“In the mood for ageing”: determinants of subjective well-being in older men and women of the population-based KORA-Age study

Introduction Higher parathyroid hormone (PTH) concentrations have been associated with increased cardiovascular disease (CVD) mortality, although data in the general population are scarce. Hypothesis We hypothesize that higher serum PTH concentrations are associated with all-cause and CVD mortality in a prospective, population-based cohort of older men and women. Methods We included 633 participants of the Hoorn Study, a population-based cohort with oversampling of subjects with impaired glucose regulation; mean age 70.1±6.6 years, 50.7% female. Serum intact PTH concentrations were measured using a 2-site immunoassay. Outcomes were all-cause and CVD mortality based on clinical files and coded according to the ICD-9. We used Cox-regression to estimate survival curves and hazard ratios (HR 95% CI) for all-cause and CVD mortality adjusted for potential confounders using season-specific PTH quartiles. Results During a median follow-up of 7.8 years, 112 participants died, of which 26 deaths (23%) were due to CVD. Survival curves showed an impaired survival for all-cause (Log-rank p=0.054) and CVD mortality (Log-rank p=0.022) for people in the highest PTH quartile (Figure 1). In a multivariate model adjusted for age, sex, smoking, education level, BMI, glucose status, systolic blood pressure, anti-hypertensive drug use, the highest PTH quartile was associated with higher all-cause mortality; HR 1.98 (1.08, 3.64). Kidney function (estimated glomerular filtration rate and micro-albuminuria) attenuated the PTH risk association, but risk persisted; HR 1.93 (95% CI 1.04, 3.58). The results for CVD mortality showed a similar pattern, although the association was only significant in a threshold model (Quartile 4 vs. Quartile 1-3) HR 2.56 (1.11, 5.94). Conclusion In conclusion, among older men and women, higher PTH concentrations are associated with higher mortality risk. We suggest to evaluate whether individuals with high PTH concentrations benefit from therapeutic approaches targeted to decrease PTH concentrations.

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Optimism and Mortality in Older Men and Women: The Rancho Bernardo Study

Journal of Aging Research ◽

10.1155/2016/5185104 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 15

Author(s):

Ericha G. Anthony ◽

Donna Kritz-Silverstein ◽

Elizabeth Barrett-Connor

Keyword(s):

Cancer Mortality ◽

Older Men ◽

Population Based ◽

Clinic Visit ◽

Men And Women ◽

Life Orientation Test ◽

Life Orientation ◽

Positive Attitudes ◽

Cox Proportional Hazard Models ◽

Older Men And Women

Purpose.To examine the associations of optimism and pessimism with all-cause, cardiovascular disease (CVD), coronary heart disease (CHD), and cancer mortality in a population-based sample of older men and women followed ≤12 years.Methods.367 men and 509 women aged ≥50 from the Rancho Bernardo Study attended a 1999–2002 research clinic visit when demographic, behavioral, and medical history were obtained and completed a 1999 mailed survey including the Life Orientation Test-Revised (LOT-R). Mortality outcomes were followed through 2012.Results.Average age at baseline was 74.1 years; during follow-up (mean = 8.1 years), 198 participants died, 62 from CVD, 22 from CHD, and 49 from cancer. Total LOT-R, optimism and pessimism scores were calculated. Participants with the highest optimism were younger and reported less alcohol use and smoking and more exercise. Cox proportional hazard models showed that higher total LOT-R and optimism, but not pessimism scores, were associated with reduced odds of CHD mortality after adjusting for age, sex, alcohol, smoking, obesity, physical exercise, and medication (HR = 0.86, 95% CI = 0.75, 0.99; HR = 0.77, 95% CI = 0.61, 0.99, resp.). No associations were found for all-cause, CVD, or cancer mortality.Conclusions.Optimism was associated with reduced CHD mortality in older men and women. The association of positive attitudes with mortality merits further study.

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