scholarly journals Predictors of Health Deterioration Among Older New Zealanders Undergoing Dialysis: A Three-Year Accelerated Longitudinal Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110222
Author(s):  
Reshma Shettigar ◽  
Ari Samaranayaka ◽  
John B. W. Schollum ◽  
Emma H. Wyeth ◽  
Sarah Derrett ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Sense Of Community ◽  
Kidney Failure ◽  
Longitudinal Cohort Study ◽  
Dialysis Patients ◽  
Longitudinal Cohort ◽  
Social Satisfaction ◽  
Patient Reported ◽  
New Zealanders

Background: Patient involvement in dialysis decision-making is crucial, yet little is known about patient-reported outcomes over time on dialysis. Objective: To examine health-related outcomes over 24 and 36 months in an older cohort of dialysis patients. Design: The “Dialysis outcomes in those aged ≥65 years study” is a prospective longitudinal cohort study of New Zealanders with kidney failure. Setting: Three New Zealand nephrology units. Patients: Kidney failure (dialysis and predialysis) patients aged 65 or above. We have previously described outcomes after 12 months of dialysis therapy relative to baseline. Measurements: Patient-reported social and health factors using the SF-36, EQ-5D, and Kidney Symptom Score questionnaires. Methods: This article describes and compares characteristics of 120 older kidney failure patients according to whether they report “Same/better” or “Worse” health 24 and 36 months later, and identifies predictors of “worse health.” Modified Poisson regression modeling estimated relative risks (RR) of worse health. Results: Of 120 patients at 12 months, 47.5% had worse health or had died by 24 months. Of those surviving at 24 months (n = 80), 40% had “Worse health” or had died at 36 months. Variables independently associated with reduced risk of “Worse health” (24 months) were as follows: Māori ethnicity (RR = 0.44; 95% CI = 0.26-0.75), Pacific ethnicity (RR = 0.39; 95% CI = 0.33-0.46); greater social satisfaction (RR = 0.57; 95% CI = 0.46-0.7). Variables associated with an increased risk of “Worse health” were as follows: problems with usual activities (RR = 1.32; 95% CI = 1.04-1.37); pain or discomfort (RR = 1.48; 95% CI = 1.34, 1.63). At 36 months, lack of sense of community (RR = 1.41; 95% CI = 1.18-1.69), 2 or more comorbidities (RR = 1.21; 95% CI = 1.13-1.29), and problems with poor health (RR = 1.47; 95% CI = 1.41-1.54) were associated with “Worse health.” Limitations: Participant numbers restricted the number of variables able to be included in the multivariable model, and hence there may have been insufficient power to detect certain associations. Conclusions: In this study, the majority of older dialyzing patients report “Same/better health” at 24 and 36 months. Māori and Pacific people report better outcomes on dialysis. Social and/or clinical interventions aimed at improving social satisfaction, sense of community, and help with usual activities may impact favorably on the experiences for older dialysis patients. Trial registration: Australian and New Zealand clinical trials registry: ACTRN12611000024943.

Predictors of Health Deterioration Among Older Adults After 12 Months of Dialysis Therapy: A Longitudinal Cohort Study From New Zealand

2017 ◽  
Vol 70 (6) ◽  
pp. 798-806 ◽  
Author(s):  
Sarah Derrett ◽  
Ari Samaranayaka ◽  
John B.W. Schollum ◽  
Bronwen McNoe ◽  
Mark R. Marshall ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
New Zealand ◽  
Longitudinal Cohort Study ◽  
Dialysis Therapy ◽  
Longitudinal Cohort ◽  
Health Deterioration

scholarly journals Testosterone in advance age: a New Zealand longitudinal cohort study: Life and Living in Advanced Age (Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu)

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016572
Author(s):  
Martin J Connolly ◽  
Ngaire Kerse ◽  
Tim Wilkinson ◽  
Oliver Menzies ◽  
Anna Rolleston ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Serum Testosterone ◽  
Older Men ◽  
Community Dwelling ◽  
Advanced Age ◽  
Longitudinal Cohort Study ◽  
Coefficient Of Determination ◽  
Total Testosterone ◽  
Longitudinal Cohort

ObjectivesSerum testosterone (T) levels in men decline with age. Low T levels are associated with sarcopenia and frailty in men aged>80 years. T levels have not previously been directly associated with disability in older men. We explored associations between T levels, frailty and disability in a cohort of octogenarian men.SettingData from all men from Life and Living in Advanced Age Cohort Study in New Zealand, a longitudinal cohort study in community-dwelling older adults.ParticipantsCommunity-dwelling (>80 years) adult men excluding those receiving T treatment or with prostatic carcinoma.Outcomes measuresAssociations between baseline total testosterone (TT) and calculated free testosterone (fT), frailty (Fried scale) and disability (Nottingham Extended Activities of Daily Living scale (NEADL)) (baseline and 24 months) were examined using multivariate regression and Wald’s χ2techniques. Subjects with the lowest quartile of baseline TT and fT values were compared with those in the upper three quartiles.ResultsParticipants: 243 men, mean (SD) age 83.7 (2.0) years. Mean (SD) TT=17.6 (6.8) nmol/L and fT=225.3 (85.4) pmol/L. On multivariate analyses, lower TT levels were associated with frailty: β=0.41, p=0.017, coefficient of determination (R2)=0.10 and disability (NEADL) (β=−1.27, p=0.017, R2=0.11), low haemoglobin (β=−7.38, p=0.0016, R2=0.05), high fasting glucose (β=0.38, p=0.038, R2=0.04) and high C reactive protein (CRP) (β=3.57, p=0.01, R2=0.06). Low fT levels were associated with frailty (β=0.39, p=0.024, R2=0.09) but not baseline NEADL (β=−1.29, p=0.09, R2=0.09). Low fT was associated with low haemoglobin (β=−7.83, p=0.0008, R2=0.05) and high CRP (β=2.86, p=0.04, R2=0.05). Relationships between baseline TT and fT, and 24-month outcomes of disability and frailty were not significant.ConclusionsIn men over 80 years, we confirm an association between T levels and baseline frailty scores. The new finding of association between T levels and disability is potentially relevant to debates on T supplementation in older men, though, as associations were not present at 24 months, further work is needed.

scholarly journals Prevalence and Predictors of Disability 24-Months after Injury for Hospitalised and Non-Hospitalised Participants: Results from a Longitudinal Cohort Study in New Zealand

PLoS ONE ◽  
2013 ◽  
Vol 8 (11) ◽  
pp. e80194 ◽  
Author(s):  
Sarah Derrett ◽  
Suzanne Wilson ◽  
Ari Samaranayaka ◽  
John Langley ◽  
Emma Wyeth ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort

Pre-Teen Gang Involvement Is Associated With Teenage Gambling Behavior: Exploratory Findings From a Longitudinal Cohort Study of Pacific Youth in New Zealand

2021 ◽  
pp. 101053952110411
Author(s):  
Maria E. Bellringer ◽  
Janet Pearson ◽  
Leon Iusitini
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Problem Gambling ◽  
Gambling Behavior ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort ◽  
Gang Involvement ◽  
Secondary Analyses ◽  
Using Data ◽  
European Youth

Pacific youth in New Zealand have a disproportionately high risk for gambling and gang involvement compared with New Zealand European youth. Limited evidence indicates that youth gang involvement is associated with problem gambling; no research shows if it is associated with gambling. We conducted exploratory secondary analyses of data from 1063 Pacific youth and their mothers using data from 2 time points (age 9 and 14 years) from a longitudinal cohort study. Gang involvement at age 9 years was significantly associated with gambling at age 14 years, with adjusted odds of 2.25 (95% CI = 1.16-4.37). Of confounders, having a mother with a partner and Cook Islands ethnicity appeared protective against gambling at age 14 years. Despite some study limitations, as youth gambling can lead to subsequent adult problem gambling, our findings highlight the importance of understanding why Pacific youth join gangs, to inform public health policies to reduce the potential for future development of harmful behaviors.

scholarly journals Mother and Infant Nutrition Investigation in New Zealand (MINI Project): Protocol for an Observational Longitudinal Cohort Study (Preprint)

2020 ◽  
Author(s):  
Ying Jin ◽  
Jane Coad ◽  
Shao J Zhou ◽  
Sheila Skeaff ◽  
Cheryl Benn ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Thyroid Function ◽  
Postnatal Depression ◽  
Infant Nutrition ◽  
Longitudinal Cohort Study ◽  
First Year ◽  
Selenium Status ◽  
Longitudinal Cohort ◽  
Iodine Status

BACKGROUND Thyroid dysfunction is associated with cognitive impairment, mood disturbance, and postnatal depression. Sufficient thyroid hormone synthesis requires adequate intake of iodine, selenium, and iron. Iodine deficiency was historically a problem for New Zealand, and initiatives were introduced to overcome the problem: (1) mandatory fortification of all bread (except organic) with iodized salt (2009) and (2) provision of subsidized iodine supplements for pregnant and breastfeeding women (2010). Subsequent to these initiatives, most adults and children have adequate iodine status; however, status among breastfeeding women and their infants remains unclear. This paper outlines the methodology of the Mother and Infant Nutrition Investigation (MINI) study: an observational longitudinal cohort study of breastfeeding women and their infants. OBJECTIVE This study will determine (1) women’s iodine intake and status among supplement users and nonusers; (2) women’s intake and status of iodine, selenium, and iron relating to thyroid function; (3) associations between women’s selenium status, thyroid function, and postnatal depression; (4) infants’ iodine and selenium status relating to first year neurodevelopment. METHODS Breastfeeding women aged over 16 years with a healthy term singleton infant were recruited from Manawatu, New Zealand. Participants attended study visits 3, 6, and 12 months postpartum. Maternal questionnaires investigated supplement use before and after birth, iodine knowledge, and demographic information. Dietary assessment and urine, blood, and breast milk samples were taken to measure iodine, selenium, and iron intake/status. The Edinburgh Postnatal Depression Scale was used repeatedly to screen for postnatal depression. Thyroid hormones (free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin, antithyroglobulin antibodies, and antithyroid peroxidase) were measured in blood samples, and thyroid gland volume was measured by ultrasound at 6 months postpartum. Infant iodine and selenium concentrations were determined in urine. The Ages and Stages Questionnaire was used to assess infant development at 4, 8, and 12 months. RESULTS Data collection was completed. Biological samples analysis, excluding nail clippings, is complete. Data analysis and presentation of the results will be available after 2020. CONCLUSIONS This study will provide data on the current iodine status of breastfeeding women. It will also provide a greater understanding of the three essential minerals required for optimal thyroid function among breastfeeding women. The prospective longitudinal design allows opportunities to examine women’s mental health and infant neurodevelopment throughout the first year, a crucial time for both mothers and their infants. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12615001028594; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369324 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/18560

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