DIET LIBERALISATION IN OLDER AUSTRALIANS DECREASES FRAILTY WITHOUT INCREASING THE RISK OF DEVELOPING CHRONIC DISEASE

2012 ◽  
pp. 1-9
Author(s):  
L. BAULDERSTONE ◽  
A. YAXLEY ◽  
M. LUSZCZ ◽  
M. MILLER
Keyword(s):  
Chronic Disease ◽  
Saturated Fat ◽  
Dietary Exposure ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Total Fat ◽  
Definition Of ◽  
The Impact ◽  
Saturated Fat Intake

Background:Successful ageing relies on the prevention of frailty and chronic disease, many of whichhave a strong link with diet. Despite evidence suggesting diet is important in the management of frailty, there islittle evidence investigating the impact of a liberal diet on the prevention of frailty and development of chronicdiseases in the elderly. Objectives:To determine the impact of a liberal diet on the development of frailty andwhether this affects the incidence of obesity, diabetes, hypertension and hyperlipidaemia. Design:Secondary dataanalysis of the Australian Longitudinal Study of Ageing, 1992 to 2000. Setting:Random selection of older adultsfrom the South Australian electoral roll. Participants:1298 older Australians (629 women, 669 men), mean age77 years. Measurements:A validated food frequency questionnaire was used to measure the dietary exposure;liberal diet defined as: energy >10% estimated requirements; sodium >1600mg; total fat >35% energy; saturatedfat >10%; refined sugar >10%; fibre <38g males and <28g females. Frailty was determined using the Friedphenotype in combination with Cesari’s biological definition of frailty. Chronic disease outcomes were measuredby medication usage and obesity defined as BMI >30kg/m². Binary logistic regression was performed usingparticipants free of chronic disease at baseline to determine the impact of each dietary exposure independently,and combined, on the development of frailty and the incidence of chronic disease over the subsequent eight years.Results:Incidence of frailty after 8 years of follow up was 14%. The incidence of diabetes after 8 years of followup was 5.3%, hypertension 39%, hyperlipidaemia 15% and obesity 6%. A liberal energy intake adjusted for ageand sex, significantly reduced the risk of developing frailty eight years post baseline (OR 0.48, 95% CI 0.30,0.77). After adjustment for age, sex and body weight, a liberal saturated fat intake (>10% of energy) increasedthe risk of hyperlipidaemia (OR 2.11, 95% CI 1.27, 3.54). A liberal intake of sodium, total fat, refined sugar andfibre did not increase the risk of diabetes, hypertension, hyperlipidaemia or obesity. Conclusions:This studysuggests that a liberal intake of energy may decrease the risk of developing frailty in the elderly withoutincreasing the risk of developing obesity, diabetes, hypertension or hyperlipidaemia. Caution should remainhowever in the prescription of diets high in saturated fat as the link established with hyperlipidaemia in youngadults appears to be consistent in the elderly. Further research is required to explore the optimal sources of energyfor a liberalised diet and the effect of a liberalised diet on other diet related health conditions.

scholarly journals Long-term effectiveness of elderly health care voucher scheme strategies: a system dynamics simulation analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public ◽  
The Impact

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.

scholarly journals A longitudinal study over 40 years to study the metabolic syndrome as a risk factor for cardiovascular diseases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lars Lind ◽  
Johan Sundström ◽  
Johan Ärnlöv ◽  
Ulf Risérus ◽  
Erik Lampa
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
Longitudinal Study ◽  
Clinical Intervention ◽  
The Elderly ◽  
Adult Men ◽  
The Metabolic Syndrome ◽  
The Impact ◽  
Over 40 Years

AbstractThe impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90–4.05) at age 50 to 1.30 (95% CI 1.05–1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

MOBILE APPLICATION REMOVES SOCIETAL BARRIERS TO P4 MEDICINE

2017 ◽  
pp. 1-3
Author(s):  
J.-P. Michel
Keyword(s):  
Cognitive Abilities ◽  
Mobile Application ◽  
New Technologies ◽  
Global Evaluation ◽  
P4 Medicine ◽  
Fertile Ground ◽  
Definition Of ◽  
The Individual ◽  
The Impact

The overlap between one innovative paradigm (P4 medicine: predictive, personalized, participatory and preventive) and another (a new definition of “Healthy ageing”) is fertile ground for new technologies; a new mobile application (app) that could broaden our scientific knowledge of the ageing process and help us to better analyse the impact of possible interventions in slowing the ageing decline. A novel mobile application is here presented as a game including questions and tests will allow in 10 minutes the assessment of the following domains: robustness, flexibility (lower muscle strength), balance, mental and memory complaints, semantic memory and visual retention. This game is completed by specific measurements, which could allow establishing precise information on functional and cognitive abilities. A global evaluation precedes advice and different types of exercises. The repetition of the tests and measures will allow a long follow up of the individual performances which could be shared (on specific request) with family members and general practitioners.

scholarly journals Impact assessment of the TFA regulation on fatty acid composition of foods in Hungary

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Varga ◽  
E Sarkadi Nagy ◽  
L Zámbó ◽  
É Illés ◽  
M Bakacs ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Trans Fatty Acids ◽  
Saturated Fat ◽  
Portion Size ◽  
World Health ◽  
Food Sources ◽  
Increased Risk ◽  
Total Fat ◽  
The Impact

Abstract Trans fatty acids are formed during the industrial processing of food, and are proven to be harmful for the human body. They have been associated with increased risk of cardiovascular disease, abdominal obesity, diabetes, and certain types of cancer. Decree 71/2013. (XI. 20.) of the Ministry of Human Capacities, which has been in force since 2014, defines the highest permitted amount of trans fats in food products placed on the market in Hungary. The impact of the decree on the industrially produced trans fatty acids (iTFA) availability and population intake was assessed in 2017. Results demonstrated that iTFA were replaced by other fatty acids due to the legislation. In 2019, we investigated food groups which had high measured TFA content before the regulation entered into force and compared the total fat and fatty acid profiles to the same brand or similar products being on the market afterwards. In collaboration with the World Health Organization, this was the first assessment to determine to which extent manufacturers increased saturated fat (SFA) content of foodstuffs to reduce iTFA content. In those product groups, which were identified as significant food sources of iTFA before introducing the regulation (biscuits, coffee creamers and flavorings, sweets, bakery products, confectionary, wafers, margarines) we found no significant changes in the total fat content, while in most foodstuffs the average proportion of SFA was higher after reformulation, as iTFA were mainly substituted with SFA in 61% of the products, with cis-MUFA in 25% and cis-PUFA in 14% of the products, respectively. Evidence from this analysis supports concerns that eliminating iTFA in certain foodstuffs leads to unwanted substitution with saturated fat, hence reducing the possible health benefits. Given the high SFA intake and the unfavourable cardiovascular statistics in Hungary, the consumption frequency and portion size control of these products are advised. Key messages Monitoring the changes of food composition is important in order to evaluate the effect of the regulation. Manufacturers should be encouraged to reduce the SFA content to a technologically feasible level.

scholarly journals The impact of exposure to cafeteria diet during pregnancy or lactation on offspring growth and adiposity before weaning

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Grace George ◽  
Sally A. V. Draycott ◽  
Ronan Muir ◽  
Bethan Clifford ◽  
Matthew J. Elmes ◽  
...  
Keyword(s):  
Maternal Obesity ◽  
Saturated Fat ◽  
Cafeteria Diet ◽  
Postnatal Life ◽  
Chow Diet ◽  
Offspring Growth ◽  
Lower Protein ◽  
Pregnancy And Lactation ◽  
Total Fat ◽  
The Impact

Abstract Exposure to maternal obesity during early-life can have adverse consequences for offspring growth and adiposity. We aimed to assess the relative contributions of exposure to maternal obesity, induced by a highly varied cafeteria diet, during pregnancy and lactation on these measures in rat offspring prior to weaning. Female Wistar rats were fed either a control (C) or cafeteria diet (O) for 8 weeks before mating, throughout pregnancy and lactation. Offspring were cross-fostered at birth to a dam on the same (CC,OO) or alternate diet prior to birth (CO,OC). Feeding a cafeteria diet based on 40 different foods, was associated with a sustained period of elevated energy intake before birth and during lactation (up to 1.7-fold), through increased sugar, total fat and saturated fat intake, and lower protein consumption. Cafeteria fed dams sustained greater weight than animals fed a control chow diet and greater perirenal adiposity by the end of lactation. Exposure to obesity during pregnancy was associated with lower offspring birth weight and body weight in early-postnatal life. In contrast, exposure during lactation alone reduced offspring weight but increased adiposity in male CO offspring before weaning. This research highlights that exposure to maternal obesity during lactation alone can programme adiposity in a sex specific manner.

scholarly journals Importance of rheology in the prediction of structural transition phenomena in geopolymer matrices loaded with phosphogypsum

2019 ◽  
Vol 286 ◽  
pp. 07005
Author(s):  
N. Lahlou ◽  
M. Ouazzani Touhami ◽  
R. Hattaf ◽  
R. Moussa
Keyword(s):  
Rheological Behavior ◽  
Structural Transition ◽  
Experimental Approach ◽  
Fresh State ◽  
Hardened State ◽  
Definition Of ◽  
The Impact ◽  
Kinetics Of

Through a purely experimental approach, we proceed here to the description of the rheological behavior of the geopolymer matrices in the fresh state according to one or other of the parameters characterizing their formulation. This consolidates the different physicochemical techniques usually used for their characterization. This comes to allow us especially the definition of drafts for the implementation of empirical laws ensuring a better follow-up in the elaboration of these materials or even more optimization in their formulation. This description also allows us to follow the structural transition phenomena from the fresh state to the hardened state. We are particularly interested in demonstrating the impact of the addition of Phosphogypsum on the rheological behavior of geopolymers or on their kinetics of setting.

Metastatic melanoma in the elderly: Case series of clinical outcome and immune characteristics

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20018-e20018
Author(s):  
U. P. Hegde ◽  
N. Chakraborty ◽  
A. Chhabra ◽  
S. Ray
Keyword(s):  
Immune System ◽  
Clinical Outcome ◽  
Elderly Patients ◽  
Metastatic Melanoma ◽  
Cutaneous Melanoma ◽  
Proliferative Activity ◽  
The Elderly ◽  
High Dose ◽  
The Impact

e20018 Background: Cutaneous melanoma incidence is rapidly rising in the elderly population. Imbalances of the immune system are described due to aging associated changes between CD4+, CD8+, T helper (Th) 1, Th 2 and T regulatory and T effector lymphocytes (lym). We describe clinical outcome in 10 elderly patients (pts) with cutaneous metastatic melanoma (CMM) and results of the immune studies done in a subgroup. Methods: Between October 2002 and October 2008, 10 elderly pts with treatment naïve CMM, 6 males and 4 female, median ages 76, range 57–84 years were treated at the University of Connecticut Health Center. Metastatic sites included soft tissue in 2 patients (pts), lung and/or liver with lymph node (LN) involvement (6 pts) and distant LN metastasis (2pts). Eight pts opted for treatment and received single or combination chemotherapy (5pts), high dose Interleukin 2 (2 pts), complete tumor resection followed by tumor derived heat shock protein vaccine (1 pt on clinical trial) and bio chemotherapy (1pt). One patient declined treatment (included in follow up). In vitro immune characteristics were studied in HLA-A2 positive subgroup (5pts) and included cytotoxic T lym (CTL) generation against self and non self peptides (Mart-1 27–35 and influenza MP derived peptide flu 58–66), proliferative activity of CD4+ lym in response to anti CD3 antibody under Th1 and Th2 conditions and regulatory T lym activity of CD4+CD25+ lym against CTL. Results: All patients tolerated treatments well resulting in 1 complete response, 4 partial responses, and 4 stable diseases. During 6 year follow up period, 6 patients died while 4 patients are living (one with disease). The median survival of all patients is 28.1 month (mo) while in those surviving (4pts) is 72 mo. Immune studies revealed preserved proliferative activity of CD4+ lym with stronger Th1 induction than Th2. The CTL responses to self and non self antigens were preserved while regulatory T lym showed weak activity against CTL. Conclusions: Some elderly patients with metastatic melanoma demonstrate improved outcomes and favorable immune characteristics. Further studies are needed to understand the impact of aging immune system on cutaneous melanoma. No significant financial relationships to disclose.

scholarly journals Higher Hemoglobin Levels Are Associated With Better Physical Performance Among Older Adults Without Anemia: A Longitudinal Analysis

2021 ◽  
Author(s):  
Ligiana Pires Corona ◽  
Flavia Cristina Drummond Andrade ◽  
Tiago Silva Alexandre ◽  
Tábatta Renata Pereira Brito ◽  
Daniella Pires Nunes ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Well Being ◽  
World Health ◽  
Aging Study ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Abstract Background Anemia is the most common hematological abnormality among older adults, and it is associated with decreased physical performance. But the role of hemoglobin in the absence of anemia remains unclear. Thus, this study aimed to assess the impact of hemoglobin levels on physical performance in Brazilian older adults without anemia. Methods The study is longitudinal in that it relies on two waves of the Saúde, Bem-Estar e Envelhecimento (SABE; Health, Well-being, and Aging) study: 2010 and 2015–2016. Mixed-effects linear regression was used to determine the effects of the hemoglobin concentrations on the Short Physical Performance Battery-SPPB over time among the 1,020 who had complete data and did not have anemia in 2010. In the follow-up, there were 562 without anemia. Analyses were stratified by sex. Results In analyses adjusted for age, education, grip strength, comorbidities, and body mass index, hemoglobin levels were positively associated with physical performance scores among older women (β = 0.15, p < 0.05) and men (β = 0.18, p < 0.05) without anemia. Conclusion Our study demonstrates that higher hemoglobin levels were associated with better physical performance among older men and women without anemia. This finding is important because, in clinical practice, most health professionals focus on the World Health Organization definition of anemia. Our study suggests the importance of hemoglobin levels among older adults, even those without anemia.

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