Abstract P057: The Association Of Diabetes Duration With Central Artery Stiffness And Its 5-year Change Among Older Adults: The Atherosclerosis Risk In Communities Study (ARIC).

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Meera Marji ◽  
Gerardo M Heiss ◽  
James R Pike ◽  
Priya Palta ◽  
Michelle Meyer ◽  
...  
Keyword(s):  
Older Adults ◽  
Arterial Stiffness ◽  
Diabetes Duration ◽  
Older Adulthood ◽  
Duration Of Diabetes ◽  
Central Artery ◽  
Rate Of Progression ◽  
Artery Stiffness ◽  
The Mean

Background: Central artery stiffness is a predictor of cardiovascular risk and mortality among individuals with diabetes. Few studies examined whether the duration of diabetes relates to arterial stiffening and its rate of progression. Objective: To examine the association of diabetes duration from midlife to older adulthood with arterial stiffness and its 5-year change. Methods: Diabetes (defined by fasting glycemia level >126 mg/dl or use of glucose lowering agents or self-reported) was ascertained at visit 1 (1988-1990), on repeated examinations and on telephone follow-up calls of 2,155 ARIC cohort members (58% women, 20% black, mean age 74 years), as well as time since ascertainment of diabetes. Carotid femoral pulse wave velocity (cfPWV), a measure of central artery stiffness, was obtained at cohort visits 5 (2011-13) and 6 or 7 (2016-19). Associations of duration of diabetes with visit 5 cfPWV and the 5-year cfPWV change from visit 5 to visit 6 or 7 were evaluated by multivariable linear regression adjusted for demographic factors. Results: Among study participants with diabetes ascertained from midlife to older adulthood (n=639 (29%)), the mean cfPWV at visit 5 was 78.6, 95%CI (52.9, 104.4) cm/s greater than those without diabetes. Over a mean of 4.9 (SD 3) years of follow-up, cfPWV increased by a median 137 cm/s. The 5-year change in cfPWV was 40.5, 95%CI (12.3, 68.8) cm/s greater among those with diabetes, as compared to those without diabetes. The mean diabetes duration was 8.1(SD 6.8) years for participants with diabetes. After adjusting for demographic factors, we observed a positive association of diabetes duration with the 5-year change in cfPWV in older adulthood (Figure). Conclusion: Duration of diabetes was associated with a greater rate of progression of central arterial stiffness in older adults.

Conservative management of ossification of the posterior longitudinal ligament

2011 ◽  
Vol 30 (3) ◽  
pp. E2 ◽  
Author(s):  
Martin H. Pham ◽  
Frank J. Attenello ◽  
Joshua Lucas ◽  
Shuhan He ◽  
Christopher J. Stapleton ◽  
...  
Keyword(s):  
Conservative Management ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Japanese Orthopaedic Association Score ◽  
Clinical Progression ◽  
Association Score ◽  
Rate Of Progression ◽  
The Mean ◽  
High Chance

Object Ossification of the posterior longitudinal ligament (OPLL) can result in significant myelopathy. Surgical treatment for OPLL has been extensively documented in the literature, but less data exist on conservative management of this condition. Methods The authors conducted a systematic review to identify all reported cases of OPLL that were conservatively managed without surgery. Results The review yielded 11 published studies reporting on a total of 480 patients (range per study 1–359 patients) over a mean follow-up period of 14.6 years (range 0.4–26 years). Of these 480 patients, 348 (72.5%) were without myelopathy on initial presentation, whereas 76 patients (15.8%) had signs of myelopathy; in 56 cases (15.8%), the presence of myelopathy was not specified. The mean aggregate Japanese Orthopaedic Association score on presentation for 111 patients was 15.3. Data available for 330 patients who initially presented without myelopathy showed progression to myelopathy in 55 (16.7%), whereas the other 275 (83.3%) remained progression free. In the 76 patients presenting with myelopathy, 37 (48.7%) showed clinical progression, whereas 39 (51.5%) remained clinically unchanged or improved. Conclusions Patients who present without myelopathy have a high chance of remaining progression free. Those who already have signs of myelopathy at presentation may benefit from surgery due to a higher rate of progression over continued follow-up.

The Role of Revascularization in Transmetatarsal Amputations

2001 ◽  
Vol 91 (10) ◽  
pp. 533-535 ◽  
Author(s):  
Javier La Fontaine ◽  
Alex Reyzelman ◽  
Gary Rothenberg ◽  
Khalid Husain ◽  
Lawrence B. Harkless
Keyword(s):  
Lower Extremity ◽  
Diabetes Duration ◽  
Amputation Level ◽  
Knee Amputation ◽  
Below The Knee ◽  
Transmetatarsal Amputation ◽  
The Mean ◽  
Lower Extremity Revascularization

Data from 37 patients who underwent a transmetatarsal amputation from January 1993 to April 1996 were reviewed. The mean age and diabetes duration of the subjects were 54.9 (± 13.2) years and 16.6 (± 8.9) years, respectively. The follow-up period averaged 42.1 (± 11.2) months. At the time of follow-up, 29 (78.4%) of the 37 patients still had foot salvage, 8 (21.6%) had progressed to below-the-knee amputation, and 15 (40.5%) had undergone lower-extremity revascularization. Twelve (80%) of the 15 revascularized patients preserved their transmetatarsal amputation level at a follow-up of 36.4 months. The authors concluded that at a maximum of 3 years follow-up after initial amputation, transmetatarsal amputation was a successful amputation level. (J Am Podiatr Med Assoc 91(10): 533-535, 2001)

scholarly journals Characteristics of Financial Exploitation in a Sample of Israeli Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 770-770
Author(s):  
Gali Weissberger ◽  
S Duke Han ◽  
Amit Shrira
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Age Differences ◽  
Service Providers ◽  
Subjective Age ◽  
Physical And Mental Health ◽  
Older Adulthood ◽  
Financial Exploitation ◽  
History Of

Abstract Financial exploitation (FE) negatively affects wellbeing in older adulthood. However, characteristics of FE and its health correlates remain poorly understood. In this study, 138 Israeli older adults answered questions regarding FE history, and completed physical and mental health questionnaires. Of 138 participants, 23 reported a history of FE. FE participants were older (M birth year = 1950.35; sd = 9.65) than non-FE participants (M birth year = 1953.79; sd = 6.06; p = 0.028) and reported lower household income (p=0.001). Groups did not differ in education level or sex breakdown. The FE group reported older subjective age (p = 0.022), worse subjective cognition (p = 0.007), more depressive symptoms (p=0.002), and marginally higher anxiety symptoms (p = 0.099) than the non-FE group. Groups did not differ in reported levels of social support or number of medical conditions. When covarying for age, differences between groups in subjective cognition and depressive symptoms remained significant (ps ≤0.022), while subjective age differences became marginal (p = 0.07). The FE group responded to follow-up questions regarding FE experiences. Reported perpetrators included companies/businesses (most commonly reported, 30%), strangers, friends/neighbors, service providers, and family. Eleven reported losing 100 NIS to 10,000 NIS, and 10 reported losing 10,001 to over 100,000 NIS. Additionally, six FE participants reported that the FE is ongoing, and two reported additional FE experiences. Findings suggest that FE is related to mental and physical health of older adults. Findings also provide preliminary information regarding characteristics of FE in a sample of Israeli older adults.

scholarly journals Longitudinal changes in extent of late gadolinium enhancement in repaired Tetralogy of Fallot: a retrospective analysis of serial CMRs

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Kwannapas Saengsin ◽  
Minmin Lu ◽  
Lynn Sleeper ◽  
Tal Geva ◽  
Ashwin Prakash
Keyword(s):  
Late Gadolinium Enhancement ◽  
Tetralogy Of Fallot ◽  
Gadolinium Enhancement ◽  
Rate Of Progression ◽  
The Mean ◽  
Linear Regression Modeling ◽  
Group 2 ◽  
Over Time ◽  
Group 1

Abstract Background Right ventricular (RV) late gadolinium enhancement (LGE) occurs due to surgical scarring and RV remodeling, and has been shown to be associated with clinical outcomes in Tetralogy of Fallot (TOF). However, it is not known if cardiovascular magnetic resonance (CMR) LGE extent progresses over time, and therefore, it is not known if serial reassessment of LGE is necessary. We determined the rate of progression in the extent of RV LGE on serial CMR examinations in repaired TOF. Methods Retrospective review of 127 patients after TOF repair (49% male, median age at first CMR 18.9 years (Interquartile range (IQR) 13.3,27.0) who had at least two CMRs (median follow-up duration of 4.0 years (IQR 2.1,5.9)) was performed. 84/127 patients had no interventions between serial CMRs (Group 1) while 43/127 patients had transcatheter or surgical intervention between CMRs (Group 2). The extent of RV LGE was assessed using 2 methods: a semiquantitative RV LGE score and a quantitative RV LGE extent expressed as % of RV mass. Mixed effects linear regression modeling to estimate changes in LGE over time. Results RV LGE was present in all patients on the first CMR. % RV LGE extent and LGE score did not increase over time in either patient group. The mean 5 year rates of change were small and negative for both % RV LGE extent [− 2.3 (95% CI − 2.9, − 1.8, p < 0.001) in Group 1, and − 1.9 (95% CI − 3.2, − 0.7, p = 0.004) in Group 2], and RV LGE score [− 0.9 (95% CI − 1.1, − 0.6, p < 0.001) in Group 1, and − 0.5 (95% CI − 1.1, − 0.0, p = 0.047) in Group 2]. Conclusions In this serial CMR evaluation of children and adults with repaired TOF, no significant progression in the extent of RV LGE was seen on intermediate term follow-up. Given recent concerns regarding the safety of gadolinium-based contrast agents, frequent assessment of LGE may not be necessary in follow-up.

scholarly journals Central artery stiffness, baroreflex sensitivity, and brain white matter neuronal fiber integrity in older adults

NeuroImage ◽  
2015 ◽  
Vol 110 ◽  
pp. 162-170 ◽  
Author(s):  
Takashi Tarumi ◽  
Daan L.K. de Jong ◽  
David C. Zhu ◽  
Benjamin Y. Tseng ◽  
Jie Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
White Matter ◽  
Baroreflex Sensitivity ◽  
Brain White Matter ◽  
Central Artery ◽  
Artery Stiffness

scholarly journals Association between teeth loss and nasogastric tube feeding dependency in older adults from Taiwan: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chun-Chieh Wang ◽  
Yu-Yen Chen ◽  
Kuo-Chuan Hung ◽  
Shang-Jung Wu ◽  
Yung-Feng Yen ◽  
...  
Keyword(s):  
Older Adults ◽  
National Health ◽  
Nasogastric Tube ◽  
Tube Feeding ◽  
Nasogastric Feeding ◽  
Number Of Teeth ◽  
Increased Risk ◽  
The Mean ◽  
Nasogastric Tube Feeding

Abstract Background To examine the association between teeth loss and nasogastric tube feeding dependency in older people. Methods The National Health Interview Survey (NHIS) 2005, 2009, and 2013 in Taiwan. Participants were selected by a multistage stratified sampling method and baseline characteristics, including socioeconomic status and health habits, were obtained by well-trained interviewers. The NHIS was linked with the National Health Insurance research database 2000–2016 and the National Deaths Dataset, which contains all the medical information of ambulatory and inpatient care. Cox regression was used to examine the association between the number of teeth lost and nasogastric tube feeding dependency. Results There were 6165 adults older than 65 years old enrolled in the analysis, with 2959 male (48%) and the mean (SD) age was 73.95(6.46) years old. The mean follow-up duration was 6.5(3.3) years. Regarding the teeth loss categories, 1660 (26.93%), 2123 (34.44%), and 2382 (38.64%) of participants were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. During 39,962 person-years of follow-up, new-onset nasogastric feeding dependency was recognized in 220(13.25%), 256(12.06%), and 461(19.35%) participants who were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. Kaplan-Meier curves demonstrated significant findings (Log-rank P < 0.01). After potential confounders were adjusted, compared with those without teeth loss, older adults who had lost 10–28 teeth had significantly increased risks of occurrence nasogastric feeding dependency (AHR, 1.31; 95% CI, 1.05–1.62; p-value = 0.02). Furthermore, a significant dose-response relation between the number of teeth lost and increased risk of nasogastric feeding was found (p for trend< 0.01). Conclusions Older adults who had lost 10–28 teeth had a significantly increased risk of nasogastric tube feeding dependency. Early identification of the oral disease is crucial for the prevention of the occurrence of teeth loss and the following nutrition problems, which would reduce risk of nasogastric tube feeding dependency.

Abstract P215: Association Of Lung Function In Mid-life With Central Artery Stiffness Later In Life, The Atherosclerosis Risk In Communities Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Kennedy Peter ◽  
James R Pike ◽  
John Preisser ◽  
Anna Kucharska-newton ◽  
Michelle Meyer ◽  
...  
Keyword(s):  
Lung Function ◽  
Arterial Stiffness ◽  
Smoking Status ◽  
Later Life ◽  
Forced Expiratory Volume ◽  
Sensitivity Analyses ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Central Artery ◽  
Artery Stiffness

Introduction: Poor lung function and aortic stiffness often co-occur, but causal and temporal relationships are equivocal. Investigating relationships between mid-life lung function and arterial stiffness later in life may highlight modifiable targets to slow arterial aging. Objective: Assess whether lung function in mid-life is associated with central artery stiffness later in life, and whether this relationship is modified by baseline smoking status, hypertension, or diabetes. Methods: We included 3,529 ARIC cohort participants (60% women; 22% Black; mean baseline age 51.4 (SD: 4.9)) who attended visits 1 (1987-1989) and 5 (2011-2013). Spirometry included forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) of high-quality grades. Central artery stiffness (carotid-femoral pulse wave velocity (cfPWV)) was measured at visit 5. Associations of mid-life lung function with later-life central artery stiffness (cfPWV>75 th percentile) were evaluated by multivariable Poisson and logistic regressions adjusted for covariates. Sensitivity analyses excluded participants with chronic obstructive pulmonary disease identified from surveillance of hospitalizations occurring in follow up (N=109). Results: Mean FEV1 at visit 1 was 3.04 L (SD: 0.73) and FVC was 3.99 L (SD: 0.96). Lung function varied by thoracic height. Visits 1 and 5 were a mean of 23.8 years apart, and mean cfPWV at visit 5 was 1167 cm/s (SD: 379). Lung function at visit 1 was inversely associated with adjusted prevalence and odds of later cfPWV>75 th percentile among those present at visit 5 (Table). Stratum-specific estimates suggested modification by baseline smoking status, hypertension, and diabetes, but were not nominally statistically different. Sensitivity analyses did not alter inferences. Conclusion: Lung function at mid-life is inversely associated with central artery stiffness in later life. Whether change in mid-life pulmonary function is associated with arterial stiffness later in life warrants further examination.

scholarly journals Elevated Muscle Sympathetic Nerve Activity Contributes to Central Artery Stiffness in Young and Middle-Age/Older Adults

Hypertension ◽  
2019 ◽  
Vol 73 (5) ◽  
pp. 1025-1035 ◽  
Author(s):  
Seth W. Holwerda ◽  
Rachel E. Luehrs ◽  
Lyndsey DuBose ◽  
Michael T. Collins ◽  
Nealy A. Wooldridge ◽  
...  
Keyword(s):  
Older Adults ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Middle Age ◽  
Muscle Sympathetic Nerve Activity ◽  
Nerve Activity ◽  
Central Artery ◽  
Artery Stiffness

scholarly journals Hilliness and the Development of Walking Difficulties Among Community-Dwelling Older People

2018 ◽  
Vol 32 (5-6) ◽  
pp. 278-284 ◽  
Author(s):  
Kirsi E. Keskinen ◽  
Merja Rantakokko ◽  
Kimmo Suomi ◽  
Taina Rantanen ◽  
Erja Portegijs
Keyword(s):  
Older Adults ◽  
Socioeconomic Factors ◽  
Behavioral Health ◽  
Odds Ratio ◽  
Road Network ◽  
Community Dwelling ◽  
Community Dwelling Older People ◽  
The Mean ◽  
Community Dwelling Older Adults

Objective: The objective of this study is to study the associations of objectively defined hilliness with the prevalence and incidence of walking difficulties among community-dwelling older adults, and to explore whether behavioral, health, or socioeconomic factors would fully or partially explain these associations. Method: Baseline interviews ( n = 848, 75-90 years) on difficulties in walking 500 m, frequency of moving through the neighborhood, and perceived hilliness as a barrier to outdoor mobility were conducted. Two-year follow-up interviews ( n = 551) on difficulties in walking 500 m were conducted among participants without baseline walking difficulties. Hilliness objectively defined as the mean slope in 500-m road network. Results: Logistic regression showed that hilliness was associated with incident walking difficulties at the 2-year follow-up (odds ratio [OR] = 1.66, 95% confidence interval [CI] = [1.09, 2.51]) but not with the prevalence of walking difficulties at baseline. Adding behavioral, health, or socioeconomic factors to the models did not markedly change the results. Discussion: Greater hilliness should be considered a risk factor for developing walking difficulties among older adults.

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