scholarly journals Association of change in cognitive function from early adulthood to middle age with risk of cause-specific mortality: the Vietnam Experience Study

2019 ◽  
Vol 73 (8) ◽  
pp. 712-716
Author(s):  
G David Batty ◽  
Ian J Deary ◽  
Martin J Shipley
Keyword(s):  
Socioeconomic Status ◽  
Cognitive Function ◽  
Middle Age ◽  
Statistical Significance ◽  
Early Adulthood ◽  
Cognitive Testing ◽  
Second Phase ◽  
Risk Of Death ◽  
Specific Mortality ◽  
Using Data

BackgroundStudies with single baseline measurements of cognitive function consistently reveal inverse relationships with mortality risk. The relation of change in functioning, particularly from early in the life course, which may offer additional insights into causality, has not, to the best of our knowledge, been tested.AimsTo examine the association of change in cognition between late adolescence and middle age with cause-specific mortality using data from a prospective cohort study.MethodsThe analytical sample consisted of 4289 former US male military personnel who were administered the Army General Technical Test in early adulthood (mean age 20.4 years) and again in middle age (mean age 38.3 years).ResultsA 15-year period of mortality surveillance subsequent to the second phase of cognitive testing gave rise to 237 deaths. Following adjustment for age, a 10-unit increase in cognitive function was related to a reduced risk of death from all causes (HR 0.84; 95% CI 0.75 to 0.93) and cardiovascular disease (HR 0.78; 95% CI 0.64 to 0.95) but not from all cancers (HR 1.14; 95% CI 0.88 to 1.47) nor injury (HR 1.02; 95% CI 0.81 to 1.29). Adjustment for markers of socioeconomic status in middle age resulted in marked attenuation in the magnitude of these associations and statistical significance at conventional levels was lost in all analyses.ConclusionsIn the present study, the apparent link between increased cognition and mortality was mediated by socioeconomic status.

P1-271: URINE ALBUMIN-TO-CREATININE RATIO TRAJECTORIES IN EARLY ADULTHOOD AND COGNITIVE FUNCTION IN MIDDLE AGE

2006 ◽  
Vol 14 (7S_Part_7) ◽  
pp. P385-P386
Author(s):  
Sanaz Sedaghat ◽  
Kristine Yaffe ◽  
Stephen Sidney ◽  
David R. Jacobs ◽  
Farzaneh Sorond ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Middle Age ◽  
Early Adulthood ◽  
Creatinine Ratio ◽  
Urine Albumin

scholarly journals Dietary macronutrient content, age-specific mortality and lifespan

2019 ◽  
Vol 286 (1902) ◽  
pp. 20190393 ◽  
Author(s):  
Alistair M. Senior ◽  
Samantha M. Solon-Biet ◽  
Victoria C. Cogger ◽  
David G. Le Couteur ◽  
Shinichi Nakagawa ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Old Age ◽  
Dietary Protein ◽  
Middle Age ◽  
Early Adulthood ◽  
Later Life ◽  
Age At Death ◽  
Specific Mortality ◽  
Median Lifespan ◽  
High Concentrations

Protein and calorie restrictions extend median lifespan in many organisms. However, studies suggest that among-individual variation in the age at death is also affected. Ultimately, both of these outcomes must be caused by effects of nutrition on underlying patterns of age-specific mortality (ASM). Using model life tables , we tested for effects of dietary macronutrients on ASM in mice ( Mus musculus ). High concentrations of protein and fat relative to carbohydrates were associated with low life expectancy and high variation in the age at death, a result caused predominantly by high mortality prior to middle age. A lifelong diet comprising the ratio of macronutrients self-selected by mouse (in early adulthood) was associated with low mortality up until middle age, but higher late-life mortality. This pattern results in reasonably high life expectancy, but very low variation in the age at death. Our analyses also indicate that it may be possible to minimize ASM across life by altering the ratio of dietary protein to carbohydrate in the approach to old age. Mortality in early and middle life was minimized at around one-part protein to two-parts carbohydrate, whereas in later life slightly greater than equal parts protein to carbohydrate reduced mortality.

The Unique Experience of Caregivers Based on Their Life Stage and Relationship to the Patient

2019 ◽  
pp. 34-49
Author(s):  
Kristin Litzelman
Keyword(s):  
Life Course ◽  
Middle Age ◽  
Life Stage ◽  
Early Adulthood ◽  
Well Being ◽  
Behavioral Risk ◽  
Cancer Caregivers ◽  
Using Data ◽  
The Life Course ◽  
Cancer Caregiving

Although caregivers are often thought of as middle-aged or older adults, cancer caregiving spans the life course. This chapter discusses the unique challenges of cancer caregiving across the life course—early adulthood (18–44 years of age); middle age (45–64 years); and older age (adults 65 years and older)—using data from the 2015 Behavioral Risk Factor Surveillance System and evidence from the extant literature. More than 4 in 10 cancer caregivers were in early adulthood. Another 4 in 10 were in middle age, and nearly 2 in 10 were in older adulthood. Normative developmental patterns differ at each life stage, with implications for supporting cancer caregivers in clinical and policy settings. Future research embracing a nuanced view of caregiving across the life course and across relationship type will enhance the ability to care for caregivers and improve cancer survivor and caregiver well-being.

scholarly journals A Cohort Study of Exposure to Antihyperglycemic Therapy and Survival in Patients with Lung Cancer

2020 ◽  
Vol 17 (5) ◽  
pp. 1747
Author(s):  
Edvardas Danila ◽  
Donata Linkevičiūtė-Ulinskienė ◽  
Rolandas Zablockis ◽  
Vygantas Gruslys ◽  
Saulius Cicėnas ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lower Risk ◽  
Statistical Significance ◽  
Risk Of Death ◽  
Antihyperglycemic Therapy ◽  
Study Results ◽  
Specific Mortality ◽  
Group A ◽  
Overall Mortality

We evaluated the effect of antihyperglycemic therapy on the survival of patients with lung cancer (LC). The analysis included patients with LC and concomitant type 2 diabetes. 15,929 patients were classified into five groups: metformin users, insulin users, metformin and insulin users, sulphonylurea users and non-diabetic group. A multivariate analysis showed that exposure to either metformin or to insulin was associated with a lower risk of LC-specific mortality, and this approached statistical significance (HR 0.82, 95% CI 0.72–92 for metformin and HR 0.65, 95% CI 0.44–95 for insulin). When deaths from all causes were considered, only metformin exposure was associated with a significantly lower risk of death (HR 0.82, 95% CI 0.73–0.92). Users of sulphonylurea were at a higher risk of LC-specific and overall mortality (HRs 1.19, 95% CI 0.99–1.43 and 1.22, 95% CI 1.03–1.45). Our study shows a positive effect of metformin on the survival of patients with LC. Moreover, our results show that exposure to insulin was associated with a lower risk of LC-specific mortality, but not with deaths from all causes. The study results suggested that users of sulphonylurea may be at a higher risk of LC-specific and overall mortality.

Childhood Abuse and Cognitive Function in a Large Cohort of Middle-Aged Women

2020 ◽  
pp. 107755952097064
Author(s):  
Andrea L. Roberts ◽  
Jennifer A. Sumner ◽  
Karestan C. Koenen ◽  
Laura D. Kubzansky ◽  
Francine Grodstein ◽  
...  
Keyword(s):  
Public Health ◽  
Socioeconomic Status ◽  
Working Memory ◽  
Cognitive Function ◽  
Childhood Abuse ◽  
Middle Age ◽  
Psychomotor Speed ◽  
Health Factors ◽  
Childhood Socioeconomic Status ◽  
Socioeconomic Status And Health

Cognitive function at middle age is of particular public health interest, as it strongly predicts later dementia. Children who have experienced abuse subsequently have worse cognitive function than those who have not. However, it remains unclear whether the association of abuse with cognitive function persists into middle age. In 2014–2016, 14,151 women ages 49–69 years who had previously responded to a childhood abuse questionnaire completed a cognitive battery. In models adjusted for childhood socioeconomic status and head trauma, combined physical, emotional, and sexual abuse was associated with lower scores on both Learning/Working Memory (severe abuse, lower scores similar to that observed in women 4.8 years older in our data) and Psychomotor Speed/Attention (severe abuse, lower scores similar to that observed in women to 2.9 years older in our data). Adjustment for adulthood socioeconomic status and health factors (e.g., smoking, hypertension) slightly attenuated associations. In exploratory analyses further adjusted for psychological distress, associations were attenuated. Women exposed versus unexposed to childhood abuse had poorer cognitive function at mid-life. Associations were particularly strong for learning and working memory and were not accounted for by adulthood health factors. Childhood abuse should be investigated as a potential risk factor for cognitive decline and dementia in old age.

The Carpentier-Edwards Classic and Physio Mitral Annuloplasty Rings: A Randomized Trial

2006 ◽  
Vol 8 (5) ◽  
pp. 389 ◽  
Author(s):  
Ghada M. M. Shahin ◽  
Geert J. M. G. van der Heijden ◽  
Michiel L. Bots ◽  
Maarten-Jan Cramer ◽  
Wybren Jaarsma ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Absolute Risk ◽  
Statistical Significance ◽  
Nyha Class ◽  
Left Ventricular ◽  
Mitral Annuloplasty ◽  
Risk Of Death ◽  
Late Failure

<P>Objective: To evaluate clinical and echocardiographic outcomes for the semi-flexible Carpentier-Edwards Physio and the rigid Classic mitral annuloplasty ring. </P><P>Methods: Ninety-six patients were randomized for either a Classic (n = 53) or a Physio (n = 43) ring from October 1995 through July 1997. Mean follow-up was 5.1 years (range .1-6.6). We included standard patient characteristics at baseline and during follow-up. Analyses were adjusted for age and gender, and for factors that differed across groups at baseline. In 2002, echocardiography was performed in 74% of the survivors. </P><P>Results: We found a 16% difference in mortality: 14% in the Physio group (n = 6) and 30% in the Classic group (n = 16) (adjusted P = .41). Life table analysis shows that the absolute risk of death after 30 months is lower in the Physio group. Intra-operative repair failure occurred in 3 patients (6%) of the Classic group, and in 4 (9%) of the Physio group, resulting in mitral valve replacement. Late failure occurred in 1 patient (2%) in the Classic group, and in 4 (9%) in the Physio group. At follow-up, left ventricular function did not differ across groups (ejection fraction 45% and 48% (adjusted P = .65)). The combined NYHA class III-IV had improved for the Classic group in 42% and for the Physio group in 34%. </P><P>Conclusion: Although the 16% difference in mortality did not reach statistical significance, it is considered clinically important. No differences in morbidity, valve function, and left ventricular function were found. Further research to explain the difference in mortality is required.</P>

Life-Course Glucose Trajectory and Cognitive Function in Middle Age—Evidence from the Bogalusa Heart Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1474-P
Author(s):  
PATRICK STUCHLIK ◽  
OWEN CARMICHAEL ◽  
EMILY HARVILLE ◽  
HUA HE ◽  
MARYELLEN ROMERO ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Life Course ◽  
Middle Age ◽  
Bogalusa Heart Study ◽  
Heart Study

scholarly journals Leisure time physical activity throughout adulthood is associated with lower medicare costs: evidence from the linked NIH-AARP diet and health study cohort

2021 ◽  
Vol 7 (1) ◽  
pp. e001038
Author(s):  
Diarmuid Coughlan ◽  
Pedro F Saint-Maurice ◽  
Susan A Carlson ◽  
Janet Fulton ◽  
Charles E Matthews
Keyword(s):  
Physical Activity ◽  
Healthcare Costs ◽  
Middle Age ◽  
Leisure Time Physical Activity ◽  
Early Adulthood ◽  
Later Life ◽  
Health Study ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
Medicare Costs

BackgroundThere is limited information about the association between long-term leisure time physical activity (LTPA) participation and healthcare costs. The purpose of this study was to investigate the association between LTPA over adulthood with later life healthcare costs in the USA.MethodsUsing Medicare claims data (between 1999 and 2008) linked to the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, we examined associations between nine trajectories of physical activity participation throughout adulthood with Medicare costs.ResultsCompared with adults who were consistently inactive from adolescence into middle age, average annual healthcare costs were significantly lower for maintainers, adults who maintained moderate (–US$1350 (95% CI: –US$2009 to –US$690) or −15.9% (95% CI: −23.6% to −8.1%)) or high physical activity levels (–US$1200 (95% CI: –US$1777 to –US$622) or −14.1% (95% CI: −20.9% to −7.3%)) and increasers, adults who increased physical activity levels in early adulthood (–US$1874 (95% CI: US$2691 to –US$1057) or −22.0% (95% CI: −31.6% to −12.4%)) or in middle age (–US$824 (95% CI: –US$1580 to –US$69 or −9.7% (95% CI −18.6% to −0.8%)). For the four trajectories where physical activity decreased, the only significant difference was for adults who increased physical activity levels during early adulthood with a decline in middle age (–US$861 (95% CI:–US$1678 to –US$45) or −10.1% (95% CI: −19.7% to −0.5%)).ConclusionOur analyses suggest the healthcare cost burden in later life could be reduced through promotion efforts supporting physical activity participation throughout adulthood.

scholarly journals Dementia Adjudication Triggers Associated With Increased Mortality for Older Australians: Evidence From ASPREE

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 161-161
Author(s):  
Jane Banaszak-Holl ◽  
Xiaoping Lin ◽  
Jing Xie ◽  
Stephanie Ward ◽  
Henry Brodaty ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Service Planning ◽  
Cox Proportional Hazards Model ◽  
Cognitive Test ◽  
Risk Of Death ◽  
Hazards Model ◽  
Using Data

Abstract Research Aims: This study seeks to understand whether those with dementia experience higher risk of death, using data from the ASPREE (ASPirin in Reducing Events in the Elderly) clinical trial study. Methods: ASPREE was a primary intervention trial of low-dose aspirin among healthy older people. The Australian cohort included 16,703 dementia-free participants aged 70 years and over at enrolment. Participants were triggered for dementia adjudication if cognitive test results were poorer than expected, self-reporting dementia diagnosis or memory problems, or dementia medications were detected. Incidental dementia was adjudicated by an international adjudication committee using the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) criteria and results of a neuropsychological battery and functional measures with medical record substantiation. Statistical analyses used a cox proportional hazards model. Results: As previously reported, 1052 participants (5.5%) died during a median of 4.7 years of follow-up and 964 participants had a dementia trigger, of whom, 575 (60%) were adjucated as having dementia. Preliminary analyses has shown that the mortality rate was higher among participants with a dementia trigger, regardless of dementia adjudication outcome, than those without (15% vs 5%, Χ2 = 205, p &lt;.001). Conclusion: This study will provide important analyses of differences in the hazard ratio for mortality and causes of death among people with and without cognitive impairment and has important implications on service planning.

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