Lipoprotein-Associated Phospholipase A2 and Risk of Carotid Atherosclerosis and Cardiovascular Events in Community-Based Older Adults in China

Angiology ◽  
2017 ◽  
Vol 69 (1) ◽  
pp. 49-58 ◽  
Author(s):  
Chunxiu Wang ◽  
Xianghua Fang ◽  
Yang Hua ◽  
Yutong Liu ◽  
Zhongying Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Carotid Artery ◽  
Phospholipase A2 ◽  
Carotid Atherosclerosis ◽  
Cvd Risk ◽  
Community Based ◽  
Chinese Older Adults ◽  
Increased Risk ◽  
Cvd Mortality

We explored the associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and carotid atherosclerosis with all phenotypes and cardiovascular disease (CVD) events in Chinese older adults. A total of 1257 adults aged ≥55 years who were free of CVD were enrolled in this cohort study. Lipoprotein-associated phospholipase A2 level was evaluated in 3 categories: Lp-PLA2 < 175, 175≤ Lp-PLA2 < 223, and Lp-PLA2 ≥ 223 ng/mL. The highest level of Lp-PLA2 was independently associated with common carotid artery intima-media thickening (≥1.0 mm; odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.14-2.26) and carotid plaque (OR: 1.42, 95% CI: 1.01-1.99) in individuals without carotid artery stenosis. At the end of the 5-year follow-up, after adjustment for CVD risk factors and carotid atherosclerosis status, Lp-PLA2 had remained an independent predictor for myocardial infarction (MI; hazard ratio [HR]: 1.90, 95% CI: 1.02-3.55) and CVD death (HR: 1.78, 95% CI: 1.02-3.13). However, no association was found with stroke. Therefore, elevated Lp-PLA2 level in the older adults studied was associated with an increased risk of carotid atherosclerosis and MI and CVD mortality. Lipoprotein-associated phospholipase A2 assessment might be used for MI and CVD death risk prediction.

scholarly journals Association Between Body Mass Index, Its Change And Cognitive Impairment Among Chinese Older Adults: A Community-Based, 9-Year Prospective Cohort Study

2021 ◽  
Author(s):  
Shanshan Wu ◽  
Xiaozhen Lv ◽  
Jie Shen ◽  
Hui Chen ◽  
Yuan Ma ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Weight Loss ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Prospective Cohort ◽  
Community Based ◽  
Chinese Older Adults ◽  
Large Weight Loss ◽  
Increased Risk

Abstract Objective To examine the association of baseline body mass index (BMI) and BMI change with cognitive impairment among older adults in China. Methods The study included data from the Chinese Longitudinal Healthy Longevity Study, a national community-based prospective cohort study from 2002-2018. Baseline BMI and BMI change measurements were available for 12,027 adults aged older than 65 years. Cognitive impairment was defined as Chinese version of the Mini Mental State Examination score less than 18. Multivariable Cox proportional hazard model was used.Results Among 12027 participants (mean age was 81.23 years old and 47.48% were male), the proportion of underweight, normal, overweight and obese at baseline was 33.87%, 51.39%, 11.39% and 3.34%, respectively. During an average of 5.9 years’ follow-up, 3086 participants (4.35 per 100 person-years) with incident cognitive impairment were identified. Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 (95% CI 0.75-0.99) among overweight group, whereas corresponding AHR was 1.02 (95% CI 0.94-1.10) in underweight and 1.01 (95% CI 0.80-1.28) in obese. Large weight loss (<-10%) was significantly associated with an increased risk of cognitive impairment (AHR, 1.42, 95% CI 1.29-1.56), compared to stable weight status group (-5%~5%). In the restricted cubic spline models, BMI change showed a L-shaped association with cognitive impairment. Conclusions BMI-defined overweight is associated with a reduced risk of cognitive impairment among Chinese older adults, while large weight loss is associated with increased risk. More attention should be paid to older adults with significant weight loss.

scholarly journals Risk Factors for Incident Carotid Artery Revascularization among Older Adults: The Cardiovascular Health Study

2016 ◽  
Vol 6 (3) ◽  
pp. 129-139 ◽  
Author(s):  
Parveen K. Garg ◽  
Willam J.H. Koh ◽  
Joseph A. Delaney ◽  
Ethan A. Halm ◽  
Calvin H. Hirsch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Carotid Artery ◽  
Cardiovascular Health ◽  
Multivariable Analysis ◽  
Population Based ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Increased Risk

Background: Population-based risk factors for carotid artery revascularization are not known. We investigated the association between demographic and clinical characteristics and incident carotid artery revascularization in a cohort of older adults. Methods: Among Cardiovascular Health Study participants, a population-based cohort of 5,888 adults aged 65 years or older enrolled in two waves (1989-1990 and 1992-1993), 5,107 participants without a prior history of carotid endarterectomy (CEA) or cerebrovascular disease had a carotid ultrasound at baseline and were included in these analyses. Cox proportional hazards multivariable analysis was used to determine independent risk factors for incident carotid artery revascularization. Results: Over a mean follow-up of 13.5 years, 141 participants underwent carotid artery revascularization, 97% were CEA. Baseline degree of stenosis and incident ischemic cerebral events occurring during follow-up were the strongest predictors of incident revascularization. After adjustment for these, factors independently associated with an increased risk of incident revascularization were: hypertension (HR 1.53; 95% CI: 1.05-2.23), peripheral arterial disease (HR 2.57; 95% CI: 1.34-4.93), and low-density lipoprotein cholesterol (HR 1.23 per standard deviation [SD] increment [35.4 mg/dL]; 95% CI: 1.04-1.46). Factors independently associated with a lower risk of incident revascularization were: female gender (HR 0.51; 95% CI: 0.34-0.77) and older age (HR 0.69 per SD increment [5.5 years]; 95% CI: 0.56-0.86). Conclusions: Even after accounting for carotid stenosis and incident cerebral ischemic events, carotid revascularization is related to age, gender, and cardiovascular risk factors. Further study of these demographic disparities and the role of risk factor control is warranted.

scholarly journals Cardiovascular mortality risk in young adults with isolated systolic hypertension: findings from population-based MONICA/KORA cohort study

2021 ◽  
Author(s):  
Atasoy Seryan ◽  
Middeke Martin ◽  
Johar Hamimatunnisa ◽  
Peters Annette ◽  
Heier Margit ◽  
...  
Keyword(s):  
Young Adults ◽  
Systolic Hypertension ◽  
Antihypertensive Medication ◽  
Population Based ◽  
Protective Effects ◽  
Isolated Systolic Hypertension ◽  
Cvd Risk ◽  
Increased Risk ◽  
Cvd Mortality

AbstractThe clinical significance of isolated systolic hypertension in young adults (ISHY) remains a topic of debate due to evidence ISHY could be a spurious condition resulting from exageratted pulse pressure amplification in “young tall men with elastic arteries”. Hence, we aimed to investigate whether ISHY is associated with an increased risk of cardivascular (CVD) mortality in a sample of 5597 young adults (49.8% men, 50.2% women) between 25 and 45 years old from the prospective population-based MONICA/KORA cohort. ISHY was prevalent in 5.2% of the population, affecting mostly men (73.1%), and associated with increased smoking, obesity, and hypercholesterolemia in comparison to participants with normal blood pressure (BP). Within a follow-up period of 25.3 years (SD ± 5.2; 141,768 person–years), 133(2.4%) CVD mortality cases were observed. Participants with ISHY had a hazard ratio (HR) of 1.89(1.01–3.53, p < 0.05) times higher risk of CVD mortality than participants with normal BP, even following adjustment for CVD risk factors. However, adjustment for antihypertensive medication (HR 0.46; 0.26–0.81, p < 0.001) and increasing height (HR 0.96; 0.93–0.99, p < 0.05) revealed independently protective effects against CVD mortality, suggesting that although ISHY is associated with an increased risk of CVD mortality, the protective effects of increasing height or antihypertensive medication should be considered in treatment rationale.

scholarly journals Association between blood pressure categories and cardiovascular disease mortality in China

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255373
Author(s):  
Jie Guo ◽  
Jun Lv ◽  
Yu Guo ◽  
Zheng Bian ◽  
Bang Zheng ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cox Regression ◽  
Cvd Risk ◽  
Hazard Ratios ◽  
Disease Mortality ◽  
Increased Risk ◽  
Diastolic Hypertension ◽  
High Prevalence ◽  
Cvd Mortality

Background Blood pressure (BP) categories are useful to simplify preventions in public health, and diagnostic and treatment approaches in clinical practice. Updated evidence about the associations of BP categories with cardiovascular diseases (CVDs) and its subtypes is warranted. Methods and findings About 0.5 million adults aged 30 to 79 years were recruited from 10 areas in China during 2004–2008. The present study included 430 977 participants without antihypertension treatment, cancer, or CVD at baseline. BP was measured at least twice in a single visit at baseline and CVD deaths during follow-up were collected via registries and the national health insurance databases. Multivariable Cox regression was used to estimate the associations between BP categories and CVD mortality. Overall, 16.3% had prehypertension-low, 25.1% had prehypertension-high, 14.1% had isolated systolic hypertension (ISH), 1.9% had isolated diastolic hypertension (IDH), and 9.1% had systolic-diastolic hypertension (SDH). During a median 10-year follow-up, 9660 CVD deaths were documented. Compared with normal, the hazard ratios (95% CI) of prehypertension-low, prehypertension-high, ISH, IDH, SDH for CVD were 1.10 (1.01–1.19), 1.32 (1.23–1.42), 2.04 (1.91–2.19), 2.20 (1.85–2.61), and 3.81 (3.54–4.09), respectively. All hypertension subtypes were related to the increased risk of CVD subtypes, with a stronger association for hemorrhagic stroke than for ischemic heart disease. The associations were stronger in younger than older adults. Conclusions Prehypertension-high should be considered in CVD primary prevention given its high prevalence and increased CVD risk. All hypertension subtypes were independently associated with CVD and its subtypes mortality, though the strength of associations varied substantially.

scholarly journals Frailty as a predictor of future falls and disability: a four-year follow-up study of Chinese older adults

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Quan Zhang ◽  
Xinyi Zhao ◽  
Huiying Liu ◽  
Hua Ding
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Chinese Older Adults ◽  
Frailty Status ◽  
Increased Risk ◽  
Lower Magnitude

Abstract Background Frailty, which is defined as aging-related multisystem impairments, can lead to adverse health outcomes. However, evidence for such a connection in Chinese older adults remains lacking. This study examined the association between frailty and future falls and disability among community-dwelling Chinese older adults. Methods Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were aged 60 years and above at baseline in 2011 and completed the follow-up survey in 2015. Outcome measures were future falls, incident disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and worsening performance of ADLs and IADLs. A multivariate logistic regression was conducted to examine the association between frailty phenotype and falls, incident disability, and worsening disability during a four-year period. Results We found that frail participants were at increased risk at follow-up for: falls (OR 1.54, 95% CI, 1.14–2.08); developing new ADL difficulties (OR 4.10, 95% CI, 2.79–6.03) and IADL difficulties (OR 3.06, 95% CI, 2.03–4.61); and worsening ADLs performance (OR 2.27, 95% CI, 1.27–4.06), after adjusting for potential confounders. Prefrailty was also significantly associated with future falls, incident disability in ADLs and IADLs, but with a lower magnitude of effect. Conclusions Frailty phenotype is an independent predictor of future falls, incident disability, and worsening performance in ADLs among Chinese older adults. The association suggests the need to pay special attention in caring for frail and prefrail elders and improving individuals’ frailty status.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

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.

scholarly journals The Framingham risk score is associated with incident frailty, or is it?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Shi ◽  
Mei-Ling Ge ◽  
Birong Dong ◽  
Qian-Li Xue
Keyword(s):  
Older Adults ◽  
Risk Score ◽  
Cox Regression ◽  
Activity Level ◽  
Cvd Risk ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Adverse Health Outcomes ◽  
Comorbidity Burden

Abstract Backgrounds Cardiovascular disease (CVD) risk factors are individually associated with frailty. This study examined whether Framingham CVD risk score (FRS) as an aggregate measure of CVD risk is associated with incident frailty among Chinese older adults. Methods This study used data from the China Health and Retirement Longitudinal Study. A sample of 3,618 participants aged 60 to 95 years and without CVD at baseline were followed for four years. FRS was calculated at baseline. Frailty status was defined as not-frail (0–2 criteria) or frail (3–5 criteria) based on the physical frailty phenotype consisting of five binary criteria (weakness, slowness, exhaustion, low activity level, and weight loss). After excluding subjects who were frail (n = 248) at baseline, discrete-time Cox regression was used to evaluate the relationship between FRS and incident frailty. Results During a median follow-up of 4.0 years, 323 (8 %) participants developed CVD and 318 (11 %) subjects had frailty onset. Higher FRS was associated with greater risk of incident frailty (HR: 1.03, 95 % CI: 1.00 to 1.06) after adjusting for education, marital status, obesity, comorbidity burden, and cognitive function. This association however was no longer significant (HR: 1.00, 95 % CI: 0.97 to 1.03) after additionally adjusting for age. These findings remained essentially unchanged after excluding subjects with depression (n = 590) at baseline or incident CVD (n = 323) during the 4-year follow-up. Conclusions The FRS was not independently associated with incident frailty after adjusting for chronological age. More research is needed to assess the clinical utility of the FRS in predicting adverse health outcomes other than CVD in older adults.

scholarly journals Virtual reality intervention to improve apathy in residential aged care: protocol for a multisite non-randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e046030
Author(s):  
Dimitrios Saredakis ◽  
Hannah A D Keage ◽  
Megan Corlis ◽  
Tobias Loetscher
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Passive Control ◽  
Aged Care ◽  
Residential Aged Care ◽  
Laptop Computer ◽  
Reminiscence Therapy ◽  
Increased Risk ◽  
Secondary Outcomes

IntroductionApathy is a prevalent neuropsychiatric symptom for older adults residing in aged care. Left untreated, apathy has been associated with accelerated cognitive decline and increased risk of mortality. Reminiscence therapy is commonly used in aged care and has demonstrated to reduce apathy. Traditional methods of reminiscence use physical objects and more recently technology including tablets and laptop computers have demonstrated potential. Virtual reality (VR) has successfully been used to treat psychological disorders; however, there is little evidence on using VR for behavioural symptoms such as apathy in older adults. Using VR to deliver reminiscence therapy provides an immersive experience, and readily available applications provide access to a large range of content allowing easier delivery of therapy over traditional forms of therapy. This study aims to identify changes in apathy after a reminiscence therapy intervention using head-mounted displays (HMDs).Methods and analysisParticipants will be allocated to one of three groups; reminiscence therapy using VR; an active control using a laptop computer or physical items and a passive control. A total of 45 participants will be recruited from residential aged care (15 in each group). The three groups will be compared at baseline and follow-up. The primary outcome is apathy, and secondary outcomes include cognition and depression. Side effects from using HMDs will also be examined in the VR group. Primary and secondary outcomes at baseline and follow-up will be analysed using linear mixed modelling.Ethics and disseminationEthics approval was obtained from the University of South Australia Human Research Ethics Committee. The results from this study will be disseminated through manuscript publications and national/international conferences.Trial registration numberACTRN12619001510134.

scholarly journals The Association of Sensory Impairment With Incident Disability-Related Cessation of Employment in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 216-216
Author(s):  
Ahmed Shakarchi ◽  
Emmanuel Garcia Morales ◽  
Nicholas Reed ◽  
Bonnielin Swenor
Keyword(s):  
Older Adults ◽  
Hearing Aids ◽  
Population Based ◽  
Sensory Impairment ◽  
Loss To Follow Up ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression ◽  
Study Participants ◽  
Adjusted Model

Abstract Sensory impairment (SI) is common among older adults, and it is an increasingly important public health challenge as the population ages. We evaluated the association between SI and incident disability-related cessation of employment in older adults using the population-based Health and Retirement Study. Participants employed in 2006 completed biennial interviews until self-reported incident disability-related cessation of employment. Participants were censored at loss to follow-up, retirement, or 2018. Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, excellent). SI was defined as poor or fair ability, and SI was categorized as neither SI (NSI), vision impairment alone (VI), hearing impairment alone (HI), and dual SI (DSI). Cox proportional hazard regression assessed the association between SI and incident disability-related cessation of employment, adjusting for demographic and health covariates. Overall, 4726 participants were included: 421 (8.9%) were with VI, 487 (10.3) with HI, and 203 (4.3%) with DSI. Mean age was 61.0 ± 6.8 years, 2488 (52.6%) were women, and 918 (19.4) were non-White. In the fully adjusted model, incident disability-related cessation of employment over the 12-year follow-up period was higher in VI (Hazard Ratio (HR)=1.30, 95% confidence interval (CI)=0.92, 1.85), HI (HR=1.60, CI=1.16, 2.22), and DSI (HR=2.02, CI=1.38, 2.96). These findings indicate that employed older adults with SI are at increased risk of incident disability-related cessation of employment, and that older adults with DSI are particularly vulnerable. Addressing SI in older adults may lengthen their contribution to the workforce.

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