scholarly journals Psychosocial and Health-Related Factors Associated With Discordance Between 13-Year Trajectories of Self-Reported Functional Limitations and Performance-Based Physical Functioning in Old Age

2019 ◽  
Vol 32 (9) ◽  
pp. 1084-1097
Author(s):  
Almar A. L. Kok ◽  
Marieke J. Henstra ◽  
Nathalie van der Velde ◽  
Didi Rhebergen ◽  
Natasja M. van Schoor
Keyword(s):  
Physical Functioning ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Functional Limitations ◽  
Population Based ◽  
Related Factors ◽  
Factors Associated ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study ◽  
And Performance

Objective: The objective of this study was to examine correlates of discordance between 13-year trajectories of self-reported functional limitations and performance-based physical functioning in older adults. Method: We included 2,135 participants from the population-based Longitudinal Aging Study Amsterdam, the Netherlands, followed across 1995-2008. Self-reported functional limitations included six (instrumental) activities of daily living. Performance-based functioning was a composite of four tests. We used latent class growth analysis and multinomial logistic regression to examine discordance and its correlates. Results: Patterns of discordance and concordance (41% concordance, 46% “overestimation” of daily functioning, 13% “underestimation”) appeared to be persistent over 13 years. Older age, male sex, cognitive impairment, absence of pain, and light alcohol use were associated with overestimation. Younger age, female sex, and lower self-rated health were associated with underestimation. Discussion: Factors associated with overestimation partly differ from those associated with underestimation. Factors that are highly stable over time are particularly good indicators of persistent discordance.

Secular trends in the prevalence of major and subthreshold depression among 55–64-year olds over 20 years

2017 ◽  
Vol 48 (11) ◽  
pp. 1824-1834 ◽  
Author(s):  
Hans W. Jeuring ◽  
Hannie C. Comijs ◽  
Dorly J. H. Deeg ◽  
Max L. Stek ◽  
Martijn Huisman ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Functional Limitations ◽  
Population Based ◽  
Secular Trends ◽  
Subthreshold Depression ◽  
Birth Cohorts ◽  
Screening Design ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study ◽  
Psychosocial Conditions

AbstractBackgroundStudying secular trends in the exposure to risk and protective factors of depression and whether these trends are associated with secular trends in the prevalence of depression is important to estimate future healthcare demands and to identify targets for prevention.MethodsThree birth cohorts of 55–64-year olds from the population-based Longitudinal Aging Study Amsterdam were examined using identical methods in 1992 (n = 944), 2002 (n = 964) and 2012 (n = 957). A two-stage screening design was used to identify subthreshold depression (SUBD) and major depressive disorder (MDD). Multinomial logistic regression analyses were used to identify secular trends in depression prevalence and to identify factors from the biopsychosocial domains of functioning that were associated with these trends.ResultsCompared with 1992, MDD became more prevalent in 2002 (OR 1.90, 95% CI 1.10–3.28, p = 0.022) and 2012 (OR 1.80, 95% CI 1.03–3.14, p = 0.039). This was largely attributable to an increase in the prevalence of chronic diseases and functional limitations. Socioeconomic and psychosocial improvements, including an increase in labor market participation, social support and mastery, hampered MDD rates to rise more and were also associated with a 32% decline of SUBD-rates in 2012 as compared with 2002 (OR 0.68, 95% CI 0.48–0.96, p = 0.03).ConclusionsAmong late middle-aged adults, there is a substantial net increase of MDD, which is associated with deteriorating physical health. If morbidity and disability continue to increase, a further expansion of MDD rates may be expected. Improving socioeconomic and psychosocial conditions may benefit public health, as these factors were protective against a higher prevalence of both MDD and SUBD.

scholarly journals Three-year trajectories in Functional Limitations and Cognitive Decline among Dutch 75+ year olds, using nine-month intervals

2021 ◽  
Author(s):  
Maura Gardeniers ◽  
Marjolein Broese van Groenou ◽  
Erik Jan Meijboom ◽  
Martijn Huisman
Keyword(s):  
Cognitive Functioning ◽  
Physical Functioning ◽  
Functional Limitations ◽  
Future Research ◽  
Short Version ◽  
Time Intervals ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study ◽  
Mini Mental Status Examination ◽  
Longitudinal Aging Study

Abstract Background Using longitudinal panel data, the aim of this study was to first identify three-year trajectories in cognitive and physical functioning among Dutch older adults. And second, to identify which main characteristics were associated with these trajectories. Methods Group-based Trajectory Modelling with mortality jointly estimated was used to identify trajectories, using a scale composed of 6 Activities of Daily Living (ADL) as a measure of physical functioning, and a short version of the mini mental status examination (sMMSE) or the IQCODE as a measure of cognitive functioning. Data came from 574 Dutch adults aged 75+, collected in five nine-month measurement waves conducted between 2015 and 2018 for the Longitudinal Aging Study Amsterdam. Results Five trajectories in physical functioning were identified: ‘high’, ‘moderate’, ‘steeply declining’, ‘gradually declining’, and ‘continuously low’. People that were older, lower educated, living in an institution, or suffered from diabetes or cerebrovascular accidents were more likely to follow a low or declining physical trajectory. For cognitive functioning four trajectories were identified: a ‘high’, ‘moderate’, ‘declining’, and ‘low’ trajectory. Old age, low education, living in an institution, and heart- and lung diseases were associated with continuously low or declining cognitive functioning. Mortality risks were highest among those experiencing the continuously low functioning trajectories. Conclusions This study identified trajectories comparable to previous studies that used longer time intervals, showing the consistent presence of heterogeneity in both physical and cognitive trajectories. Co-modelling mortality resulted in bigger group sizes for the more adverse trajectories. The favourable trajectories, containing most of the participants, were mostly characterized by absence of disease, whereas trajectories showing decline did not share a common indicator. Specific chronic diseases were associated with different rates of decline, however there was no factor that was associated with all declining trajectories; future research could focus on finding such an indicator.

scholarly journals Frailty Changes Predict Mortality in 4 Longitudinal Studies of Aging

2020 ◽  
Author(s):  
Erwin Stolz ◽  
Emiel O Hoogendijk ◽  
Hannes Mayerl ◽  
Wolfgang Freidl
Keyword(s):  
Mortality Risk ◽  
Clinical Decision Making ◽  
Frailty Index ◽  
Credible Interval ◽  
Clinical Decision ◽  
Population Based ◽  
Time To Event Data ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study ◽  
Longitudinal Aging Study

Abstract Background Baseline frailty index (FI) values have been shown to predict mortality among older adults, but little is known about the effects of changes in FI on mortality. Methods In a coordinated approach, we analyzed data from 4 population-based cohorts: the Health and Retirement Study (HRS), the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Survey of Ageing (ELSA), and the Longitudinal Aging Study Amsterdam (LASA), comprising a total of 24 961 respondents (65+), 95 897 observations, up to 9 repeated FI assessments, and up to 23 years of mortality follow-up. The effect of time-varying FI on mortality was modeled with joint regression models for longitudinal and time-to-event data. Results Differences (of 0.01) in current FI levels (hazard ratio [HR] = 1.04, 95% credible interval [CI] = 1.03–1.05) and baseline FI levels (HR = 1.03, 95% CI = 1.03–1.05) were consistently associated with mortality across studies. Importantly, individuals with steeper FI growth also had a higher mortality risk: An increase in annual FI growth by 0.01 was associated with an increased mortality risk of HR = 1.56 (95% CI = 1.49–1.63) in HRS, HR = 1.24 (95% CI = 1.13–1.35) in SHARE, HR = 1.40 (95% CI = 1.25–1.52) in ELSA, and HR = 1.71 (95% CI = 1.46–2.01) in LASA. Conclusions FI changes predicted mortality independently of baseline FI differences. Repeated assessment of frailty and individual’s frailty trajectory could provide a means to anticipate further health deterioration and mortality and could thus support clinical decision making.

scholarly journals Endogenous subclinical thyroid disorders, physical and cognitive function, depression, and mortality in older individuals

2011 ◽  
Vol 165 (4) ◽  
pp. 545-554 ◽  
Author(s):  
Renate T de Jongh ◽  
Paul Lips ◽  
Natasja M van Schoor ◽  
Kelly J Rijs ◽  
Dorly J H Deeg ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Subclinical Hypothyroidism ◽  
Population Based ◽  
Thyroid Disorders ◽  
Older Individuals ◽  
Cross Sectional ◽  
Thyroid Medication ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study ◽  
Subclinical Thyroid Disorders

ObjectiveTo what extent endogenous subclinical thyroid disorders contribute to impaired physical and cognitive function, depression, and mortality in older individuals remains a matter of debate.DesignA population-based, prospective cohort of the Longitudinal Aging Study Amsterdam.MethodsTSH and, if necessary, thyroxine and triiodothyronine levels were measured in individuals aged 65 years or older. Participants were classified according to clinical categories of thyroid function. Participants with overt thyroid disease or use of thyroid medication were excluded, leaving 1219 participants for analyses. Outcome measures were physical and cognitive function, depressive symptoms (cross-sectional), and mortality (longitudinal)ResultsSixty-four (5.3%) individuals had subclinical hypothyroidism and 34 (2.8%) individuals had subclinical hyperthyroidism. Compared with euthyroidism (n=1121), subclinical hypo-, and hyper-thyroidism were not significantly associated with impairment of physical or cognitive function, or depression. On the contrary, participants with subclinical hypothyroidism did less often report more than one activity limitation (odds ratio 0.44, 95% confidence interval (CI) 0.22–0.86). After a median follow-up of 10.7 years, 601 participants were deceased. Subclinical hypo- and hyper-thyroidism were not associated with increased overall mortality risk (hazard ratio 0.89, 95% CI 0.59–1.35 and 0.69, 95% CI 0.40–1.20 respectively).ConclusionsThis study does not support disadvantageous effects of subclinical thyroid disorders on physical or cognitive function, depression, or mortality in an older population.

scholarly journals Serum IGF1, metabolic syndrome, and incident cardiovascular disease in older people: a population-based study

2013 ◽  
Vol 168 (3) ◽  
pp. 393-401 ◽  
Author(s):  
Christa C van Bunderen ◽  
Mirjam M Oosterwerff ◽  
Natasja M van Schoor ◽  
Dorly J H Deeg ◽  
Paul Lips ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Older People ◽  
Population Based ◽  
Mortality Data ◽  
The Metabolic Syndrome ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study ◽  
Definition Of ◽  
Relationship Of ◽  
The Relationship

ObjectiveHigh as well as low levels of IGF1 have been associated with cardiovascular diseases (CVD). The relationship of IGF1 with (components of) the metabolic syndrome could help to clarify this controversy. The aims of this study were: i) to investigate the association of IGF1 concentration with prevalent (components of) the metabolic syndrome; and ii) to examine the role of (components of) the metabolic syndrome in the relationship between IGF1 and incident CVD during 11 years of follow-up.MethodsData were used from the Longitudinal Aging Study Amsterdam, a cohort study in a representative sample of the Dutch older population (≥65 years). Data were available in 1258 subjects. Metabolic syndrome was determined using the definition of the US National Cholesterol Education Program Adult Treatment Panel III. CVD were ascertained by self-reports and mortality data.ResultsLevels of IGF1 in the fourth quintile were associated with prevalent metabolic syndrome compared with the lowest quintile (odds ratio: 1.59, 95% confidence interval (CI) 1.09–2.33). The middle up to the highest quintile of IGF1 was positively associated with high triglycerides in women. Metabolic syndrome was not a mediator in the U-shaped relationship of IGF1 with CVD. Both subjects without the metabolic syndrome and low IGF1 levels (hazard ratio (HR) 1.75, 95% CI 1.12–2.71) and subjects with the metabolic syndrome and high IGF1 levels (HR 2.28, 95% CI 1.21–4.28) demonstrated increased risks of CVD.ConclusionsIn older people, high-normal IGF1 levels are associated with prevalent metabolic syndrome and high triglycerides. Furthermore, this study suggests the presence of different pathomechanisms for both low and high IGF1 levels and incident CVD.

scholarly journals Trajectories and Determinants of Physical Activity during COVID-19 Pandemic: A Population-Based Study of Middle-Aged and Elderly Individuals in The Netherlands

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3832
Author(s):  
Amy Hofman ◽  
Marlou A. M. Limpens ◽  
Tosca O. E. de Crom ◽  
Mohammad Arfan Ikram ◽  
Annemarie I. Luik ◽  
...  
Keyword(s):  
Physical Activity ◽  
The Netherlands ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Public Health Problem ◽  
Population Based ◽  
World Health ◽  
Major Public Health Problem ◽  
Middle Aged ◽  
Health Organization

Physical inactivity is a major public health problem, and there are concerns this might have increased during the COVID-19 pandemic. We aimed to identify distinct trajectories of physical activity over a 6-week period after the first restrictive measures and to explore determinants of these trajectories in a population-based cohort of middle-aged and elderly in the Netherlands (n = 5777). We observed that at least 59% of participants did not meet the World Health Organization recommendations for physical activity. Using latent class trajectory analyses over three time points, we identified five distinct trajectories, including four steady trajectories at different levels (very low, low, medium and high) and one increasing trajectory. Using multinomial logistic regression analyses, we observed that, compared to the ‘steadily high’ trajectory, participants in the ‘steadily very low’ trajectory were more often older, lower educated, reporting poorer physical health, more depressive symptoms, consuming a less healthy diet, smoking, and lower alcohol use, and were less often retired. A similar pattern of determinants was seen for those in the increasing trajectory, albeit with smaller effect sizes. Concluding, we observed low levels of physical activity that generally remained during the pandemic. The determinants we described can help identify groups that require additional preventive interventions.

scholarly journals Maternal Risk Factors Associated with Poor Postpartum Healthcare Utilization

2020 ◽  
Author(s):  
michael e silverman ◽  
Holly Loudon ◽  
Laudy Burgos
Keyword(s):  
Mount Sinai Hospital ◽  
Population Based ◽  
Postpartum Care ◽  
Related Factors ◽  
Maternal Risk ◽  
Factors Associated ◽  
Ambulatory Practice ◽  
Mount Sinai ◽  
Prenatal Visits

Abstract Objectives: Perceptions regarding the benefits of postpartum care among mothers and clinicians often differ. Clinicians generally perceive postpartum care as preventative, whereas pregnant and postpartum women often lack knowledge about its preventative benefits. As a result many women choose not to return for scheduled postpartum care visits. Methods: To examine if clinically relevant demographic and birth related factors are informative predictors for postpartum healthcare follow-up care, we conducted a population based cohort study of all women who delivered a child in 2012 – 2015 at the New York Mount Sinai Hospital Obstetrics and Gynecology Ambulatory Practice. Data was ascertained from electronic health records.Results: Of the 4,240 unique women who delivered between 2012-2015 at the Mount Sinai Hospital OB/GYN Ambulatory Practice, 1,685 (39.7%) did not return for their postpartum care follow-up appointment. The number of prenatal visits, maternal age, and parity were significantly associated with postpartum care follow-up. Conclusion for Practice: The purpose of this study was to determine identifiable factors associated with reduced postpartum healthcare follow-up utilization. Several clinically relevant variables were associated with the reduced likelihood for attending postpartum care visits. Because pregnant women represent a medically captured population, the results of this study point to the need to increase postpartum healthcare literacy during perinatal appointments especially among younger mothers, women who have had previous deliveries, and those with fewer prenatal visits.

Application of latent class analysis in assessing the mental health of medical students during the COVID-19 Epidemic (Preprint)

2020 ◽  
Author(s):  
Fei Wang
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
High Risk ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Risk Group ◽  
Multinomial Logistic Regression ◽  
High Risk Group ◽  
Class Analysis ◽  
Related Factors

BACKGROUND The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. The mental health of medical students under the COVID-19 epidemic has attracted much attention. OBJECTIVE This study aims to identify subgroups of medical students based on mental health status and explore the influencing factors during the COVID-19 epidemic in China. METHODS A total of 29,663 medical students were recruited during the epidemic of COVID-19 in China. Latent class analysis of the mental health of medical students was performed using M-plus software to identify subtypes of medical students. The latent class subtypes were compared using the chi-square test. Multinomial logistic regression was used to examine associations between identified classes and related factors. RESULTS In this study, three distinct subgroups were identified, namely, the high-risk group, the low-risk group and the normal group. Therefore, medical students can be divided into three latent classes, and the number of students in each class is 4325, 9321 and 16,017. The multinomial logistic regression results showed that compared with the normal group, the factors influencing mental health in the high-risk group were insomnia, perceived stress, family psychiatric disorders, fear of being infected, drinking, individual psychiatric disorders, sex, educational level and knowledge of COVID-19, according to the intensity of influence from high to low. CONCLUSIONS Our findings suggested that latent class analysis can be used to categorize different medical students according to their mental health subgroup during the outbreak of COVID-19. The main factors influencing the high-risk group and low-risk group are basic demographic characteristics, disease history, COVID-19 related factors and behavioral lifestyle, among which insomnia and perceived stress have the greatest impact. School administrative departments could utilize more specific measures on the basis of different subgroups, and provide targeted measures.

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