416 The impact of Obstructive Sleep Apnea severity on age-related comorbities: a population-based study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A165-A165
Author(s):  
Mayra Silva ◽  
Dalva Poyares ◽  
Luciana Oliveira ◽  
Monica Andersen ◽  
Sergio Tufik ◽  
...  
Keyword(s):  
Older Adults ◽  
Late Onset ◽  
Clinical Manifestations ◽  
Population Based ◽  
Baseline Survey ◽  
Older Individuals ◽  
Blood Tests ◽  
Age Related ◽  
Obstructive Sleep ◽  
The Impact

Abstract Introduction Although age per se has been considered a risk factor for OSA, evidence suggest OSA in older adults may be less severe and OSA diagnostic criteria might be adjusted for this age group. Concurrently, it is likely the late-onset OSA is a distinct phenotype having different pathophysiological mechanisms, as well as clinical manifestations and consequences. We sought to investigate the clinical consequences of OSA severity in older adults from a representative sample of the older population living in the São Paulo city. Methods From the baseline survey including 1042 participants in 2007, 715 were reassessed in 2016 completing full in-lab PSG, health-related questionnaires, blood tests, and blood pressure measurements. Individuals > 60 y.o. (n=199) of both genders were included in the analysis. Participants were stratified according to OSA presence and severity in 3 groups G1 (non and mild OSA n=83); G2 (moderate OSA n=56); G3 (severe OSA n=60). General Linear Model (GLM) tests and Chi-square were carried out. Results Participants mean age was 70.02±7.31 and mean body mass index (BMI) 28.61±5.39, 40.71% of men. The only comorbidity associated with OSA severity was arterial hypertension occurring in 61.7% of G3, 46.4% of G4 and 41% of G1 (p=0.04). Severe OSA participants were more likely to use a higher (>2/day) number of medications (p=0.03). Finally, out of all blood tests only cortisol was significantly higher in severe OSA group (p<0.001) Conclusion Severe OSA in older individuals of the general population is not associated with metabolic conditions, such as diabetes, but it was associated with hypertension. Severe OSA may be a stressful condition, since it was associated with higher cortisol in this population. Support (if any) Associaçao Fundo Incentivo a Pesquisa (AFIP)

Conclusion

2016 ◽  
Author(s):  
Maria A. Sullivan
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
The Elderly ◽  
Social Consequences ◽  
Individual Therapy ◽  
Older Individuals ◽  
Prescribing Practices ◽  
Elderly Age ◽  
Age Related ◽  
The Impact

Addiction in older adults very often goes unrecognized, for several reasons: social biases about the elderly, age-related metabolic changes, and the inappropriate use of prescription benzodiazepines and opioids to address untreated anxiety and mood conditions. Alcohol or substance-use disorders (SUDs) in older individuals may present in subtle and atypical ways. Strategies to overcome such difficulties include systematic screening using validated instruments, patient education regarding the impact of psychoactive substances on health, and cautious prescribing practices. Relying on standard DSM criteria may result in a failure to detect an SUD that presents with cognitive symptoms or physical injury, as well as the absence of work or social consequences. Older individuals can benefit from the application of risk-stratification measures, and they can be referred, e.g., to age-appropriate group therapy and non-confrontational individual therapy focusing on late-life issues of loss and sources of social support, as well as be offered medication management for alcohol or substance use disorder. Although research has been limited in this population, treatment outcomes have been found to be superior in older adults than younger adults.

Frailty, sarcopenia, and falls in cardiovascular disease

ESC CardioMed ◽  
2018 ◽  
pp. 2950-2954
Author(s):  
Antonio Cherubini ◽  
Massimiliano Fedecostante
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Clinical Manifestations ◽  
Drug Effects ◽  
Adverse Outcomes ◽  
Assessment Tools ◽  
Management Approach ◽  
Older Individuals ◽  
Related Factors ◽  
Age Related

Frailty reflects a state of high vulnerability to stressors, even at low intensity, putting frail older adults at high risk of adverse outcomes. Sarcopenia (i.e. skeletal muscle decline) explains many of the clinical manifestations of the frailty syndrome and is the key component of physical frailty. Many frailty assessment tools are built around the concept of sarcopenia. Frailty is not only a consequence of the ageing process, but cardiovascular disease can contribute to its genesis, also sharing common pathogenetic pathways. Falls are very common in older individuals and are the best example of the interplay between age-related conditions and diseases. Falls, as well as frailty and sarcopenia, are most often multifactorial in nature. Cardiovascular disorders are among the risk factors that have been identified to cause falls in older adults; in particular, unexplained and recurrent falls. Orthostatic hypotension, carotid sinus syndrome, and adverse drug effects are the most important cardiovascular disease-related factors that have been found to be associated with falls in older people. Implementing the comprehensive geriatric assessment, a multidomain and multidisciplinary evaluation and management approach, represents the best strategy to properly manage older patients with cardiovascular disease.

scholarly journals Plasmatic Hippuric Acid as a Hallmark of Frailty in an Italian Cohort: The Mediation Effect of Fruit–Vegetable Intake

2021 ◽  
Author(s):  
Laura Brunelli ◽  
Annalisa Davin ◽  
Giovanna Sestito ◽  
Maria Chiara Mimmi ◽  
Giulia De Simone ◽  
...  
Keyword(s):  
Older Adults ◽  
Hippuric Acid ◽  
Vegetable Intake ◽  
Vegetable Consumption ◽  
Frailty Index ◽  
Population Based ◽  
Mediation Effect ◽  
Older Individuals ◽  
Related Condition ◽  
Age Related

Abstract Frailty syndrome is an age-related condition involving a loss of resilience, susceptibility to adverse health outcomes, and poor quality of life. This study was conducted in the framework of InveCe.Ab, an ongoing longitudinal population-based study. Plasma from 130 older individuals (older adults aged 76–78 years) was analyzed and validated (on 303 participants) using mass spectrometry-based metabolomics approaches. Equivalence tests showed that metabolites from the central cellular metabolic pathways were equivalent in frail and fit participants. Hippuric acid was the only cometabolite that distinguished fit from frail older adults. Logistic regression analysis indicated that high hippuric acid levels are significantly associated with a reduction of the risk of frailty after 4 years. Mediation analysis using a Frailty Index, hippuric acid, and fruit–vegetable intake supported the role of fruit–vegetable consumption in the hippuric acid relationship with the Frailty Index. These data point to low plasma hippuric acid as a plausible hallmark of frailty status, associated with lower fruit–vegetable intakes.

scholarly journals 1131 Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A430-A431
Author(s):  
G L Dunietz ◽  
R D Chervin ◽  
J F Burke ◽  
A S Conceicao ◽  
T J Braley
Keyword(s):  
Older Adults ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Statistical Significance ◽  
Older Individuals ◽  
Survey Period ◽  
Lower Odds ◽  
Obstructive Sleep ◽  
Osa Treatment ◽  
The Impact

Abstract Introduction Obstructive Sleep Apnea (OSA) has been linked to dementia and Alzheimer’s Disease (AD), as well as pre-dementia. The potential benefits of OSA treatment on cognitive performance are inconclusive. Further, the impact of OSA treatment on the development of neurodegenerative disorders has not been sufficiently studied. This study examined associations between Positive Airway Pressure (PAP) therapy and incident diagnosis of pre-dementia (MCI), dementia (DNOS), or AD in a population-level sample of older adults. Methods Using a random 5% sample from Medicare claims data (persons age 65 and older), individuals with an ICD-9 diagnosis code for OSA prior to 2011 (n=53,321) were selected for analyses. Over the survey period (2011-2013), we further identified persons newly diagnosed with MCI (n=443), DNOS (n=378), or AD (n=1,057). We also identified individual HCPCS claims for PAP equipment as evidence of prescription, and repeated HCPCS claims for supplies as evidence of adherence to PAP treatment. Logistic regression models were used to adjust for potential confounders including age, gender, hypertension, and Parkinson’s Disease that might increase risk for dementia. Results Seventy-eight percent of beneficiaries with OSA were prescribed PAP, and 74% showed evidence of adherent use. After adjustment for potential confounders, prescription of PAP was associated with significantly lower odds of incident AD and DNOS (OR=0.78, 95% CI: 0.69, 0.89; and OR=0.69, 95% CI: 0.55, 0.85). Lower odds of MCI, approaching statistical significance, were also observed among beneficiaries who were prescribed PAP (OR=0.82, (95% CI: 0.66, 1.02). Evidence of adherence to PAP was significantly associated with lower odds of incident AD (OR=0.65, 95% CI: 0.56, 0.76). Conclusion Among older individuals with OSA, PAP prescription and adherence are each associated with a significantly lower risk of incident AD or DNOS, though not MCI. Although a prospective cohort design cannot prove causality, results suggest that treatment of OSA could reduce risk of subsequent dementia. Support This study was supported by The American Academy of Sleep Medicine Foundation Strategic Research Award 115-SR-15 (PI Braley).

scholarly journals Image Reconstruction Reveals the Impact of Aging on Face Perception

2019 ◽  
Author(s):  
Chi-Hsun Chang ◽  
Dan Nemrodov ◽  
Natalia Drobotenko ◽  
Adrian Nestor ◽  
Andy C. H. Lee
Keyword(s):  
Older Adults ◽  
Image Reconstruction ◽  
Face Perception ◽  
Healthy Aging ◽  
Individual Variability ◽  
Older Individuals ◽  
Age Related ◽  
Facial Shape ◽  
The Impact ◽  
Insight Into

AbstractExtensive work has demonstrated a decline in face recognition abilities associated with healthy aging. To date, however, there has been limited insight into the nature and the extent of aging-related alterations in internal face representations. Here, we sought to address these issues by using an image reconstruction approach that capitalizes on the structure of behavioral data to reveal the pictorial content of visual representations. To this end, healthy young and older adults provided similarity judgments with pairs of face images. Facial shape and surface features were subsequently derived from the structure of the data for each participant and combined into image reconstructions of facial appearance. Our findings revealed that image reconstruction was successful for every participant, irrespective of age. However, reconstruction accuracies of shape and surface information were lower for older individuals than young individuals. Specifically, facial features diagnostic for face perception, such as eye shape and skin tone, were reconstructed poorly in older adults relative to young adults. At the same time, we found that age-related effects only accounted for a relatively small proportion of individual variability in face representations. Thus, our results provide novel insight into age-related changes in visual perception, they account for the decline in facial recognition occurring with age and they demonstrate the utility of image reconstruction to uncovering internal representations across a variety of populations.

scholarly journals Sex disparities in cardiovascular health metrics among rural-dwelling older adults in China: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaolei Han ◽  
Ziying Jiang ◽  
Yuanjing Li ◽  
Yongxiang Wang ◽  
Yajun Liang ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Cardiovascular Health ◽  
Rural China ◽  
Descriptive Analysis ◽  
Population Based ◽  
Baseline Survey ◽  
Chinese Older Adults ◽  
Face To Face ◽  
Sex Disparities

Abstract Background Cardiovascular health (CVH) metrics among Chinese older adults are poorly understood. We investigated sex disparities in CVH metrics and their management among rural-dwelling older adults in China. Methods This community-based study included 5026 participants (age ≥ 65 years; 57.2% women) in the baseline survey of a multimodal intervention study in rural China. In March–September 2018, data were collected through face-to-face interviews, clinical examinations, and laboratory tests. We defined six CVH metrics (three behavioral factors—smoking, body mass index, and physical activity; three biological factors—blood pressure, total cholesterol, and blood glucose) following the modified American Heart Association’s recommendations. We performed descriptive analysis separately for men and women. Results Of all participants, only 0.8% achieved ideal levels in all six CVH metrics. Men were more likely than women to have ideal levels in all CVH metrics but smoking. Women had higher prevalence of ideal global (9.7% vs. 7.8%) and behavioral (18.3% vs. 9.5%) CVH metrics (p < 0.001), whereas men had higher prevalence of ideal biological CVH metrics (5.4% vs. 3.5%, p < 0.001). The prevalence of ideal global and behavioral CVH metrics increased with age in both women and men (p for trend< 0.001). Women were more likely to be aware of their hypertension and diabetes, and to receive antihypertensive treatment, while men were more likely to achieve the goal of high cholesterol treatment (p < 0.05). Conclusions The CVH metrics among older adults living in the rural communities in China are characterized by an extremely low proportion of optimal global CVH metrics and distinct sex differences, alongside poor management of major biological risk factors. Trial registration ChiCTR1800017758 (Aug 13, 2018).

scholarly journals Incidence of diabetes mellitus among people living with and without HIV in British Columbia, Canada between 2001 and 2013: a longitudinal population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e048744
Author(s):  
Andreea Bratu ◽  
Taylor McLinden ◽  
Katherine Kooij ◽  
Monica Ye ◽  
Jenny Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
British Columbia ◽  
Cohort Study ◽  
Population Based ◽  
Incidence Rates ◽  
Trend Test ◽  
People Living With Hiv ◽  
Age Related ◽  
Hiv Serostatus ◽  
The Impact

IntroductionPeople living with HIV (PLHIV) are increasingly at risk of age-related comorbidities such as diabetes mellitus (DM). While DM is associated with elevated mortality and morbidity, understanding of DM among PLHIV is limited. We assessed the incidence of DM among people living with and without HIV in British Columbia (BC), Canada, during 2001–2013.MethodsWe used longitudinal data from a population-based cohort study linking clinical data and administrative health data. We included PLHIV who were antiretroviral therapy (ART) naïve at baseline, and 1:5 age-sex-matched persons without HIV. All participants had ≥5 years of historic data pre-baseline and ≥1 year(s) of follow-up. DM was identified using the BC Ministry of Health’s definitions applied to hospitalisation, physician billing and drug dispensation datasets. Incident DM was identified using a 5-year run-in period. In addition to unadjusted incidence rates (IRs), we estimated adjusted incidence rate ratios (IRR) using Poisson regression and assessed annual trends in DM IRs per 1000 person years (PYs) between 2001 and 2013.ResultsA total of 129 PLHIV and 636 individuals without HIV developed DM over 17 529 PYs and 88,672 PYs, respectively. The unadjusted IRs of DM per 1000 PYs were 7.4 (95% CI 6.2 to 8.8) among PLHIV and 7.2 (95% CI 6.6 to 7.8) for individuals without HIV. After adjustment for confounding, HIV serostatus was not associated with DM incidence (adjusted IRR: 1.03, 95% CI 0.83 to 1.27). DM incidence did not increase over time among PLHIV (Kendall trend test: p=0.9369), but it increased among persons without HIV between 2001 and 2013 (p=0.0136).ConclusionsAfter adjustment, HIV serostatus was not associated with incidence of DM, between 2001 and 2013. Future studies should investigate the impact of ART on mitigating the potential risk of DM among PLHIV.

scholarly journals Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-214
Author(s):  
Michael McKee ◽  
Yunshu Zhou ◽  
Joshua Ehrlich ◽  
Elham Mahmoudi ◽  
Jennifer Deal ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Self Care ◽  
Household Activity ◽  
Cross Sectional ◽  
Age Related ◽  
Increased Risk ◽  
Lower Mobility ◽  
Independent Effects ◽  
The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p &lt;0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p&lt;.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p&lt;.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

scholarly journals The Impact of Behavioral Intervention on Obesity Mediated Declines in Mobility Function: Implications for Longevity

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Joe Nocera ◽  
Thomas W. Buford ◽  
Todd M. Manini ◽  
Kelly Naugle ◽  
Christiaan Leeuwenburgh ◽  
...  
Keyword(s):  
Older Adults ◽  
Aging Process ◽  
Strong Predictor ◽  
Functional Limitations ◽  
Mobility Performance ◽  
Mobility Function ◽  
Age Related ◽  
Close Relationship ◽  
Primary Focus ◽  
The Impact

A primary focus of longevity research is to identify prognostic risk factors that can be mediated by early treatment efforts. To date, much of this work has focused on understanding the biological processes that may contribute to aging process and age-related disease conditions. Although such processes are undoubtedly important, no current biological intervention aimed at increasing health and lifespan exists. Interestingly, a close relationship between mobility performance and the aging process has been documented in older adults. For example, recent studies have identified functional status, as assessed by walking speed, as a strong predictor of major health outcomes, including mortality, in older adults. This paper aims to describe the relationship between the comorbidities related to decreased health and lifespan and mobility function in obese, older adults. Concurrently, lifestyle interventions, including diet and exercise, are described as a means to improve mobility function and thereby limit the functional limitations associated with increased mortality.

scholarly journals Age-Related Differences in Actual-Ideal Personality Trait Level Discrepancies

2020 ◽  
Author(s):  
Marie Hennecke ◽  
Paul Schumann ◽  
jule specht
Keyword(s):  
Older Adults ◽  
Big Five ◽  
Personality Trait ◽  
Age Effects ◽  
Big Five Personality ◽  
Age Related ◽  
Trait Level ◽  
Patterns Of Behavior ◽  
Nationally Representative ◽  
The Impact

People differ from each other in their typical patterns of behavior, thought, and emotion and these patterns are considered to constitute their personalities (Funder, 2001). For various reasons, for example because certain trait levels may help to attain certain goals or fulfill certain social roles, people may experience that their actual trait levels are different from their ideal trait levels. In this study, we investigated (1) the impact of age on discrepancies between actual and ideal Big Five personality trait levels and (2) the impact of these discrepancies on personality trait changes across a period of two years. We use data of a large, nationally representative, and age-diverse sample (N = 4,057, 17-94 years, M = 53 years). Results largely confirmed previously reported age effects on actual personality trait levels but were sometimes more complex. Ideal trait levels exceeded actual trait levels more strongly for younger compared to older adults. Unexpectedly, neither ideal trait levels nor their interaction with beliefs about the extent to which personality is malleable vs. fixed predicted trait change over two years (controlling for actual trait levels). We conclude that ideal-actual trait level discrepancies may provide an impetus for change but that they appear to neither alone nor in combination with the belief that personality trait change is possible suffice to produce such change. We discuss commitment, self-efficacy, and strategy knowledge as potential additional predictors of trait change.

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