Prevalence and Risk Factors of Untreated Thyroid Dysfunctions in the Older Caucasian Adults: Results of Polsenior 2 Survey

Abstract Background: To determine the prevalence of treated and untreated thyroid dysfunction and to identify factors associated with increased risk of undiagnosed thyroid dysfunction in older adults.Methods The population of 5987 community-dwelling Polish Caucasian seniors aged 60 years and above who participated in the PolSenior 2 study (2018 – 2019). Population-based cross-sectional multidisciplinary study in design. Data from structured questionnaires, geriatric tests and scales were obtained from all study participants who underwent anthropometric and blood pressure measurements during three home visits. Assessment of thyroid function was based on TSH serum measurements.ResultsThe prevalence of thyroid dysfunction in the Polish population aged 60 years or above was estimated at 15.5% (21.5% in women and 7.2% in men), with 3.2% of undiagnosed individuals among them. The prevalence of hypothyroidism and hyperthyroidism in the studied group was 13.9% (19.4% in women and 6.3% in men) and 1.6% (2.1% in women and 0.9% in men) respectively. In multiple regression analysis independent risk factors for thyroid disorders being untreated were older age (> 75 years), male sex, a low education level (primary or lower) and low utilization of medical services.Conclusions One-fifth of Polish Caucasian seniors with hypothyroidism and one-third with hyperthyroidism is untreated. Older, poorly educated and rarely utilizing medical services seniors, especially men, are more frequently untreated for thyroid dysfunction and some of them do not benefit from contemporary achievements of medicine.

Download Full-text

Multi-country cross-sectional study of colonization with multidrug-resistant organisms: protocol and methods for the Antibiotic Resistance in Communities and Hospitals (ARCH) studies

BMC Public Health ◽

10.1186/s12889-021-11451-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Aditya Sharma ◽

Ulzii-Orishikh Luvsansharav ◽

Prabasaj Paul ◽

Joseph D. Lutgring ◽

Douglas R. Call ◽

...

Keyword(s):

Risk Factors ◽

Multidrug Resistant ◽

Population Based ◽

Community Dwelling ◽

Mitigation Strategies ◽

Invasive Infection ◽

Cross Sectional ◽

Global Epidemiology ◽

Multidrug Resistant Organisms ◽

High Threat

Abstract Background Antimicrobial resistance is a global health emergency. Persons colonized with multidrug-resistant organisms (MDROs) are at risk for developing subsequent multidrug-resistant infections, as colonization represents an important precursor to invasive infection. Despite reports documenting the worldwide dissemination of MDROs, fundamental questions remain regarding the burden of resistance, metrics to measure prevalence, and determinants of spread. We describe a multi-site colonization survey protocol that aims to quantify the population-based prevalence and associated risk factors for colonization with high-threat MDROs among community dwelling participants and patients admitted to hospitals within a defined population-catchment area. Methods Researchers in five countries (Bangladesh, Chile, Guatemala, Kenya, and India) will conduct a cross-sectional, population-based prevalence survey consisting of a risk factor questionnaire and collection of specimens to evaluate colonization with three high-threat MDROs: extended-spectrum cephalosporin-resistant Enterobacteriaceae (ESCrE), carbapenem-resistant Enterobacteriaceae (CRE), and methicillin-resistant Staphylococcus aureus (MRSA). Healthy adults residing in a household within the sampling area will be enrolled in addition to eligible hospitalized adults. Colonizing isolates of these MDROs will be compared by multilocus sequence typing (MLST) to routinely collected invasive clinical isolates, where available, to determine potential pathogenicity. A colonizing MDRO isolate will be categorized as potentially pathogenic if the MLST pattern of the colonizing isolate matches the MLST pattern of an invasive clinical isolate. The outcomes of this study will be estimates of the population-based prevalence of colonization with ESCrE, CRE, and MRSA; determination of the proportion of colonizing ESCrE, CRE, and MRSA with pathogenic characteristics based on MLST; identification of factors independently associated with ESCrE, CRE, and MRSA colonization; and creation an archive of ESCrE, CRE, and MRSA isolates for future study. Discussion This is the first study to use a common protocol to evaluate population-based prevalence and risk factors associated with MDRO colonization among community-dwelling and hospitalized adults in multiple countries with diverse epidemiological conditions, including low- and middle-income settings. The results will be used to better describe the global epidemiology of MDROs and guide the development of mitigation strategies in both community and healthcare settings. These standardized baseline surveys can also inform future studies seeking to further characterize MDRO epidemiology globally.

Download Full-text

A bio-psycho-social approach for frailty amongst Singaporean Chinese community-dwelling older adults – evidence from the Singapore Longitudinal Aging Study

BMC Geriatrics ◽

10.1186/s12877-019-1367-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Nigel Teo ◽

Pei Shi Yeo ◽

Qi Gao ◽

Ma Shwe Zin Nyunt ◽

Jie Jing Foo ◽

...

Keyword(s):

Older Adults ◽

Nursing Home ◽

Functional Disability ◽

Empirical Studies ◽

Social Contact ◽

Population Based ◽

Community Dwelling ◽

Severe Disability ◽

Cross Sectional ◽

Increased Risk

Abstract Background Few empirical studies support a bio-psycho-social conceptualization of frailty. In addition to physical frailty (PF), we explored mental (MF) and social (SF) frailty and studied the associations between multidimensional frailty and various adverse health outcomes. Methods Cross-sectional and longitudinal analyses were conducted using data from a population-based cohort (SLAS-1) of 2387 community-dwelling Singaporean Chinese older adults. Outcomes examined were functional and severe disability, nursing home referral and mortality. PF was defined by shrinking, weakness, slowness, exhaustion and physical inactivity, 1–2 = pre-frail, 3–5 = frail; MF was defined by ≥1 of cognitive impairment, low mood and poor self-reported health; SF was defined by ≥2 of living alone, no education, no confidant, infrequent social contact or help, infrequent social activities, financial difficulty and living in low-end public housing. Results The prevalence of any frailty dimension was 63.0%, dominated by PF (26.2%) and multidimensional frailty (24.2%); 7.0% had all three frailty dimensions. With a few exceptions, frailty dimensions share similar associations with many socio-demographic, lifestyle, health and behavioral factors. Each frailty dimension varied in showing independent associations with functional (Odds Ratios [ORs] = 1.3–1.8) and severe disability prevalence at baseline (ORs = 2.2–7.3), incident functional disability (ORs = 1.1–1.5), nursing home referral (ORs = 1.5–3.4) and mortality (Hazard Ratios = 1.3–1.5) after adjusting for age, gender, medical comorbidity and the two other frailty dimensions. The addition of MF and SF to PF incrementally increased risk estimates by more than 2 folds. Conclusions This study highlights the relevance and utility of PF, MF and SF individually and together. Multidimensional frailty can better inform policies and promote the use of targeted multi-domain interventions tailored to older adults’ frailty statuses.

Download Full-text

Lacune and Large Perivascular Space: Two Kinds of Cavities Are of Different Risk Factors and Stroke Risk

Cerebrovascular Diseases ◽

10.1159/000508732 ◽

2020 ◽

Vol 49 (5) ◽

pp. 522-530

Author(s):

Jiangtao Zhang ◽

Fei Han ◽

Xinyu Liang ◽

Mingli Li ◽

Dingding Zhang ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Stroke Risk ◽

Population Based ◽

Carrier Status ◽

Perivascular Spaces ◽

Increased Risk ◽

Ordinal Logistic Regression Analysis ◽

Study Participants

Background and Purpose: To compare the risk factors and risk of stroke between lacune and large perivascular spaces (PVSs) in a community-based sample. Methods: Large PVSs were assessed using 3.0T MRI in a population-based cohort consisting of 1,204 participants. The relationship between cardiovascular risk factors, neuroimaging changes, and incidental stroke risk and the presence of lacune or large PVSs was assessed with univariate and multivariable ordinal logistic regression analysis. Results: Of the 1,204 study participants (55.7 ± 9.3 years, 37.0% men), a total of 347 large PVSs were detected in 235 (19.5%) subjects, while a total of 219 lacunes were detected in 183 subjects (15.2%). The presence of lacunes was found to be significantly associated with age, male gender, hypertension, and diabetes, whereas only age (p < 0.01) and ApoEε4 carrier status (p < 0.01) were related to the presence of large PVSs. Those who had lacunes detected on MRI at baseline had a significant increased risk of stroke (hazard ratio [HR] 4.68; 95% confidence interval [CI], 1.15–19.07) during the 3-year follow-up independent of age, gender, and other vascular risk factors. However, there was no significant relationship between the presence of large PVSs and incident stroke (HR 3.84; 95% CI, 0.82–18.04). Conclusions: The lack of association between large PVSs and cardiovascular risk factors or risk of stroke indicated a nonvascular pathogenic mechanism underlying large PVSs, suggesting the importance of distinguishing large PVSs from lacunes in clinical practice.

Download Full-text

Association of dietary approaches to stop hypertension eating style and risk of sarcopenia

Scientific Reports ◽

10.1038/s41598-020-76452-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Sanaz Soltani ◽

Rezvan Hashemi ◽

Ramin Heshmat ◽

Ahmadreza Dorosty Motlagh ◽

Ahmad Esmaillzadeh

Keyword(s):

Older People ◽

Population Based ◽

Community Dwelling ◽

Muscle Performance ◽

Limited Attention ◽

Dash Score ◽

Cross Sectional ◽

Dash Diet ◽

European Working ◽

Study Participants

Abstract The association between habitual intake of the “dietary approaches to stop hypertension” (DASH) eating plan and sarcopenia has received limited attention. The present study aimed to investigate the association between adherence to DASH dietary pattern and sarcopenia and its components including muscle mass, muscle strength, and muscle performance among community-dwelling older adults population. This population-based cross-sectional study was performed in 2011 among 300 older people (150 men and 150 women) aged ≥ 55 years, who were selected using cluster random sampling method. Dietary intake of study participants were examined by the use of a Block-format 117-item food frequency questionnaire (FFQ). The DASH score was constructed based on eight main foods and nutrients emphasized or minimized in the DASH diet. All components of sarcopenia was measured using standard protocols and sarcopenia was defined based on both former and new European Working Group on Sarcopenia in Older People (EWGSOP) guidelines. Mean age and BMI of study participants were 66.7 ± 7.7 years and 27.3 ± 4.2 kg/m2, respectively. Totally, 31 individuals meet the criteria of EWGSOP2-sarcopenia. We found no significant association between adherence to the DASH diet and EWGSOP2-sarcopenia either before (OR 1.08; 95% CI 0.45–2.54) or after adjustment for potential confounders (OR 1.04; 95% CI 0.39–2.75). The same findings were obtained in the gender-stratified analyses (men: OR 2.29; 95% CI 0.39–13.29 and women: 0.75; 95% CI 0.23–2.45). In conclusion, we found that adherence to the DASH-style diet was not significantly associated with odds of sarcopenia. Future prospective studies are required to confirm these findings.

Download Full-text

Prevalence and Determinants of Undernutrition in A Sample of Dutch Community-Dwelling Older Adults: Results from Two Online Screening Tools

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091562 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1562 ◽

Cited By ~ 5

Author(s):

Jos W. Borkent ◽

Elke Naumann ◽

Emmelyne Vasse ◽

Ellen van der Heijden ◽

Marian A. E. de van der Schueren

Keyword(s):

Risk Factors ◽

Older Adults ◽

Healthy Aging ◽

General Information ◽

Community Dwelling ◽

Screening Tools ◽

Nutritional Risk ◽

Cross Sectional ◽

Increased Risk ◽

Screen Ii

To stimulate undernutrition screening among Dutch community-dwelling adults, a website was developed with general information on healthy eating for healthy aging and self-tests. Based on cross-sectional data obtained from the self-tests, we studied nutritional risk factors (early determinants) as well as risk of undernutrition (late symptoms). SCREEN II (n = 2470) was used to asses nutritional risk factors. This tool consists of 16 items regarding nutritional intake, perception of body weight, appetite, oral health and meal preparation. An adjusted SNAQ65+ (n = 687) was used to assess risk of undernutrition. This four-item tool contains questions on weight loss, appetite, walking stairs and body mass index. Differences between age-groups (65–74, 75–84, ≥85) were tested by logistic regression. Overall prevalence of nutritional risk factors was 84.1%, and increased risk of undernutrition was 56.8%. Participants aged ≥85 scored worst on almost all items of the SCREEN II and the SNAQ65+. In conclusion: A large proportion of older adults reported early determinants for increased nutrition risk, while a smaller, yet remarkable proportion scored positive on undernutrition risk. Internet screening may be a useful, contemporary, and easy, accessible way to reach older adults who are at nutritional risk and may thus contribute to early identification and prevention of undernutrition.

Download Full-text

Blunted Diurnal Cortisol Pattern Is Associated With Frailty: A Cross-Sectional Study of 745 Participants Aged 65 to 90 Years

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-3079 ◽

2014 ◽

Vol 99 (3) ◽

pp. E464-E468 ◽

Cited By ~ 40

Author(s):

Hamimatunnisa Johar ◽

Rebecca T. Emeny ◽

Martin Bidlingmaier ◽

Martin Reincke ◽

Barbara Thorand ◽

...

Keyword(s):

Salivary Cortisol ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Cortisol Reactivity ◽

Diurnal Cortisol ◽

Frailty Status ◽

Increased Risk ◽

Cortisol Levels ◽

Study Participants

Background: The role of neuroendocrine alterations in the etiology of frailty syndrome is still poorly understood. Hypothalamic-pituitary-adrenal axis dysregulation is a plausible candidate pathway contributing to frailty. Thus, we sought to examine the associations of diurnal cortisol secretion with frailty in older adults. Methods: A cross-sectional analysis was conducted among 745 study participants (age 65–90 years, mean age 75.1 years) of the population-based KORA Age study. Associations between salivary cortisol measures at awakening (morning 1 [M1]), 30 minutes after awakening (M2), and evening (E) and frailty criteria were determined. Results: Lower cortisol levels in the first morning sample (M1) (P = .18) and M2 (P = .14) and increased E levels (P = .004) were observed in prefrail (35.17%, n = 262) and frail (3.36%, n = 25) individuals, in a dose-response manner. Frailty was strongly associated with smaller ratios of morning to evening levels; M1 to E ratio (P = .02) and M2 to E ratio (P = .003). Higher evening cortisol levels were associated with a 24% increased risk of a prefrail state (odds ratio, 1.22; 95% confidence interval, 1.03–1.44). A smaller morning to evening ratio was associated with an increased risk of low grip strength (1.42, 1.09–1.86) and gait speed (1.31, 1.02–1.68). Conclusion: Frailty status is associated with blunted cortisol reactivity as demonstrated by lower morning and higher evening salivary cortisol levels.

Download Full-text

Prevalence of Impaired Kidney Function in the German Elderly: Results from the Berlin Aging Study II (BASE-II)

Gerontology ◽

10.1159/000454831 ◽

2017 ◽

Vol 63 (3) ◽

pp. 201-209 ◽

Cited By ~ 4

Author(s):

Maximilian König ◽

Maik Gollasch ◽

Ilja Demuth ◽

Elisabeth Steinhagen-Thiessen

Keyword(s):

Risk Factors ◽

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

The Elderly ◽

Community Dwelling ◽

Structured Interviews ◽

Cross Sectional ◽

Increased Risk ◽

Aging Study

Background: In aging populations with an ever-growing burden of risk factors such as obesity, diabetes, and hypertension, chronic kidney disease (CKD) is on the rise. However, little is known about its exact prevalence among elderly adults, and often albuminuria is not included in the definition of CKD. Moreover, novel equations for the estimated glomerular filtration rate (eGFR) have recently emerged, which have not been applied comprehensively to older adults. Data on CKD awareness among the elderly are sparse. Objectives: To determine the prevalence of CKD among older adults by eGFR and albumin/creatinine ratio (ACR), compare the performance of 6 established and novel eGFR formulas, explore risk factors, and determine the awareness of CKD in a large cohort of community-dwelling elderly from Germany. Methods: A total of 1,628 subjects from the Berlin Aging Study II (BASE-II) were included in this analysis (mean age 68.7 years; 51.2% female). Extensive cross-sectional data on sociodemographics, lifestyle, medication, and diagnoses were inquired during structured interviews and a medical examination, and blood and urine parameters were measured. Results: In all, 77.1% of the subjects had hypertension, 12.4% had diabetes, and 18.3% were obese. The prevalence of CKD strongly depended on the eGFR equations used: 25.4% (full age spectrum [FAS] equation), 24.6% (Berlin Initiative Study), 23.1% (Lund-Malmö revised), 19.3% (Cockcroft-Gault), 16.4% (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI]), and 14.7% (Modification of Diet in Renal Disease [MDRD]). Of the subjects with an eGFRFAS <60 mL/min/1.73 m2 and/or an ACR >30 mg/g, only 3.9% were aware of having CKD. Polypharmacy, age, BMI, coronary artery disease, non-HDL cholesterol, and female sex were independently associated with CKD. Conclusions: CKD is prevalent among older adults in Germany, but awareness is low. The FAS equation detects higher rates of CKD than MDRD and CKD-EPI, which are most widely used at present. Also, when CKD is defined based on eGFR and albuminuria, considerably more people are identified than by eGFR alone. Finally, polypharmacy is associated with an increased risk for CKD in the elderly.

Download Full-text

The association between metabolic syndrome and elevated serum alanine transaminase levels in an indigenous population in Northern Taiwan: a community-based study

10.21203/rs.3.rs-15642/v1 ◽

2020 ◽

Author(s):

Yi-Fang Chen ◽

Yen-An Lin ◽

Wei-Chung Yeh ◽

Yu-Chung Tsao ◽

Wen-Cheng Li ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Indigenous Population ◽

Elevated Serum ◽

Serum Triglyceride ◽

Population Based ◽

Alanine Transaminase ◽

Cross Sectional ◽

Increased Risk ◽

Northern Taiwan

Abstract Background: Metabolic syndrome (MetS), a prevalent health condition in Taiwan, places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. Nevertheless, only limited studies about MetS have been conducted among indigenous peoples in Taiwan; these studies identified a high prevalence of MetS among an indigenous population, which encouraged us to investigate further. Thus, our study aims to determine the prevalence of MetS among the indigenous Taiwanese population and to explore the relationship between MetS and associated risk factors, especially serum alanine transaminase (ALT). Methods: This is an observational, population-based, cross-sectional study that was conducted in remote villages of an indigenous community in northern Taiwan between 2010 and 2015. A total of 454 participants, 47.36% male and 52.64% female, were eligible for analysis. The participants underwent anthropometric assessment and measurements of blood pressure, serum triglyceride levels, fasting plasma glucose levels, serum HDL-C levels and serum ALT levels. MetS was defined based on the revised NCEP/ATPIII criteria from Taiwan Health Promotion Administration. Results: A total of 454 participants were included in the analysis. There were 277 people with MetS and 177 people without. The prevalence of MetS was 61.01%. The average age was 49.50 years old. People with MetS had a significantly higher ALT level (average 31.21±25.00 U/L vs. 23.29±15.98 U/L, p<0.001) than those without MetS. In addition, the chi-square comparison showed that participants with abnormal ALT levels (>36 U/L) had a tendency towards a higher prevalence of MetS (76.7% vs. 57.3%, p=0.001) than those with normal ALT levels (≤36 U/L). The adjusted odds ratio (OR) of abnormal ALT levels for MetS was 2.58 (95% CI=1.23-5.44, p=0.01). The area under the ROC curve (AUC) of the ALT level was 0.63 (95% CI=0.58-0.68, p<0.001), which showed that the ALT level was positively associated with MetS. Conclusions: The overall prevalence of MetS was 61.01% in the highland indigenous population in Taiwan, which suggests an unignorable health problem that should actively be addressed. Furthermore, these findings indicated that higher serum ALT levels (>36 U/L) were associated with an increased risk of MetS.

Download Full-text

Incidence and Risk Factors of Elder Mistreatment in the Community: A Longitudinal Population-Based Study

Innovation in Aging ◽

10.1093/geroni/igab046.335 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 88-88

Author(s):

David Burnes ◽

David Hancock ◽

John Eckenrode ◽

Mark Lachs ◽

Karl Pillemer

Keyword(s):

Risk Factors ◽

Older Adults ◽

Physical Abuse ◽

Emotional Abuse ◽

Population Based ◽

Community Dwelling ◽

Computer Assisted ◽

Elder Mistreatment ◽

Financial Abuse ◽

Increased Risk

Abstract Prior population-based elder mistreatment (EM) risk factor research has focused on problem prevalence using cross-sectional designs, which cannot make causal inferences between proposed risk factors and EM or discern existing cases from new cases entering the population. This study sought to estimate the incidence of EM and identify risk factors for new cases. It is a ten-year prospective, population-based cohort study with data collected between 2009 (Wave 1) and 2019 (Wave 2). Based on Wave 1 random, stratified sampling to recruit English/Spanish-speaking, cognitively intact, community-dwelling older adults (age ≥ 60) across New York State, this study conducted computer assisted telephone interviews (CATI) with 628 respondents participating in both Wave 1 and Wave 2 interviews (response rate=60.7%). Ten-year EM incidence was regressed on factors related to physical vulnerability, living arrangement, and socio-cultural characteristics using logistic regression. Ten-year incidence rates included overall EM (11.4%), financial abuse (8.5%), emotional abuse (4.1%), physical abuse (2.3%), and neglect (1.0%). Poor self-rated health at Wave 1 significantly predicted increased risk of new Wave 2 overall EM (odds ratio [OR]=2.8), emotional abuse (OR=3.67), physical abuse (OR=4.21), and financial abuse (OR=2.8). Black older adults were at significantly heightened risk of overall EM (OR=2.61), specifically financial abuse (OR=2.8). Change from co-residence (Wave 1) toward living alone (Wave 2) significantly predicted financial abuse (OR=2.74). Healthcare visits represent important opportunities to detect at-risk older adults. Race is highlighted as an important social determinant for EM requiring urgent attention. This study represents the first longitudinal, population-based EM incidence study.

Download Full-text

The Use of Multiple Correspondence Analysis and K-means to Explore Associations between Risk Factors and Patient Characteristics in Colorectal Cancer (Preprint)

10.2196/preprints.29056 ◽

2021 ◽

Author(s):

Dídac Florensa ◽

Jordi Mateo ◽

Francesc Solsona ◽

Teresa Pedrol ◽

Miquel Mesas ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Correspondence Analysis ◽

Multiple Correspondence Analysis ◽

Clinical History ◽

Patient Characteristics ◽

Population Based ◽

Cross Sectional ◽

Risk Of Death ◽

Increased Risk

BACKGROUND Previous works have shown that risk factors are associated with an increased risk of colorectal cancer. OBJECTIVE The purpose of this study was to detect these associations in the region of Lleida (Catalonia) using Multiple Correspondence Analysis (MCA) and K-means. METHODS The cross-sectional study was made up of 1,085 colorectal cancer episodes between 2012 and 2015, extracted from the Population-based Cancer Registry (PCR) for the province of Lleida (Spain), the Primary Care Centers database and the Catalan Health Service Register. The relations between risk factors and patient characteristics were identified using MCA and K-means. RESULTS The combination of these techniques helps to detect clusters of patients with similars risk factors. Risk of death is associated with elderly people and obesity or overweight. Stage III is related with people aged ≥65 and rural/semi-urban population while younger people were related with stage 0. CONCLUSIONS MCA and K-means were a significant help for detecting associations between risk factors and patient characteristics. These techniques have proven to be effective tools for analyzing the incidence of some factors in colorectal cancer. The outcomes obtained help to corroborate suspected trends, as well as stimulating new hypotheses about the previous clinical history and how to prevent it.

Download Full-text