Associations of Gait Disorders and Recurrent Falls in Older People: A Prospective Population-Based Study

Gerontology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Kathrin Marini ◽  
Philipp Mahlknecht ◽  
Oliver Schorr ◽  
Melanie Baumgartner ◽  
Roberto De Marzi ◽  
...  
Keyword(s):  
Gait Speed ◽  
Population Based ◽  
Gait Disorders ◽  
Study Cohort ◽  
Adverse Health Outcomes ◽  
Recurrent Falls ◽  
Early Fall ◽  
Relationship Of ◽  
Fall Risk Screening

<b><i>Background:</i></b> Recurrent falls represent a major source of serious adverse health outcomes in the general older population. Gait impairment has been linked to recurrent falls, but there are only limited long-term data on this association. <b><i>Objectives:</i></b> The objective of the study was to investigate the association of gait disorders (GDs) and gait tests with future falls in an existing longitudinal population-based cohort. <b><i>Method:</i></b> The study was performed in participants of the Bruneck Study cohort 2010 aged 60–97 years, with prospective 5-year follow-up. At baseline, participants underwent a clinical gait assessment (to determine neurological and non-neurological GDs according to an established classification) and were also evaluated by quantitative and semiquantitative gait tests (Hauser Index, Tinetti balance and gait test, and gait speed). Logistic regression analysis adjusted for age and sex was used to determine the relationship of baseline variables with incident recurrent falls at 5-year follow-up. <b><i>Results:</i></b> Of 328 included participants, 22 (6.7%) reported recurrent falls at follow-up. Baseline presence of GDs was associated with recurrent falls at follow-up (odds ratio [OR] 4.2; 95% confidence interval [CI] 1.6–11.1; <i>p</i> = 0.004), and this effect was largely driven by neurological GDs (OR 5.5; 95% CI 1.7–17.4; <i>p</i> = 0.004). All 3 simple gait tests were predictive for incident falls (Hauser Index, <i>p</i> = 0.002; Tinetti test, <i>p</i> = 0.006; and gait speed, <i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> Clinical assessment of GDs and gait tests both had independent significant predictive value for recurrent falls over a 5-year follow-up period. This highlights the potential of such assessments for early fall risk screening and timely implementation of fall-preventive measures.

scholarly journals Overuse of short-acting β2-agonists in asthma is associated with increased risk of exacerbation and mortality: a nationwide cohort study of the global SABINA programme

2020 ◽  
Vol 55 (4) ◽  
pp. 1901872 ◽  
Author(s):  
Bright I. Nwaru ◽  
Magnus Ekström ◽  
Pål Hasvold ◽  
Fredrik Wiklund ◽  
Gunilla Telg ◽  
...  
Keyword(s):  
Cox Regression ◽  
Asthma Management ◽  
Baseline Period ◽  
Population Based ◽  
Short Acting ◽  
Adverse Health Outcomes ◽  
Increased Risk ◽  
Asthma Patients ◽  
Β2 Agonists

BackgroundOveruse of short-acting β2-agonists (SABA) may indicate poor asthma control and adverse health outcomes. Contemporary population-based data on use, risk factors and impact of SABA (over)use on asthma exacerbations and mortality are scarce, prompting initiation of the global SABINA (SABA use IN Asthma) programme.MethodsBy linking data from Swedish national registries, asthma patients aged 12–45 years with two or more collections of drugs for obstructive lung disease during 2006–2014 were included. SABA overuse was defined as collection of more than two SABA canisters in a 1-year baseline period following inclusion. SABA use was grouped into 3–5, 6–10 and ≥11 canisters per baseline-year. Cox regression was used to examine associations between SABA use and exacerbation (hospitalisations and/or oral corticosteroid claims) and mortality.ResultsThe analysis included 365 324 asthma patients (mean age 27.6 years; 55% female); average follow-up was 85.4 months. 30% overused SABA, with 21% collecting 3–5 canisters per year, 7% collecting 6–10 canisters per year and 2% collecting ≥11 canisters per year. Increasing number of collected SABA canisters was associated with increased risk of exacerbation, as follows. 3–5 canisters: hazard ratio (HR) 1.26 (95% CI 1.24–1.28); 6–10 canisters: 1.44 (1.41–1.46); and ≥11 canisters: 1.77 (1.72–1.83), compared to two or fewer canisters per year. Higher SABA use was associated with incrementally increased mortality risk (2564 deaths observed), as follows. 3–5 canisters: HR 1.26 (95% CI 1.14–1.39); 6–10 canisters 1.67 (1.49–1.87); and ≥11 canisters: 2.35 (2.02–2.72) compared to two or fewer canisters per year.ConclusionOne-third of asthma patients in Sweden collected three or more SABA canisters annually. SABA overuse was associated with increased risks of exacerbation and mortality. These findings emphasise that monitoring of SABA usage should be key in improving asthma management.

Congenital collagenopathies increased the risk of inguinal hernia developing and repair: analysis from a nationwide population-based cohort study

2021 ◽  
Author(s):  
Hao Han Chang ◽  
Yung Shun Juan ◽  
Ching Chia Li ◽  
Hsiang Ying Lee ◽  
Jian Han Chen
Keyword(s):  
Inguinal Hernia ◽  
Population Based ◽  
Collagen Disease ◽  
Control Group ◽  
Study Cohort ◽  
Diagnostic Code ◽  
Research Database ◽  
Asian Men ◽  
Male Patients

Abstract Introduction: The aim of this study is to explore whether male patients diagnosed of congenital collagen diseases had higher risk of occurrence inguinal hernia than patients who do not had these diseases.Method: Data were collected from National Health Insurance Research Database (NHIRD) of Taiwan retrospectively. 1801 male patients who diagnosed of congenital collagen disease by using ICD-9 CM diagnostic code was the study cohort, and in the other hand, after propensity score matching, 6493 man without congenital collagen disease were enrolled as control group. The primary endpoint was receiving inguinal hernia repair during observation period.Result: During median 133.9 months follow-up period, the risk of inguinal hernia in collagen cohort was significantly higher than the control group (HR = 2.237, 95% CI:1.646–3.291, p < 0.001). Furthermore, this phenomenon also presented in patient younger than 18 (HR:3.040 95% CI: 1.819–5.083, p < 0.001) and in age 18–80 (HR: 1.909, 95% CI: 1.186–3.073, p < 0.001).Conclusion: Asian men, regardless of age, with congenital collagen disease are at the risk of developing inguinal hernia. Detailed physical examination and well patient education should be performed while facing these patients.

scholarly journals DEFINITIONS MATTER WHEN DIAGNOSING MILD COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S115-S115
Author(s):  
Carol Derby ◽  
Charles B Hall ◽  
Mindy Katz
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Incidence Rate ◽  
Population Based ◽  
Study Cohort ◽  
Dramatic Reduction ◽  
Cognitively Normal ◽  
Aging Study ◽  
Normal Cognition

Abstract Prior studies have shown that when standard diagnostic criteria are applied, the majority of individuals diagnosed with aMCI do not progress to clinical dementia, with a much larger proportion reverting to normal cognition. This suggests that a prospective confirmation of aMCI diagnosis may improve the specificity of the classification. We examined the rates of aMCI reversion using two definitions: one based on a single annual assessment, and one requiring a diagnosis over two consecutive annual assessments within the population based Einstein Aging Study Cohort. Using the definition that used a single annual assessment resulted in 224 incident aMCI cases in 5,321 person years of follow-up, for an incidence rate of 4.21 cases per 100 person years. Requiring the confirmatory diagnosis resulted in only 94 incident aMCI cases in 5736 person years of follow-up, for an incidence rate of 1.64 cases per 100 person years. 41% of the persons diagnosed with aMCI using the single annual assessment were cognitively normal at the next follow-up. Only 14% of the persons diagnosed with incident aMCI using the definition requiring later confirmation ever returned to being cognitively normal. When the aMCI definition that required confirmation was used, a dramatic reduction in the incidence rate of aMCI was observed in persons born after 1930, similar to what has been reported in the same cohort for dementia, but there was no such difference for the definition based on a single annual assessment.

scholarly journals Durability of Humoral Immune Responses to SARS-CoV-2 in Citizens of Ariano Irpino (Campania, Italy): A Longitudinal Observational Study With an 11.5-Month Follow-Up

2021 ◽  
Vol 9 ◽  
Author(s):  
Annachiara Coppola ◽  
Carlo Buonerba ◽  
Davide Cardinale ◽  
Gabriella Lo Conte ◽  
Donato Sansone ◽  
...  
Keyword(s):  
Observational Study ◽  
Neutralizing Antibodies ◽  
Multiple Logistic Regression Analysis ◽  
Population Based ◽  
Study Cohort ◽  
Humoral Immune ◽  
Humoral Immune Responses ◽  
Longitudinal Observational Study ◽  
Asymptomatic Individuals

As of November 17, 2021, SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2), the causative agent of COVID-19 (COronaVIrus Disease 19), has infected ~250 million people worldwide, causing around five million deaths. Titers of anti-SARS-CoV-2 neutralizing antibodies were relatively stable for at least 9 months in a population-based study conducted in Wuhan, China, both in symptomatic and in asymptomatic individuals. In the mass screening campaign conducted in the town of Ariano Irpino (Avellino, Italy) in May, 2020, 5.7% (95% CI: 5.3-6-1) of the 13,444 asymptomatic citizens screened were positive for anti-nucleocapsid antibodies against SARS-CoV-2. Among these, 422 citizens were re-tested for anti SARS-CoV-2 antibodies in January, 2021 and/or in April, 2021 and enrolled in this longitudinal observational study. Median (interquartile range) age of the study cohort was 46 years (29–59), with 47 (11.1%) participants of minor age, while 217 (51.4%) participants were females. There was no evidence of re-infection in any of the subjects included. Presence of anti-nuclear antibodies antibodies (Elecysis, Roche) was reported in 95.7 and 93.7% of evaluable participants in January and April, 2021. Multiple logistic regression analysis used to explore associations between age, sex and seroprevalence showed that adults vs. minors had significantly lower odds of having anti-S1 antibodies (Biorad) both in January, 2021 and in April, 2021. Our findings showed that antibodies remained detectable at least 11.5 months after infection in &gt;90% of never symptomatic cases. Further investigation is required to establish duration of immunity against SARS-CoV-2.

Abstract 15126: Cardiorespiratory Fitness and Atrial Fibrillation: A Population-based Follow-up Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Danesh K Kella ◽  
Jari Laukkanen ◽  
Michael S Lloyd ◽  
Sudhir Kuir ◽  
Rainer Rauramaa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiorespiratory Fitness ◽  
Disease Status ◽  
Population Based ◽  
History Of ◽  
Disease Study ◽  
Relationship Of ◽  
The Relationship ◽  
Fourth Quartile

Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide and has a complex association with exercise capacity. The relationship of atrial fibrillation with cardiorespiratory fitness (CRF) has not been previously investigated. Methods: Cardiorespiratory fitness, as assessed by maximal oxygen uptake (VO2max), was measured at baseline in 1,950 middle-aged men (mean 52.6 ± 5.1 years) from the Kuopio Ischaemic Heart Disease Study (KIHD). Results: During an average follow-up of 19.5 years, there were 305 incident AF cases (annual AF rate of 65.1/1000 person-years, 95% CI: 58.2 to 72.8). Overall a non-linear association was observed between CRF and incident atrial fibrillation. Rate of incident AF varied from 11.5 (95% CI: 9.4-14.0) for the first quartile of CRF, to 9.1 (95% CI: 7.4-11.2) for second quartile, 5.7 (95% CI: 4.4-7.4) for third quartile and 6.3 (95% CI: 5.0-8.0) for the fourth quartile respectively, Figure 1. Usual levels of CRF were non-linearly associated with AF risk, Figure 2. Age-adjusted HR comparing top versus bottom fourth of usual CRF levels was 0.67(95% CI: 0.48-0.95), which attenuated to 0.98 (95% CI: 0.66-1.43) upon further adjustment for several risk factors. These findings were comparable across age, body mass index, history of smoking, diabetes and cardiovascular disease status at baseline. Conclusions: Improved fitness as indicated by higher levels of CRF is protective of atrial fibrillation within an optimal range, beyond which the risk of atrial fibrillation rises again. Our findings are congruent with emerging data on the complex relationship between physical fitness and incident AF.

scholarly journals Association of Cholecystectomy with the Risk of Prostate Cancer in Patients with Gallstones

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 544
Author(s):  
Chien-Hua Chen ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Prostate Cancer ◽  
Health Insurance ◽  
Index Date ◽  
Population Based ◽  
Hazard Ratio ◽  
Study Cohort ◽  
Research Database ◽  
Control Cohort ◽  
Taiwan National Health Insurance

Objectives: To assess the association of cholecystectomy with the risk of prostate cancer in patients with gallstones. Methods: This nationwide population-based cohort study was conducted by retrieving the Longitudinal Health Insurance Research Database (LHID2000) for inpatient claims in the Taiwan National Health Insurance (NHI) program. The study cohort consisted of 72,606 men aged ≥ 20 years with gallstones undergoing cholecystectomy between 2000 and 2010. The control cohort consisted of the men with gallstones, but without cholecystectomy, by 1:1 propensity score matching with the study cohort based on age, sex, urbanization, occupation, comorbidities, and the index date. We compared the hazard ratio of prostate cancer between both of the cohorts. Results: The incidence of prostate cancer was 0.76/1000 person-years for the non-cholecystectomy cohort and 1.28/1000 person-years for the cholecystectomy cohort [aHR (adjusted hazard ratio) = 1.67, 95% confidence interval (CI = 1.45–1.92), respectively (p < 0.001). When compared with the non-cholecystectomy cohort, the hazard ratio of prostate cancer for the cholecystectomy cohort was 1.49-fold greater (95% CI = 1.04–2.11) for follow-up ≤ 1 year, 1.52-fold greater (95% CI = 1.24–1.86) for follow-up 1–5 years, and 1.99-fold greater (95% CI = 1.56–2.53) for follow-up > 5 years, respectively. Conclusions: Cholecystectomy is associated with an increased hazard ratio of prostate cancer in gallstones patients, and the risk increases with an incremental period of follow-up. This observational study cannot ascertain the detrimental mechanisms of cholecystectomy for the development of prostate cancer, and cholecystectomy is not recommended for the prevention of prostate cancer based on our study.

scholarly journals Sodium intake and kidney function in the general population: an observational, population-based study

2020 ◽  
Author(s):  
Massimo Cirillo ◽  
Giancarlo Bilancio ◽  
Pierpaolo Cavallo ◽  
Raffaele Palladino ◽  
Oscar Terradura-Vagnarelli ◽  
...  
Keyword(s):  
General Population ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Sodium Intake ◽  
Multivariable Analysis ◽  
Population Based ◽  
Study Cohort ◽  
Cross Sectional ◽  
Adult Participants

Abstract Background The relationships of sodium intake to kidney function within the population have been poorly investigated and are the objective of the study. Methods This observational, population-based, cross-sectional and longitudinal study targeted 4595 adult participants of the Gubbio study with complete data at baseline exam. Of these participants, 3016 participated in the 15-year follow-up (mortality-corrected response rate 78.4%). Baseline measures included sodium:creatinine ratio in timed overnight urine collection, used as an index of sodium intake, together with serum creatinine, sex, age and other variables. Follow-up measures included serum creatinine and other variables. Estimated glomerular filtration rate (eGFR, mL/min/1.73 m2) was calculated using serum creatinine, sex and age and was taken as an index of kidney function. Results The study cohort was stratified in sex- and age-controlled quintiles of baseline urine sodium:creatinine ratio. A higher quintile associated with higher baseline eGFR (P &lt; 0.001). In multivariable analysis, the odds ratio (OR) of Stage1 kidney function (eGFR ≥90 mL/min/1.73 m2) was 1.98 times higher in Quintile 5 compared with Quintile 1 [95% confidence interval (CI) 1.50–2.59, P &lt; 0.001]. The time from baseline to follow-up was 14.1 ± 2.5 years. Baseline to follow-up, the eGFR change was more negative along quintiles (P &lt; 0.001). In multivariable analysis, the OR in Quintile 5 compared with Quintile 1 was 2.21 for eGFR decline ≥30% (1.18–4.13, P = 0.001) and 1.38 for worsened stage of kidney function (1.05–1.82, P = 0.006). Findings were consistent within subgroups. Conclusions Within the general population, an index of higher sodium intake associated cross-sectionally with higher kidney function but longitudinally with greater kidney function decline.

scholarly journals Mortality Risk Among Older People Who Did Versus Did Not Sustain a Fracture: Baseline Prefracture Strength and Gait Speed as Predictors in a 15-Year Follow-Up

2019 ◽  
Vol 75 (10) ◽  
pp. 1996-2002
Author(s):  
Kaisa Koivunen ◽  
Elina Sillanpää ◽  
Mikaela von Bonsdorff ◽  
Ritva Sakari ◽  
Timo Törmäkangas ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Mortality Risk ◽  
Gait Speed ◽  
Cox Regression ◽  
Population Based ◽  
Knee Extension ◽  
Cox Regression Analysis ◽  
Knee Extension Strength ◽  
Incidence And Mortality

Abstract Background Physiological reserve, as indicated by muscle strength and gait speed, may be especially determinant of survival in people who are exposed to a health stressor. We studied whether the association between strength/speed and mortality risk would be stronger in the time period after a fracture compared to other time periods. Methods Participants were population-based sample of 157 men and 325 women aged 75 and 80 years at baseline. Maximal 10-m gait speed and maximal isometric grip and knee extension strength were tested at the baseline before the fracture. Subsequent fracture incidence and mortality were followed up for 15 years. Cox regression analysis was used to estimate fracture time-stratified effects of gait speed and muscle strength on mortality risk in three states: (i) nonfracture state, (ii) the first postfracture year, and (iii) after the first postfracture year until death/end of follow-up. Results During the follow-up, 20% of the men and 44% of the women sustained a fracture. In both sexes, lower gait speed and in women lower knee extension strength was associated with increased mortality risk in the nonfracture state. During the first postfracture year, the mortality risk associated with slower gait and lower strength was increased and higher than in the nonfracture state. After the first postfracture year, mortality risk associated with lower gait speed and muscle strength attenuated. Conclusions Lower gait speed and muscle strength were more strongly associated with mortality risk after fracture than during nonfracture time, which may indicate decreased likelihood of recovery.

scholarly journals Alcohol consumption and suicide among middle-aged men in Japan

2006 ◽  
Vol 188 (3) ◽  
pp. 231-236 ◽  
Author(s):  
Tatsuo Akechi ◽  
Motoki Iwasaki ◽  
Yosuke Uchitomi ◽  
Shoichiro Tsugane
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Large Population ◽  
Health Centre ◽  
Population Based ◽  
Study Cohort ◽  
Public Health Centre ◽  
Heavy Drinkers ◽  
Icd 10

BackgroundFew studies have investigated large population-based cohorts for an association between alcohol consumption and suicide.AimsTo investigate the possible association between alcohol intake and suicide.MethodWe used nationwide population-based cohort data from the Japan Public Health Centre-Based Prospective Study cohort. Atotal of 43 383 men aged 40–69 years participated. Death from suicide was defined according to ICD–10 as codes X60-X84.ResultsDuringthe367817person-years of follow-up, there were 168 suicides. Compared with occasional drinkers, the pooled multivariate relative risk (RR; with 95% CI) of suicide for non-drinkers and regular heavy drinkers was 2.3 (1.2–4.6) and 2.3 (1.2–4.7) respectively. The RR increased with the amount of alcohol consumed (P for trend =0.004).ConclusionsThere is a U-shaped association between alcohol consumption and subsequent suicide.

scholarly journals Visual impairment increases the risk of dementia, especially in young males in a 12-year longitudinal follow-up study of a national cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ga-In Lee ◽  
Sang Ah Chi ◽  
Kyunga Kim ◽  
Sang Won Seo ◽  
Hee Jin Kim ◽  
...  
Keyword(s):  
Visual Impairment ◽  
Household Income ◽  
Cox Regression ◽  
Population Based ◽  
Study Cohort ◽  
National Data ◽  
Young Males ◽  
Hazard Ratios ◽  
National Cohort

AbstractWe investigated the effect of visual impairment (VI) on dementia development in a national cohort. In this 12-year nationwide population-based retrospective cohort study, national data were collected from National Health Insurance Cooperation of South Korea from 2002 to 2017, comprising 799,074 subjects selected from the dementia-free cohort representative of the Korean population. Crude hazard ratios (HRs) as well as age- and sex-adjusted HRs and confidence intervals (CIs) for the development of dementia were estimated using multivariable Cox regression models. VI significantly increased the risk of dementia with a HR of 2.726 (95% CI 2.251–3.300, p < 0.0001) after adjusting for age, sex, and interaction between age, sex, and VI. HR of interaction between VI and age for dementia was 0.539 (95% CI 0.436–0.667, p < 0.0001). In the sensitivity analysis after adjustment for age, sex, household income level, BMI and other comorbidities, VI showed higher risk for all the type of dementia (p < 0.0001). In subgroup analysis of VI, young males showed the highest risk for development of dementia with a HR of 2.687 (95% CI 2.219–3.254, p < 0.0001). VI significantly increased the risk of dementia in the study cohort, and young males with VI appeared to be the most susceptible to the development of dementia.

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