2715. Pneumococcal Community-Acquired Pneumonia Attributed to PCV13 Serotypes in Hospitalized Adults: Comparison of the 50–64 and 65+ Age Groups

Abstract Background In healthy adults aged ≥65 years, direct immunization with the 13-valent pneumococcal conjugate vaccine (PCV13) was shown effective at preventing vaccine-type pneumococcal community-acquired pneumonia (pCAP) and invasive pneumococcal disease (IPD). Although PCV13 was licensed for use in Canadian adults aged >50 years, it was recommended for immunocompromised individuals who are at highest risk of IPD. In 2016, a recommendation was issued for use of PCV13 in immunocompetent adults aged ≥65 years, for the prevention of pCAP and IPD. This study aimed to compare pCAP cases attributed to PCV13 serotypes in adults aged 50–64 and ≥65 years. Methods Active surveillance for CAP and IPD was performed from 2010 to 2015 in adult hospitals across five Canadian provinces. To identify pCAP, blood culture, sputum culture, or a PCV13 serotype-specific urine antigen detection (ssUAD) were used. Serotype was assigned using Quellung reaction, PCR, or ssUAD. All pCAP cases were categorized by serotype and age groups. Patient demographics and outcome data were collected. Results Over years 2010–2015, 6687 CAP cases were tested. 835 pCAP cases were identified, of which 418 (50%) caused by a PCV13 serotype. The majority (74%) of PCV13-associated pCAP occurred in the adults aged ≥50 years, whereas only 41.4% (173/418) were in adults ≥65 years. PCV13 pCAP cases declined over the years, likely through herd immunity from childhood immunization. The yearly proportion of pCAP attributed to PCV13 serotypes for ages ≥50 remained high (67.5 to 80.6%), compared those occurring in the ≥65 age groups (35.1 to 49.4%). Compared with test-negative controls, pCAP cases in both age groups were more likely to be admitted to ICU, require mechanical ventilation, and had higher mortality. Of pCAP deaths, 61.4% and 82.3% were in the ≥65 and ≥50 age cohorts, respectively. Conclusion From year 2010 to 2015, adults hospitalized with PCV13 pCAP in the ≥65 age cohort accounted for less than half of the cases, whereas including the 50–64 age cohort increased the proportion to 74%. Similarly, the proportion of PCV13 pCAP deaths that occurred in adults aged ≥50 years was 82%, compared with 61% in the ≥65 age cohort. Expansion of PCV13 recommendations to include adults 50–64 years of age should be considered. Disclosures All authors: No reported disclosures.

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Age-stratified burden of pneumococcal community acquired pneumonia in hospitalised Canadian adults from 2010 to 2015

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2019-000550 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000550 ◽

Cited By ~ 6

Author(s):

Jason LeBlanc ◽

May ElSherif ◽

Lingyun Ye ◽

Donna MacKinnon-Cameron ◽

Ardith Ambrose ◽

...

Keyword(s):

Mechanical Ventilation ◽

Burden Of Illness ◽

Pneumococcal Vaccination ◽

Community Acquired Pneumonia ◽

Age Cohorts ◽

Vaccine Recommendations ◽

Vaccine Type ◽

Age Cohort ◽

Testing Patient ◽

The Impact

BackgroundIn Canada, 13-valent pneumococcal conjugate vaccine (PCV13) is recommended in childhood, in individuals at high risk of invasive pneumococcal disease (IPD) and in healthy adults aged ≥65 years for protection against vaccine-type IPD and pneumococcal community-acquired pneumonia (pCAP). Since vaccine recommendations in Canada include both age-based and risk-based guidance, this study aimed to describe the burden of vaccine-preventable pCAP in hospitalised adults by age.MethodsSurveillance for community-acquired pneumonia (CAP) in hospitalised adults was performed prospectively from 2010 to 2015. CAP was radiologically confirmed, and pCAP was identified using blood and sputum culture and urine antigen testing. Patient demographics and outcomes were stratified by age (16–49, 50–64, ≥65 and ≥50 years).ResultsOf 6666/8802 CAP cases tested, 830 (12.5%) had pCAP, and 418 (6.3%) were attributed to a PCV13 serotype. Of PCV13 pCAP, 41% and 74% were in adults aged ≥65 and ≥50 years, respectively. Compared with non-pCAP controls, pCAP cases aged ≥50 years were more likely to be admitted to intensive care units (ICUs) and to require mechanical ventilation. Older adults with pCAP were less likely to be admitted to ICU or required mechanical ventilation, given their higher mortality and goals of care. Of pCAP deaths, 67% and 90% were in the ≥65 and ≥50 age cohorts, respectively.ConclusionsAdults hospitalised with pCAP in the age cohort of 50–64 years contribute significantly to the burden of illness, suggesting that an age-based recommendation for adults aged ≥50 years should be considered in order to optimise the impact of pneumococcal vaccination programmes in Canada.

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Age analysis of the population mortality from diabetes mellitus in the Tula region

Journal of New Medical Technologies eJournal ◽

10.12737/5613 ◽

2014 ◽

Vol 8 (1) ◽

pp. 1-11 ◽

Cited By ~ 3

Author(s):

Макишева ◽

R. Makisheva ◽

Хромушин ◽

Viktor Khromushin ◽

Хадарцев ◽

...

Keyword(s):

Mortality Rate ◽

Adult Population ◽

Age Groups ◽

Endocrine System ◽

Initial Increase ◽

Male Population ◽

Female Population ◽

Men And Women ◽

Age Cohorts ◽

Age Cohort

The article analyzes 182897 deaths of the adult population of the Tula region from the mortality register from 2007 to 2013 by age cohorts 15-19; 20-24; 25-34; 35-44; 45-54; 55-64; 65-74; >=75, of which 4882 case of death from diabetes. The increasing incidence of diseases of the endocrine system, disorders of nutrition and metabolism is identified and is accordingly 63,7; 66,5; 68,4; 68,3; 69,4; 71,0 per 1000 population. The mortality rate in the Tula region in 2012 from diabetes was 59,86 per 100000 population. The analysis of mortality shows that the ratio of women to men for the period from 2007 to 2013 increases with increasing age in a power-law dependence from 0,6 to 4,49. In the age cohort 45-54 men and women, there is a decrease in the number of cases. The initial increase and the subsequent significant decline in the number of cases have a place for men in this cohort. For women, the mortality rate decreases with larger slope than for men. The dynamics of the mortality of men and women in the cohort 55-64 is characterized by an increase in the number of cases in 2007-2010 and the decrease in 2011-2013. In this cohort, the mortality rate among men increased (except 2013), and the mortality rate of the female population varies only slightly. Mortality of women, men, and for men and women in the cohort 65-74 years decreases, and in the cohort of 75 and over increased. Positive aspects of age analysis is the transfer of deaths from age groups 45-54, 55-64, 65-74 in a cohort of older ages 75 years or more. Negative aspects of age analysis is the increased mortality of the male population in the cohort 55-64 in 2007- 2012, men and women of this cohort in 2007 - 2010 years, as well as the high mortality of the female population from diabetes, compared with the male population of the Tula region.

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Osteosarcoma: A Comparison of Jaw versus Nonjaw Localizations and Review of the Literature

Sarcoma ◽

10.1155/2013/316123 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

H. van den Berg ◽

W. H. Schreuder ◽

J. de Lange

Keyword(s):

Older Patients ◽

Age Groups ◽

Incidence Rates ◽

Steady Increase ◽

Review Of The Literature ◽

Tumor Patients ◽

Age Cohorts ◽

Age Cohort ◽

Steep Decline ◽

Age Range

Purpose. It is assumed that osteosarcomas of the jaws mainly occur at older ages, whereas the most prominent sites, that is, the long bones, are more affected at ages <20. Jaw-localized tumors are less malignant and have lower metastatic spread rates.Patients and Methods. This study analyses the nationwide data of the Dutch Cancer Registry on osteosarcoma during the period from 1991 to 2010. Age-corrected incidence rates were calculated.Results. In 949, 38 patients had tumors in the maxilla and in 58 in the mandible. Median age for maxilla, mandible, and other localizations was 45.5, 49, and 23 years, respectively. Age-corrected incidence for osteosarcomas increased after a steep decline for the age cohorts from 20 to 60 years to nearly the same level as the younger patients. The incidence for maxillary lesions showed a steady increase from 0.46 to 1.60 per million over all age ranges; the highest incidence for mandibular lesions was found in the age cohort from 60 to 79 years. In respect to histology, no shifts for age were found, except for Paget’s disease-related osteosarcoma. In older patients, chemotherapy was omitted more often. Overall survival was similar for all age groups, except for extragnatic tumor patients in the age range of 60–79 years.Conclusions. Osteosarcomas have comparable incidences below the age of 20 as compared with ages >60 years. Poorer outcome in older people is likely due to refraining from chemotherapy.

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Age and Physical Activity among Canadian Women and Men: Findings from Longitudinal National Survey Data

Journal of Aging and Physical Activity ◽

10.1123/japa.8.1.1 ◽

2000 ◽

Vol 8 (1) ◽

pp. 1-19 ◽

Cited By ~ 19

Author(s):

James Curtis ◽

Philip White ◽

Barry McPherson

Keyword(s):

Physical Activity ◽

Inverse Relationship ◽

Leisure Time ◽

Age Groups ◽

Group Differences ◽

Activity Levels ◽

Age Group ◽

Activity Involvement ◽

Age Cohorts ◽

Age Cohort

This study reports on age-group differences in leisure-time sport and physical activity involvement among a large sample of Canadians interviewed at 2 points during the 1980s. Comparisons are made for 5 age cohorts, for men and women, and without and with multivariate controls. The results contradict the usual finding of an inverse relationship between age and level of physical activity. On measures of (a) activity necessary to produce health benefits and (b) energy expenditure. Canadians over 65 were as active as, or more active than, their younger counterparts, and their activities did not decline over the 7 years between interviews. The extent of change varied by age and across women and men. Among women, increases in involvement were greatest in the middle-aged. Among men, the greatest increase was in the oldest age groups. For both genders, the youngest age cohort showed the smallest change over time, and there was evidence of slight declines in activity levels among young men.

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A simulation study on the relative role of age groups under differing pertussis transmission scenarios

10.1101/247007 ◽

2018 ◽

Cited By ~ 2

Author(s):

Ana I. Bento ◽

Aaron A. King ◽

Pejman Rohani

Keyword(s):

Herd Immunity ◽

Age Groups ◽

Transmission Model ◽

Relative Role ◽

Older Individuals ◽

Age Cohorts ◽

Relative Risks ◽

Transmission Mechanisms ◽

Acellular Vaccines ◽

The Impact

AbstractPertussis has resurged in many countries where it was once regarded as under control, with the recent outbreaks showing a shift in incidence towards teens and older individuals. Here, using an age-stratified transmission model, we tested two potential causes for underlying changes in pertussis transmission dynamics. We did so assuming hypothesized mechanisms supporting present-day pertussis epidemiology: (I) improved diagnostics, (II) acellular vaccines leading to asymptomatic transmission (III) both. We used the relative risks and odds ratio methods to examine the impact of these differing assumptions on signatures of relative roles of key age groups through time, allowing us to explore those age cohorts that disproportionately account for transmission. Our findings show that for epidemics after the vaccine switch, a scenario with increased adult reporting and no asymptomatic transmission reflect a loss of signal, where no age group appears to be key. While scenarios with asymptomatic transmission, reflect a population where children (1-10 years old) are still disproportionally at risk. These results demonstrate that understanding the underlying transmission mechanisms in a population are paramount for vaccination policies in attaining herd immunity and eventually eradication.

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Analysis of mortality dynamics of the age cohorts population in the Tula region

Journal of New Medical Technologies eJournal ◽

10.12737/5609 ◽

2014 ◽

Vol 8 (1) ◽

pp. 1-14 ◽

Cited By ~ 1

Author(s):

Хромушин ◽

Viktor Khromushin ◽

Хадарцев ◽

Aleksandr Khadartsev ◽

Китанина ◽

...

Keyword(s):

Detailed Analysis ◽

Adult Population ◽

Age Groups ◽

International Project ◽

Automatic Determination ◽

Age Cohorts ◽

Control Actions ◽

Logical Sequence ◽

Age Cohort

The article presents the analysis results of 182897 rates of deaths of the adult population in the Tula region since 2007 to 2013, which were obtained by means of software, in the frame of the international project. To ensure high validity of data, the automatic determination of the initial reason to deaths, automatic transposition of the lines of the reasons to deaths for recovering the logical sequence, posthumous diagnostics were used. The Analysis of the age cohorts was carried out based on the graphs constructed for each age cohort schedule with the imposed trend. Mortality monitoring made by Public Health of the Tula region, as well as measures control allowed to reduce the mortality in cohort 45-54 age which resulted in the displacement of the high mortality of this cohort in a cohort of older age 55-64. Little progress in reducing mortality in men compared with women was identified. There is a steady decline in mortality, which requires detailed analysis of the age groups 25-34, 35-44 men and 20-24, 35-44 women and the development of control actions. To further reduce mortality, it is advisable to focus on the age cohort 55-64. Received and verified data is the basis for a detailed analysis by class of diseases.

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Group Disparities in Educational Outcomes: An Age Cohort Perspective

Indian Journal of Human Development ◽

10.1177/09737030211042054 ◽

2021 ◽

Vol 15 (2) ◽

pp. 334-352

Author(s):

Vachaspati Shukla

Keyword(s):

Educational Attainment ◽

Educational Outcomes ◽

Social Groups ◽

Age Groups ◽

Social Background ◽

Gender Disparity ◽

Age Cohorts ◽

Younger Age ◽

Age Cohort ◽

And Gender

This article attempts to evaluate differential progress in educational attainment across social groups segregating the attainments at the level of age cohorts. It argues that mapping of educational attainment across age cohorts offers a robust understanding of educational progress, as it sheds light on the likelihood of younger age-groups getting educated in comparison with the older ones. This article examines attainments across five levels of education among the population subgroups which are categorised based on region (rural–urban), social background (SC/ST and Others), and gender (male–female) among others. The analysis reveals that group disparities tend to be lower among the younger age groups but increase along with rising levels of educational attainment. Gender disparity nearly disappears in the youngest age cohort among the better off groups. This exercise at the level of age cohorts offers an optimism that differentials seem to narrow down in recent times, which is not as stark at the aggregate subgroup levels.

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Older Adults with Chronic Myelogenous Leukemia (CML), During the Tyrosine Kinase Inhibitor (TKI) Era, Can Be Successfully Treated with Reduced Intensity Conditioning (RIC) Hematopoietic Cell Transplant (HCT) Using Sibling or Unrelated Donors: A Center for International Blood and Marrow Transplant Research (CIBMTR) Analysis

Blood ◽

10.1182/blood.v118.21.494.494 ◽

2011 ◽

Vol 118 (21) ◽

pp. 494-494

Author(s):

Erica D Warlick ◽

Brian McClune ◽

Tanya L. Pedersen ◽

Kwang W Awn ◽

Joseph H. Antin ◽

...

Keyword(s):

Overall Survival ◽

Board Of Directors ◽

Older Patients ◽

Age Groups ◽

Advisory Committees ◽

Age Cohorts ◽

Gvhd Prophylaxis ◽

Age Cohort ◽

Unrelated Donors ◽

Conditioning Intensity

Abstract Abstract 494 The introduction of tyrosine kinase inhibitors (TKI) and advent of RIC and non-myeloablative (NMA) conditioning hematopoietic cell transplants (HCT) have changed and the therapeutic strategy for patients with CML. We analyzed the post HCT outcomes of CML patients aged 40 and older undergoing RIC/NMA HCT in 2001–2007. Detailed information regarding pre HCT TKI use or rationale for timing of transplant was not available; however, the analysis time period captures the entry of TKIs into clinical practice. Outcomes were compared between age cohorts of 40–49, 50–59, and ≥ 60 years. Overall survival (OS), Day +100 acute graft versus host disease (aGVHD) grades II-IV, chronic (cGVHD), transplant-related mortality (TRM), relapse, and disease-free survival (DFS) were analyzed with multivariate analysis testing the impact of age, gender, disease status at HCT (CP1vs. CP2/accelerated phase (AP) vs. blast phase (BP), sex match, HLA match, GVHD prophylaxis, and conditioning intensity (RIC versus NMA as described by Bacigalupo et all 2009) on outcomes. A total of 306 CML patients underwent HCT at 125 centers: 117 (38%) aged 40–49; 119 (39%) aged 50–59; and 70 (23%) aged ≥ 60. At HCT most patients in the 40–49 age cohort were in CP1 (72%), while only 44% of patients aged 50–59 and 31% aged ≤ 60 were in CP1. Interval from diagnosis to HCT for CP1 patients was similar across age groups with a large percentage of each age cohort undergoing HCT ≥ 2 years (32%, 40%, and 45%, respectively). Sibling donors were the stem cell source for 56% of those aged 40–49; older cohorts had a higher percentage of unrelated donors (58 and 60%, respectively). Primarily peripheral blood grafts (78%, 80% and 90%) and RIC (78%, 76% and 70%) were used across age groups, respectively. GVHD prophylaxis was similar. Three year OS and cGVHD, Day +100 grade II-IV acute GVHD, and 1 year TRM were similar in all age cohorts. Three year relapse incidence increased and DFS decreased with age. Importantly in analysis of CP1 patients only, relapse and DFS were similar in each age cohort.Table 1:Univariate AnalysisOutcomeAge 40–49 Probability (95% CI)Age 50–59 Probability (95% CI)Age ≥ 60 Probability (95% CI)P-valueEntire CohortOSA54% (44–64)52% (42–61)41% (30–54)0.26aGVHDB II-IV26% (18–34)32% (24–40)32% (21–43)0.53cGVHDA58% (47–68)51% (41–61)43% (33–55)0.19TRMC18% (11–26)20% (13–27)13% (6–22)0.43RelapseA36% (27–46)43% (34–52)66% (53–77)0.001DFSA35% (26–45)32% (24–41)16% (7–27)0.01CP1 OnlyRelapseA34% (23–46)42% (28–56)51% (29–72)0.40DFSA43% (31–55)36% (23–51)39% (19–61)0.81A=3 year; B=Day +100; C=1 year Multivariate analysis confirmed the significant adverse impact of advanced CML (AP/CP2+ and BP) at HCT, NMA conditioning intensity, male gender, and older age on relapse and DFS. Overall survival was not impacted by age, but was significantly worse with advanced CML at HCT. (Table 2)Table 2:Multivariate AnalysisOutcomeRR95% CIP valueRelapse:Age:10.69–1.6420.000340–491.0641.441–3.60750–592.28≥60Disease Status:10.1319–0.9170.01CP11.3350.0036–1.403AP/CP2+2.823BPConditioning Intensity10.222–0.469<0.0001NMA0.323RICGender10.397–0.830.0032Male0.574FemaleOverall SurvivalAge:10.55–1.2260.4240–490.8210.683–1.61850–591.051≥60Disease Status:11.206–2.47<0.0001CP11.7263.199–10.0740.42AP/CP2+5.677BPGender:10.0189–0.4810.019Male0.671Female These data indicate that HCT is safe in older patients with CML with equivalent acute and chronic GVHD, TRM, and OS across age cohorts. Relapse increased in patients receiving NMA conditioning and in those aged 60 and above; most of whom had advanced disease. However, for HCT during CP1 relapse risks and DFS were similar, regardless of age. Allogeneic HCT using RIC conditioning for older patients with CP1 CML can control relapse with acceptable toxicity and survival. Comparison of outcomes with second line TKI versus HCT are as yet unreported but these favorable findings indicate appropriate consideration of HCT for older patients with CML. Disclosures: Gupta: Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees.

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How do women's diets compare with the new Australian dietary guidelines?

Public Health Nutrition ◽

10.1017/s1368980014000135 ◽

2014 ◽

Vol 18 (2) ◽

pp. 218-225 ◽

Cited By ~ 14

Author(s):

Gita D Mishra ◽

Danielle AJM Schoenaker ◽

Seema Mihrshahi ◽

Annette J Dobson

Keyword(s):

Pregnant Women ◽

Young Women ◽

Age Groups ◽

Cross Sectional Study ◽

Dietary Guidelines ◽

Young Cohort ◽

Cross Sectional ◽

Age Cohorts ◽

Age Cohort ◽

Nationally Representative

AbstractObjectiveTo compare women's diets with recommended intakes from the new Australian Dietary Guidelines (ADG 2013).DesignCross-sectional study using data from the Australian Longitudinal Study on Women's Health. Diet was assessed using a validated FFQ.SettingTwo nationally representative age cohorts of Australian women.SubjectsWomen in the young cohort (born 1973–1978, aged 31–36 years) and mid-age cohort (born 1946–1951, aged 50–55 years). Women (n 18 226) were categorised into three groups: ‘young women’ (n 5760), young ‘pregnant women’ at the time or who had given birth in the 12 months prior to the survey (n 1999) and ‘mid-age women’ (n 10 467).ResultsLess than 2 % of women in all three groups attained the ADG 2013 recommendation of five daily servings of vegetables, with the majority needing more than two additional servings. For young women, less than one-third met recommendations for fruit (32%) and meat and alternatives (28 %), while only a small minority did so for dairy (12 %) and cereals (7 %). Fifty per cent of pregnant women met guidelines for fruit, but low percentages reached guidelines for dairy (22 %), meat and alternatives (10 %) and cereals (2·5 %). For mid-age women, adherence was higher for meat and alternatives (41 %) and cereals (45 %), whereas only 1 % had the suggested dairy intake of four daily servings.ConclusionsFor most women to follow ADG 2013 recommendations would require substantially increased consumption of cereals, vegetables and dairy. Findings have implications for tailoring the dissemination of dietary guidelines for women in different age groups and for pregnant women.

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Epidemiology of age-dependent prevalence of Bovine Herpes Virus Type 1 (BoHV-1) in dairy herds with and without vaccination

Veterinary Research ◽

10.1186/s13567-020-00842-5 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Jonas Brock ◽

Martin Lange ◽

Maria Guelbenzu-Gonzalo ◽

Natascha Meunier ◽

Ana Margarida Vaz ◽

...

Keyword(s):

Age Groups ◽

Dairy Herds ◽

Sudden Increase ◽

Eradication Programme ◽

Age Cohorts ◽

Age Related ◽

Seroprevalence Data ◽

Age Dependent ◽

Age Cohort ◽

Cattle Herds

Abstract Many studies report age as a risk factor for BoHV-1 infection or seropositivity. However, it is unclear whether this pattern reflects true epidemiological causation or is a consequence of study design and other issues. Here, we seek to understand the age-related dynamics of BoHV-1 seroprevalence in seasonal calving Irish dairy herds and provide decision support for the design and implementation of effective BoHV-1 testing strategies. We analysed seroprevalence data from dairy herds taken during two Irish seroprevalence surveys conducted between 2010 and 2017. Age-dependent seroprevalence profiles were constructed for herds that were seropositive and unvaccinated. Some of these profiles revealed a sudden increase in seroprevalence between adjacent age-cohorts, from absent or low to close to 100% of seropositive animals. By coupling the outcome of our data analysis with simulation output of an individual-based model at the herd scale, we have shown that these sudden increases are related to extensive virus circulation within a herd for a limited time, which may then subsequently remain latent over the following years. BoHV-1 outbreaks in dairy cattle herds affect animals independent of age and lead to almost 100% seroconversion in all age groups, or at least in all animals within a single epidemiological unit. In the absence of circulating infection, there is a year-on-year increase in the age-cohort at which seroprevalence changes from low to high. The findings of this study inform recommendations regarding testing regimes in the context of contingency planning or an eradication programme in seasonal calving dairy herds.

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