Abstract P014: Lower eGFR and Proteinuria Were Independently Associated With Lower Cognitive Abilities in Community-dwelling Men in Japan: SESSA study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Akira Fujiyoshi ◽  
Takayoshi Ohkubo ◽  
Katsuyuki Miura ◽  
Akihiko Shiino ◽  
Naoko Miyagawa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Abilities ◽  
Estimated Glomerular Filtration Rate ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Community Based ◽  
Lower Egfr ◽  
The Mean ◽  
The Relationship

Introduction: The relationship between chronic kidney disease (CKD) and cognitive function remains to be determined. Existing studies focused primarily on estimated glomerular filtration rate (eGFR) but not proteinuria in relation to cognitive function. Hypothesis: In a community-based sample, lower eGFR and presence of proteinuria are cross-sectionally independently associated with lower cognition. Methods: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) randomly recruited and examined participants from Shiga, Japan in 2006-08 at baseline. Among 824 male participants in the follow-up exam (2010-12), we restricted our analyses to those who underwent the Cognitive Abilities Screening Instrument (CASI), age ≥65 years-old, free of stroke, with no missing pertinent covariates. We calculated eGFR (creatinine-based) according to the 2012-guideline by the Japanese Society of Nephrology. We then divided the participants into three groups by eGFR of ≥60, 59-40, and <40 (mL/min/1.73m 2 ), and separately divided into three groups according to proteinuria using urine dipstick: (-), (-/+), and ≥(1+). We defined CKD as either eGFR <60 or proteinuria ≥ (-/+). In linear regression with CASI score being a dependent variable, we computed the score adjusted for age, highest education attained, smoking, drinking, body mass index, hypertension, diabetes, and dyslipidemia. Results: We analyzed 541 men. The mean [standard deviation] of age and unadjusted score were 72.6 [4.3] years and 89.7 [6.0]. Prevalence of CKD was 56%. The score was significantly lower in participants with CKD than those without it (P=0.03). eGFR and proteinuria categories were separately and jointly associated with lower CASI score in a graded fashion (Ps for trend <0.05 in all the models tested. Table 1 ). Conclusions: Lower eGFR and higher degree of proteinuria were independently associated with lower cognitive function in the community-based men. CKD even in its early phase may predispose to lower cognitive function.

scholarly journals Estimated Glomerular Filtration Rate is a Predictive Factor for High-Sensitivity Cardiac Troponin T in a Community-Based 4.8-year Prospective Study

2020 ◽  
Author(s):  
Jie Han ◽  
Xiaona Wang ◽  
Ping Ye ◽  
Ruihua Cao ◽  
Wenkai Xiao ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Filtration Rate ◽  
Myocardial Injury ◽  
Estimated Glomerular Filtration Rate ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Community Based ◽  
Highly Sensitive ◽  
The Relationship

Abstract Objectives: Persistent elevation of cardiac troponin T (cTnT), which is considered as a sensitive and specific biomarker of myocardial injury, is frequently observed in patients with renal insufficiency. Meanwhile, estimated glomerular filtration rate (eGFR) is an independent risk factor of cardiovascular diseases. With a highly sensitive assay, the prevalence of detectable highly sensitive cTnT (hs-cTnT) is greatly improved even in general population. The aim of this study was to better understand the relationship between renal function (eGFR) and myocardial injury (hs-cTnT) in a community-based population.Methods: We analyzed the relationship between baseline eGFR and follow-up hs-cTnT, and the change of hs-cTnT in 1354 participants after 4.8 years follow-up.Results: In Pearson’s correlation analysis, baseline eGFR showed a negative relationship with follow-up hs-cTnT (r=-0.439; P < 0.001). In multiple linear regression analysis, baseline eGFR was independently and negatively associated with follow-up hs-cTnT (β=-0.310, P = 0.005). Stepwise logistic regression models revealed that baseline eGFR was significantly associated with the change in hs-cTnT after 4.8 years follow-up. However, the change in eGFR was not associated with the change in hs-cTnT.Conclusions: Baseline eGFR levels were independently and negatively associated with follow-up hs-cTnT. Furthermore, baseline eGFR levels were an independent predictor of the change in hs-cTnT 4.8 years follow-up, indicating a relationship between renal function and myocardial injury in a community-based population.

scholarly journals A Public Health Analysis of the Relationship Between Loneliness, Isolation, and Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 240-240
Author(s):  
Christina Victor
Keyword(s):  
Public Health ◽  
Cognitive Function ◽  
Screening Tools ◽  
Community Based ◽  
Public Health Perspective ◽  
Dementia Screening ◽  
The Relationship ◽  
Negative Health Outcomes ◽  
Substantial Heterogeneity

Abstract Loneliness and isolation are now characterised as major public health problems largely because of reported associations with negative health outcomes including dementia. We adopt a public health perspective and review the relationship between loneliness/isolation and dementia focussing on how these concepts are defined, measured, and reported. We identified community based longitudinal studies which measured loneliness/isolation at baseline and dementia at follow up (minimum 12 months) published up to February 2021. We identified 12 papers for loneliness and 15 for isolation which demonstrated substantial heterogeneity in how exposure (loneliness/ isolation) and outcome (dementia) were measured and reported. For example, dementia was measured in 5 different ways: death, hospitalisation, clinical diagnosis, dementia screening tools or cognitive function. Evidence to support a relationship between loneliness/isolation and dementia is inconclusive largely because of this methodological heterogeneity. Using consistent exposure and outcome measures is a prerequisite for determining the health consequences of loneliness and isolation.

Factors Associated with Lower Cognitive Performance Scores Among Older Japanese Men in Hawaii and Japan

2021 ◽  
pp. 1-10
Author(s):  
Naoko Miyagawa ◽  
Takayoshi Ohkubo ◽  
Akira Fujiyoshi ◽  
Akihiko Shiino ◽  
Randi Chen ◽  
...  
Keyword(s):  
Educational Attainment ◽  
Cognitive Abilities ◽  
Subclinical Atherosclerosis ◽  
Lifestyle Factors ◽  
Community Dwelling ◽  
Multivariable Logistic Regression Analysis ◽  
Cross Sectional ◽  
Japanese Men ◽  
History Of ◽  
Cardiometabolic Factors

Background: Few studies have compared factors related to cognitive function among people with similar genetic backgrounds but different lifestyles. Objective: We aimed to identify factors related to lower cognitive scores among older Japanese men in two genetically similar cohorts exposed to different lifestyle factors. Methods: This cross-sectional study of community-dwelling Japanese men aged 71–81 years included 2,628 men enrolled in the Kuakini Honolulu-Asia Aging Study based in Hawaii and 349 men in the Shiga Epidemiological Study of Subclinical Atherosclerosis based in Japan. We compared participant performance through Cognitive Abilities Screening Instrument (CASI) assessment in Hawaii (1991–1993) and Japan (2009–2014). Factors related to low cognitive scores (history of cardiovascular disease, cardiometabolic factors, and lifestyle factors) were identified with questionnaires and measurements. Multivariable logistic regression analysis was used to calculate the adjusted odds ratios (ORs) of a low (<  82) CASI score based on different factors. Results: CASI scores were lower in Hawaii than in Japan [21.2%(n = 556) versus 12.3%(n = 43), p <  0.001], though this was not significant when adjusted for age and educational attainment (Hawaii 20.3%versus Japan 17.9%, p = 0.328). History of stroke (OR = 1.65, 95%confidence interval = 1.19–2.29) was positively associated with low cognitive scores in Hawaii. Body mass index ≥25 kg/m2 tended to be associated with low cognitive scores in Japan; there was a significant interaction between the cohorts. Conclusion: Cognitive scores differences between cohorts were mostly explained by differences in educational attainment. Conversely, cardiovascular diseases and cardiometabolic factors differentially impacted cognitive scores among genetically similar older men exposed to different lifestyle factors.

Sleep symptomatology is associated with greater subjective cognitive concerns: Findings from the community-based Healthy Brain Project

SLEEP ◽  
2021 ◽  
Author(s):  
Jessica Nicolazzo ◽  
Katharine Xu ◽  
Alexandra Lavale ◽  
Rachel Buckley ◽  
Nawaf Yassi ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Sleep Quality ◽  
Cognitive Performance ◽  
Sex Education ◽  
Severity Index ◽  
Analysis Of Covariance ◽  
Psychomotor Function ◽  
Community Based ◽  
The Relationship ◽  
Insomnia Severity

Abstract Study objectives To examine if sleep symptomatology was associated with subjective cognitive concerns or objective cognitive performance in a dementia-free community-based sample. Methods A total of 1421 middle-aged participants (mean±standard deviation = 57±7; 77% female) from the Healthy Brain Project completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) to measure sleep quality, insomnia symptom severity, and daytime sleepiness, respectively. Participants were classified as having no sleep symptomatology (normal scores on each sleep measure), moderate sleep symptomatology (abnormal scores on one sleep measure), or high sleep symptomatology (abnormal scores on at least two sleep measures), using established cut-off values. Analysis of covariance was used to compare objective cognitive function (Cogstate Brief Battery) and subjective cognitive concerns (Modified Cognitive Function Instrument) across groups. Results Following adjustments for age, sex, education, mood, and vascular risk factors, persons classified as having high sleep symptomatology, versus none, displayed more subjective cognitive concerns (d=0.24) but no differences in objective cognitive performance (d=0.00-0.18). Subjective cognitive concerns modified the association between sleep symptomatology and psychomotor function. The strength of the relationship between high sleep symptomatology (versus none) and psychomotor function was significantly greater in persons with high as compared with low cognitive concerns (β±SE =-0.37±0.16; p=0.02). Conclusions More severe sleep symptomatology was associated with greater subjective cognitive concerns. Persons reporting high levels of sleep symptomatology may be more likely to display poorer objective cognitive function in the presence of subjective cognitive concerns.

scholarly journals Cycle length of nonsustanied ventricular tachycardias among ICD patients: implications on subsequent appropriate therapies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Javier Jiménez-Candil ◽  
Olga Duran ◽  
Armando Oterino ◽  
Jendri Pérez ◽  
Juan Carlos Castro ◽  
...  
Keyword(s):  
At Risk ◽  
Secondary Prevention ◽  
Beta Blocker ◽  
Cycle Length ◽  
Close Relationship ◽  
Appropriate Therapy ◽  
The Mean ◽  
Ventricular Tachycardias ◽  
The Relationship

Abstract Background ICD patients with episodes of nonsustained ventricular tachycardias (NSVT) are at risk of appropriate therapies. However, the relationship between the cycle length (CL) of such NSVTs and the subsequent incidence of appropriate interventions is unknown. Methods 416 ICD patients with LVEF < 45% were studied. ICD programming was standardized. NSVT was defined as any VT of 5 or more beats at ≥ 150 bpm occurred in the first 6 months after implantation that terminated spontaneously and was not preceded by any appropriate therapy. The mean follow-up was 41 ± 27 months. Results We analyzed 2201 NSVTs (mean CL = 323 ms) that occurred in 250 patients; 111 of such episodes were fast (CL ≤ 300 ms). Secondary prevention (HR = 1.7; p < 0.001), number of NSVT episodes (HR = 1.05; 95% CI 1.04–1.07; p < 0.001) and beta-blocker treatment (HR = 0.7; p = 0.04) were independent predictors of appropriate interventions; however, the mean CL of NSVTs was not (p = 0.6). There was a correlation between the mean CL of NSVTs and the CL of the first monomorphic VT: r = 0.88; p < 0.001. This correlation was especially robust in individuals with > 5 NSVTs (r = 0.97; p < 0.001), with an agreement between both values greater than 95%. Patients with any fast NSVT experienced a higher incidence of VF episodes (26%) compared to those without NVSTs (3%) or with only slow NSVTs (7%); p < 0.001. Conclusions Unlike the burden, the CL of NSVTs is not a predictor of subsequent appropriate interventions. However, there is a close relationship between the CL of NSVTs and that of arrhythmias that will later lead to appropriate therapies.

Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

2021 ◽  
Author(s):  
K Makino ◽  
S Lee ◽  
S Bae ◽  
I Chiba ◽  
K Harada ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Frailty Status ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

The relationship between muscle quality and incidence of falls in older community-dwelling women: An 18-month follow-up study

2018 ◽  
Vol 110 ◽  
pp. 241-246 ◽  
Author(s):  
André Bonadias Gadelha ◽  
Silvia Gonçalves Ricci Neri ◽  
Martim Bottaro ◽  
Ricardo M. Lima
Keyword(s):  
Community Dwelling ◽  
Muscle Quality ◽  
Follow Up Study ◽  
The Relationship

scholarly journals Kidney Measures with Diabetes and Hypertension on Cardiovascular Disease: The Atherosclerosis Risk in Communities Study

2015 ◽  
Vol 41 (4-5) ◽  
pp. 409-417 ◽  
Author(s):  
Nadine Alexander ◽  
Kunihiro Matsushita ◽  
Yingying Sang ◽  
Shoshana Ballew ◽  
Bakhtawar K. Mahmoodi ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Regression Models ◽  
Estimated Glomerular Filtration Rate ◽  
Cox Regression ◽  
Cardiovascular Outcomes ◽  
Creatinine Ratio ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Lower Egfr

Background: Whether the association of chronic kidney disease (CKD) with cardiovascular risk differs based on diabetes mellitus (DM) and hypertension (HTN) status remains unanswered. Methods: We investigated 11,050 participants from the Atherosclerosis Risk in Communities Study (fourth examination (1996-1998)) with follow-up for cardiovascular outcomes (coronary disease, heart failure and stroke) through 2009. Using the Cox regression models, we quantified cardiovascular risk associated with estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) in individuals with and without DM and/or HTN and assessed their interactions. Results: Individuals with DM and HTN generally had higher cardiovascular risk relative to those without at all the levels of eGFR and ACR. Cardiovascular risk increased with lower eGFR and higher ACR regardless of DM and HTN status (e.g. adjusted hazards ratio (HR) for eGFR 30-44 vs. 90-104 ml/min/1.73 m2, 2.32 (95% CI, 1.66-3.26) in non-diabetics vs. 1.83 (1.25-2.67) in diabetics and 2.45 (2.20-5.01) in non-hypertensives vs. 1.51 (1.27-1.81) in hypertensives and corresponding adjusted HR for ACR 30-299 vs. <10 mg/g, 1.70 (1.45-2.00) vs. 1.34 (1.10-1.64) and 1.42 (1.10-1.85) vs. 1.57 (1.36-1.81), respectively). Only the ACR-DM interaction reached significance, with a shallower relative risk gradient among diabetics than among non-diabetics (p = 0.02). Analysis of individual cardiovascular outcomes showed similar results. Conclusion: Although individuals with DM and HTN generally had higher cardiovascular risk relative to those without these complications, both low eGFR and high ACR were associated with cardiovascular diseases regardless of the presence or absence of DM and HTN. These findings reinforce the importance of CKD in cardiovascular outcomes.

scholarly journals Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: a randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e019042 ◽  
Author(s):  
Helene G van der Meer ◽  
Hans Wouters ◽  
Lisa G Pont ◽  
Katja Taxis
Keyword(s):  
Cognitive Function ◽  
Side Effects ◽  
Medication Review ◽  
Community Dwelling ◽  
Mortality Data ◽  
Digit Symbol Substitution Test ◽  
Significant Difference ◽  
Secondary Outcomes ◽  
Randomised Controlled

ObjectiveTo evaluate if a pharmacist-led medication review is effective at reducing the anticholinergic/sedative load, as measured by the Drug Burden Index (DBI).DesignRandomised controlled single blind trial.Setting15 community pharmacies in the Northern Netherlands.Participants157 community-dwelling patients aged ≥65 years who used ≥5 medicines for ≥3 months, including at least one psycholeptic/psychoanaleptic medication and who had a DBI≥1.InterventionA medication review by the community pharmacist in collaboration with the patient’s general practitioner and patient.Primary and secondary outcomes measuresThe primary outcome was the proportion of patients whose DBI decreased by at least 0.5. Secondary outcomes were the presence of anticholinergic/sedative side effects, falls, cognitive function, activities of daily living, quality of life, hospital admission and mortality. Data were collected at baseline and 3 months follow-up.ResultsMean participant age was 75.7 (SD, 6.9) years in the intervention arm and 76.6 (SD, 6.7) years in the control arm, the majority were female (respectively 69.3% and 72.0%). Logistic regression analysis showed no difference in the proportion of patients with a≥0.5 decrease in DBI between intervention arm (17.3%) and control arm (15.9%), (OR 1.04, CI 0.47 to 2.64, p=0.927). Intervention patients scored higher on the Digit Symbol Substitution Test, measure of cognitive function (OR 2.02, CI 1.11 to 3.67, p=0.021) and reported fewer sedative side effects (OR 0.61, CI 0.40 to 0.94, p=0.024) at follow-up. No significant difference was found for other secondary outcomes.ConclusionsPharmacist-led medication review as currently performed in the Netherlands was not effective in reducing the anticholinergic/sedative load, measured with the DBI, within the time frame of 3 months. Preventive strategies, signalling a rising load and taking action before chronic use of anticholinergic/sedative medication is established may be more successful.Trial registration numberNCT02317666.

scholarly journals Is Autonomy Always Beneficial for Work Engagement? A Six-year Four-Wave Follow-Up Study

2020 ◽  
Vol 6 (1) ◽  
pp. 16-27
Author(s):  
Piia Seppälä ◽  
Anne Mäkikangas ◽  
Jari J. Hakanen ◽  
Asko Tolvanen ◽  
Taru Feldt
Keyword(s):  
Work Engagement ◽  
Initial Level ◽  
Multilevel Regression ◽  
Specific Point ◽  
Relationship Patterns ◽  
The Mean ◽  
Regression Mixture ◽  
The Relationship ◽  
Predictive Relationship

Work engagement is expected to result from job resources such as autonomy. However, previous results have yielded that the autonomy–work engagement relationship is not always particularly strong. Whereas previous longitudinal studies have examined this relationship as an average at a specific point in time, this study examined whether this relationship is different within individuals from one time to another over the years. Furthermore, experiences of work engagement are expected to affect how employees benefit from autonomy, but no studies have so far investigated whether the initial level of work engagement affects the autonomy–work engagement relationship. This study aimed to first identify the different kinds of longitudinal relationship patterns between autonomy and work engagement, and then to investigate whether the identified relationship patterns differ in terms of the initial mean level of work engagement. The four-wave study was conducted among Finnish managers (n = 329) over a period of six years. Multilevel regression mixture analysis identified five relationship patterns. Four of the patterns showed a positive predictive relationship between autonomy and work engagement. However, the relationship was statistically significant in only one of these patterns. Furthermore, when the initial mean level of work engagement was high, autonomy related more strongly to work engagement. However, an atypical pattern was identified that showed a negative association between autonomy and work engagement. In this pattern, the mean level of work engagement was low. Consequently, autonomy may not always enhance work engagement; sometimes this relationship may even be negative.

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