scholarly journals Cohort profile: Indian Network of Population-Based Surveillance Platforms for Influenza and Other Respiratory Viruses among the Elderly (INSPIRE)

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052473
Author(s):  
Anand Krishnan ◽  
Lalit Dar ◽  
Ritvik Amarchand ◽  
Aslesh Ottapura Prabhakaran ◽  
Rakesh Kumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Economic Burden ◽  
Respiratory Infections ◽  
Open Data ◽  
Healthcare Utilisation ◽  
Wealth Quintile ◽  
Community Dwelling ◽  
Acute Lower Respiratory Infection ◽  
Syncytial Virus

PurposeWe describe here a multicentric community-dwelling cohort of older adults (>60 years of age) established to estimate incidence, study risk factors, healthcare utilisation and economic burden associated with influenza and respiratory syncytial virus (RSV) in India.ParticipantsThe four sites of this cohort are in northern (Ballabgarh), southern (Chennai), eastern (Kolkata) and western (Pune) parts of India. We enrolled 5336 participants across 4220 households and began surveillance in July 2018 for viral respiratory infections with additional participants enrolled annually. Trained field workers collected data about individual-level and household-level risk factors at enrolment and quarterly assessed frailty and grip strength. Trained nurses surveilled weekly to identify acute respiratory infections (ARI) and clinically assessed individuals to diagnose acute lower respiratory infection (ALRI) as per protocol. Nasal and oropharyngeal swabs are collected from all ALRI cases and one-fifth of the other ARI cases for laboratory testing. Cost data of the episode are collected using the WHO approach for estimating the economic burden of seasonal influenza. Handheld tablets with Open Data Kit platform were used for data collection.Findings to dateThe attrition of 352 participants due to migration and deaths was offset by enrolling 680 new entrants in the second year. All four sites reported negligible influenza vaccination uptake (0.1%–0.4%), low health insurance coverage (0.4%–22%) and high tobacco use (19%–52%). Ballabgarh had the highest proportion (54.4%) of households in the richest wealth quintile, but reported high solid fuel use (92%). Frailty levels were highest in Kolkata (11.3%) and lowest in Pune (6.8%). The Chennai cohort had highest self-reported morbidity (90.1%).Future plansThe findings of this cohort will be used to inform prioritisation of strategies for influenza and RSV control for older adults in India. We also plan to conduct epidemiological studies of SARS-CoV-2 using this platform.

scholarly journals Diagnostic Power of Circulatory Metabolic Biomarkers as Metabolic Syndrome Risk Predictors in Community-Dwelling Older Adults in Northwest of England (A Feasibility Study)

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2275
Author(s):  
Razieh Hassannejad ◽  
Hamsa Sharrouf ◽  
Fahimeh Haghighatdoost ◽  
Ben Kirk ◽  
Farzad Amirabdollahian
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
Roc Analysis ◽  
Cross Validation ◽  
Community Dwelling ◽  
Tnf Α ◽  
Diagnostic Power ◽  
Metabolic Biomarkers ◽  
Community Dwelling Older Adults

Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.

scholarly journals A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults

2021 ◽  
pp. 1-14
Author(s):  
Magdalena I. Tolea ◽  
Jaeyeong Heo ◽  
Stephanie Chrisphonte ◽  
James E. Galvin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Risk Score ◽  
Clinical Sample ◽  
Community Sample ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Risk Scores ◽  
Predictive Values

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by >  85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.

scholarly journals Polish Translation and Validation of the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire to Assess Nutritional and Non-Nutritional Risk Factors of Sarcopenia in Older Adults

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1061
Author(s):  
Roma Krzymińska-Siemaszko ◽  
Ewa Deskur-Śmielecka ◽  
Arkadiusz Styszyński ◽  
Katarzyna Wieczorowska-Tobis
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Risk Assessment ◽  
Predictive Value ◽  
High Sensitivity ◽  
Community Dwelling ◽  
Nutritional Risk ◽  
Polish Language ◽  
Community Dwelling Older Adults ◽  
Translation And Validation

A simple, short, cheap, and reasonably sensitive and specific screening tool assessing both nutritional and non-nutritional risk factors for sarcopenia is needed. Potentially, such a tool may be the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire, which is available in a seven-item (MSRA-7) and five-item (MSRA-5) version. The study’s aim was Polish translation and validation of both MSRA versions in 160 volunteers aged ≥60 years. MSRA was validated against the six sets of international diagnostic criteria for sarcopenia used as the reference standards. PL-MSRA-7 and PL-MSRA-5 both had high sensitivity (≥84.9%), regardless of the reference standard. The PL-MSRA-5 had better specificity (44.7–47.2%) than the PL-MSRA-7 (33.1–34.7%). Both questionnaires had similarly low positive predictive value (PL-MSRA-5: 17.9–29.5%; PL-MSRA-7: 14.4–25.2%). The negative predictive value was generally high for both questionnaires (PL-MSRA-7: 89.8–95.9%; PL-MSRA-5: 92.3–98.5%). PL-MSRA-5 had higher accuracy than the PL-MSRA-7 (50.0–55% vs. 39.4–45%, respectively). Based on the results, the Mini Sarcopenia Risk Assessment questionnaire was successfully adopted to the Polish language and validated in community-dwelling older adults from Poland. When compared with PL-MSRA-7, PL-MSRA-5 is a better tool for sarcopenia risk assessment.

scholarly journals 10-Year Renal Function Trajectories in Community-Dwelling Older Adults: Exploring the Risk Factors for Different Patterns

2018 ◽  
Vol 7 (10) ◽  
pp. 373
Author(s):  
Chia-Ter Chao ◽  
Yung-Ming Chen ◽  
Fu-Hui Ho ◽  
Kun-Pei Lin ◽  
Jen-Hau Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Logistic Regression ◽  
Renal Function ◽  
Estimated Glomerular Filtration Rate ◽  
Community Dwelling ◽  
Multivariate Logistic Regression ◽  
Improve Risk Stratification ◽  
Leukocyte Counts ◽  
Community Dwelling Older Adults

Longitudinal changes of renal function help inform patients’ clinical courses and improve risk stratification. Rare studies address risk factors predicting changes in estimated glomerular filtration rate (eGFR) over time in older adults, particularly of Chinese ethnicity. We identified prospectively enrolled community-dwelling older adults (≥65 years) receiving annual health examinations between 2005 and 2015 with serum creatinine available continuously in a single institute, and used linear regression to derive individual’s annual eGFR changes, followed by multivariate logistic regression analyses to identify features associated with different eGFR change patterns. Among 500 elderly (71.3 ± 4.2 years), their mean annual eGFR changes were 0.84 ± 1.67 mL/min/1.73 m2/year, with 136 (27.2%) and 238 (47.6%) classified as having downward (annual eGFR change <0 mL/min/1.73 m2/year) and upward eGFR (≥1 mL/min/1.73 m2/year) trajectories, respectively. Multivariate logistic regression showed that higher age (odds ratio (OR) 1.08), worse renal function (OR 13.2), and more severe proteinuria (OR 9.86) or hematuria (OR 3.39) were predictive of a declining eGFR while greater waist circumference (OR 1.06) and higher leukocyte counts (OR 1.21) were predictive of an uprising 10-year eGFR. These findings elucidate important features associated with geriatric renal function variations, which are expected to improve their renal care.

scholarly journals Prevalence and Multidimensional Risk Factors of Physical Frailty in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study

2020 ◽  
Author(s):  
Heeeun Jung ◽  
Miji Kim ◽  
Yunhwan Lee ◽  
Chang Won Won
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cohort Study ◽  
Medical Condition ◽  
Glycosylated Hemoglobin ◽  
Community Dwelling ◽  
National Standard ◽  
Timed Up And Go ◽  
Frailty Phenotype ◽  
Community Dwelling Older Adults

Frailty is defined as a state of increased vulnerability to stressors, and it predicts the disability and mortality in the older population. This study aimed to investigate standardized prevalence and multidimensional risk factors associated with frailty among the Korean community-dwelling older adults. We analyzed the baseline data of 2,907 adults aged 70&ndash;84 years (mean age 75.8&plusmn;3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and pre-frailty was 7.9% (95% confidence interval [CI] 6.8&ndash;8.9%) and 57.2% (95% CI 45.1&ndash;48.8%), respectively. The following 14 risk factors had a significant association with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer timed up and go, and low short physical performance battery score (p&lt;0.05). Physico-nutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

The role of meaning in life in community-dwelling older adults with depression and relationship to other risk factors

2017 ◽  
Vol 23 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Jana Volkert ◽  
Martin Härter ◽  
Maria Christina Dehoust ◽  
Berta Ausín ◽  
Alessandra Canuto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Meaning In Life ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

Risk factors for future falls among community-dwelling older adults without a fall in the previous year: A prospective one-year longitudinal study

2020 ◽  
Vol 91 ◽  
pp. 104161 ◽  
Author(s):  
Jaqueline Mello Porto ◽  
Natália Camargo Rodrigues Iosimuta ◽  
Renato Campos Freire Júnior ◽  
Roberta de Matos Brunelli Braghin ◽  
Érika Leitner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Longitudinal Study ◽  
Community Dwelling ◽  
One Year ◽  
Community Dwelling Older Adults

scholarly journals Childhood infectious diseases and old age cognitive functioning: a nationally representative sample of community-dwelling older adults

2020 ◽  
pp. 1-8
Author(s):  
A. Rotstein ◽  
S. Z. Levine
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Infectious Diseases ◽  
Cognitive Functioning ◽  
Old Age ◽  
Early Life ◽  
Representative Sample ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Nationally Representative

ABSTRACT Background: Cumulative evidence suggests that health-related risk factors during midlife and old-age are associated with cognitive impairment. However, studies are needed to clarify the association between early-life risk factors and impaired cognitive functioning to increment existing knowledge. Objective: To examine the association between childhood infectious diseases and late-life cognitive functioning in a nationally representative sample of older adults. Participants: Eligible respondents were 2994 community-dwelling individuals aged 65–85. Measurements: Cognitive functioning was assessed using the Mini-Mental State Examination (MMSE). Childhood infectious diseases (i.e. chicken pox, measles, and mumps) were self-reported. The study covariates were age, sex, highest educational level achieved, smoking status, body mass index, and depression. The primary statistical analysis examined the association between the number of childhood infectious diseases and total MMSE scores, accounting for all study covariates. Regression models of progressive complexity were examined for parsimony. The robustness of the primary results was tested in 17 sensitivity analyses. Results: The most parsimonious model was a linear adjusted model (Bayesian Information Criterion = 12646.09). Late-life cognitive functioning significantly improved as the number of childhood infectious diseases increased (β = 0.18; 95% CI = 0.11, 0.26; p < 0.001). This effect was not significantly attenuated in all sensitivity analyses. Conclusion: The current study results are consistent with prior ecological findings indicating that some childhood infectious diseases are associated with better cognitive functioning in old-age. This points to an early-life modifiable risk factor associated with older-life cognitive functioning. Our results may reflect selective mortality and/or beneficial effects via hormetic processes.

Sign in / Sign up

Export Citation Format

Share Document