scholarly journals Identifying predictors of high sodium excretion in patients with heart failure: A mixed effect analysis of longitudinal data

2013 ◽  
Vol 13 (6) ◽  
pp. 549-558 ◽  
Author(s):  
Ruth Masterson Creber ◽  
Maxim Topaz ◽  
Terry A Lennie ◽  
Christopher S Lee ◽  
Houry Puzantian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sodium Excretion ◽  
Community Dwelling ◽  
World Health ◽  
Mixed Effect ◽  
Prospective Longitudinal Study ◽  
High Sodium ◽  
Obesity And Diabetes ◽  
Patients With Heart Failure ◽  
Prospective Longitudinal

Background: A low-sodium diet is a core component of heart failure self-care but patients have difficulty following the diet. Aim: The aim of this study was to identify predictors of higher than recommended sodium excretion among patients with heart failure. Methods: The World Health Organization Five Dimensions of Adherence model was used to guide analysis of existing data collected from a prospective, longitudinal study of 280 community-dwelling adults with previously or currently symptomatic heart failure. Sodium excretion was measured objectively using 24-hour urine sodium measured at three time points over six months. A mixed effect logistic model identified predictors of higher than recommended sodium excretion. Results: The adjusted odds of higher sodium excretion were 2.90, (95% confidence interval (CI): 1.15–4.25, p<0.001) for patients who were obese; 2.80 (95% CI: 1.33–5.89, p=0.007) for patients with diabetes; and 2.22 (95% CI: 1.09–4.53, p=0.028) for patients who were cognitively intact. Conclusion: Three factors were associated with excess sodium excretion and two factors, obesity and diabetes, are modifiable by changing dietary food patterns.

Accelerated sarcopenia and outcomes in older adults with cancer: The Health ABC Study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11526-11526
Author(s):  
Grant Richard Williams ◽  
Yanjun Chen ◽  
Kelly Kenzik ◽  
Andrew Michael McDonald ◽  
Shlomit S. Shachar ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Composition ◽  
Cancer Diagnosis ◽  
Cox Regression ◽  
Community Dwelling ◽  
Mixed Effect ◽  
Prospective Longitudinal Study ◽  
Targeted Interventions ◽  
Prospective Longitudinal ◽  
Time Varying Covariates

11526 Background: Progressive loss of muscle mass and strength (sarcopenia) is a well-known phenomenon of aging; however, little is known about the contribution of a cancer diagnosis to sarcopenia and its subsequent impact on disability. Using a prospective cohort of older adults from pre- to post-cancer diagnosis and a similarly-followed non-cancer cohort, we examined the trajectory of sarcopenia measures and their association with overall survival (OS) and major disability among those with cancer. Methods: The Health, Aging, and Body Composition (Health ABC) Study is a prospective longitudinal study where 3,075 community-dwelling older adults (70-79y) underwent 6 annual assessments of body composition and were followed for development of sentinel events (cancer, disability, death). Appendicular lean mass (ALM [kg]) was a sum of DXA-based lean tissue of all extremities. Hand grip strength (HGS [kg]) was averaged from 2 trials per hand. Gait speed (GS) was evaluated over a 20m course. We used linear mixed effect models to compare the change in ALM, HGS, and GS between individuals who subsequently developed cancer and those who did not, adjusting for age, race, gender, enrollment site. Among patients with cancer, we used multivariable cox regression for time from cancer diagnosis to mortality and major disability (cane/walker, inability to walk 0.25 mile/climb 10 steps, assistance with activities of daily living) treating sarcopenia measures as time-varying covariates. Results: Mean age at enrollment was 75y; 52% female; 42% black; 515 new cancers (prostate: 23%, colorectal: 15%, lung: 13%, breast: 11%). Compared with non-cancer controls, we found significantly steeper declines in HGS ( p= 0.03) and GS ( p< 0.001), and a trend in ALM ( p= 0.07) prior to cancer diagnosis; and a significantly steeper decline in ALM ( p< 0.001), but no difference in HGS ( p= 0.6) or GS ( p= 0.4) after cancer diagnosis. Slow GS was associated with a 44% increase in mortality ( p= 0.02) and a 70% increase in disability ( p= 0.02), but not ALM or HGS. Conclusions: Accelerated loss in sarcopenia measures both prior to and after a cancer diagnosis, and association with disability and mortality in older adults with cancer, present opportunities for targeted interventions.

Kansas City Cardiomyopathy Questionnaire Administered to Hospitalized Patients With Heart Failure

2016 ◽  
Vol 24 (2) ◽  
pp. 245-257
Author(s):  
Rebecca Tucker ◽  
Jill R. Quinn ◽  
Ding-Geng (Din) Chen ◽  
Leway Chen
Keyword(s):  
Heart Failure ◽  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Psychometric Properties ◽  
Convergent Validity ◽  
Kansas City ◽  
Community Dwelling ◽  
Kansas City Cardiomyopathy Questionnaire ◽  
Patients With Heart Failure ◽  
Confirmatory Factor

Background and Purpose: The psychometric properties of the Kansas City Cardiomyopathy Questionnaire (KCCQ) have been examined primarily in community-dwelling patients with heart failure (HF). The objective of this research was to examine the properties of the KCCQ administered to patients hospitalized with HF (N = 233). Methods: Confirmatory factor analysis, Cronbach’s alphas, and correlations were performed to examine the scale’s dimensions, reliability, and validity. Results: Confirmatory factor analysis indicated a 5-factor solution (63.6% of the variance). The Cronbach’s alpha levels were greater than .70, except for the self-efficacy dimension (.60). Convergent validity was not verified between the KCCQ and several illness severity measures. Conclusions: The psychometric properties of the KCCQ may be different based on the population in which the KCCQ is administered, which may have clinical implications.

Associations between socio-economic status measures and functional change among older people in Taiwan

2005 ◽  
Vol 25 (3) ◽  
pp. 377-395 ◽  
Author(s):  
HERNG-CHIA CHIU ◽  
YING-HUI HSIEH ◽  
LIH-WEN MAU ◽  
MEI-LIN LEE
Keyword(s):  
Older People ◽  
Economic Status ◽  
Functional Change ◽  
Community Dwelling ◽  
Study Cohort ◽  
Economic Resource ◽  
Prospective Longitudinal Study ◽  
Level Of Education ◽  
Socio Economic Status ◽  
Prospective Longitudinal

The major purpose of this study was to examine the effects of socio-economic status (SES) on changes in functional abilities, as measured by Activities of Daily Living (ADL) scales, among older people in Taiwan. A prospective longitudinal study design was used. A panel of 874 community-dwelling older people were followed over four years (1994 to 1998). Three SES indicators, education, having ‘extra’ money (more than required for basic necessities), and principal lifetime occupation were included in separate multiple logistic regression models of functional change in physical ADL (PADL) and in instrumental ADL (IADL). Over the four years, the study cohort experienced greater decreases in IADL functioning than in PADL functioning. Having ‘extra’ money was significantly and negatively associated with PADL decline, while level of education had a strong positive relationship with IADL functioning. In addition to SES, age was significantly associated with PADL and IADL functioning change. The paper also reports a comparison of similar findings from several eastern and western countries. This has established that among the available SES indicators, the level of education has most consistently been shown in both eastern and western population studies to be related to health and health change, and that self-perceived economic resource is also related to older people's health in Asian populations.

scholarly journals Impact of Educational Weaning Knowledge and Practices of Parents and Guardians of Children under Two Years Old at the David Rose Health Centre

2019 ◽  
pp. 21-22
Author(s):  
Padmini Bissessar ◽  
Kenesha Adams ◽  
Gina Chin ◽  
Sheena Chin ◽  
Paul Garraway ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Repeated Measures ◽  
Health Centre ◽  
World Health Organisation ◽  
Educational Interventions ◽  
World Health ◽  
Post Intervention ◽  
Prospective Longitudinal Study ◽  
Repeated Measures Design ◽  
Prospective Longitudinal

Objectives: To assess the knowledge of weaning, of parents and guardians, of children under two-years-old, attending David Rose Health Centre. To assess whether there is an association between selected demographic variables, and the weaning knowledge. To educate the parents and guardians on the World Health Organisation recommended weaning practices. To assess the change in knowledge of weaning after the delivery of an educational intervention. Design and Methods: A prospective longitudinal study with repeated measures design obtained 120 participants using a convenient, non-probability sampling method. Data was collected using a pre-intervention and post-intervention questionnaire. The data was processed using the SPSS Version 24 Software Program and analysed with a scoring system developed by the researchers using the PAHO/WHO “Guiding Principles for Complementary Feeding of the Breastfed Child”. Results: Both educational interventions increased the participants knowledge from good to almost 100%. Conclusions: Most parents and guardians had good baseline knowledge. However, there were certain aspects where they lacked or had inaccurate knowledge. Overall, their knowledge improved regardless of the type of educational intervention they were exposed to. Recommendations: Future studies should be held in classroom settings, with more time allowed to assess change of knowledge.

Medication Adherence Among Community-Dwelling Patients With Heart Failure

SciVee ◽  
2011 ◽  
Author(s):  
Shannon m. Dunlay ◽  
Jessica m. Eveleth ◽  
Nilay d. Shah ◽  
Sheila m. Mcnallon ◽  
Véronique l. Roger
Keyword(s):  
Heart Failure ◽  
Medication Adherence ◽  
Community Dwelling ◽  
Patients With Heart Failure

scholarly journals Protein intake and transitions between frailty states and to death in very old adults: the Newcastle 85+ study

2019 ◽  
Vol 49 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Nuno Mendonça ◽  
Andrew Kingston ◽  
Antoneta Granic ◽  
Carol Jagger
Keyword(s):  
Energy Intake ◽  
Sex Education ◽  
Protein Intake ◽  
Community Dwelling ◽  
Physical Endurance ◽  
Prospective Longitudinal Study ◽  
Very Old ◽  
Old Adults ◽  
State Models ◽  
Prospective Longitudinal

Abstract Objectives To examine the association of protein intake with frailty progression in very old adults. Design The Newcastle 85+ study, a prospective longitudinal study of people aged 85 years old in Northeast England and followed over 5 years. Setting and Participants 668 community-dwelling older adults (59% women) at baseline, with complete dietary assessment and Fried frailty status (FFS). Measures Dietary intake was estimated with 2 × 24-h multiple pass recalls at baseline. FFS was based on five criteria: shrinking, physical endurance/energy, low physical activity, weakness and slow walking speed and was available at baseline and 1.5, 3 and 5 years. The contribution of protein intake (g/kg adjusted body weight/day [g/kg aBW/d]) to transitions to and from FFS (robust, pre-frail and frail) and to death over 5 years was examined by multi-state models. Results Increase in one unit of protein intake (g/kg aBW/d) decreased the likelihood of transitioning from pre-frail to frail after adjusting for age, sex, education and multimorbidity (hazard ratios [HR]: 0.44, 95% confidence interval [CI]: 0.25–0.77) but not for the other transitions. Reductions in incident frailty were equally present in individuals with protein intake ≥0.8 (HR: 0.60, 95% CI: 0.43–0.84) and ≥1 g/kg aBW/d (HR: 0.63, 95% CI: 0.44–0.90) from 85 to 90 years. This relationship was attenuated after adjustment for energy intake, but the direction of the association remained the same (e.g. g/kg aBW/d model: HR: 0.71, 95% CI: 0.36–1.41). Conclusion High protein intake, partly mediated by energy intake, may delay incident frailty in very old adults. Frailty prevention strategies in this age group should consider adequate provision of protein and energy.

Atrial natriuretic peptides in man

1987 ◽  
Vol 65 (8) ◽  
pp. 1697-1700 ◽  
Author(s):  
M. Gary Nicholls ◽  
Hamid Ikram ◽  
Ian G. Crozier ◽  
Eric A. Espiner ◽  
Tim G. Yandle
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Physiological Role ◽  
High Sodium ◽  
Patients With Heart Failure ◽  
Normal Man ◽  
Urine Electrolytes ◽  
Pulmonary Arterial ◽  
Atrial Natriuretic

Research on the physiological role of atrial peptides in man is limited, and the potential for these peptides, or more stable analogues, in therapeutics is uncertain. It is clear, however, that plasma levels of immunoreactive atrial natriuretic peptide (IR-ANP) are increased in volunteers taking a high sodium diet, and are elevated in patients with heart failure, chronic renal failure, and primary aldosteronism. There is suggestive evidence that IR-ANP levels are increased also in essential hypertension, although overlap with normotensives is considerable. Injection or infusion of artrial peptides into man results in a diuresis, an increased output of urine electrolytes, a fall in blood pressure and a rise in heart rate, suppression of aldosterone and sometimes of renin also, and stimulation of norepinephrine. In essential hypertensives, urinary effects may be greater than in normotensives. Heart failure patients show a rise in cardiac output and falls in both systemic and pulmonary arterial pressure. Over the next few years and especially if specific antagonists can be developed, the physiologic and pathophysiologic roles of atrial peptides in normal man and in clinical disorders should be clarified. It is possible that stable analogues of atrial peptides will find a place in the treatment of cardiac failure, renal failure, and perhaps hypertension.

Sign in / Sign up

Export Citation Format

Share Document