Cognitive leisure activity and all-cause mortality in older adults: a 4-year community-based cohort

Abstract Background Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a negative correlation between cognitive leisure activity and cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported. Objectives This study aims to explore the relationships between cognitive leisure activity and all-cause mortality in a community-based older people cohort in China. Methods The current study sample comprised 4003 community residents aged ≥60 y who were enrolled in June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a cognitive leisure activity index (CLAI) score. Time-Dependent Cox Regression Model and Kaplan-Meier survival analysis were used to examine the association of cognitive leisure activity with all-cause mortality. Results During the 4-year follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8, 26.7, 6.1 and 0.35% reported CLAI scores of 0, 1, 2 and 3, respectively. A strong association was noted between the CLA score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54–0.97, P = 0.028). Stratified analysis suggested that a higher CLAI score was significantly associated with a decreased risk of all-cause mortality mainly among those who were male, aged ≥80 y, cognitively impaired, and not diagnosed with cancer (P < 0.05). Conclusion Cognitive leisure activity was positively associated with reduced risk of death from all cause among the older people in major city of China, which helped promote a comprehensive understanding of health characteristics at advanced ages.

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Cognitive Leisure Activity and All-cause Mortality in Older Adults: A 4-Year Community-based Cohort

10.21203/rs.3.rs-42686/v2 ◽

2021 ◽

Author(s):

Qianyi Xiao ◽

Xin Liu ◽

Ye Ruan ◽

Limei Huang ◽

Yanfei Guo ◽

...

Keyword(s):

Older Adults ◽

Computer Use ◽

Proportional Hazards ◽

Activity Index ◽

Strong Association ◽

Leisure Activity ◽

Cox Proportional Hazards ◽

Community Based ◽

Risk Of Death ◽

All Cause Mortality

Abstract Background: Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a protective role of cognitive leisure activity against cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported.Objectives: This study aims to explore the relationships between cognitive leisure activity and all-cause mortality in a community-based elderly cohort in China.Methods: The current study sample comprised 4003 community residents aged ≥ 60 y who were enrolled in June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a cognitive leisure activity index (CLAI) score. Cox proportional hazards analysis and Kaplan-Meier survival analysis were used to examine the association of cognitive leisure activity with all-cause mortality.Results: During the 4-year follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8%, 26.7%, 6.1% and 0.35% reported CLAI scores of 0, 1, 2 and 3, respectively. A strong association was noted between the CLA score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54-0.96, P = 0.025). Stratified analysis suggested that a higher CLAI score was significantly associated with a decreased risk of all-cause mortality mainly among those who were male, aged ≥ 80 y, cognitively impaired, and not diagnosed with cancer (P < 0.05).Conclusion: Cognitive leisure activity has beneficial effect on reduced risk of death from all cause among the elderly in China, which helped promote a comprehensive understanding of health characteristics at advanced ages.

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Mental Activity and All-Cause Mortality in Older Adults: A 4-Year Community-Based Cohort

10.21203/rs.3.rs-42686/v1 ◽

2020 ◽

Author(s):

Qianyi Xiao ◽

Xin Liu ◽

Ye Ruan ◽

Limei Huang ◽

Yanfei Guo ◽

...

Keyword(s):

Older Adults ◽

Computer Use ◽

Proportional Hazards ◽

Activity Index ◽

Strong Association ◽

Protective Role ◽

Cox Proportional Hazards ◽

Mental Activity ◽

Community Based ◽

All Cause Mortality

Abstract Background The mental activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous researches suggest a protective role of mental activity against cognitive impairment. However, the relationship between mental activity and all-cause mortality has rarely been reported. Objectives This study aims to explore the effect of mental activity on all-cause mortality in a community-based elderly cohort in China. Methods The current study sample comprised 4003 community residents age ≥ 60 y who were enrolled at June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a mental activity index (MAI) score. Cox proportional hazards analysis and Kaplan-Meier survival analysis were used to examined the effect of mental activity on all-cause mortality. Results During 4 y of follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8%, 26.7%, 6.1% and 0.35% reported 0, 1, 2 and 3 MAI score, respectively. There was a strong association between the MAI score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54–0.96, P = 0.025). Stratified analysis suggested that higher MAI score was significantly associated with decreased risk of all-cause mortality mainly among those who were male, aged ≥ 80 y, physical inactive, and diagnosed without cancer in past (P < 0.05). Conclusion Mental activity could reduce the risk for death from all cause, which help promote a comprehensive understanding of health characteristics at advanced ages.

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Higher sRAGE Levels Predict Mortality in Frail Older Adults with Cardiovascular Disease

Gerontology ◽

10.1159/000512287 ◽

2021 ◽

pp. 1-9

Author(s):

Lee Butcher ◽

Jose Antonio Carnicero ◽

Karine Pérès ◽

Marco Colpo ◽

David Gomez Cabrero ◽

...

Keyword(s):

Older Adults ◽

Cox Regression ◽

Population Based ◽

Blood Levels ◽

Roc Curve Analysis ◽

Baseline Serum ◽

Frailty Status ◽

Risk Of Death ◽

Survival Difference ◽

Increased Risk

Introduction: The evidence that blood levels of the soluble receptor for advanced glycation end products (sRAGE) predict mortality in people with cardiovascular diseases (CVD) is inconsistent. To clarify this matter, we investigated if frailty status influences this association. Methods: We analysed data of 1,016 individuals (median age, 75 years) from 3 population-based European cohorts, enrolled in the FRAILOMIC project. Participants were stratified by history of CVD and frailty status. Mortality was recorded during 8 years of follow-up. Results: In adjusted Cox regression models, baseline serum sRAGE was positively associated with an increased risk of mortality in participants with CVD (HR 1.64, 95% CI 1.09–2.49, p = 0.019) but not in non-CVD. Within the CVD group, the risk of death was markedly enhanced in the frail subgroup (CVD-F, HR 1.97, 95% CI 1.18–3.29, p = 0.009), compared to the non-frail subgroup (CVD-NF, HR 1.50, 95% CI 0.71–3.15, p = 0.287). Kaplan-Meier analysis showed that the median survival time of CVD-F with high sRAGE (>1,554 pg/mL) was 2.9 years shorter than that of CVD-F with low sRAGE, whereas no survival difference was seen for CVD-NF. Area under the ROC curve analysis demonstrated that for CVD-F, addition of sRAGE to the prediction model increased its prognostic value. Conclusions: Frailty status influences the relationship between sRAGE and mortality in older adults with CVD. sRAGE could be used as a prognostic marker of mortality for these individuals, particularly if they are also frail.

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‘Fat but powerful’ paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-103720 ◽

2021 ◽

pp. bjsports-2020-103720

Author(s):

Julian Alcazar ◽

David Navarrete-Villanueva ◽

Asier Mañas ◽

Alba Gómez-Cabello ◽

Raquel Pedrero-Chamizo ◽

...

Keyword(s):

Older Adults ◽

Waist Circumference ◽

Older People ◽

Multicentre Study ◽

Mortality Risk ◽

Muscle Power ◽

Smoking Status ◽

Relative Power ◽

Fat Percentage ◽

All Cause Mortality

ObjectivesTo assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the ‘fat but powerful’ (F+P) (or ‘fat but fit’) paradox in older adults.MethodsA total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated.ResultsAccording to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively).ConclusionPowerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

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Predictors of three-month mortality among hospitalized older adults in Togo

10.21203/rs.3.rs-38973/v2 ◽

2020 ◽

Author(s):

Fifonsi Adjidossi GBEASOR-KOMLANVI ◽

Martin Kouame TCHANKONI ◽

Akila Wimima BAKOUBAYI ◽

Matthieu Yaovi LOKOSSOU ◽

Arnold SADIO ◽

...

Keyword(s):

Older Adults ◽

Hospital Mortality ◽

Cox Regression ◽

Sub Saharan Africa ◽

Mortality Data ◽

Kaplan Meier ◽

All Cause Mortality ◽

Hospitalized Older Adults ◽

Sub Saharan

Abstract Background: Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo.Methods: We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality.Results: The median age of the 650 older adults included in the study period was 61 years, IQR: [55-70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4-20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5% and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases.Conclusion: Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

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Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01026-2 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Xiaoyao Li ◽

Shuang Zhao ◽

Keping Chen ◽

Wei Hua ◽

Yangang Su ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

High Risk ◽

Sudden Cardiac Death ◽

Dose Response ◽

Cardiac Death ◽

Cox Regression ◽

Cardiac Resynchronization ◽

All Cause Mortality

Abstract Background Cardiovascular implantable electronic devices (CIEDs) with physical activity (PA) recording function can continuously and automatically collect patients’ long-term PA data. The dose-response association of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRTD)-measured PA with cardiovascular outcomes in patients at high risk of sudden cardiac death (SCD) was investigated. Methods In total, 822 patients fulfilling the inclusion criteria were included and divided into three groups according to baseline PA tertiles: tertile 1 (< 8.04%, n = 274), tertile 2 (8.04–13.24%, n = 274), and tertile 3 (> 13.24%, n = 274). The primary endpoint was cardiac death, the secondary endpoint was all-cause mortality. Results During a mean follow-up of 59.7 ± 22.4 months, cardiac death (18.6% vs 8.8% vs 5.5%, tertiles 1–3, P < 0.001) and all-cause mortality (39.4% vs 20.4% vs 9.9%, tertiles 1–3, P < 0.001) events decreased according to PA tertiles. Compared with patients younger than 60 years old, older patients had a lower average PA level (9.6% vs 12.8%, P < 0.001) but higher rates of cardiac death (13.2% vs 8.1%, P = 0.024) and all-cause mortality (28.4% vs 16.7%, P < 0.001) events. Adjusted multivariate Cox regression analyses showed that a higher tertile of PA was associated with a lower risk of cardiac death (hazard ratio (HR) 0.41, 95% confidence interval (CI): 0.25–0.68, tertile 2 vs tertile 1; HR 0.28, 95% CI: 0.15–0.51, tertile 3 vs tertile 1, Ptrend < 0.001). Similar results were observed for all-cause mortality. The dose-response curve showed an inverse non-linear pattern, and a significant reduction in endpoint risk was observed at the low-moderate PA level. The HR for cardiac death was reduced by half with 12.32% PA (177 min), and the HR for all-cause mortality was reduced by half with 11.92% PA (172 min). Subgroup analysis results indicated that older adults could benefit from PA and the range for achieving optimal benefits might be lower. Conclusions PA monitoring may aid in long-term management of patients at high risk of SCD. More PA will generate better survival benefits, but even low-moderate PA is already good especially for older adults, which is relatively easy to achieve.

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Can a simple measure of vigorous physical activity predict future mortality? Results from the OXCHECK study

Public Health Nutrition ◽

10.1079/phn2003548 ◽

2004 ◽

Vol 7 (4) ◽

pp. 557-562 ◽

Cited By ~ 14

Author(s):

Melvyn Hillsdon ◽

Margaret Thorogood ◽

Mike Murphy ◽

Lesley Jones

Keyword(s):

Physical Activity ◽

Cox Regression ◽

Vigorous Physical Activity ◽

Previous History ◽

Self Report ◽

Moderate Intensity ◽

Risk Of Death ◽

All Cause Mortality ◽

Intensity Physical Activity

AbstractBackground:As epidemiological studies have become more complex, demands for short, easily administered measures of risk factors have increased. This study investigates whether such a measure of physical activity is associated with the risk of death from all causes and death from specific causes.Methods:A prospective follow-up study of 11 090 men and women, aged 35–64 years, recruited from five UK general practices who responded to a postal questionnaire in 1989. Self-reported frequency of vigorous-intensity physical activity and data on confounding factors were collected at baseline survey. Death notifications up to 31 December 2001 were provided by the Office for National Statistics. The relative risk (and 95% confidence interval) of dying associated with each level of exposure to physical activity was estimated by the hazard ratio in a series of Cox regression models.Results:After > 10 years' follow-up there were 825 deaths among the 10 522 subjects with no previous history of angina or myocardial infarction. Participation in vigorous exercise was associated with a significantly lower risk of all-cause mortality. Similar associations were found for ischaemic heart disease and cancer mortality, although the relationships were not significant at the 5% level.Conclusions:Simple measures of self-reported vigorous physical activity are associated with the risk of future mortality, at least all-cause mortality in a somewhat selected group. Interpretation of the finding should be treated with caution due to the reliance on self-report and the possibility that residual confounding may underlie the associations. Because moderate-intensity physical activity is also beneficial to health, short physical activity questionnaires should include measures of such physical activity in the future.

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Dental Health Behaviors, Dentition, and Mortality in the Elderly: The Leisure World Cohort Study

Journal of Aging Research ◽

10.4061/2011/156061 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 22

Author(s):

Annlia Paganini-Hill ◽

Stuart C. White ◽

Kathryn A. Atchison

Keyword(s):

Older Adults ◽

Oral Health ◽

Health Behaviors ◽

Cox Regression ◽

Dental Health ◽

Significant Risk ◽

Dental Floss ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Increased Risk

In the last decade the effect of oral health on the general health and mortality of elderly people has attracted attention. We explored the association of dental health behaviors and dentition on all-cause mortality in 5611 older adults followed from 1992 to 2009 (median=9years) and calculated risk estimates using Cox regression analysis in men and women separately. Toothbrushing at night before bed, using dental floss everyday, and visiting the dentist were significant risk factors for longevity. Never brushing at night increased risk 20–35% compared with brushing everyday. Never flossing increased risk 30% compared with flossing everyday. Not seeing a dentist within the last 12 months increased risk 30–50% compared with seeing a dentist two or more times. Mortality also increased with increasing number of missing teeth. Edentulous individuals (even with dentures) had a 30% higher risk of death compared with those with 20+ teeth. Oral health behaviors help maintain natural, healthy and functional teeth but also appear to promote survival in older adults.

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The Effect of Music Therapy on Cognitive Functioning Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.2837 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 784-784

Author(s):

Kuei-Min Chen

Keyword(s):

Older Adults ◽

Social Interaction ◽

Older People ◽

Music Therapy ◽

Cognitive Functioning ◽

Brain Health ◽

Community Based Interventions ◽

Community Based ◽

Therapy Interventions ◽

The Impact

Abstract Music creates and fosters connection and interrelationships between individuals and encourages social interaction. Indeed, community-based interventions are a powerful way to engage older people. This presentation will provide an overview of music therapy and the impact it can have on the cognitive functioning of older people. Examples of music therapy interventions in the community can be found in nursing homes, hospitals, or communities. Differences in receptive (passive) music therapy and active music therapy will be discussed along with the impact these therapies may have on individuals experiencing cognitive decline. Moreover, studies of music therapy combined with other activities, such as exercise or art will be discussed. This research will be presented within the context of the recommendations put forth by the Global Council on Brain Health aimed at adults aged 50+.

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Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal Analysis in China

Frontiers in Medicine ◽

10.3389/fmed.2021.697389 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xurui Jin ◽

Shangzhi Xiong ◽

Changzheng Yuan ◽

Enying Gong ◽

Xian Zhang ◽

...

Keyword(s):

Older Adults ◽

Apolipoprotein E ◽

Cox Regression ◽

Population Based ◽

Fish Intake ◽

Chinese Older Adults ◽

Healthy Longevity ◽

All Cause Mortality ◽

Diet Pattern ◽

Interactive Relationship

Introduction: The interactions between apolipoprotein E (APOE) genotype and diet pattern changes were found significant in several trials, implying that APOE gene may modify the effect of animal protein-rich food on health outcomes. We aim to study the interaction of APOE genotype with the effect of meat, fish and egg intake on mortality.Methods: This population-based study enrolled 8,506 older adults (mean age: 81.7 years, 52.3% female) from the Chinese Longitudinal Healthy Longevity Study. The intake frequency of meat, fish and egg was assessed by 3-point questions at baseline. Cox regression was conducted to calculate the hazard ratios for all-cause mortality of intake levels of meat, fish and egg. The analyses were stratified by APOE genotype and sex. The analyses were performed in 2020.Results: In the multivariable-adjusted models, meat and fish intake was associated with all-cause mortality (high vs. low intake: meat: HR: 1.14, 95% CI: 1.01, 1.28; fish: HR: 0.83, 95% CI: 0.73, 0.95). APOE genotype have significant interactions with meat and fish intake (Ps < 0.05). Compared with low fish intake, high fish intake was associated with lower risk of mortality (HR: 0.74, 95% CI: 0.56–0.98) only among the APOE ε4 carriers. High meat intake was significantly associated with higher risks of mortality (HR: 1.13, 95% CI: 1.04–1.25) only among the APOE ε4 non-carriers. The interactive relationship was restricted among the male. No significant findings were observed between egg and mortality among carriers or non-carriers.Conclusions: Among Chinese older adults, the significance of associations of mortality with reported meat or fish intake depended on APOE-E4 carriage status. If validated by other studies, our findings provide evidence for gene-based “precision” lifestyle recommendations.

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