Variants of the Circle of Willis as seen on magnetic resonance angiography and carotid siphon calcifications in community-dwelling older adults

Background and purpose Information on the association between anatomical variants of the Circle of Willis (CoW) and intracranial atherosclerotic disease (ICAD) is limited and results are controversial. In this population-based study, we aimed to assess whether an incomplete CoW is associated with high calcium content in carotid siphons (a reliable biomarker of ICAD) in community-dwelling older adults of Amerindian ancestry. Methods Individuals aged ≥60 years enrolled in the Three Villages Study received a head computed tomography (CT) and magnetic resonance angiogram (MRA) of intracranial vessels. The CoW was classified in complete or incomplete according to the presence or absence of one A1 segment of the anterior cerebral artery or one or both P1 segments of posterior cerebral arteries. Calcium content in carotid siphons was rated as low or high. A multivariate logistic model was fitted to assess the independent association between incompleteness of the CoW and high calcium content in carotid siphons, after adjusting for demographics and cardiovascular risk factors. Results A total of 581 individuals were enrolled (mean age: 71 ± 8.4 years; 57% women). MRA revealed an incomplete CoW in 227 (39%) individuals, and high-resolution CT disclosed high calcium content in carotid siphons in 185 (32%). A risk factor logistic regression model showed no independent association between incompleteness of the CoW and high calcium content in carotid siphons (odds ratio: 0.91; 95% confidence interval: 0.62–1.34; p = 0.631). Conclusion Study results disclosed no association between anatomical variants of the CoW and the presence of high calcium content in carotid siphons.

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Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic

Journal of Primary Care & Community Health ◽

10.1177/21501327211047781 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110477

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera ◽

Denisse A. Rumbea ◽

Pedro Pérez ◽

Bettsy Y. Recalde ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Regression Models ◽

Community Dwelling ◽

The Body ◽

Study Results ◽

The Impact ◽

Community Dwelling Older Adults

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.

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Social Frailty Is Independently Associated with Mood, Nutrition, Physical Performance, and Physical Activity: Insights from a Theory-Guided Approach

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124239 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4239 ◽

Cited By ~ 4

Author(s):

Kalene Pek ◽

Justin Chew ◽

Jun Pei Lim ◽

Suzanne Yew ◽

Cai Ning Tan ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Outcomes ◽

Physical Performance ◽

Community Dwelling ◽

Physical Frailty ◽

Life Space ◽

Independent Association ◽

Community Dwelling Older Adults ◽

Significant Covariates

Notwithstanding the increasing body of evidence that links social determinants to health outcomes, social frailty is arguably the least explored among the various dimensions of frailty. Using available items from previous studies to derive a social frailty scale as guided by the Bunt social frailty theoretical framework, we aimed to examine the association of social frailty, independently of physical frailty, with salient outcomes of mood, nutrition, physical performance, physical activity, and life–space mobility. We studied 229 community-dwelling older adults (mean age 67.22 years; 72.6% females) who were non-frail (defined by the FRAIL criteria). Using exploratory factor analysis, the resultant 8-item Social Frailty Scale (SFS-8) yielded a three-factor structure comprising social resources, social activities and financial resource, and social need fulfilment (score range: 0–8 points). Social non-frailty (SNF), social pre-frailty (SPF), and social frailty (SF) were defined based on optimal cutoffs, with corresponding prevalence of 63.8%, 28.8%, and 7.4%, respectively. In logistic regression adjusted for significant covariates and physical frailty (Modified Fried criteria), there is an association of SPF with poor physical performance and low physical activity (odds ratio, OR range: 3.10 to 6.22), and SF with depressive symptoms, malnutrition risk, poor physical performance, and low physical activity (OR range: 3.58 to 13.97) compared to SNF. There was no significant association of SPF or SF with life–space mobility. In summary, through a theory-guided approach, our study demonstrates the independent association of social frailty with a comprehensive range of intermediary health outcomes in more robust older adults. A holistic preventative approach to frailty should include upstream interventions that target social frailty to address social gradient and inequalities.

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CARE DEPENDENCY: EXPERIENCES AND EXPECTATIONS OF COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.2326 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S624-S624

Author(s):

Jan S Jukema ◽

Sharon Oude Veldhuis ◽

Jacqueline Van Alphen ◽

Jopie Jorritsma ◽

Frits De Lange

Keyword(s):

Older Adults ◽

Ethic Of Care ◽

Influential Factors ◽

Community Dwelling ◽

Care Needs ◽

Living Situation ◽

Equal Distribution ◽

Study Results ◽

Diverse Groups ◽

Community Dwelling Older Adults

Abstract “Not to be a burden” is a common phrase used by community-dwelling older adults in discussing their dependency on others in care for their daily life. This attitude may lead to conflicts with relatives, neighbors, or professionals when in their opinion, care is necessary and, ultimately, may result in unmet care needs. The goal of this study is to gain a better understanding of how older adults experience their increased dependency on others and to contribute to the development of an ethic of care. Thirty-two participants of a larger research sample (n=64) from a descriptive qualitative research were purposefully selected, resulting in an equal distribution of the following variables: gender, living situation, living with or without partner, and having children or not. From a multiphase qualitative analysis with five researchers, including two senior citizens four themes emerged: (1) relationships in the context of care; (2) experiences with giving, receiving and asking for care; (3) future perspectives towards receiving and asking for care; and (4) actual practices of caregiving and receiving. Our study clarifies how community-dwelling older adults deal with the changes in their dependency on others. The study results highlight particular dynamics which appear, at least, partly in contrast with current policy regarding care at home. Moreover, it contributes to an empirical refinement of the concepts of dependency and interdependency in an ethic of care. Further studies are needed to clarify the influential factors on asking for care in diverse groups of older adults and the response from their network.

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Silent Brain Infarction on Magnetic Resonance Imaging and Neurological Abnormalities in Community-Dwelling Older Adults

Stroke ◽

10.1161/01.str.28.6.1158 ◽

1997 ◽

Vol 28 (6) ◽

pp. 1158-1164 ◽

Cited By ~ 135

Author(s):

Thomas R. Price ◽

Teri A. Manolio ◽

Richard A. Kronmal ◽

Steven J. Kittner ◽

Nancy C. Yue ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Older Adults ◽

Magnetic Resonance ◽

Brain Infarction ◽

Community Dwelling ◽

Resonance Imaging ◽

Neurological Abnormalities ◽

Silent Brain Infarction ◽

Community Dwelling Older Adults

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Natural aging course of paraspinal muscle and back extensor strength in community-dwelling older adults (sarcopenia of spine, SarcoSpine): a prospective cohort study protocol

BMJ Open ◽

10.1136/bmjopen-2019-032443 ◽

2019 ◽

Vol 9 (9) ◽

pp. e032443 ◽

Cited By ~ 1

Author(s):

Ju Chan Kim ◽

Shi-Uk Lee ◽

Se Hee Jung ◽

Jae-Young Lim ◽

Dong Hyun Kim ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Muscle Strength ◽

Natural Aging ◽

Community Dwelling ◽

Paraspinal Muscle ◽

Back Muscle ◽

Back Muscle Strength ◽

Study Results ◽

Community Dwelling Older Adults

IntroductionSarcopenia in the lumbar paraspinal muscles is receiving renewed attention as a cause of spinal degeneration. However, there are few studies on the precise concept and diagnostic criteria for spinal sarcopenia. Here, we develop the concept of spinal sarcopenia in community-dwelling older adults. In addition, we aim to observe the natural ageing process of paraspinal and back muscle strength and investigate the association between conventional sarcopenic indices and spinal sarcopenia.Methods and analysisThis is a prospective observational cohort study with 120 healthy community-dwelling older adults over 4 years. All subjects will be recruited in no sarcopenia, possible sarcopenia or sarcopenia groups. The primary outcomes of this study are isokinetic back muscle strength and lumbar paraspinal muscle quantity and quality evaluated using lumbar spine MRI. Conventional sarcopenic indices and spine specific outcomes such as spinal sagittal balance, back performance scale and Sorenson test will also be assessed.Ethics and disseminationBefore screening, all participants will be provided with oral and written information. Ethical approval has already been obtained from all participating hospitals. The study results will be disseminated in peer-reviewed publications and conference presentations.Trial registration numberNCT03962530

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OBJECTIVE AND SUBJECTIVE SLEEP DURATION AND ACTIVITY LEVEL IN OLDER ADULTS WITH MILD DEMENTIA

Innovation in Aging ◽

10.1093/geroni/igz038.1941 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S527-S528

Author(s):

Miranda V McPhillips ◽

Jinyoung Kim ◽

Darina V Petrovsky ◽

Junxin Li ◽

Sonia Talwar ◽

...

Keyword(s):

Older Adults ◽

Sleep Duration ◽

Community Dwelling ◽

Activity Level ◽

Clinical Dementia Rating ◽

Mild Dementia ◽

Subjective Sleep ◽

Wrist Actigraphy ◽

Independent Association ◽

Community Dwelling Older Adults

Abstract Little is known about the relationship between sleep duration and activities of daily living (ADLs) in those with mild dementia. We sought to examine the independent relationship between objective and subjective sleep duration and ADLs in community-dwelling older adults with mild dementia. Analyses were conducted on baseline data from participants enrolled in the Healthy Patterns Clinical Trial (Hodgson; R01NR015226). Measures included 24-hour wrist actigraphy for objective sleep duration, proxy-reported Pittsburgh Sleep Quality Index (sleep duration subscale) for subjective sleep duration and the Barthel Index for performance of ADLs. We used Spearman’s correlation and multivariate linear regression. A total of 30 individuals (56.7% male) aged 74.6 (SD 7.4) with mean Clinical Dementia Rating (CDR) scores of 1 (SD 0.5) were enrolled. Objective sleep duration ranged from 2.7 to 11.5 with mean 6.7 (SD 2.4) hours; subjective sleep duration ranged from 4 to 13.5 with mean 7.9 (SD 2.4) hours. Longer objective and subjective sleep duration were significantly associated with worse ADL scores (r = -0.48, p = 0.03; r = -0.59, p=0.007, respectively) in bivariate analyses. After controlling for age, CDR, and depression, subjective sleep duration was independently associated with ADLs (β = -1.90, p =0.03) and objective sleep duration trended toward significance (β = -1.47, p =0.10). These preliminary results suggest self-reported longer sleep could be indicative of declines in ADLs in older adults with mild dementia. Further prospective studies are necessary to determine the independent association between objectively assessed sleep duration and ADLs in patients with mild dementia.

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71 Discriminative Ability of a Falls Screening Mobile Application in Identifying Fallers among Community Dwelling Older Adults: Preliminary Results

Age and Ageing ◽

10.1093/ageing/afz164.71 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Jing Wen Goh ◽

Devinder Kaur Ajit Singh ◽

Suzana Shahar

Keyword(s):

Older Adults ◽

Mobile Application ◽

Community Dwelling ◽

Activity Level ◽

Falls Prevention ◽

Discriminative Ability ◽

Cross Sectional ◽

Falls Risk ◽

Study Results ◽

Community Dwelling Older Adults

Abstract Introduction Early falls screening among community dwelling older adults is important as a part of falls prevention strategy. Falls Screening Mobile Application (FallSA) was demonstrated to be accepted, reliable and valid to be used for self-risk assessment among community dwelling older adults in an earlier study. However, its discriminative ability is unknown. We aimed to examine the discriminative ability of FallSA in classifying fallers and non-fallers among community dwelling older adults. Methodology A total of 182 community dwelling older adults with mean age of 71.42 ± 5.1 participated in this cross sectional study. Participants demographic and falls history data were obtained. Participants with one or more falls were categorized as fallers. FallSA was used to identify participants falls risk. Independent t-test was used to compare falls risk score among fallers and non-fallers for its discriminative ability. Results Approximately 20% participants were categorized as fallers. Majority of the fallers were females (66.7%), had lower physical activity level and higher scores of geriatric depression scales compared to non-fallers. There was a significant (p< 0.01) different in the FallSA score between fallers (7.33±1.77) and non-fallers (4.34±1.72). Conclusion Our study results showed that FallSA could be used to discriminate fallers and non-fallers in community dwelling older adults. Further studies are in progress to determine the predictive validity of FallSA.

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