scholarly journals LIFE COURSE ORIGINS OF FRAILTY IN LATER LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S59-S59
Author(s):  
Monica Williams-Farrelly ◽  
Kenneth F Ferraro
Keyword(s):  
Health Outcomes ◽  
Parental Behavior ◽  
Later Life ◽  
Clinical State ◽  
Adult Health ◽  
Logistic Regression Models ◽  
Health Outcomes Research ◽  
Age Related ◽  
And Function ◽  
Retirement Study

Abstract Frailty, generally characterized as a clinical state of increased vulnerability resulting from age-related decline in reserve and function across multiple physiologic systems, has been gaining attention in recent years due to its high correlates with a number of poor health outcomes including falls, hospitalization, and mortality. Similar to other adult health outcomes, research on the etiology of frailty has begun to move from proximal risk factors only to those more distal in time. This research uses data from the Health and Retirement study (2004-2016) to examine whether childhood exposures predict developing frailty in later life. A series of ordinal logistic regression models were estimated to test whether six domains of childhood exposures (socioeconomic status, infectious disease, chronic disease, impairments, risky adolescent behavior, and risky parental behavior) were associated with frailty, composed of five components: unintentional weight loss, weakness, slowness, exhaustion, and low energy expenditure (Fried et al., 2001). After adjusting for demographic factors, experiencing multiple SES misfortunes or risky adolescent behaviors in childhood are associated with higher odds of frailty in later life (OR= 1.24 and 2.37, respectively), while experiencing any infectious diseases is associated with lower odds of frailty (OR= 0.67 and 0.72). After further adjusting for adult characteristics, experiencing 2 or more chronic diseases in childhood is associated with a 1.35 higher odds of incident frailty over an 8-year period. These results reveal some of the early exposures that may raise frailty risk in later life but also the mid-life factors that mediate those risks.

Introduction

2020 ◽  
pp. 1-6
Author(s):  
Alisoun Milne
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Outcomes ◽  
Later Life ◽  
Social Categories ◽  
Age Related ◽  
Wide Range ◽  
Life Itself ◽  
Life Course Analysis

Despite much emphasis on mental illness in later life, limited work has focused on mental health. This book aims to address this deficit by exploring, and explaining, mental health outcomes in later life through the lens of critical social gerontology and via the conduit of life course analysis. It adopts an approach underpinned by a commitment to understanding, and making visible, the role of lifecourse, and age related inequalities in creating or amplifying risks to mental health, as well as exploring those issues that afford protection. It aims to offer a critical review of existing discourse and disrupt the ‘taken for granted’ paradigm, including in the dementia arena. This approach not only recognises that mental health in later life is a complex multi-dimensional issue that cuts across time, cohort, social categories and individual experiences but that it is affected by a wide range of lifecourse and age related issues. It also encourages the development of understanding that adopts a wide lens of analysis and of policy and service related responses that reduce risks to mental health during the lifecourse and in later life itself. Further, it engages with the potential to learn from older people’s perspectives and lives.

scholarly journals Mitochondrial transformations in the aging human placenta

2020 ◽  
Vol 319 (6) ◽  
pp. E981-E994
Author(s):  
Lucy A. Bartho ◽  
Joshua J. Fisher ◽  
James S. M. Cuffe ◽  
Anthony V. Perkins
Keyword(s):  
Human Placenta ◽  
Cell Biology ◽  
Later Life ◽  
Cellular Damage ◽  
Gestational Length ◽  
Free Radical Theory ◽  
Radical Theory ◽  
Cellular Environment ◽  
Age Related ◽  
And Function

Mitochondria play a key role in homeostasis and are central to one of the leading hypotheses of aging, the free radical theory. Mitochondria function as a reticulated network, constantly adapting to the cellular environment through fusion (joining), biogenesis (formation of new mitochondria), and fission (separation). This adaptive response is particularly important in response to oxidative stress, cellular damage, and aging, when mitochondria are selectively removed through mitophagy, a mitochondrial equivalent of autophagy. During this complex process, mitochondria influence surrounding cell biology and organelles through the release of signaling molecules. Given that the human placenta is a unique organ having a transient and somewhat defined life span of ∼280 days, any adaption or dysfunction associated with mitochondrial physiology as a result of aging will have a dramatic impact on the health and function of both the placenta and the fetus. Additionally, a defective placenta during gestation, resulting in reduced fetal growth, has been shown to influence the development of chronic disease in later life. In this review we focus on the mitochondrial adaptions and transformations that accompany gestational length and share similarities with age-related diseases. In addition, we discuss the role of such changes in regulating placental function throughout gestation, the etiology of gestational complications, and the development of chronic diseases later in life.

scholarly journals Water, Sanitation and the Risk of Chronic Conditions among Older Persons in Ghana: Results from the WHO Study on Global AGEing and adult health (SAGE) Wave 2

2020 ◽  
Author(s):  
Razak M Gyasi ◽  
Shiellah N. Simiyu ◽  
Moussa Bagayoko
Keyword(s):  
Older People ◽  
Chronic Conditions ◽  
Later Life ◽  
Well Being ◽  
Adult Health ◽  
Significant Interaction Effect ◽  
Water And Sanitation ◽  
Logistic Regression Models ◽  
Sanitation Services ◽  
Global Ageing

Abstract Objective Water and sanitation have been related to the health of populations, yet, the effects of these factors on the occurrence of chronic conditions (CC) in later life have been least explored. This study examines the association of CC with water and sanitation among older Ghanaians and whether the associations are moderated by gender and residence. Methods Data from the WHO-SAGE Wave 2 comprising of 4735 adults aged ≥ 50 years were analyzed in this study. The primary outcome was CC and the exposures included sources of water, sanitation facilities and the sharing of sanitation facilities. Generalized logistic regression models estimated the effects of water and sanitation indicators on the occurrence of CC. Results Overall, 18.8% of the sample reported at least one CC. Compared to men and rural residents, women and urban residents respectively were more likely to report CC (p < 0.001). After full adjustments, logistic regressions showed that the use of unimproved sanitation (OR = 1.732, CI: 1.377–5.418) and sharing of sanitation facilities (OR = 1.624, CI: 1.095–1.320) were associated with higher odds of CC. However, the use of water did not reach significance (p = 0.125). We found a significant interaction effect for type of toilet × gender (OR = 3.498, CI: 1.744–16.442), source of water × residence (OR = 5.935, CI: 1.320-26.685) and type of toilet × residence (OR = 1.998, CI: 1.462–8.642). Conclusions The use of unimproved sanitation facilities and the sharing of sanitation facilities are associated with the occurrence of CC among older people. Policy and public health interventions targeted at improving the health and well-being of older people should conspicuously include improving access to sanitation services.

Self-Assessed Health into Late Adulthood

GeroPsych ◽  
2016 ◽  
Vol 29 (4) ◽  
pp. 177-187 ◽  
Author(s):  
Allyson S. Graf ◽  
Julie Hicks Patrick
Keyword(s):  
Health Promotion ◽  
Health Outcomes ◽  
Single Point ◽  
Later Life ◽  
Future Research ◽  
Cross Sectional ◽  
Late Adulthood ◽  
Age Related ◽  
Personal Perceptions ◽  
Self Assessed Health

Abstract. Self-assessed health (SAH) is the personal assessment of one’s own health ( Idler & Benyamini, 1997 ; Jylhä, 2009 ). It is often measured using a single item asking whether adults rate their health as excellent, very good, good, fair, or poor. When measured at a single point in time, SAH relates to a variety of short-term and long-term health outcomes and behaviors, including morbidity, healthcare utilization, and mortality ( Benyamini, 2008 ; Mossey & Shapiro, 1982 ; Westerhof & Wurm, 2015 ). Recently, attention has shifted away from examining SAH at a single point in time toward understanding whether SAH trajectories can better predict health outcomes ( Ayyagari et al., 2012 ; Schmitz et al., 2013 ). Therefore, it is critical to understand the factors contributing to the SAH process. This article provides a multidisciplinary overview of SAH and SAH change while illustrating the benefits of adopting a lifespan approach in future research. The current SAH literature, including cross-sectional and longitudinal studies, is used to examine what is known about the SAH process into late adulthood. From the literature, it is clear SAH is a multidimensional construct, susceptible to age-related change and sociohistorical contexts. Understanding the developmental mechanisms and multiple influences underlying change, however, may help further the use of SAH as a life-long health-promotion tool. Lifespan concepts are applied to expand discussion and recommendations are made concerning the application of alternative variables and methodologies. Future studies of SAH should consider these personal perceptions of health not only as predictors of health outcomes in later life, but also as tools for effective health promotion in everyday life.

scholarly journals MIDLIFE HEALTH FACTORS AND LATER-LIFE COGNITIVE DISEASE: RESULTS FROM THE 1998-2014 HEALTH AND RETIREMENT STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S950-S951
Author(s):  
Benson Wu ◽  
Mohammad Usama Toseef ◽  
Wassim Tarraf ◽  
Hector M González
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Multinomial Logistic Regression ◽  
Later Life ◽  
Cognitive Status ◽  
Older Age ◽  
Fine Motor ◽  
Health And Retirement Study ◽  
Reported Health ◽  
Retirement Study

Abstract Understanding lifecourse determinants of older-age health outcomes is indispensable for resources planning and optimizing public health in light of continued gains in longevity in the US and worldwide. Data increasingly points to midlife health and modifiable risk factors as critical targets for improving older-age health outcomes and mitigating potential cognitive impairment and disease. We used 16-years of biennial data (1998-2014) from the Health and Retirement Study (unweighted-n=6,724), to examine how a comprehensive battery of midlife (age 50-64 years) health measures (disability, physical function, comorbid conditions, and self-reported health) affect cognitive status (using Langa-Weir criteria: Normal, Cognitively Impaired Not Dementia (CIND), and Dementia) and death 16-years later. Additionally, we test for racial/ethnic and gender modifications in the effects of these conditions on the outcomes of interest. We used survey multinomial logistic regression models adjusting for predisposing sociodemographic factors, health-enabling economic characteristics and health behaviors. Relative risk ratios (RRR) across all unadjusted models varied from 1.36-4.84 and 1.36-3.31 for those with dementia and who died in 2014 respectively, suggesting worse health outcomes in midlife are associated with higher dementia/mortality risk in later-life. After covariates-adjustment, comorbidities (RRR=1.15[1.04,1.27]) and Self-reported Health (RRR=1.36[1.22,1.52]) were associated with CIND, and attenuation was particularly pronounced for IADLS (RRR=3.15[2.25,4.43]) and Fine Motor Skills (RRR=1.94[1.46,2.57]) for individuals with dementia in 2014. Neither sex nor race/ethnicity modified these associations. Modifying the midlife health profile of US adults can yield important public health savings and reductions in structural and social health burdens through extenuating the prevalence of dementias and reducing excess mortality.

scholarly journals Clinical Screening Tools for Sarcopenia and Its Management

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Solomon C. Y. Yu ◽  
Kareeann S. F. Khow ◽  
Agathe D. Jadczak ◽  
Renuka Visvanathan
Keyword(s):  
Physical Exercise ◽  
Health Outcomes ◽  
Muscle Mass ◽  
Review Paper ◽  
Screening Tools ◽  
Clinical Screening ◽  
Effective Interventions ◽  
Age Related ◽  
Nutrition Supplementation ◽  
And Function

Sarcopenia, an age-related decline in muscle mass and function, is affecting the older population worldwide. Sarcopenia is associated with poor health outcomes, such as falls, disability, loss of independence, and mortality; however it is potentially treatable if recognized and intervened early. Over the last two decades, there has been significant expansion of research in this area. Currently there is international recognition of a need to identify the condition early for intervention and prevention of the disastrous consequences of sarcopenia if left untreated. There are currently various screening tools proposed. As yet, there is no consensus on the best tool. Effective interventions of sarcopenia include physical exercise and nutrition supplementation. This review paper examined the screening tools and interventions for sarcopenia.

scholarly journals Exclusion of Medicare Advantage Enrollees From Medicare Health Outcomes Analyses: Potential for Bias

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 172-172
Author(s):  
Arseniy Yashkin ◽  
Igor Akushevich ◽  
Anatoliy Yashin
Keyword(s):  
Health Outcomes ◽  
Claims Data ◽  
Univariate Analysis ◽  
Medicare Advantage ◽  
Explanatory Factors ◽  
Age Related ◽  
Education Status ◽  
Reported Data ◽  
Crude Prevalence ◽  
Retirement Study

Abstract The aim of this paper is to assess the extent of the potential bias introduced by the exclusion of the Medicare Advantage (MA) population– an increasingly sizeable (31% of all beneficiaries in 2017) subset of the Medicare population which does not provide claims data to the Centers for Medicare and Medicaid Services– from Medicare-based health outcomes and epidemiologic analyses. Using self-reported data from the Health and Retirement Study together with monthly information on Medicare enrollment, we compared MA enrollees with individuals enrolled in traditional Medicare (TM) on 42 variables representing demographic, socioeconomic, adverse health behavior and health status-related characteristics over the 1991-2015 period. We used both univariate analysis (t-tests and standardized differences) and multivariate logistic regression to compare the two groups. We found that apart from differences in economic (higher in TM group) and education status (lower in MA group) – which have been increasing in magnitude over the 1991-2015 period– the MA subset was highly comparable with the traditional Medicare (TM) population. Even though the TM population was characterized by slightly higher levels of morbidity, the resulting crude prevalence rates for common age-related diseases in the TM/MA groups were within each other’s 95% confidence intervals and did not represent a major source of bias. MA membership was not associated with increased mortality at any point over the 1991-2015 period. We conclude that exclusion of the MA population will not lead to notable bias in health outcome analyses apart from those for which income and education are important explanatory factors.

scholarly journals Cross-cultural evidence does not support universal acceleration of puberty in father-absent households

2018 ◽  
Author(s):  
Rebecca Sear ◽  
Paula Sheppard ◽  
David Coall
Keyword(s):  
Life History ◽  
Health Outcomes ◽  
Family Environment ◽  
Early Life ◽  
Reproductive Development ◽  
Later Life ◽  
Father Absence ◽  
Life History Strategies ◽  
Empirical Literature ◽  
Adult Health

Father absence in early life is consistently shown to be associated with accelerated reproductive development in girls. Evolutionary social scientists have proposed several adaptive hypotheses for this finding. Though there is variation in the detail of these hypotheses, they all assume that family environment in early life influences the development of life history strategy, and, broadly, that early reproductive development is an adaptive response to father absence. Empirical evidence to support these hypotheses, however, is derived from WEIRD (Western, Educated, Industrialised, Rich and Democratic) populations. Data from a much broader range of human societies is necessary in order to properly test adaptive hypotheses. Here we review the empirical literature on father absence and puberty in both sexes, focusing on recent studies which have tested this association beyond the WEIRD world. We find that relationships between father absence and age at puberty are more varied in contexts beyond WEIRD societies, and when relationships beyond the father-daughter dyad, are considered. This has implications for our understanding of how early life environment is linked to life history strategies, and for our understanding of pathways to adult health outcomes, given that early reproductive development may be linked to negative health outcomes in later life.

scholarly journals Childhood intelligence attenuates the association between biological ageing and health outcomes in later

2019 ◽  
Author(s):  
Anna J. Stevenson ◽  
Daniel L. McCartney ◽  
Robert F. Hillary ◽  
Paul Redmond ◽  
Adele M. Taylor ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Cognitive Ability ◽  
Later Life ◽  
Chronological Age ◽  
Cross Sectional ◽  
Biological Ageing ◽  
Age Related ◽  
Epigenetic Age ◽  
Epigenetic Age Acceleration ◽  
Early Life Factors

AbstractThe identification of biomarkers that discriminate individual ageing trajectories is a principal target in ageing research. Some of the most promising predictors of biological ageing have been developed using DNA methylation. One recent candidate, which tracks age-related phenotypes in addition to chronological age, is ‘DNAm PhenoAge’. Here, we performed a phenome-wide association analysis of this biomarker in a cohort of older adults to assess its relationship with a comprehensive set of both historical and contemporaneously-measured phenotypes. Higher than expected DNAm PhenoAge compared to chronological age, known as epigenetic age acceleration, was found to associate with a number of blood, cognitive, physical fitness and lifestyle variables, and with mortality. Notably, DNAm PhenoAge, assessed at age 70, was associated with cognitive ability at age 11, and with educational attainment. Adjusting for age 11 cognitive ability attenuated the majority of the cross-sectional later-life associations between DNAm PhenoAge and health outcomes. These results highlight the importance of early-life factors on healthy ageing.

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