scholarly journals Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen prospective osteoporosis screening study (APOSS)

2020 ◽  
Vol 11 ◽  
pp. 204209862092985
Author(s):  
Samuel R. Neal ◽  
Adrian D. Wood ◽  
Andrew D. Ablett ◽  
Jenny S. Gregory ◽  
Jordan Guillot ◽  
...  
Keyword(s):  
Middle Age ◽  
Later Life ◽  
Middle Aged ◽  
Initial Exposure ◽  
Osteoporosis Screening ◽  
Anticholinergic Medications ◽  
Recurrent Falls ◽  
Screening Study ◽  
Anticholinergic Burden

Background: Anticholinergic burden (ACB) is a recognised risk factor for falls in older people; however, whether ACB in middle age predicts falls in later life is unknown. Methods: We examined this association in the middle-aged women of the Aberdeen Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the second health visit (1997–1999, study baseline) using the Anticholinergic Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent falls (⩾2 falls) during the 12 months prior to follow up 2007–2011. Multinomial logistic regression analyses adjusted for potential confounders including demographics, comorbidities and falls history. Results: A total of 2125 women {mean age (standard deviation [SD]): 54.7 (2.2) years at baseline and 66.0 (2.2) years at follow up} were included. Prevalence of baseline ACB score of 0, 1 and ⩾2 was 87.1%, 7.3% and 5.6%, respectively. Compared with no ACB, ACB ⩾2 was associated with recurrent falls in the previous 12 months [adjusted odds ratio (OR): 2.34, 95% confidence interval (CI): 1.31, 4.19] at an average of 11 years after initial exposure. No such association was found for an ACB score of 1. Conclusions: These findings highlight the potential negative effects of anticholinergic medications in middle age. While cautious use of anticholinergic medications is advisable, further longitudinal research should be conducted to confirm these findings before any specific clinical recommendations can be made.

Anticholinergic Medication Use, Dopaminergic Genotype, and Recurrent Falls

2021 ◽  
Author(s):  
Andrea L Rosso ◽  
Zachary A Marcum ◽  
Xiaonan Zhu ◽  
Nicolaas Bohnen ◽  
Caterina Rosano
Keyword(s):  
Fall Risk ◽  
Medication Use ◽  
Effect Modification ◽  
Anticholinergic Medication ◽  
Anticholinergic Medications ◽  
Recurrent Falls ◽  
Health Aging ◽  
Dopamine Signaling

Abstract Background Anticholinergic medications are associated with fall risk. Higher dopaminergic signaling may provide resilience to these effects. We tested interactions between anticholinergic medication use and dopaminergic genotype on risk for recurrent falls over 10 years. Methods Participants in the Health, Aging, and Body Composition (Health ABC) study (n = 2 372, mean age = 73.6; 47.8% men; 60.0% White) without disability or anticholinergic use at baseline were followed for up to 10 years for falls. Medication use was documented in 7 of 10 years. Highly anticholinergic medications were defined by Beers criteria, 2019. Recurrent falls were defined as ≥2 in the 12 months following medication assessment. Generalized estimating equations tested the association of anticholinergic use with recurrent falls in the following 12 months, adjusted for demographics, health characteristics, and anticholinergic use indicators. Effect modification by dopaminergic genotype (catechol-O-methyltransferase [COMT]; Met/Met, higher dopamine signaling, n = 454 vs Val carriers, lower dopamine signaling, n = 1 918) was tested and analyses repeated stratified by genotype. Results During follow-up, 841 people reported recurrent falls. Anticholinergic use doubled the odds of recurrent falls (adjusted odds ratio [OR] [95% CI] = 2.09 [1.45, 3.03]), with suggested effect modification by COMT (p = .1). The association was present in Val carriers (adjusted OR [95% CI] = 2.16 [1.44, 3.23]), but not in Met/Met genotype (adjusted OR [95% CI] = 1.70 [0.66, 4.41]). Effect sizes were stronger when excluding baseline recurrent fallers. Conclusion Higher dopaminergic signaling may provide protection against increased 12-month fall risk from anticholinergic use. Assessing vulnerability to the adverse effects of anticholinergic medications could help in determination of risk/benefit ratio for prescribing and deprescribing anticholinergics in older adults.

scholarly journals Religiosity and Perceived Social Support Enhance Older Adults’ Resilience after the 2016 Flood

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 929-929
Author(s):  
Katie Cherry ◽  
Matthew Calamia ◽  
Emily Elliott ◽  
Angelina Cantelli
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Perceived Social Support ◽  
Later Life ◽  
Well Being ◽  
Severe Weather ◽  
Post Traumatic Stress ◽  
Middle Aged ◽  
Age Related

Abstract In 2016, catastrophic flooding destroyed homes and property across south Louisiana. This study is part of a larger program of research that addresses the role of prior hurricane and flood experiences on current health and well-being in later life. Participants were predominately middle-aged and older adults who varied in current and prior severe weather experiences (M age=49.6 years, age range 18-88 years). All were tested during the immediate aftermath of the 2016 flood (Wave 1; N=223) and most participated in a follow-up assessment 9 (+/- 3) months later (Wave 2; N=202). Cherry et al. (2021) reported that greater flood stressors at Wave 1, such as displacement, flood-related losses, and damage to homes and property, were associated with more symptoms of post-traumatic stress disorder (PTSD). In this study, we tested the hypothesis that age, religiosity, and perceived social support would be positively associated with post-flood resilience at the Wave 2 follow-up. Results indicated that age was positively associated with religiosity and resilience, and negatively correlated with symptoms of PTSD. Additionally, faith community involvement, non-organizational religiosity, and religious beliefs and practices were all significantly correlated with post-flood resilience. Perceived social support was positively associated with resilience, and inversely correlated with PTSD symptoms. These data suggest that religiosity and perceived social support are valuable resources that foster post-disaster resilience among middle aged and older adults. Implications of these data for current views on age-related strengths and vulnerabilities after severe weather events are discussed.

Abstract P069: Serum Uric Acid Trajectories and Type 2 Diabetes and Hypertension in Middle Age

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Hao Ma ◽  
Xuan Wang ◽  
Xiang Li ◽  
Xiaoyu Guo ◽  
Lu Qi ◽  
...  
Keyword(s):  
Middle Age ◽  
Mixture Modeling ◽  
Multivariate Models ◽  
Stable Group ◽  
Middle Aged ◽  
Men And Women ◽  
Increased Risk ◽  
Increasing Trend

Objective: To identify SUA level trajectories throughout 12 years and to examine their associations with incident diabetes and hypertension among middle-aged men and women. Methods: A total of 7187 participants from the Mudanjiang Chronic Non-communicable Diseases Study, who were aged 30-60 years and without diabetes or hypertension at baseline, were included. The participants were followed for an average of 10.5 years by annual examinations. Latent mixture modeling was used to identify trajectories of SUA over time. Results: Consistently among women and men, five distinct trajectories of SUA were identified: low-stable, low-increasing, moderate-stable, moderate-increasing, and high-stable. In multivariate models, compared with low-stable group, for women, the adjusted hazards ratio of diabetes was 2.11 (95%CI 1.08-4.23) in the low-increasing group, 1.78 (0.81-3.92) in the moderate-stable group, 2.01 (1.02-3.97) in the moderate-increasing group, 3.00 (1.55-5.83) in the high-stable group, whereas no association was found among men. In addition, compared with low-stable group, all other trajectory groups had an increased risk of hypertension in both men and women, except for moderate-stable group in women. Participants in the moderate-increasing group exhibited the highest risk of hypertension (for women, 2.42 [1.72-3.39], for men, 2.57 [2.05-3.24]). Further adjustment for weight change during follow-up period completely ablated the trajectories-diabetes associations, except for the high-stable group in women, but the trajectories-hypertension associations remained significant in each group. Conclusions: We found that a persistent elevated or an increasing trend of SUA levels was significant associated with an increased risk of hypertension among middle-aged women and men; only persistently high UA level was associated with diabetes among women.

Abstract P001: Life′s Simple 7 in Middle-age and Prognosis After Myocardial Infarction in Later Life

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Yejin Mok ◽  
Yingying Sang ◽  
Shoshana H Ballew ◽  
Casey M Rebholz ◽  
Gerardo Heiss ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Middle Age ◽  
Later Life ◽  
Adverse Outcomes ◽  
Dietary Quality ◽  
Life’S Simple 7 ◽  
Life's Simple 7

Background: The AHA recommends focusing on seven traditional risk factors (Life’s Simple 7) for cardiovascular health promotion, primarily based on their impact on the risk of incident cardiovascular disease. However, the contribution of Life’s simple 7 in mid-life to prognosis after myocardial infarction (MI) in later life is unknown. Methods: In 13,500 participants from the Atherosclerosis Risk in Communities (ARIC) study (age 45-64 years) at Visit 1 (1987-1989), a 14-point score of Life’s simple 7 was constructed according to the status of each of seven factors (smoking, body mass index, physical activity, dietary quality, total cholesterol, blood pressure, and fasting glucose). We quantified the association between this score and adverse outcomes after validated incident hospitalized MI occurring during ARIC follow-up, using Cox proportional hazards models adjusting for age at MI, gender, race, and year of MI occurrence. Results: 1,341 participants had a definite or probable hospitalized MI after the ARIC baseline visit (median elapsed time between baseline and MI occurrence, 24.4 years [IQR 17.5-25.4]). Of these, 807 (60%) had cardiovascular outcomes of interest after MI during a median follow-up of 3.0 years. Higher Life’s Simple 7 score (better cardiovascular health) in middle-age was associated with lower risk of adverse outcomes after MI in later life (Table). For example, individuals with Life’s Simple 7 score ≥10 had 50-80% lower risk of cardiovascular mortality, recurrent MI, and heart failure compared to those with score ≤3. The associations were largely consistent across years of MI occurrence and when we restricted the follow-up after MI to 1-3 years. Conclusion: A better AHA Life’s Simple 7 in middle-age was associated not only with lower incidence but also with a lower risk of adverse outcomes after MI in later life. Our findings suggest a secondary prevention benefit of striving for ideal CV health status in mid-life, further supporting AHA promotion of Life’s Simple 7.

Pedophilic Episodes in Middle Age and Senescence: An Intergenerational Encounter

1995 ◽  
Vol 40 (3) ◽  
pp. 125-129 ◽  
Author(s):  
M. Cormier Bruno ◽  
Renée Fugère ◽  
Ingrid Thompson-Cooper
Keyword(s):  
Forensic Psychiatry ◽  
Middle Age ◽  
Previous History ◽  
Later Life ◽  
Careful Analysis ◽  
Acting Out ◽  
Emotional Context ◽  
History Of ◽  
The Relationship

The study of pedophilic episodes in later life shows how acting out in a particular emotional context can help the offender to reorganize his life. After reviewing 36 cases referred to the McGill Clinic in Forensic Psychiatry between 1980–1989, a previous history of offender victimization was found in 12 cases. Careful analysis of all the cases showed reactivation of conflict in their family of procreation in 34 cases. Various psychodynamic hypotheses are suggested through the longitudinal history of the perpetrator and the nature of the relationship between victim and perpetrator. Analysis of a longitudinal follow-up in 26 cases suggests that through various mechanisms of organization, disorganization and reorganization, the pedophilic episode represented an opportunity for these middle-aged and senescent pedophiles to resolve some issues underlying their pedophilic interests, leading to a higher level of maturity, thereby preventing relapse of pedophilic episodes.

Self-Perceived Age Changes in Sex Role Self Concept

1983 ◽  
Vol 16 (3) ◽  
pp. 183-191 ◽  
Author(s):  
J. Thomas Puglisi
Keyword(s):  
Middle Age ◽  
Sex Role ◽  
Later Life ◽  
Self Concept ◽  
Age Changes ◽  
Middle Aged ◽  
Men And Women ◽  
Significant Evidence ◽  
Adult Men ◽  
Perceived Age

A prospective/retrospective study of sex role self concept was conducted in order to explore the hypothesis that adult men and women experience a convergence of sex roles in later life. Young (age seventeen to twenty-nine), middle aged (age thirty to fifty-nine), and older (age sixty to eighty-five) adults (twenty-one male, forty-one female in each group) rated themselves on Bern Sex Role Inventory items, first describing themselves at age twenty, next at age forty-five, and finally at age seventy. Self-perceived age changes in sex role self concept reported by these three groups of adults produced strikingly similar patterns. In each case, both men and women evidenced high masculine self descriptions related to middle age (projected age forty-five) followed by decreases in masculinity in later life (projected age seventy). Only the projections of middle aged respondents displayed even marginally significant evidence in favor of sex role convergence.

scholarly journals Anticholinergic Medication Use, Dopaminergic Genotype, and Recurrent Falls

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 756-756
Author(s):  
Andrea Rosso ◽  
Xiaonan Zhu ◽  
Zachary Marcum ◽  
Nico Bohnen ◽  
Briana Sprague ◽  
...  
Keyword(s):  
Generalized Estimating Equations ◽  
Fall Risk ◽  
Medication Use ◽  
Effect Modification ◽  
Anticholinergic Medication ◽  
Anticholinergic Medications ◽  
Recurrent Falls ◽  
Increase Risk ◽  
Dopamine Signaling

Abstract Anticholinergic medications (A-chol) increase risk for falls; higher dopaminergic signaling may provide resilience to these effects. In 2489 older adults (mean age=74; 52% women) with 10 years of data on medication use, falls, and dopaminergic genotype (catechol-O-methyltransferase (COMT)), we assessed the association of A-chol use with recurrent falls (≥2) over the subsequent 12 months using generalized estimating equations. Effect modification by COMT (met/met, higher dopamine signaling, n=473 vs val carriers, lower dopamine signaling, n=2016) was tested; analyses were then stratified by COMT and adjusted for demographics and A-chol use indicators. During follow-up, 843 people reported recurrent falls. A-chol use doubled the odds of recurrent falls (OR [95%CI]=2.13[1.74, 2.60]), with a suggested effect modification by COMT (p=0.1). The association was present in val carriers (adjusted OR [95%CI]=1.93[1.36, 2.73]) but not in met/met (adjusted OR [95%CI]=1.30[0.53, 3.22]). Higher dopaminergic signaling may provide protection against the effects of A-chol use on fall risk.

scholarly journals Physical fitness is a modifiable predictor of early cardiovascular death: A 35-year follow-up study of 2014 healthy middle-aged men

2018 ◽  
Vol 25 (15) ◽  
pp. 1655-1663 ◽  
Author(s):  
Kristian Engeseth ◽  
Erik E Prestgaard ◽  
Julian E Mariampillai ◽  
Irene Grundvold ◽  
Knut Liestol ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Physical Fitness ◽  
Cardiovascular Risk Factors ◽  
Middle Age ◽  
Smoking Status ◽  
Cardiovascular Death ◽  
Middle Aged

Background Physical fitness has been shown to predict cardiovascular death during long-term follow-up. In the present study we aimed to investigate how physical fitness and other cardiovascular risk factors at middle-age influenced the risk of cardiovascular death during the early (0–11 years), intermediate (12–23 years) and late (24–35 years) parts of a 35-year observation period. Methods and results Age-adjusted physical fitness was calculated in 2014 apparently healthy, middle-aged men after maximal bicycle electrocardiogram-tests in 1972–1975 (Survey 1) and 1979–1982 (Survey 2). The men were assessed through 35 years after Survey 1, and 28 years after Survey 2 by Cox proportional hazards models. Low Survey 1 physical fitness was independently associated with increased risks of early and intermediate, but not late, cardiovascular death. Survey 1 to Survey 2 change in physical fitness, age, smoking status, systolic blood pressure and cholesterol impacted cardiovascular death risks in all periods. Family history of coronary heart disease impacted early and intermediate, but not late, cardiovascular death. Conclusions Most classical cardiovascular risk factors were strong predictors of early, intermediate and late cardiovascular death. Physical fitness measured at median age 50 years was independently associated with risk of early cardiovascular death, but the association weakened as time progressed. Change in physical fitness during middle-age impacted cardiovascular death risk in a full lifetime perspective. Thus, our data suggest that physical fitness is a modifiable cardiovascular risk factor with limited duration in contrast to the sustained impact of smoking, blood pressure and cholesterol on cardiovascular mortality.

scholarly journals Life Employment Histories in Middle Age and Their Association With Health Outcomes in Later Life: A Sequence Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 65-65
Author(s):  
Oejin Shin ◽  
BoRin Kim ◽  
Sojung Park ◽  
JiYoung Kang ◽  
Ilan Kwon ◽  
...  
Keyword(s):  
Sequence Analysis ◽  
Health Outcomes ◽  
Middle Age ◽  
Panel Study ◽  
Later Life ◽  
Full Time ◽  
Middle Aged ◽  
Employment History ◽  
Precarious Employment ◽  
Mixed Pattern

Abstract Despite consistent evidence on the negative effect of precarious employment on health, little is known about the dynamic pattern of employment over the life course on later year health. Using the longitudinal data (1-18 waves) from the Korean Labor & Income Panel Study (KLIPS) (n=1,705), this study aimed to (1) identify long term change patterns of employment in two middle-age groups (early middle-aged: 40-49 / late middle-aged: 50-59), (2) examine the association between the patterns and self-rated health in old age. We apply sequence analysis with 18 years of working status and conducted regression health outcomes in the 18th wave. The result of sequence analysis found the differential employment patterns: among the early middle-aged, five patterns were identified consistently full-time, consistently not- working, transit to self-employed, mixed pattern, retired. Among the late middle-aged, five patterns were identified: consistently full time, mixed pattern, consistently retired, transit to not- working, consistently not working. Regression results indicated a negative association between precarious employment history and health in later years: Among the early middle-aged, members in the “consistently full-time” were likely to have better health compared to “transit to self-employed”. Among the later middle-aged, “retired” and “transit to not –working” were likely to have better health compared to “mixed pattern group”. The findings suggest the importance of employment history in middle age to predict the health outcome in later life. Policies to support experiencing precarious or self-employment are needed to prevent health disparity in later life.

Sign in / Sign up

Export Citation Format

Share Document