The Modified Healthy Ageing Index Is Associated with Mortality and Disability: The Rugao Longevity and Ageing Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Hui Zhang ◽  
Yinsheng Zhu ◽  
Meng Hao ◽  
Jiucun Wang ◽  
Zhengdong Wang ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Predictive Ability ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Adverse Outcomes ◽  
Healthy Ageing ◽  
Sensitivity Analyses ◽  
Logistic Regression Models ◽  
Ageing Study

<b><i>Introduction:</i></b> The Healthy Ageing Index (HAI) has been shown not only to have wider applicability and predictive ability but also to adequately predict mortality in Western populations. There is still a lack of studies validating the applicability of the HAI in China. <b><i>Objective:</i></b> To evaluate the applicability of the HAI and validate whether the HAI is suitable for monitoring ageing in the elderly population in China. <b><i>Methods:</i></b> Data were obtained from the Rugao Longevity and Ageing Study. The modified HAI was constructed based on systolic blood pressure, chronic pulmonary diseases, cognitive function, fasting glucose, and kidney function. It was calculated in 1719 individuals aged 70–84 years at baseline. The adverse outcomes were mortality and disability. Demographic, physiologic, and clinical data were collected. Cox proportional hazards and logistic regression models were used to analyze the relationship between the modified HAI and adverse outcomes. <b><i>Results:</i></b> A total of 1,719 older adults were analyzed in our study. A total of 793 (46.13%) males were recruited. The mean age was 75.69 ± 3.93 years. At the 5-year follow-up, there were 266 deaths and 275 individuals with disabilities. In the multivariable models, the modified HAI was associated with mortality (hazard ratio = 1.11, 95% confidence interval [CI]: 1.03–1.20) and disability (odds ratio = 1.11, 95% CI: 1.05–1.18). In the sensitivity analyses, similar associations remained after imputing missing data using multiple imputation and excluding participants with major cardiovascular disease at baseline. <b><i>Conclusion:</i></b> The modified HAI was a robust and independent predictor of adverse outcomes. It is a valid and feasible tool for monitoring ageing in older adults.

scholarly journals 1135 Longer And More Frequent Naps Predict Incident Alzheimer’s Dementia In Community-based Older Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A432-A432
Author(s):  
P Li ◽  
L Gao ◽  
A Gaba ◽  
L Yu ◽  
A S Buchman ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
The Elderly ◽  
Sleep Time ◽  
Cox Proportional Hazards ◽  
Alzheimer’S Dementia ◽  
Alzheimer's Dementia ◽  
Cox Proportional Hazards Models ◽  
Motor Activities ◽  
Underlying Mechanisms

Abstract Introduction Excessive napping duration has been associated with cognitive decline. The effect of napping frequency is less understood, and little is known about the development of Alzheimer’s dementia associated with napping. We tested whether longer or more frequent naps in the elderly are linked to the development of incident Alzheimer’s dementia. Methods We studied 1,180 older adults (age: 81.0±7.3 [SD]) in the Rush Memory and Aging Project who have been followed for up to 14 years. Motor activities of up to 10 days were recorded at baseline to assess napping characteristics objectively. We defined daytime napping episodes as motor activity segments between 10AM and 7PM with continuous zero-activity for ≥10min but &lt;1h (to avoid off-wrist periods). Segments that were &lt;5min apart were merged. Alzheimer’s dementia diagnosis was determined using the criteria of the National Institute of Neurological and Communicative Disorders and Strone and the Alzheimer’s Disease and Related Disorders Association. Cox proportional hazards models were performed to examine the associations of daily napping duration and frequency with incident AD. Results Of 1,180 non-demented participants at baseline (including 264 with mild cognitive impairment), 277 developed Alzheimer’s dementia within 5.74±3.36 years. On average, participants napped for 38.3±1.0 (SE) min and1.56±0.04 (SE) times per day at baseline. After adjustment for age, sex, and education, every 30-min increase in daily napping duration was associated with a 20% increase in the risk of incident AD (95% confidence interval [CI]: 9%-31%; p=0.0002). One more nap per day was associated with a 19% increase in the risk of AD (95% CI: 8%-30%; p=0.0003). These associations remained after further adjustment for total sleep time. Conclusion Longer and more frequent daytime naps predict a higher risk of incident Alzheimer’s dementia. Future studies are needed to examine specific underlying mechanisms. Support This work was supported by NIH grants RF1AG064312, RF1AG059867, R01AG017917, and R01AG56352.

Impact of anemia on hospitalization and mortality in older adults

Blood ◽  
2006 ◽  
Vol 107 (10) ◽  
pp. 3841-3846 ◽  
Author(s):  
Bruce F. Culleton ◽  
Braden J. Manns ◽  
Jianguo Zhang ◽  
Marcello Tonelli ◽  
Scott Klarenbach ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Prognostic Significance ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Normal Kidney ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Community Dwelling Older Adults

Although anemia is common in older adults, its prognostic significance is uncertain. A total of 17 030 community-dwelling subjects 66 years and older were identified between July 1 and December 31, 2001, and followed until December 31, 2004. Cox proportional hazards analyses were performed to determine the associations between anemia (defined as hemoglobin < 110 g/L) and hemoglobin and all-cause mortality, all-cause hospitalization, and cardiovascular-specific hospitalization. Overall, there were 1983 deaths and 7278 first hospitalizations. In patients with normal kidney function, adjusting for age, sex, diabetes mellitus, and comorbidity, anemia was associated with an increased risk for death (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.55-5.12), first all-cause hospitalization (HR, 2.16; 95% CI, 1.88-2.48), and first cardiovascular-specific hospitalization (HR, 2.49; 95% CI, 1.99-3.12). An inverse J-shaped relationship between hemoglobin and all-cause mortality was observed; the lowest risk for mortality occurred at hemoglobin values between 130 to 150 g/L for women and 140 to 170 g/L for men. Anemia is associated with an increased risk for hospitalization and death in community-dwelling older adults. Consideration should be given to redefine “normal” hemoglobin values in the elderly. Clinical trials are also necessary to determine whether anemia correction improves quality or quantity of life in this population.

scholarly journals All-Cause Mortality Risk Associated With Solid Fuel Use Among Chinese Elderly People: A National Retrospective Longitudinal Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Shisi Shen ◽  
Min Luo ◽  
Xuchen Meng ◽  
Ying Deng ◽  
Shuwen Cheng
Keyword(s):  
Solid Fuel ◽  
Mortality Risk ◽  
Proportional Hazards ◽  
Dietary Diversity ◽  
The Elderly ◽  
Potential Interaction ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Fuel Use ◽  
Clean Fuels

Background: The adverse health effects of air pollutants are widely reported, and the elderly are susceptible to toxic environments. This study aimed to evaluate the association between use of solid fuels for cooking and mortality among the elderly.Methods: A total of 5,732 and 3,869 participants from the Chinese Longitudinal Healthy Longevity Survey were enrolled in two (2014 and 2018) and three surveys (2011, 2014, and 2018) of survey. Cooking fuel was divided into clean and solid fuel. Cox proportional hazards models were used to estimate the mortality hazard ratio (HR). Subgroup analyses were performed to assess the potential interaction effect.Results: Among the participants in the 2011–2018 survey, 53% reported using solid fuel. Such group was associated with a 9% increase in mortality risk relative to clean fuel users (HR = 1.09, 95% CI = 1.01–1.18). Among participants in the 2014–2018 survey, 339 reported a switch from solid to clean fuels and they were not at increased mortality risk relative to the 488 people that reported a stable use of clean fuels (HR = 1.14, 95% CI = 0.99–1.31) although the estimated HR was similar to the one for stable solid fuel users (HR = 1.19, 95%CI = 1.04–1.36 n = 509). Interaction and stratified analyses showed that solid fuel use had an impact on mortality in participants who were non-current smokers, had low dietary diversity scores, and were living in areas with high PM2.5 concentrations (&gt;50 μg/m3) and city population below 8 million (P for interaction &lt; 0.05). The association was robust in the three sensitivity analyses.Conclusion: The finding showed a clear association between solid fuel use and mortality among older Chinese, and an even stronger association between risk of mortality and solid fuel use among individuals exposed to high levels of PM2.5.

scholarly journals Increased Hemoglobin A1c Time in Range Reduces Adverse Health Outcomes in Older Adults With Diabetes

2021 ◽  
Author(s):  
Julia C. Prentice ◽  
David C. Mohr ◽  
Libin Zhang ◽  
Donglin Li ◽  
Aaron Legler ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Glycemic Variability ◽  
Baseline Period ◽  
Cox Proportional Hazards ◽  
Adverse Outcomes ◽  
Target Range ◽  
Patient Specific ◽  
Time In Range

<b>Objective: </b><a>Short and long-term glycemic variability are risk factors for diabetes complications</a>. However, there are no validated A1c target ranges or measures of A1c stability in older adults. We evaluated<b> </b>the association of a patient-specific A1c variability measure, A1c time in range (A1c TIR), on major adverse outcomes.<b></b> <p><b> </b></p> <p><b>Research Design and Methods: </b> We conducted a retrospective observational study using administrative data from the Department of Veterans Affairs and Medicare from 2004 - 2016<b>. </b>Patients were ≥65 years old with diabetes and at least four A1c tests during a three-year baseline period. A1c TIR was the percentage of days during the baseline in which A1c was in an individualized target range (from 6.0-7.0% up to 8.0-9.0%) based on clinical characteristics and predicted life expectancy. Increasing A1c TIR was divided into categories of 20% increments and linked to mortality and cardiovascular disease (CVD) (i.e. myocardial infarction [MI] and stroke).</p> <p><b> </b></p> <p><b>Results: </b>The study included 402,043 Veterans (mean [SD] age, 76.9 [5.7] years; 98.8% male). During an average of 5.5 years of follow-up, A1c TIR had a graded relationship with mortality and CVD. Cox proportional hazards models showed lower A1c TIR was associated with increased mortality (A1c TIR 0-<20%; Hazard Ratio (HR) = 1.22; 95% CI, 1.20-1.25) and CVD (A1c TIR 0-<20%; HR = 1.14; 95% CI, 1.11-1.19) when compared to A1c TIR 80-100%. Competing risk models and shorter follow-up (e.g. 24 months) showed similar results. <b></b></p> <p><b> </b></p> <p><b>Conclusion: </b>In older adults with diabetes, maintaining A1c levels within individualized target ranges is associated with lower risk of mortality and CVD. </p>

Effects of social network diversity on mortality, cognition and physical function in the elderly: a longitudinal analysis of the Chicago Health and Aging Project (CHAP)

2018 ◽  
Vol 72 (11) ◽  
pp. 990-996 ◽  
Author(s):  
Talha Ali ◽  
Charlotte Juul Nilsson ◽  
Jennifer Weuve ◽  
Kumar B Rajan ◽  
Carlos F Mendes de Leon
Keyword(s):  
Older Adults ◽  
Social Networks ◽  
Social Network ◽  
Physical Function ◽  
Proportional Hazards ◽  
The Elderly ◽  
Network Size ◽  
Cox Proportional Hazards ◽  
Function Coefficient ◽  
Network Diversity

BackgroundHaving a larger social network has been shown to have beneficial effects on health and survival in adults, but few studies have evaluated the role of network diversity, in addition to network size. We explore whether social network diversity is associated with mortality, cognition and physical function among older black and white adults.MethodsData are obtained from the Chicago Health and Aging Project, a longitudinal, population-based study of adults aged 65 years and older at baseline. Using Cox proportional hazards regression, we estimate the hazard of mortality by network diversity (n=6497). The association between network diversity and cognition (n=6560) and physical function (n=6561) is determined using generalised estimating equations. Models were adjusted for age, gender, race, socioeconomic status, marital status and health-related variables.ResultsIn fully adjusted models, elderly with more diverse social networks had a lower risk of mortality (HR=0.93, p<0.01) compared with elderly with less diverse networks. Increased diversity in social networks was also associated with higher global cognitive function (coefficient=0.11, p<0.001) and higher physical function (coefficient=0.53, p<0.001).ConclusionsSocial networks are particularly important for older adults as they face the greatest threats to health and depend on network relationships, more than younger individuals, to meet their needs. Increasing diversity, and not just increasing size, of social networks may be essential for improving health and survival among older adults.

scholarly journals Gender differences in longevity in free-living older adults who eat-with-others: a prospective study in Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016575 ◽  
Author(s):  
Yi-Chen Huang ◽  
Hsing-Ling Cheng ◽  
Mark L Wahlqvist ◽  
Yuan-Ting C Lo ◽  
Meei-Shyuan Lee
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
The Elderly ◽  
Health Condition ◽  
Cox Proportional Hazards ◽  
Dietary Quality ◽  
Secondary Outcome ◽  
Free Living ◽  
Dietary Recall ◽  
All Cause Mortality

ObjectivesSocial activities such as ‘eating-with-others’ can positively affect the ageing process. We investigated the gender-specific association between eating arrangements and risk of all-cause mortality among free-living older adults.SettingA representative sample from the Elderly Nutrition and Health Survey in Taiwan during 1999–2000.ParticipantsSome 1894 participants (955 men and 939 women) who aged ≥65 and completed eating arrangement question as well as confirmed survivorship information.Primary and secondary outcome measuresEating arrangements, health condition and 24-hour dietary recall information were collected at baseline. We classified eating arrangements as the daily frequency of eating-with-others (0–3). Survivorship was determined by the National Death Registry until the end of 2008. Cox proportional-hazards regression was used to assess the association between eating-with-others and mortality risk.ResultsOverall, 63.1% of men and 56.4% of women ate with others three times a day. Both men and women who ate with others were more likely to have higher meat and vegetable intakes and greater dietary quality than those who ate alone. The HRs (95% CI) for all-cause mortality when eating-with-others two and three times per day were 0.42 (0.28 to 0.61), 0.67 (0.52 to 0.88) in men and 0.68 (0.42 to 1.11), 0.86 (0.64 to 1.16) in women, compared with those who ate alone. Multivariable HRs (95% CI) adjusted for sociodemographic, nutritional and ‘activities of daily living’ covariates were 0.43 (0.25 to 0.73), 0.63 (0.41 to 0.98) in men and 0.68 (0.35 to 1.30), 0.69 (0.39 to 1.21) in women. With further adjustment for financial status, HR was reduced by 54% in men who ate with others two times a day. Pathway analysis shows this to be dependent on improved dietary quality by eating-with-others.ConclusionsEating-with-others is an independent survival factor in older men. Providing a social environment which encourages eating-with-others may benefit survival of older people, especially for men.

scholarly journals Sex-Specific Associations of Established and Emerging Cardiac Biomarkers with All-Cause Mortality in Older Adults: The ActiFE Study

2015 ◽  
Vol 61 (2) ◽  
pp. 389-399 ◽  
Author(s):  
Dhayana Dallmeier ◽  
Michael Denkinger ◽  
Richard Peter ◽  
Kilian Rapp ◽  
Allan S Jaffe ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Troponin T ◽  
Total Mortality ◽  
High Sensitivity ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Cardiac Biomarkers ◽  
All Cause Mortality

Abstract BACKGROUND N-terminal pro B-type natriuretic peptide (NT-proBNP) has strong prognostic value for all-cause mortality in the general population. High-sensitivity assays now allow detection of cardiac troponins even in asymptomatic populations. We examined the association between NT-proBNP, high-sensitivity cardiac troponin T (hs-cTnT), and hs-cTnI and all-cause mortality in older adults. METHODS We conducted a longitudinal cohort study [Activity and Function in the Elderly in Ulm (ActiFE Ulm)] including 1506 community-dwelling adults ≥65 years old with NT-proBNP, hs-cTnT, and hs-cTnI measured at baseline. We evaluated the associations between log-transformed biomarker concentrations and 4-year total mortality, accounting for possible confounders, with Cox proportional hazards models. RESULTS We observed 125 deaths among 1422 participants (median follow-up 4 years). We detected effect modification by sex for all biomarkers (all P values &lt;0.05) expressed as hazard ratio (HR) for death per 1-unit increment of ln(biomarker concentration) in women (n = 618, 37 deaths) compared with men (n = 804, 88 deaths): HR 2.97 (95% CI 2.04–4.33) vs 1.73 (1.40–2.13) for NT-proBNP; 3.67 (2.31–5.81) vs 2.15 (1.61–2.87) for hs-cTnT; and 3.32 (2.13–5.18) vs 1.92 (1.55–2.38) for hs-cTnI. Among 777 participants with undetectable hs-cTnT (&lt;5 ng/L), hs-cTnI remained associated with all-cause mortality in age- and sex-adjusted analysis. CONCLUSIONS NT-proBNP, hs-cTnT, and hs-cTnI were independently associated with all-cause mortality in older adults. The strength of these associations varied between men and women, emphasizing the need for additional sex-specific research among older people.

scholarly journals Diabetes, Disability, and Dementia Risk: Results From the HEPESE

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 574-574
Author(s):  
Elizabeth Vasquez ◽  
Meghana Gadgil ◽  
Weihu Zhang ◽  
Jacqueline L Angel
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Oldest Old ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Mexican Origin ◽  
Foreign Born ◽  
Dementia Risk ◽  
Diabetes Status

Abstract The relationship between cognitive function, diabetes and disability among the oldest-old remains largely unexplored, particularly in the Latino population. This study examines dementia risk and diabetes status in a Mexican-origin older adult sample. The data are drawn from eight waves (1993 -2013) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE; N=3,039, mean age at baseline=73.6 (±6.8)). We use multivariable Cox proportional hazards models to predict the relation between diabetes and time to incident dementia (MMSE&lt;24, 1+ IADL), with risk adjustment for age of migration, socioeconomic status, acculturation, and health. Diabetes prevalence at baseline was 27.8 %. Diabetes was associated with a higher risk of developing dementia (HR)=1.22, p&lt;0.001). Foreign-born older adults who migrated at ages 20- 49 had a higher survival probability of being dementia-free (HR=0.84, p=0.001). Our results further highlight the importance of evaluating differences in the cognitive outcomes of Mexican origin older adults.

scholarly journals Adaptive metabolic and inflammatory responses identified using accelerated aging metrics are linked to adverse outcomes in severe SARS-CoV-2 infection

2021 ◽  
Author(s):  
Alejandro Márquez-Salinas ◽  
Carlos A Fermín-Martínez ◽  
Neftalí Eduardo Antonio-Villa ◽  
Arsenio Vargas-Vázquez ◽  
Enrique C. Guerra ◽  
...  
Keyword(s):  
Critical Illness ◽  
Proportional Hazards ◽  
Inflammatory Responses ◽  
Age Groups ◽  
Accelerated Aging ◽  
Cox Proportional Hazards ◽  
Adverse Outcomes ◽  
Adaptive Responses ◽  
Predictive Capacity ◽  
Risk Of Death

Abstract Background Chronological age (CA) is a predictor of adverse COVID-19 outcomes; however, CA alone does not capture individual responses to SARS-CoV-2 infection. Here, we evaluated the influence of aging metrics PhenoAge and PhenoAgeAccel to predict adverse COVID-19 outcomes. Furthermore, we sought to model adaptive metabolic and inflammatory responses to severe SARS-CoV-2 infection using individual PhenoAge components. Methods In this retrospective cohort study, we assessed cases admitted to a COVID-19 reference center in Mexico City. PhenoAge and PhenoAgeAccel were estimated using laboratory values at admission. Cox proportional hazards models were fitted to estimate risk for COVID-19 lethality and adverse outcomes (ICU admission, intubation, or death). To explore reproducible patterns which model adaptive responses to SARS-CoV-2 infection, we used k-means clustering using PhenoAge components. Results We included 1068 subjects of whom 222 presented critical illness and 218 died. PhenoAge was a better predictor of adverse outcomes and lethality compared to CA and SpO2 and its predictive capacity was sustained for all age groups. Patients with responses associated to PhenoAgeAccel&gt;0 had higher risk of death and critical illness compared to those with lower values (log-rank p&lt;0.001). Using unsupervised clustering we identified four adaptive responses to SARS-CoV-2 infection: 1) Inflammaging associated with CA, 2) metabolic dysfunction associated with cardio-metabolic comorbidities, 3) unfavorable hematological response, and 4) response associated with favorable outcomes. Conclusions Adaptive responses related to accelerated aging metrics are linked to adverse COVID-19 outcomes and have unique and distinguishable features. PhenoAge is a better predictor of adverse outcomes compared to CA.

scholarly journals Elevated plasma growth and differentiation factor 15 predicts incident anemia in older adults aged 60 years and older

2020 ◽  
Author(s):  
Yuko Yamaguchi ◽  
Marta Zampino ◽  
Toshiko Tanaka ◽  
Stefania Bandinelli ◽  
Yusuke Osawa ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Differentiation Factor ◽  
Hazards Model ◽  
Increased Risk ◽  
The Relationship

Abstract Background Anemia is common in older adults and associated with greater morbidity and mortality. The causes of anemia in older adults have not been completely characterized. Although elevated circulating growth and differentiation factor 15 (GDF-15) has been associated with anemia in older adults, it is not known whether elevated GDF-15 predicts the development of anemia. Methods We examined the relationship between plasma GDF-15 concentrations at baseline in 708 non-anemic adults, aged 60 years and older, with incident anemia during 15 years of follow-up among participants in the Invecchiare in Chianti (InCHIANTI) Study. Results During follow-up, 179 (25.3%) participants developed anemia. The proportion of participants who developed anemia from the lowest to highest quartile of plasma GDF-15 was 12.9%, 20.1%, 21.2%, and 45.8%, respectively. Adults in the highest quartile of plasma GDF-15 had an increased risk of developing anemia (Hazards Ratio 1.15, 95% Confidence Interval 1.09, 1.21, P&lt;.0001) compared to those in the lower three quartiles in a multivariable Cox proportional hazards model adjusting for age, sex, serum iron, soluble transferrin receptor, ferritin, vitamin B12, congestive heart failure, diabetes mellitus, and cancer. Conclusions Circulating GDF-15 is an independent predictor for the development of anemia in older adults.

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