New Coronal Caries in Older Adults: Implications for Prevention

To characterize the extent and severity of coronal caries among older US adults and document their need for prevention interventions, we systematically reviewed studies on coronal caries incidence, increment, and attack rate. We abstracted six studies and calculated summary measures using a random-effects model (95% confidence interval [95%CI]). We tested for heterogeneity and identified associated factors by examining the correlation between outcome measures and baseline population risk and study characteristics. We re-calculated summary measures after adjusting outcomes that netted out examiner reversals. Incidence and increment varied significantly by study. Adjusting studies for netting out examiner reversals reduced heterogeneity significantly. Annual attack rate among adjusted North American studies was 1.4 surfaces per 100 surfaces (95%CI = 1.0–1.9), or approximately 1 new carious surface per person per year. These rates are equal to or higher than those in children and indicate a need for caries-prevention services.

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Estimating Rates of New Root Caries in Older Adults

Journal of Dental Research ◽

10.1177/154405910408300810 ◽

2004 ◽

Vol 83 (8) ◽

pp. 634-638 ◽

Cited By ~ 140

Author(s):

S.O. Griffin ◽

P.M. Griffin ◽

J.L. Swann ◽

N. Zlobin

Keyword(s):

Older Adults ◽

Confidence Intervals ◽

Random Effects Model ◽

Root Caries ◽

Age Group ◽

National Data ◽

Summary Measure ◽

Caries Increment ◽

Annual Total ◽

Summary Measures

Although older adults are keeping their teeth longer, no national data are available on new caries in this age group. To characterize the extent of caries among older adults, we systematically reviewed studies on root caries incidence, increment, attack rate, and annual total (root + coronal) caries increment. We used a random-effects model to estimate annual summary measures and their 95% confidence intervals (CI) and tested for heterogeneity. For the 9 studies reporting root caries incidence, the summary measure equaled 23.7% (CI = 17.1–30.2%). For the 9 studies reporting root caries increment, the summary measure was 0.47 surfaces (CI = 0.34–0.61). For the 7 studies reporting total caries increment, the summary measure equaled 1.31 surfaces (95% CI = 1.01–1.61 surfaces). Because of heterogeneity, summary measures should be interpreted with caution. This research suggests, however, that older adults experience high rates of new caries and could benefit from caries-prevention programs.

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Plasma acylcarnitines and risk of lower-extremity functional impairment in older adults: a nested case–control study

Scientific Reports ◽

10.1038/s41598-021-82912-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Francisco Félix Caballero ◽

Ellen A. Struijk ◽

Alberto Lana ◽

Antonio Buño ◽

Fernando Rodríguez-Artalejo ◽

...

Keyword(s):

Older Adults ◽

Confidence Interval ◽

Lower Extremity ◽

Functional Impairment ◽

Odds Ratio ◽

Case Control Study ◽

Case Control ◽

Community Dwelling ◽

Control Study ◽

Long Chain

AbstractElevated concentrations of acylcarnitines have been associated with higher risk of obesity, type 2 diabetes and cardiovascular disease. The aim of the present study was to assess the association between L-carnitine and acylcarnitine profiles, and 2-year risk of incident lower-extremity functional impairment (LEFI). This case–control study is nested in the Seniors-ENRICA cohort of community-dwelling older adults, which included 43 incident cases of LEFI and 86 age- and sex- matched controls. LEFI was assessed with the Short Physical Performance Battery. Plasma L-carnitine and 28 acylcarnitine species were measured. After adjusting for potential confounders, medium-chain acylcarnitines levels were associated with 2-year incidence of LEFI [odds ratio per 1-SD increase: 1.69; 95% confidence interval: 1.08, 2.64; p = 0.02]. Similar results were observed for long-chain acylcarnitines [odds ratio per 1-SD increase: 1.70; 95% confidence interval: 1.03, 2.80; p = 0.04]. Stratified analyses showed a stronger association between medium- and long-chain acylcarnitines and incidence of LEFI among those with body mass index and energy intake below the median value. In conclusion, higher plasma concentrations of medium- and long-chain acylcarnitines were associated with higher risk of LEFI. Given the role of these molecules on mitochondrial transport of fatty acids, our results suggest that bioenergetics dysbalance contributes to LEFI.

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Longer Residence in the United States is Associated With More Physical Function Limitations in African Immigrant Older Adults

Journal of Applied Gerontology ◽

10.1177/0733464820977608 ◽

2020 ◽

pp. 073346482097760

Author(s):

Manka Nkimbeng ◽

Yvonne Commodore-Mensah ◽

Jacqueline L. Angel ◽

Karen Bandeen-Roche ◽

Roland J. Thorpe ◽

...

Keyword(s):

United States ◽

Older Adults ◽

Confidence Interval ◽

Physical Function ◽

Racial Discrimination ◽

African Immigrants ◽

The United States ◽

African Immigrant ◽

High Discrimination ◽

The Mean

Acculturation and racial discrimination have been independently associated with physical function limitations in immigrant and United States (U.S.)-born populations. This study examined the relationships among acculturation, racial discrimination, and physical function limitations in N = 165 African immigrant older adults using multiple linear regression. The mean age was 62 years ( SD = 8 years), and 61% were female. Older adults who resided in the United States for 10 years or more had more physical function limitations compared with those who resided here for less than 10 years ( b = −2.62, 95% confidence interval [CI] = [–5.01, –0.23]). Compared to lower discrimination, those with high discrimination had more physical function limitations ( b = −2.51, 95% CI = [–4.91, –0.17]), but this was no longer significant after controlling for length of residence and acculturation strategy. Residing in the United States for more than 10 years is associated with poorer physical function. Longitudinal studies with large, diverse samples of African immigrants are needed to confirm these associations.

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Adherence to antihypertensive medications and associated factors among hypertensive patients in Ethiopia: Systematic review and meta-analysis

SAGE Open Medicine ◽

10.1177/2050312120982459 ◽

2020 ◽

Vol 8 ◽

pp. 205031212098245

Author(s):

Assefa Tola Gemeda ◽

Lemma Demissie Regassa ◽

Adisu Birhanu Weldesenbet ◽

Bedasa Taye Merga ◽

Nanti Legesse ◽

...

Keyword(s):

Systematic Review ◽

Medication Adherence ◽

Confidence Interval ◽

Odds Ratio ◽

Associated Factors ◽

Antihypertensive Medication ◽

Meta Analysis ◽

Group Analysis ◽

Hypertensive Patients ◽

Pooled Prevalence

The foundation of controlling hypertension is adherence to antihypertensive medication adherence. This systematic review and meta-analysis aimed to assess the magnitude and associated factors of adherence to antihypertensive medication among adult hypertensive patients in Ethiopia. A comprehensible bibliographic searching was conducted from PubMed, EMBASE, Scopus, and Web of Science core collection. All published and unpublished studies that had been accessible before 31 May 2020, and written in English were eligible. Joanna Briggs Institute assessment tool was used to evaluate the quality of the findings of the included studies. Stata software 16.0 was used to analyze the data. Study-specific estimates were pooled to determine the overall prevalence estimate across studies using a random-effects meta-analysis model. Publication bias and heterogeneity were checked. Fourteen studies with a total of 4938 hypertensive patients were included in the final systematic review and meta-analysis. The pooled prevalence of medication adherence among hypertensive patients in Ethiopia was 65.41% (95% confidence interval: 58.91–71.91). Sub-group analysis shown that the pooled prevalence of medication adherence was the highest (69.07%, 95% confidence interval: 57.83–80.31, I2 = 93.51) among studies using questionnaire technique whereas the lowest in Morisky Medication Adherence Scale eight-items (60.66%, 95% confidence interval: 48.92–72.40, I2 = 97.16). Moreover, medication adherence was associated with the presence of comorbidities (pooled odds ratio = 0.23, 95% confidence interval: 0.07–0.38, p = 0.030, I2 = 54.9%) and knowledge about the disease and its management (pooled odds ratio = 2.98, 95% confidence interval: 1.72–4.24, p = 0.04, I2 = 55.55%) but not with place of residence (pooled odds ratio = 1.22, 95% confidence interval: 0.51–1.93, p = 0.00, I2 = 76.9%). Despite a lack of uniformity among included studies, adherence to antihypertensive medication among the hypertensive population in Ethiopia was moderate. The presence of comorbidities and/or complications reduced the odds of adherence whereas having good knowledge about the disease increased chance of medication adherence among hypertensive patients.

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Hypertension and associated factors in older adults in South Africa : cardiovascular topics

CardioVascular Journal of Africa ◽

10.5830/cvja-2013-002 ◽

2013 ◽

Vol 24 (3) ◽

pp. 66-71 ◽

Cited By ~ 41

Author(s):

Karl Peltzer ◽

Nancy Phaswana-Mafuya

Keyword(s):

South Africa ◽

Older Adults ◽

Associated Factors

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Sleep-Disordered Breathing Is Associated With Impaired Odor Identification in Older U.S. Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa276 ◽

2020 ◽

Author(s):

Jesse K Siegel ◽

Xiandao Yuan ◽

Kristen E Wroblewski ◽

Martha K McClintock ◽

Jayant M Pinto

Keyword(s):

Older Adults ◽

Central Nervous System ◽

Nervous System ◽

Sleep Apnea ◽

Confidence Interval ◽

Odds Ratio ◽

Sleep Disordered Breathing ◽

Odor Identification ◽

Odor Sensitivity ◽

Disordered Breathing

Abstract Background Sleep-disordered breathing (SDB) is a common, underdiagnosed condition in older adults with major health consequences, including disrupted central nervous system functioning. Whether SDB may affect sensory function is unclear. We sought to address this question by comparing 2 forms of olfactory testing which measure peripheral and central olfactory processing. Methods We assessed SDB (survey-reported snoring frequency, nighttime apneic events, or diagnosis of sleep apnea) in the National Social Life, Health, and Aging Project, a nationally representative sample of older U.S. adults. Odor sensitivity (peripheral) and odor identification (central) were assessed with validated instruments. Logistic regression was used to test the relationship between SDB and olfaction, accounting for relevant covariates, including demographics, cognition, and comorbidity. Results Twenty-nine percent of older U.S. adults reported symptoms of SDB (apneic events or nightly snoring). Of these, only 32% had been diagnosed with sleep apnea. Older adults with SDB (those who reported symptoms or have been diagnosed with sleep apnea) were significantly more likely to have impaired odor identification (odds ratio 2.13, 95% confidence interval 1.19–3.83, p = .012) in analyses that accounted for age, gender, race/ethnicity, education, cognition, comorbidities (including depression), and body mass index. Presence of SDB was not associated with impaired odor sensitivity (odds ratio 1.03, 95% confidence interval 0.75–1.43, p = .84). Conclusion SDB is highly prevalent but underdiagnosed in older U.S. adults and is associated with impaired odor identification but not odor sensitivity. These data support the concept that SDB affects pathways in the central nervous system which involve chemosensory processing.

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The Epidemiology of US High School Basketball Injuries, 2005–2007

The American Journal of Sports Medicine ◽

10.1177/0363546508322893 ◽

2008 ◽

Vol 36 (12) ◽

pp. 2328-2335 ◽

Cited By ~ 161

Author(s):

Laurel A. Borowski ◽

Ellen E. Yard ◽

Sarah K. Fields ◽

R. Dawn Comstock

Keyword(s):

High School ◽

Confidence Interval ◽

Rate Ratio ◽

Knee Injuries ◽

Injury Rate ◽

The United States ◽

Basketball Players ◽

Knee Ligament ◽

Prevention Interventions ◽

Nationally Representative

Background With more than a million high school athletes playing during the 2006–2007 academic year, basketball is one of the most popular sports in the United States. Hypothesis Basketball injury rates and patterns differ by gender and type of exposure. Study Design Descriptive epidemiology study. Methods Basketball-related injury data were collected during the 2005–2006 and 2006–2007 academic years from 100 nationally representative US high schools via Reporting Information Online. Results High school basketball players sustained 1518 injuries during 780 651 athlete exposures for an injury rate of 1.94 per 1000 athlete exposures. The injury rate per 1000 athlete exposures was greater during competition (3.27) than during practice (1.40; rate ratio, 2.33; 95% confidence interval, 2.10–2.57) and was greater among girls (2.08) than among boys (1.83; rate ratio, 1.14; 95% confidence interval, 1.03–1.26). The ankle/foot (39.7%), knee (14.7%), head/face/neck (13.6%), arm/hand (9.6%), and hip/thigh/upper leg (8.4%) were most commonly injured. The most frequent injury diagnoses were ligament sprains (44.0%), muscle/tendon strains (17.7%), contusions (8.6%), fractures (8.5%), and concussions (7.0%). Female basketball players sustained a greater proportion of concussions (injury proportion ratio, 2.41; 95% confidence interval, 1.49–3.91) and knee injuries (injury proportion ratio, 1.71; 95% confidence interval, 1.27–2.30), whereas boys more frequently sustained fractures (injury proportion ratio, 1.87; 95% confidence interval, 1.27–2.77) and contusions (injury proportion ratio, 1.52; 95% confidence interval, 1.00–2.31). The most common girls’ injury requiring surgery was knee ligament sprains (47.9%). Conclusion High school basketball injury patterns vary by gender and type of exposure. This study suggests several areas of emphasis for targeted injury prevention interventions.

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An epidemiological investigation of the 2019 suspected pertussis outbreak in northwestern Nigeria

SAGE Open Medicine ◽

10.1177/20503121211008344 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110083

Author(s):

Omoleke Semeeh ◽

Biniam Getachew ◽

Yusuf Taofik ◽

Lukman Surajudeen ◽

Assad Hassan ◽

...

Keyword(s):

Confidence Interval ◽

Disease Transmission ◽

Attack Rate ◽

Odds Ratio ◽

Case Fatality Rate ◽

Adjusted Odds Ratio ◽

Case Fatality ◽

Immunization Coverage ◽

Fatality Rate ◽

Vaccine Preventable Diseases

Introduction: In 2019, we investigated the profile of the cases and controls and the determinants of pertussis transmission in Kebbi State, Northwestern Nigeria, to inform better immunization and surveillance strategies. Methods: Community-based unmatched case–control study and review of the 2019 pertussis routine surveillance data in the affected settlements in the state were conducted. A total of 52 suspected cases of pertussis and 107 control from two local government areas in Kebbi State were recruited. Data were analyzed using descriptive and inferential statistics. Results: The highest attack rate was observed among between 1- and 4-year age group followed by children less than 1-year old, and the least attack rate was among those above 15 years. The overall attack rate and the case fatality rate were 2.10% and 0.10%, respectively. A higher attack rate was observed among women, whereas the case fatality rate was more among males. From the community survey, we observed that the cases were less likely to have pertussis vaccination history (adjusted odds ratio = 0.28, 95% confidence interval = 0.11–0.74) compared with the controls. Knowing pertussis prevention methods were found protective for pertussis transmission (adjusted odds ratio = 0.14, 95% confidence interval = 0.04–0.45). Conclusion: This study showed the vulnerability of children under 5 years, especially under 1 year, to vaccine-preventable diseases in rural populations, where “real” immunization coverage is sub-optimal, and the dominant socio-demographic factors are supportive of disease transmission. We found immunization and knowledge of the preventive measures to be protective against pertussis outbreaks. Therefore, routine immunization services must be intensified to improve coverage and prevent future pertussis outbreak(s).

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