Dual Sensory Impairment in Older Adults Increases the Risk of Mortality: A Population-Based Study

Abstract The scarce knowledge of multimorbidity development hampers the effectiveness of clinical interventions. We aimed to identify multimorbidity clusters, trace their evolution in a cohort of older adults, and detect the clinical trajectories of single individuals as they move among clusters over 12 years. Population-based study including 2931 persons 60+ with ≥2 diseases participating in the SNAC-K study. A fuzzy c-means cluster algorithm was used to group participants by disease patterns at baseline and follow-ups. Migration from one cluster to another was tracked over time, and the association between the clusters and mortality was tested. At baseline 52% of participants were classified into five clinically meaningful disease clusters: psychiatric and respiratory (5%), heart (9%), respiratory and musculoskeletal (16%), cognitive and sensory impairment (10%), and eye diseases and cancer (11%). The remaining 48% of participants (unspecified group) were grouped in any cluster at baseline but greatly contributed to the other clusters at follow-ups. Multimorbidity clusters that included cardiovascular and neuropsychiatric diseases presented a significantly higher mortality risk (odds ratios ranging 1.58–6.00) than the group not part of any clusters. Clusters characterized by cardiovascular and neuropsychiatric diseases included 25% of the study population at baseline and 28% of participants at six years, and they accounted for 51% of deaths at six years and 57% of deaths at twelve years. Multimorbidity clusters and clinical trajectories of older adults with multimorbidity show great dynamism over time. The multimorbidity clusters and trajectories identified in this study may help identifying groups with similar needs and prognosis.

Download Full-text

Mortality After Trauma Craniotomy is Decreasing in Older Adults –Nationwide Population-Based Study

World Neurosurgery ◽

10.1016/j.wneu.2021.05.090 ◽

2021 ◽

Author(s):

Jussi P. Posti ◽

Teemu M. Luoto ◽

Päivi Rautava ◽

Ville Kytö

Keyword(s):

Older Adults ◽

Population Based ◽

Population Based Study

Download Full-text

The Association of Sensory Impairment With Incident Disability-Related Cessation of Employment in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.697 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 216-216

Author(s):

Ahmed Shakarchi ◽

Emmanuel Garcia Morales ◽

Nicholas Reed ◽

Bonnielin Swenor

Keyword(s):

Older Adults ◽

Hearing Aids ◽

Population Based ◽

Sensory Impairment ◽

Loss To Follow Up ◽

Increased Risk ◽

Cox Proportional Hazard Regression ◽

Study Participants ◽

Adjusted Model

Abstract Sensory impairment (SI) is common among older adults, and it is an increasingly important public health challenge as the population ages. We evaluated the association between SI and incident disability-related cessation of employment in older adults using the population-based Health and Retirement Study. Participants employed in 2006 completed biennial interviews until self-reported incident disability-related cessation of employment. Participants were censored at loss to follow-up, retirement, or 2018. Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, excellent). SI was defined as poor or fair ability, and SI was categorized as neither SI (NSI), vision impairment alone (VI), hearing impairment alone (HI), and dual SI (DSI). Cox proportional hazard regression assessed the association between SI and incident disability-related cessation of employment, adjusting for demographic and health covariates. Overall, 4726 participants were included: 421 (8.9%) were with VI, 487 (10.3) with HI, and 203 (4.3%) with DSI. Mean age was 61.0 ± 6.8 years, 2488 (52.6%) were women, and 918 (19.4) were non-White. In the fully adjusted model, incident disability-related cessation of employment over the 12-year follow-up period was higher in VI (Hazard Ratio (HR)=1.30, 95% confidence interval (CI)=0.92, 1.85), HI (HR=1.60, CI=1.16, 2.22), and DSI (HR=2.02, CI=1.38, 2.96). These findings indicate that employed older adults with SI are at increased risk of incident disability-related cessation of employment, and that older adults with DSI are particularly vulnerable. Addressing SI in older adults may lengthen their contribution to the workforce.

Download Full-text

Total Cerebral Small Vessel Disease Score and Anthropometric Indices: A Population-Based Study in Older Adults of Amerindian Ancestry

European Neurology ◽

10.1159/000517915 ◽

2021 ◽

pp. 1-4

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera

Keyword(s):

Older Adults ◽

Small Vessel Disease ◽

Brain Magnetic Resonance Imaging ◽

Population Based ◽

Cerebral Small Vessel Disease ◽

The Body ◽

Small Vessel ◽

Population Based Study ◽

Vessel Disease ◽

Ordinal Logistic Regression Model

A total of 590 older adults of Amerindian ancestry living in rural Ecuador received anthropometric measurements and a brain magnetic resonance imaging to estimate the total cerebral small vessel disease (cSVD) score. A fully adjusted ordinal logistic regression model, with categories of the total cSVD score as the dependent variable, disclosed significant associations between the waist circumference, the waist-to-hip, and the waist-to-height ratios – but not the body mass index (BMI) – and the cSVD burden. Indices of abdominal obesity may better correlate with severity of cSVD than the BMI in Amerindians. Phenotypic characteristics of this population may account for these results.

Download Full-text