scholarly journals Loneliness as a risk factor for frailty transition among Chinese old people

2020 ◽  
Author(s):  
SHA SHA ◽  
Xu Yuebin ◽  
Chen Lin
Keyword(s):  
Strong Predictor ◽  
Frailty Index ◽  
Outcome Variable ◽  
Old People ◽  
Physical Frailty ◽  
Healthy Longevity ◽  
Increased Risk ◽  
Confounding Variables ◽  
Definition Of ◽  
High Level

Abstract Background: previous literature has reported that loneliness is a strong predictor of frailty risk, yet less is known about the role of loneliness in frailty transition types. In this study, we examined whether and how loneliness is related to frailty transition among Chinese old people. Methods: our study used participants (aged>=60) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely and grouped into three levels: never, seldom, and often. FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.Results: greater loneliness at baseline reduced the possibility of remaining robust or prefrail physical frailty state after adjusting for confounding variables (3-year period: OR=0.78, p<0.001;6-year period: OR=0.84, p<0.05). Greater loneliness was associated with an increased risk of worsening physical frailty after years: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (p<0.01) after 3 years and 1.34 (p<0.001) after 6 years, adjusted for confounding variables. The association between loneliness and change in the frailty index differed in survey periods: often loneliness at baselines was found to reduce the possibility of participants remaining nonfrail (OR= 0.83, p<0.05) and increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, p<0.001; often loneliness: OR= 1.74, p<0.001) after 6 years. Besides, loneliness at baselines was significantly associated with frailty transition at follow-up among males, even after adjusting for all potential confounding variables. However, a similar association was not observed among females.Conclusion: old people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to suffer from frailty transition than female elderly in China.

scholarly journals Loneliness as a risk factor for frailty transition among Chinese old people

2020 ◽  
Author(s):  
SHA SHA ◽  
Xu Yuebin ◽  
Chen Lin
Keyword(s):  
Strong Predictor ◽  
Frailty Index ◽  
Outcome Variable ◽  
Old People ◽  
Physical Frailty ◽  
Healthy Longevity ◽  
Increased Risk ◽  
Confounding Variables ◽  
High Level

Abstract Background: previous literature has reported that loneliness is a strong predictor of frailty risk, yet less is known about the role of loneliness in frailty transition types. In this study, we examined whether and how loneliness is related to frailty transition among Chinese old people. Methods: our study used participants (aged>=60) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty. Results: greater loneliness at baseline reduced the possibility of remaining robust or prefrail physical frailty state after 3 years (OR=0.78, 95%CI: 0.68 - 0.91, p<0.01), adjusted for all confounding variables. Greater loneliness was associated with an increased risk of worsening physical frailty after years: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01 - 1.41, p<0.05) after 3 years and 1.34 (95%CI: 1.08 - 1.66, p<0.01) after 6 years, adjusted for confounding variables. The association between loneliness and change in the frailty index differed in survey periods: loneliness at baselines was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, 95%CI: 1.25 - 2.55, p<0.01; often loneliness: OR= 1.74, 95%CI: 1.21 - 2.50, p<0.01) after 6 years, but no significant sign was shown in 3 years follow-up. Besides, loneliness at baselines was significantly associated with frailty transition at follow-up among males, even after adjusting for all potential confounding variables. However, a similar association was not observed among females. Conclusion: old people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to suffer from frailty transition than female elderly in China.

scholarly journals Loneliness as a risk factor for frailty transition among older Chinese people

2020 ◽  
Author(s):  
SHA SHA ◽  
Yuebin Xu ◽  
Lin Chen
Keyword(s):  
Strong Predictor ◽  
Frailty Index ◽  
Outcome Variable ◽  
Physical Frailty ◽  
Healthy Longevity ◽  
Increased Risk ◽  
Older Chinese ◽  
Definition Of ◽  
High Level

Abstract Background: Previous literature has reported that loneliness is a strong predictor of frailty risk. However, less is known about the role of loneliness in frailty transition types. This study aimed to examine whether and how loneliness are related to frailty transition among older Chinese people.Methods: Our study used participants (aged ≥60 years) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. The FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of the frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.Results: Greater loneliness at baseline reduced the possibility of remaining in a robust or prefrail physical frailty state after 3 years (OR=0.78, 95%CI: 0.68–0.91, p<0.01). Greater loneliness was associated with an increased risk of worsening physical frailty over time: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01–1.41, p<0.05) after 3 years and 1.34 (95%CI: 1.08–1.66, p<0.01) after 6 years. The association between loneliness and change in the frailty index differed in the survey periods: loneliness at baseline was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, 95%CI: 1.25–2.55, p<0.01; often loneliness: OR= 1.74, 95%CI: 1.21–2.50, p<0.01) after 6 years, but no significance was shown in the 3-year follow up. Additionally, loneliness at baselines was significantly associated with frailty transition at follow up among the male participants. However, a similar association was not observed among the female participants.Conclusion: Older people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to an increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to have a worse frailty transition than female elderly in China.

scholarly journals Loneliness as a risk factor for frailty transition among older Chinese people

2020 ◽  
Author(s):  
SHA SHA ◽  
Yuebin Xu ◽  
Lin Chen
Keyword(s):  
Strong Predictor ◽  
Frailty Index ◽  
Outcome Variable ◽  
Chinese People ◽  
Physical Frailty ◽  
Healthy Longevity ◽  
Increased Risk ◽  
Older Chinese ◽  
High Level

Abstract Background: Previous literature has reported that loneliness is a strong predictor of frailty risk. However, less is known about the role of loneliness in frailty transition types. This study aimed to examine whether and how loneliness are related to frailty transition among older Chinese people. Methods: Our study used participants (aged ≥60 years) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. The FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of the frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.Results: Greater loneliness at baseline reduced the possibility of remaining in a robust or prefrail physical frailty state after 3 years (OR=0.78, 95%CI: 0.68–0.91, p<0.01). Greater loneliness was associated with an increased risk of worsening physical frailty over time: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01–1.41, p<0.05) after 3 years and 1.34 (95%CI: 1.08–1.66, p<0.01) after 6 years. The association between loneliness and change in the frailty index differed in the survey periods: loneliness at baseline was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, 95%CI: 1.25–2.55, p<0.01; often loneliness: OR= 1.74, 95%CI: 1.21–2.50, p<0.01) after 6 years, but no significance was shown in the 3-year follow up. Additionally, loneliness at baselines was significantly associated with frailty transition at follow up among the male participants. However, a similar association was not observed among the female participants.Conclusion: Older people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to an increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to have a worse frailty transition than female elderly in China.

scholarly journals Loneliness as a risk factor for frailty transition among Chinese old people

2019 ◽  
Author(s):  
SHA SHA ◽  
Xu Yuebin ◽  
Chen Lin
Keyword(s):  
Significant Relationship ◽  
Frailty Index ◽  
Adverse Outcomes ◽  
Outcome Variable ◽  
Odds Ratios ◽  
Physical Frailty ◽  
Healthy Longevity ◽  
Increased Risk ◽  
Confounding Variables ◽  
High Level

Abstract Background: loneliness has been observed to be associated with subsequent adverse outcomes. Our study aims to investigate whether and how loneliness is related to frailty transition. Methods: our study used 8425 participants (aged>=60) from 2008 and 2011 waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely and isolated and grouped into three levels of loneliness: never, seldom and often. Frailty was contrasted in physical frailty and frailty index. Frailty transition as outcome variable has been designed as two types according the mearsurement of frailty: remaining robust or prefrail, improvement, worsening and remaining frail was used to describe the transition of physical frailty, and we created three categories of frailty index change to investigate the association between loneliness and frailty transition. Results: greater loneliness reduced the possibility of remaining robust or prefrail physical frailty state after adjusting: odds ratios (95% CI) was 0.78(0.67-0.90), adjusted for age, gender, components number of frail scale at baseline and all other confounding variables. Greater loneliness was associated with an increased risk of worsening physical frailty after 3 years: compared with those never loneliness, the odds ratios (95% CI) for people who often loneliness were 1.19(1.01-1.40), adjusted for age, gender and components number of frail scale at baseline and all other confounding variables. The association between loneliness and the possibility of remaining robust or prefrail physical frailty states had no gender difference, adjusted for age and components number of frail scale at baseline, whereas loneliness was no longer significant in female participants after adjusting for all covariates. Male participants with often loneliness had an increased risk of worsening physical frailty state even with all covariates. By contrast, loneliness showed no significant relationship with physical frailty improvement and remaining frail. We found no significant relationship with loneliness under the model of the frailty index. Conclusion: old adults with a high level of loneliness tend to be physical frailty state in the future, and male older with a high level of loneliness had an increased risk of worsening physical frailty state.

scholarly journals Post-natalizumab disease reactivation in multiple sclerosis: systematic review and meta-analysis

2019 ◽  
Vol 12 ◽  
pp. 175628641983780 ◽  
Author(s):  
Luca Prosperini ◽  
Revere P. Kinkel ◽  
Augusto A. Miravalle ◽  
Pietro Iaffaldano ◽  
Simone Fantaccini
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Disease Activity ◽  
Meta Analysis ◽  
Random Effect ◽  
Patient Characteristics ◽  
Increased Risk ◽  
Disease Reactivation ◽  
Definition Of ◽  
High Level

Background: Natalizumab (NTZ) is sometimes discontinued in patients with multiple sclerosis, mainly due to concerns about the risk of progressive multifocal leukoencephalopathy. However, NTZ interruption may result in recrudescence of disease activity. Objective: The objective of this study was to summarize the available evidence about NTZ discontinuation and to identify which patients will experience post-NTZ disease reactivation through meta-analysis of existing literature data. Methods: PubMed was searched for articles reporting the effects of NTZ withdrawal in adult patients (⩾18 years) with relapsing–remitting multiple sclerosis (RRMS). Definition of disease activity following NTZ discontinuation, proportion of patients who experienced post-NTZ disease reactivation, and timing to NTZ discontinuation to disease reactivation were systematically reviewed. A generic inverse variance with random effect was used to calculate the weighted effect of patients’ clinical characteristics on the risk of post-NTZ disease reactivation, defined as the occurrence of at least one relapse. Results: The original search identified 205 publications. Thirty-five articles were included in the systematic review. We found a high level of heterogeneity across studies in terms of sample size (10 to 1866 patients), baseline patient characteristics, follow up (1–24 months), outcome measures (clinical and/or radiological), and definition of post-NTZ disease reactivation or rebound. Clinical relapses were observed in 9–80% of patients and peaked at 4–7 months, whereas radiological disease activity was observed in 7–87% of patients starting at 6 weeks following NTZ discontinuation. The meta-analysis of six articles, yielding a total of 1183 patients, revealed that younger age, higher number of relapses and gadolinium-enhanced lesions before treatment start, and fewer NTZ infusions were associated with increased risk for post-NTZ disease reactivation ( p ⩽ 0.05). Conclusions: Results from the present review and meta-analysis can help to profile patients who are at greater risk of post-NTZ disease reactivation. However, potential reporting bias and variability in selected studies should be taken into account when interpreting our data.

Abstract P452: Stem Cells Defect And Alarmins S100A8/A9 Overexpression Associate With Early-stage Frailty And Poor Cardiovascular Health In Older Adults

2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Benedetta Maria Bonora ◽  
Maria Teresa Palano ◽  
Gianluca Testa ◽  
Gian Paolo Fadini ◽  
Elena Sangalli ◽  
...  
Keyword(s):  
Older Adults ◽  
Inflammatory Cytokines ◽  
Peripheral Blood ◽  
Early Stage ◽  
Frailty Index ◽  
Cardiovascular Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Physical Frailty ◽  
Hematopoietic Stem ◽  
Increased Risk

Importance: Frailty affects the physical, cognitive, and social domains exposing older adults to an increased risk of cardiovascular diseases and death. The mechanisms linking frailty and cardiovascular outcomes are mostly unknown. Objective: Here, we studied the association of hematopoietic stem/progenitor cells (HSPCs) and molecular markers of inflammaging with the cardiopulmonary phenotype and prospective adverse events of individuals classified according to levels of frailty. Methods: We conducted one observational study on two patients’ cohorts of older adults characterized for their frailty status examining the abundance (flow cytometry) and gene expression profile (RNAseq) of HSPCs, and the levels of cardiac dysfunction-associated alarmins S100A8/A9 and inflammatory cytokines (ELISA). Results: In a cohort of pre-frail 35 individuals (average age: 75 years), a physical frailty score above the median identified subjects with initial alterations in cardiorespiratory function and increased alarmins S100A8/A9 and inflammatory cytokines in peripheral blood. RNA sequencing revealed S100A8/A9 upregulation in HSPCs from the bone marrow (>10-fold) and peripheral blood (>200-fold) of individuals with greater physical frailty. We then interrogated the biomarkers in a cohort of 104 frail individuals (average age: 81 years) with multi-domain health deficits. Reduced levels of circulating HSPCs and increased S100A8/A9 concentrations were independently associated with the frailty index. Remarkably, low HSPCs and high S100A8/A9 simultaneously predicted major adverse cardiovascular events at 1-year follow-up after adjustment for age and frailty index. Conclusions and Relevance: Inflammaging resulting from alarmin and pro-inflammatory cytokines in pre-frail individuals is followed by pauperization of HSPCs in frail older people with comorbidities. S100A8/A9 upregulation is activated within HSPCs, identifying a phenotype that drives poor cardiovascular outcomes.

scholarly journals Attitudes to Ageing and Change in Frailty Status: The English Longitudinal Study of Ageing

Gerontology ◽  
2017 ◽  
Vol 64 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Catharine R. Gale ◽  
Cyrus Cooper
Keyword(s):  
Longitudinal Study ◽  
Relative Risk ◽  
Older People ◽  
Positive Attitude ◽  
Frailty Index ◽  
Physical Frailty ◽  
Negative Attitudes ◽  
Confounding Variables ◽  
English Longitudinal Study ◽  
Risk Ratios

Background: Older people with more negative attitudes to ageing are at increased risk of several adverse outcomes, including decline in physical function and increased difficulties with activities of daily living. Objective: We investigated whether negative attitudes to ageing increase the risk of the onset or progression of frailty. Method: Participants were 3,505 men and women aged 60 years and over from the English Longitudinal Study of Ageing. They completed a 12-item questionnaire on attitudes to ageing. Exploratory factor analysis was used to examine the structure of these items, and a single factor was derived which we labelled “physical and psychological loss.” Frailty was assessed by the Fried phenotype of physical frailty at waves 2 and 4, and by a frailty index at waves 2-5. Results: Having a more positive attitude to ageing as regards “physical and psychological loss” was associated with a decreased risk of becoming physically frail or pre-frail at follow-up. For a standard deviation increment in score, the relative risk ratios (95% confidence interval), adjusted for age, sex and baseline level of physical frailty, were 0.86 (0.79, 0.94) for pre-frailty and 0.72 (0.63, 0.83) for frailty. Further adjustment for other potential confounding variables had only slight attenuating effects on these associations: multivariable-adjusted relative risk ratios were 0.89 (0.81, 0.98) for pre-frailty and 0.78 (0.68, 0.91) for frailty. Attitude to ageing was not associated with change in the frailty index over time after adjustment for potential confounding variables. Conclusion: Older people who have a more positive attitude to ageing are at reduced risk of becoming physically frail or pre-frail. Future research needs to replicate this finding and discover the underlying mechanisms. Attitude to ageing was not a risk factor for change in the more broadly defined frailty index.

scholarly journals Childhood inflammatory and metabolic disease following exposure to antibiotics in pregnancy, antenatally, intrapartum and neonatally

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 144 ◽  
Author(s):  
Ronald F. Lamont ◽  
Birgitte Møller Luef ◽  
Jan Stener Jørgensen
Keyword(s):  
Metabolic Disease ◽  
Immune System ◽  
Antibiotic Use ◽  
Atopic Disease ◽  
Outcome Variable ◽  
Increased Risk ◽  
Confounding Variables ◽  
Dose Dependent ◽  
Robust Evidence ◽  
In Pregnancy

Background: There are concerns that the use of antibiotics before, during or immediately after pregnancy may have adverse effects on the neonatal gut microbiome and adversely affect the development of the infant immune system, leading to the development of childhood allergy, asthma, atopic disease and obesity. Methods: In this narrative review, we have explored a number of hypotheses, including the “Barker hypothesis”, the “hygiene hypothesis”, the link between inflammation and metabolic disease, and the influence of the neonatal gut microbiota on the development of the immune system in infants. Results: We found evidence to link the use of antibiotics before, during or immediately after pregnancy with an increased risk of childhood allergy, asthma, atopy and obesity. Conclusions: Although we found robust evidence to link antibiotic use in pregnancy with obesity and an “allergic triad” of asthma, eczema and hay fever, care must be taken when interpreting the findings because of the lack of adjustment for confounding variables in published studies. These may be (i) whether or not the mother had the same outcome variable (for example, asthma) as the infant, for which the mother may have received the antibiotics; (ii) the indication, timing or number of antibiotic courses given; (iii) the use of broad-spectrum or narrow-range antibiotics; (iv) the dose-dependent nature of the effector; and (v) the class of antibiotics used.

Pelvic congestion syndrome and left renal compression syndrome - clinical features and therapeutic approaches

VASA ◽  
2016 ◽  
Vol 45 (4) ◽  
pp. 275-282 ◽  
Author(s):  
Christina Jeanneret ◽  
Konstantin Beier ◽  
Alexander von Weymarn ◽  
Jürg Traber
Keyword(s):  
Varicose Veins ◽  
Left Renal Vein ◽  
Standing Position ◽  
Ovarian Vein ◽  
Pelvic Congestion Syndrome ◽  
Compression Syndrome ◽  
Abstract Knowledge ◽  
Increased Risk ◽  
Definition Of ◽  
Pelvic Congestion

Abstract. Knowledge of the anatomy of the pelvic, gonadal and renal veins is important to understand pelvic congestion syndrome (PCS) and left renal vein compression syndrome (LRCS), which is also known as the nutcracker syndrome. LRCS is related to PCS and to the presence of vulvar, vaginal and pudendal varicose veins. The diagnosis of the two syndromes is difficult, and usually achieved with CT- or phlebography. The gold standard is the intravenous pressure measurement using conventional phlebography. The definition of PCS is described as pelvic pain, aggravated in the standing position and lasting for more than 6 months. Pain in the left flank and microhaematuria is seen in patients with LRCS. Women with multiple pregnancies are at increased risk of developing varicose vein recurrences with pelvic drainage and ovarian vein reflux after crossectomy and stripping of the great saphenous vein. The therapeutic options are: conservative treatment (medroxyprogesteron) or interventional (coiling of the ovarian vein) or operative treatment (clipping of the ovarian vein). Controlled prospective trials are needed to find the best treatment.

Europe

2020 ◽  
pp. 649-666
Author(s):  
Andrea Renda
Keyword(s):  
Artificial Intelligence ◽  
Digital Technology ◽  
Policy Framework ◽  
Expert Group ◽  
Ethical Guidelines ◽  
Ethical Implications ◽  
Strong Focus ◽  
Ethics Guidelines ◽  
Definition Of ◽  
High Level

This chapter assesses Europe’s efforts in developing a full-fledged strategy on the human and ethical implications of artificial intelligence (AI). The strong focus on ethics in the European Union’s AI strategy should be seen in the context of an overall strategy that aims at protecting citizens and civil society from abuses of digital technology but also as part of a competitiveness-oriented strategy aimed at raising the standards for access to Europe’s wealthy Single Market. In this context, one of the most peculiar steps in the European Union’s strategy was the creation of an independent High-Level Expert Group on AI (AI HLEG), accompanied by the launch of an AI Alliance, which quickly attracted several hundred participants. The AI HLEG, a multistakeholder group including fifty-two experts, was tasked with the definition of Ethics Guidelines as well as with the formulation of “Policy and Investment Recommendations.” With the advice of the AI HLEG, the European Commission put forward ethical guidelines for Trustworthy AI—which are now paving the way for a comprehensive, risk-based policy framework.

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