inflammation, and insulin resistance on aging. Due to the prevalence of metabolic syndrome, this poses a significant risk to public health. The assessment of the effects of insulin, growth hormone, and insulin-like growth factors remains controversial. A healthy, mentally and physically active lifestyle, calorie reduction is definitely beneficial. The evaluation of life-prolonging agents is still controversial. Orv Hetil. 2021; 162(33): 1318–1327.

scholarly journals An FQHC Research Network in Oral Health: Enhancing the Workforce and Reducing Disparities

2007 ◽  
Vol 122 (5) ◽  
pp. 592-601 ◽  
Author(s):  
Christine A. Riedy ◽  
Kiet A. Ly ◽  
Vickie Ybarra ◽  
Peter Milgrom
Keyword(s):  
Health Disparities ◽  
Oral Health ◽  
Care Delivery ◽  
Medical Science ◽  
Safety Net ◽  
Health Centers ◽  
Research Network ◽  
Dental Staff ◽  
Practice Based Research ◽  
Improve Health Care Delivery

Federally Qualified Health Centers (FQHCs) contribute greatly to reducing health disparities by providing care to underserved communities. Yet these safety-net clinics face chronic manpower shortages and turnover. Practice-Based Research Networks aid in translating medical science from bench to clinical practice. These networks have been used to understand and improve health-care delivery and reduce disparities. Initiatives to strengthen lagging translational research in dentistry have begun, but there is no FQHC research network that addresses oral health. This article reviews the potential for, and outlines a model of, an Oral Health FQHC Research Network. It characterizes the needs for an FQHC research network, describes a successful FQHC research-oriented program, and outlines an Oral Health FQHC Research Network conceptual model. It argues that strengthening FQHCs through involvement of their dental staff in clinical research may enhance their jobs, draw staff closer to the community, and strengthen their ability to reduce health disparities.

scholarly journals Inverse Correlation Between Alzheimer’s Disease and Cancer: Short Overview

2021 ◽  
Author(s):  
Agnieszka Zabłocka ◽  
Wioletta Kazana ◽  
Marta Sochocka ◽  
Bartłomiej Stańczykiewicz ◽  
Maria Janusz ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Kinase Inhibitor ◽  
Fungal Infections ◽  
Neurological Diseases ◽  
Inverse Correlation ◽  
Biological Mechanisms ◽  
Age Related ◽  
Common Risk Factors

AbstractThe negative association between Alzheimer’s disease (AD) and cancer suggests that susceptibility to one disease may protect against the other. When biological mechanisms of AD and cancer and relationship between them are understood, the unsolved problem of both diseases which still touches the growing human population could be overcome. Actual information about biological mechanisms and common risk factors such as chronic inflammation, age-related metabolic deregulation, and family history is presented here. Common signaling pathways, e.g., p53, Wnt, role of Pin1, and microRNA, are discussed as well. Much attention is also paid to the potential impact of chronic viral, bacterial, and fungal infections that are responsible for the inflammatory pathway in AD and also play a key role to cancer development. New data about common mechanisms in etiopathology of cancer and neurological diseases suggests new therapeutic strategies. Among them, the use of nilotinib, tyrosine kinase inhibitor, protein kinase C, and bexarotene is the most promising.

Genitourinary syndrome of menopause: a modern approach to treatment

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 16-20
Author(s):  
Madina I. Mazitova ◽  
Rezeda R. Mardieva
Keyword(s):  
Life Expectancy ◽  
Menopausal Syndrome ◽  
Modern Approach ◽  
Age Related ◽  
Appropriate Treatment ◽  
Past Half Century ◽  
Quality Life ◽  
Common Marker ◽  
Active Interest ◽  
Genitourinary Syndrome

Life expectancy over the past half century has increased significantly and by 2025 approximately one in six people on Earth will be over 60 years old, thus, age-related diseases become even more relevant, this also applies to menopausal syndrome in postmenopausal women. The average age of menopause is 5052 years. In the world 25 million women annually experience menopause and only 10% of them have no pathological manifestations. Genitourinar menopausal syndrome is the second most common marker of menopause. Urogenital disorders are a fairly common nosology, which is confirmed by numerous studies, but not every woman considers it necessary to report a problem to a doctor, considering this a natural course of aging. The increase in life expectancy and rejuvenation of the population is undoubtedly associated with socio-social development and the achievement of medicine, the purpose of which is also to increase the extension of the term of a healthy and quality life. Studies conducted in recent decades to study atrophic hypoestrogenic changes in the urogenital tract will allow us to reconsider our attitude to genitourinar menopausal syndrome and to select appropriate treatment for various groups of patients. But the inability of women, at times, to declare their symptoms associated with vulvovaginal atrophy, and the lack of active interest in this issue by doctors, especially gynecologists, leaves this problem unresolved.

Correlation Between Telomere Attrition of Zona Fasciculata and Adrenal Weight Reduction in Older Men

2019 ◽  
Vol 105 (3) ◽  
pp. e200-e210
Author(s):  
K Nonaka ◽  
Junko Aida ◽  
Kaiyo Takubo ◽  
Yuto Yamazaki ◽  
Xin Gao ◽  
...  
Keyword(s):  
Sex Differences ◽  
Weight Reduction ◽  
Adrenal Glands ◽  
Older Men ◽  
Adrenal Weight ◽  
Zona Fasciculata ◽  
Biological Mechanisms ◽  
Telomere Attrition ◽  
Age Related ◽  
Age Related Changes

Abstract Context Although numerous theories are reported on sex differences in longevity, the underlying biological mechanisms remain unknown. We previously reported that telomere length in the zona reticularis cells of the human adrenal cortex was significantly longer in older than that in younger subjects. However, we could not evaluate sex differences in the telomere lengths. Objective To compare the telomere lengths of adrenocortical and adrenal medullar cells between men and women from infancy through older adulthood. Methods Adrenal glands of 30 male (aged 0 to 100 years) and 25 female (aged 0 to 104 years) autopsied subjects were retrieved from autopsy files. Using quantitative fluorescence in situ hybridization, relative telomere lengths were determined in the parenchymal cells of the 3 adrenocortical zones and medulla. Age-related changes in the weight of adrenal glands were also investigated. Main results Older male subjects (aged 65 years or older) had significantly shorter telomere lengths in zona fasciculata (ZF) cells compared to the corresponding female subjects. In men, older subjects exhibited a significant age-related reduction in adrenal weight; however, no age-related changes in adrenal weight were detected in women. Conclusion Telomere attrition of ZF cells was correlated with adrenal weight reduction in older men but not in older women, suggesting a decreased number of ZF cells in older men. This may help us understand the possible biological mechanisms of sex difference in longevity of humans.

scholarly journals Dating and relationship violence victimization and perpetration among 11–16 year olds in Wales: a cross-sectional analysis of the School Health Research Network (SHRN) survey

2019 ◽  
Author(s):  
Honor Young ◽  
Sara Jayne Long ◽  
G J Melendez-Torres ◽  
Hyun Sue Kim ◽  
Gillian Hewitt ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
School Health ◽  
Public Health Problem ◽  
Self Report ◽  
Research Network ◽  
Major Public Health Problem ◽  
Relationship Violence ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Age Related

Abstract Background This study examines the prevalence of dating and relationship violence (DRV) victimization, perpetration and joint victimization and perpetration, and associations between DRV and socio-demographic characteristics. Methods Cross-sectional self-report data from 74 908 students aged 11–16 from 193 schools across Wales were collected and analysed using generalized estimating equations to examine prevalence and predictors of emotional and physical DRV victimization, perpetration and joint victimization and perpetration. Results More girls reported emotional victimization (28%) and perpetration (18%) than boys (20% and 16%, respectively). More girls (8%) than boys (7%) reported physical perpetration. However, boys (17%) reported more physical victimization than girls (12%). Age-related trajectories of DRV victimization and perpetration were stronger in girls than in boys. Students from single or step parent homes, those in care, and certain ethnic minority groups had increased odds of DRV. No association was found between socioeconomic status and DRV. Conclusions Age-related trajectories and the lack of social patterning by socioeconomic status point to the value of early, universal interventions, while some evidence of ethnic patterning and family structure-related risk factors suggest areas for further research and targeted interventions. DRV continues to be a major public health problem for which little UK-specific intervention evidence exists.

Age at natural menopause and development of chronic conditions and multimorbidity: results from an Australian prospective cohort

2020 ◽  
Vol 35 (1) ◽  
pp. 203-211 ◽  
Author(s):  
Xiaolin Xu ◽  
Mark Jones ◽  
Gita D Mishra
Keyword(s):  
Study Design ◽  
Chronic Conditions ◽  
Conflicts Of Interest ◽  
Premature Menopause ◽  
Multiple Chronic Conditions ◽  
Australian Government ◽  
Natural Menopause ◽  
Age Related ◽  
National Cohort ◽  
Prospective Study Design

Abstract STUDY QUESTION Is age at natural menopause (ANM) associated with the development of multiple chronic conditions (multimorbidity) in postmenopausal life? SUMMARY ANSWER Women with premature menopause experience increased odds of developing individual chronic conditions and multimorbidity. WHAT IS KNOWN ALREADY ANM is considered as a marker of age-related morbidity and mortality in postmenopausal life. Multimorbidity affects more than 60% of older women and has been recognized as the most common ‘chronic condition’. Few studies have examined the association between ANM and the development of multimorbidity. STUDY DESIGN, SIZE, DURATION A prospective national cohort study of 11 258 Australian women, aged 45–50 years in 1996. Women were followed from 1996 to 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS Information about ANM and 11 chronic conditions (diabetes, hypertension, heart disease, stroke, arthritis, osteoporosis, asthma, chronic obstructive pulmonary disease, depression, anxiety and breast cancer) were estimated approximately every 3 years. Multimorbidity is defined as 2 or more of these 11 conditions. Generalized estimating equations were used to link the categorical ANM with individual chronic conditions and multimorbidity. MAIN RESULTS AND THE ROLE OF CHANCE Among 5107 women reporting ANM, 2.3% experienced premature menopause (≤40 years) and 55.1% developed multimorbidity. Compared with women who experienced menopause at age 50–51 years, women with premature menopause had twice the odds of experiencing multimorbidity by age 60 (OR = 1.98, 95% CI 1.31 to 2.98) and three times the odds of developing multimorbidity in their 60s (OR = 3.03, 95% CI 1.62 to 5.64). Women with premature menopause also experienced higher incidence of most individual chronic conditions. LIMITATIONS, REASONS FOR CAUTION The main limitation of this study was the use of self-reported data, but with repeated assessments from prospective study design and the validity of most of the chronic conditions from hospital data, the potential for non-differential misclassification is minimized. WIDE IMPLICATIONS OF THE FINDINGS To our knowledge, this is the first study to assess the association of premature menopause and development of multimorbidity in a larger national cohort of mid-aged women. Health professionals should consider comprehensive screening and assessment of risk factors for multimorbidity when treating women who experienced premature menopause. STUDY FUNDING/COMPETING INTEREST(S) The Australian Longitudinal Study on Women’s Health was supported by the Australian Government Department of Health. X.X. is funded by an International Postgraduate Research Scholarship from the Australian government and a UQ Centennial Scholarship from The University of Queensland. G.D.M. is supported by the National Health and Medical Research Council Principal Research Fellowship (APP1121844). None of the authors has any conflicts of interest to declare.

scholarly journals Age-related factors influence HIV testing within subpopulations: a cross-sectional survey of MSM within the Celtic nations

2019 ◽  
Vol 95 (5) ◽  
pp. 351-357
Author(s):  
Jenny Dalrymple ◽  
Kareena McAloney-Kocaman ◽  
Paul Flowers ◽  
Lisa M McDaid ◽  
Jamie Scott Frankis
Keyword(s):  
Hiv Testing ◽  
Online Survey ◽  
Future Research ◽  
Sociocultural Factors ◽  
Health Improvement ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Age Related

ObjectivesDespite a recent fall in the incidence of HIV within the UK, men who have sex with men (MSM) continue to be disproportionately affected. As biomedical prevention technologies including pre-exposure prophylaxis are increasingly taken up to reduce transmission, the role of HIV testing has become central to the management of risk. Against a background of lower testing rates among older MSM, this study aimed to identify age-related factors influencing recent (≤12 months) HIV testing.MethodsCross-sectional subpopulation data from an online survey of sexually active MSM in the Celtic nations—Scotland, Wales, Northern Ireland and Ireland (n=2436)—were analysed to compare demographic, behavioural and sociocultural factors influencing HIV testing between MSM aged 16–25 (n=447), 26–45 (n=1092) and ≥46 (n=897).ResultsMultivariate logistic regression demonstrated that for men aged ≥46, not identifying as gay (OR 0.62, CI 0.41 to 0.95), location (Wales) (OR 0.49, CI 0.32 to 0.76) and scoring higher on the personalised Stigma Scale (OR 0.97, CI 0.94 to 1.00) significantly reduced the odds for HIV testing in the preceding year. Men aged 26–45 who did not identify as gay (OR 0.61, CI 0.41 to 0.92) were also significantly less likely to have recently tested for HIV. For men aged 16–25, not having a degree (OR 0.48, CI 0.29 to 0.79), location (Republic of Ireland) (OR 0.55, CI 0.30 to 1.00) and scoring higher on emotional competence (OR 0.57, CI 0.42 to 0.77) were also significantly associated with not having recently tested for HIV.ConclusionKey differences in age-related factors influencing HIV testing suggest health improvement interventions should accommodate the wide diversities among MSM populations across the life course. Future research should seek to identify barriers and enablers to HIV testing among the oldest and youngest MSM, with specific focus on education and stigma.

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