scholarly journals Sixteen-year predictors of successful aging from a Southern Brazilian cohort The PALA study

2018 ◽  
Vol 12 (3) ◽  
pp. 228-234 ◽  
Author(s):  
Juciclara Rinaldi ◽  
Gabriele do Canto Souza ◽  
Ana Luiza Camozzato ◽  
Márcia Lorena Fagundes Chaves

ABSTRACT Successful aging (SA) is a current positive aging-related perspective and it is important to determine the variables associated with this concept. Most longitudinal population-based studies on predictors of SA were carried out in developed countries. Objective: This investigation evaluated which baseline characteristics predicted successful aging in 16 years of follow-up in a southern Brazilian cohort - the Porto Alegre Longitudinal Aging study. Methods: At baseline, 345 community-dwelling healthy independent individuals aged 60 or older were assessed for medical and psychiatric conditions, memory, orientation, judgment and problem solving, functioning in the community and at home, and hobbies. SA, according to Rowe and Kahn’s definition, was the outcome assessed in the last evaluation at a maximum 16-year follow-up. All baseline variables were evaluated as potential predictors for the outcome SA. Results: Of the 345 individuals evaluated at baseline, 32 (9.3%) participants were classified as successful agers in the follow-up. Younger age (OR=0.926, 95%CI=0.863-0.994), female gender (OR=0.226, 95%CI=0.072-0.711) and higher MMSE (OR=1.220, 95%CI=1.031-1.444) were predictors of SA for the 16-year follow-up in a logistic regression model. Conclusion: In contrast with our previous hypothesis, the impact of the socioeconomic and socio-environmental characteristics was small, as was the baseline classification into successful and normal aging.

2021 ◽  
Vol 80 (4) ◽  
pp. 1465-1470
Author(s):  
Olivier Beauchet ◽  
Harmehr Sekhon ◽  
Cyrille P. Launay ◽  
Pierrette Gaudreau ◽  
José A. Morais ◽  
...  

Background: Motoric cognitive risk syndrome (MCR) and mild cognitive impairment (MCI) are two pre-dementia stages with an overlap, which may influence the risk for dementia. Objective: The study aims to examine the association of MCR, MCI, and their combination with incident dementia in Quebec community-dwelling older adults. Methods: 1,063 older adults (i.e., ≥65) were selected from a population-based observational cohort study known as the “Nutrition as a determinant of successful aging: The Quebec longitudinal study” (NuAge). Participants were separated into four groups at the baseline assessment: those without MCR and MCI (i.e., cognitively healthy individual; CHI), those with MCR alone, those with MCI alone, and those with MCR plus MCI. Incident dementia was recorded at each annual visit during a 3-year follow-up. Results: The prevalence of CHI was 87.2%, MCR 3.0%, MCI 8.8%, and MCR plus MCI 0.9%. The overall incidence of dementia was 2.4% and was significantly associated with MCR alone (Odd Ratio (OR) = 5.00 with 95% Confidence interval (CI) = [1.01;24.59] and p = 0.049), MCI alone (OR = 6.04 with 95% CI = [2.36;15.47] and p≤0.001), and the combination of MCR and MCI (OR = 25.75 with 95% CI = [5.32;124.66] and p≤0.001). Conclusion: Combining MCR and MCI increased the risk for incident dementia. These results also demonstrated that this combination is a better predictor of dementia than MCI or MCR alone.


2018 ◽  
Vol 47 (4) ◽  
pp. 589-594 ◽  
Author(s):  
Lu Gao ◽  
Rowan Calloway ◽  
Emily Zhao ◽  
Carol Brayne ◽  
Fiona E Matthews ◽  
...  

Abstract Background death certification data are routinely collected in most developed countries. Coded causes of death are a readily accessible source and have the potential advantage of providing complete follow-up, but with limitations. Objective to investigate the reliability of using death certificates for surveillance of dementia, the time trend of recording dementia on death certificates and predictive factors of recording of dementia. Subjects individuals aged 65 and over in six areas across England and Wales were randomly selected for the Medical Research Council Cognitive Function and Ageing Study (CFAS) and CFAS II with mortality follow-up. Methods prevalence of dementia recorded on death certificates were calculated by year. Reporting of dementia on death certificates compared with the study diagnosis of dementia, with sensitivity, specificity and Cohen’s κ were estimated. Multivariable logistic regression models explored the impact of potential factors on the reporting of dementia on the death certificate. Results the overall unadjusted prevalence of dementia on death certificates rose from 5.3% to 25.9% over the last 26 years. Dementia reported on death certificates was poor with sensitivity 21.0% in earlier cohort CFAS, but it had increased to 45.2% in CFAS II. Dementia was more likely to be recorded on death certificates in individuals with severe dementia, or those living in an institution, yet less likely reported if individuals died in hospital. Conclusion recording dementia on death certificate has improved significantly in the England and Wales. However, such information is still an underestimate and should be used alongside epidemiological estimations.


Author(s):  
Noah A. Schuster ◽  
Sascha de Breij ◽  
Laura A. Schaap ◽  
Natasja M. van Schoor ◽  
Mike J. L. Peters ◽  
...  

Abstract Purpose Delay of routine medical care during the COVID-19 pandemic may have serious consequences for the health and functioning of older adults. The aim of this study was to investigate whether older adults reported cancellation or avoidance of medical care during the first months of the COVID-19 pandemic, and to explore associations with health and socio-demographic characteristics. Methods Cross-sectional data of 880 older adults aged ≥ 62 years (mean age 73.4 years, 50.3% female) were used from the COVID-19 questionnaire of the Longitudinal Aging Study Amsterdam, a cohort study among community-dwelling older adults in the Netherlands. Cancellation and avoidance of care were assessed by self-report, and covered questions on cancellation of primary care (general practitioner), cancellation of hospital outpatient care, and postponed help-seeking. Respondent characteristics included age, sex, educational level, loneliness, depression, anxiety, frailty, multimorbidity and information on quarantine. Results 35% of the sample reported cancellations due to the COVID-19 situation, either initiated by the respondent (12%) or by healthcare professionals (29%). Postponed help-seeking was reported by 8% of the sample. Multimorbidity was associated with healthcare-initiated cancellations (primary care OR = 1.92, 95% CI = 1.09–3.50; hospital OR = 1.86, 95% CI = 1.28–2.74) and respondent-initiated hospital outpatient cancellations (OR = 2.02, 95% CI = 1.04–4.12). Depressive symptoms were associated with postponed help-seeking (OR = 1.15, 95% CI = 1.06–1.24). Conclusion About one third of the study sample reported cancellation or avoidance of medical care during the first months of the pandemic, and this was more common among those with multiple chronic conditions. How this impacts outcomes in the long term should be investigated in future research.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Zvi Gellis ◽  
Kim McClive-Reed ◽  
Bonnie Kenaley ◽  
Eunhae Kim

Abstract Meaning in life for older persons has become a focal research point, with findings that a greater sense of meaning is associated with better outcomes on a range of health and well-being factors. Our study examined relationships between scores on several personality scales, including the Meaning in Life Questionnaire (Steger et al., 2009) and the WHO-5 Well-Being Index, a proxy measure of mood/depression. Community-dwelling members (N=535) of Osher Lifelong Learning Institutes aged 50 and up (mean age 71.4, SD = 6.93) at 3 U.S. sites completed surveys. Higher wellness levels were significantly correlated with increased resilience, optimism, life satisfaction, and presence of meaning in life, while lower levels were associated with greater searching for meaning in life. A multivariate linear regression model (F = 55.597, df = 4, p = .000, R = .566, R2 = .320) showed that wellness scores increased with higher scores in optimism (ß = .348, p =.000), resilience (ß = .183, p = .000), and presence of meaning in life (ß = .106, p = .019). However, searching for meaning in life significantly predicted decreases in wellness scores (ß = -.084, p=.019). These results support those of previous studies, suggesting that for older persons, an ongoing search for meaning in life is linked to negative outcomes than a perception of existing meaning in life. A variety of available interventions aimed at increasing meaning and purpose in life (Guerrero-Torelles et al., 2017) may contribute to better health and well-being in older adults.


Author(s):  
Yukako Tani ◽  
Masamichi Hanazato ◽  
Takeo Fujiwara ◽  
Norimichi Suzuki ◽  
Katsunori Kondo

Abstract Sidewalks are indispensable environmental resources for daily life in that they encourage physical activity. However, the percentage of sidewalks installation is low even in developed countries. We examined the association between neighborhood sidewalk environment and dementia in Japan. We conducted a 3-year follow-up (2010-2013) among participants in a Japan Gerontological Evaluation Study, a population-based cohort study of community-dwelling older adults. We ascertained the incidence of dementia for 76,053 participants from the public long-term care insurance system. We calculated sidewalk coverage (sidewalk area as a percentage of road area) within 436 residential neighborhood units using the geographic information system. Multilevel survival models were used to estimate hazard ratios (HR) for the incidence of dementia. During the follow-up, 5310 dementia cases were found. In urban areas, compared with the lowest quartile for sidewalk coverage, the HR was 0.42 (95% confidence interval (CI): 0.33–0.54) for the highest quartile, adjusting for individual covariates. After successive adjustments for other neighborhood factors (land slope, numbers of hospitals, grocery stores, parks, stations and bus stops, education level, and unemployment rate), the HR remained statistically significant (HR=0.75, 95% CI: 0.59–0.94). Living in neighborhoods with high sidewalks installation was associated with low dementia incidence in urban areas.


BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui-Yin Yow ◽  
John Jeh Lung Tiong ◽  
Chun-Wai Mai ◽  
Esther van der Werf ◽  
Zulkifli Md Zainuddin ◽  
...  

Abstract Background Nocturia is widely prevalent condition with detrimental effects on quality of life and general health. In Malaysia, there is a lack of up-to-date prevalence study on nocturia. This study aimed to investigate the prevalence of nocturia and awareness pertaining to nocturia among Malaysian adults. Methods A cross-sectional population-based study was conducted among Malaysian adults aged ≥ 18 years old. The data was collected by mixed mode self-administered questionnaire from May 2019 to September 2019. Nocturia was defined as one or more voids at night. Results There were a total of 4616 respondents with 74.5% of response rate. The overall prevalence of nocturia among Malaysian adults was found to be 57.3%. In multivariate analysis, respondents aged 31–40 (1.91 [1.52–2.40]) or > 60 years old (2.03 [1.48–2.71]), and those who presented with hypertension (2.84 [2.28–3.53]), diabetes mellitus (1.78 [1.42–2.25]), renal disease (3.58 [1.93–6.63]) or overactive bladder (1.61 [1.10–2.35]) were associated with higher prevalence of nocturia. A significantly lower disease prevalence (p < 0.05) was noted among those aged 41–50 (0.73 [0.59–0.91]), male (0.78 [0.69–0.88]) and Chinese (0.47 [0.30–0.74]) or Indian (0.34 [0.21–0.54]) ethnicities. A total of 37.3% of respondents with nocturia reported that they faced sleeping difficulty about half the time or more after waking up in the middle of night. Those who had ≥ 2 voids per night experienced significantly higher mean bother score than those who had 1 void per night (p < 0.001). Approximately half (56.7%) of all respondents were not aware that night time urination is a medical condition. Only 25.2% of respondents with nocturia had sought medical attention for their nocturia. Conclusions The prevalence of nocturia among Malaysian adults is high and strongly influenced by age, sex, race and comorbidities. However, the general awareness pertaining to nocturia being a health issue remains low among Malaysians. The findings also highlighted the impact of nocturia on sleep and the need for nocturia education to better address this disease.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 407
Author(s):  
Laetitia Lengelé ◽  
Olivier Bruyère ◽  
Charlotte Beaudart ◽  
Jean-Yves Reginster ◽  
Médéa Locquet

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).


Thorax ◽  
2016 ◽  
Vol 71 (Suppl 3) ◽  
pp. A13.1-A13
Author(s):  
V Navaratnam ◽  
AW Fogarty ◽  
T McKeever ◽  
N Thompson ◽  
G Jenkins ◽  
...  

Author(s):  
Erwin Stolz ◽  
Emiel O Hoogendijk ◽  
Hannes Mayerl ◽  
Wolfgang Freidl

Abstract Background Baseline frailty index (FI) values have been shown to predict mortality among older adults, but little is known about the effects of changes in FI on mortality. Methods In a coordinated approach, we analyzed data from 4 population-based cohorts: the Health and Retirement Study (HRS), the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Survey of Ageing (ELSA), and the Longitudinal Aging Study Amsterdam (LASA), comprising a total of 24 961 respondents (65+), 95 897 observations, up to 9 repeated FI assessments, and up to 23 years of mortality follow-up. The effect of time-varying FI on mortality was modeled with joint regression models for longitudinal and time-to-event data. Results Differences (of 0.01) in current FI levels (hazard ratio [HR] = 1.04, 95% credible interval [CI] = 1.03–1.05) and baseline FI levels (HR = 1.03, 95% CI = 1.03–1.05) were consistently associated with mortality across studies. Importantly, individuals with steeper FI growth also had a higher mortality risk: An increase in annual FI growth by 0.01 was associated with an increased mortality risk of HR = 1.56 (95% CI = 1.49–1.63) in HRS, HR = 1.24 (95% CI = 1.13–1.35) in SHARE, HR = 1.40 (95% CI = 1.25–1.52) in ELSA, and HR = 1.71 (95% CI = 1.46–2.01) in LASA. Conclusions FI changes predicted mortality independently of baseline FI differences. Repeated assessment of frailty and individual’s frailty trajectory could provide a means to anticipate further health deterioration and mortality and could thus support clinical decision making.


2021 ◽  
Vol 42 (3) ◽  
pp. 825-833
Author(s):  
Arianna Manini ◽  
Michela Brambilla ◽  
Laura Maggiore ◽  
Simone Pomati ◽  
Leonardo Pantoni

Abstract Background During Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people’s lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD). Methods Between April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients’ BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed. Results A total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown. Conclusion This is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.


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