Factors associated with longevity: design and preliminary data of the MADRID+90 study

The progressive ageing of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy ageing and which with the emergence of age-related diseases, especially Alzheimer's type dementia. The project “Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid” (MADRID+90) brings together a powerful multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological ageing, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of the ageing phenomenon.

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MADRID+90 study on factors associated with longevity: Study design and preliminary data

PLoS ONE ◽

10.1371/journal.pone.0251796 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251796

Author(s):

Miguel A. Fernández-Blázquez ◽

Teodoro del Ser ◽

Belén Frades-Payo ◽

Marina Ávila-Villanueva ◽

Meritxell Valentí-Soler ◽

...

Keyword(s):

Healthy Aging ◽

Cognitive Status ◽

Cognitive Testing ◽

Economic Consequences ◽

Strong Increase ◽

Second Phase ◽

Factors Associated ◽

Age Related ◽

The Impact ◽

The City

The progressive aging of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy aging and which with the emergence of age-related diseases, especially Alzheimer’s type dementia. The project “Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid” (MADRID+90) brings together a multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological aging, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of rapidly aging societies.

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Events and placemaking: the case of the Festival Internacional Cervantino in Guanajuato, Mexico

International Journal of Event and Festival Management ◽

10.1108/ijefm-05-2016-0041 ◽

2017 ◽

Vol 8 (1) ◽

pp. 24-38 ◽

Cited By ~ 10

Author(s):

Daniel Barrera-Fernández ◽

Marco Hernández-Escampa

Keyword(s):

Service Failure ◽

Field Work ◽

Point Of View ◽

Urban Spaces ◽

Content Type ◽

Local Perception ◽

Intangible Heritage ◽

New Policies ◽

The Impact ◽

The City

Purpose The purpose of this paper is to focus on the Festival Internacional Cervantino, which represents one of the major cultural events in Latin America. Based on theoretical propositions regarding tourism as an experience, perception of visitors was studied focussing on emotional factors. Urban perception was also addressed, especially where public service failure affected the experience and therefore, the placemaking. Design/methodology/approach A mixed methodology was applied. First, the event experience scale (EES) methodology for visitors’ perception was performed in order to collect data directly from tourists. The relationship between the festival and the visit to heritage resources and attractions was especially highlighted and analysed. Urban field work focussed on expressing the location of the most visited areas during festival days. Public services were also assessed where perception was affected negatively. Interviews were applied to public administration officials and public policy-related documents were collected in order to understand the expectation of visitors, previous to the experience itself. Local perception was also contrasted with the rest of the data. Findings Attracted by information about the historic and colonial nature of the city, tourists gather massively in Guanajuato during the festival. This event in particular yields in some aspects to a transient placemaking, mainly related to inner perception and the event as such is highly appreciated. It was also found that the foreign figure of Cervantes was incorporated into the intangible heritage discourse of the city and linked to the event itself. However, some urban spaces and services need improvement to consolidate a positive experience of visitors who complain about specific factors such as traffic, accessibility, waste disposal and environmental noise. Social implications The fact that the event has caused some problems in a number of urban aspects suggests that new policies might be proposed in order to fill these gaps, especially by the corresponding government agencies. Another issue relates to the concentration of the economic profits and its lack of distribution, which right now does not contribute to social sustainability, yet the event demands high actions and costs to the city and local people. Originality/value The research has been useful to give another point of view to existing surveys and conclusions of the impact of the festival. The application of EES has yielded some improvements that could be made in further applications of the same methodology. Application of EES to assess the impact of events in urban spaces and services can be applied to many other cities that host festivals in their city centres.

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Abstract W P80: Predictors of Cognitive Status in Post-Aneurysm Surgery Patients

Stroke ◽

10.1161/str.46.suppl_1.wp80 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Andrea Holcombe ◽

James Torner ◽

Steven Anderson ◽

Emine Bayman ◽

Michael Todd ◽

...

Keyword(s):

Risk Factors ◽

Subarachnoid Hemorrhage ◽

Surgical Treatment ◽

Cognitive Status ◽

Cognitive Testing ◽

World Federation ◽

Aneurysm Surgery ◽

Cognitive Changes ◽

Factors Associated ◽

Post Surgery

Introduction: Patients who undergo surgical treatment for ruptured intracranial aneurysms may have a different risk profile for a spectrum of cognitive impairment based upon characteristics at presentation of their subarachnoid hemorrhage. Methods: The Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) is a multi-center, prospective, randomized clinical trial investigation of whether induced hypothermia during surgical treatment for subarachnoid hemorrhage resulted in improved outcomes. Cognitive status was defined by raw Mini-Mental Status Examination (MMSE) cutoff scores. A normal cognition was defined as a MMSE score of 28 or greater. Mildly impaired patients were defined as a score of 24-27, and severely impaired patients were defined as those with a score of less than 24. Age was analyzed by five-year age groups, with the exception of patients 30 or younger and patients 75 and older. Ordinal logistic regression was utilized to determine the final predictors. Results: Of the 1,000 patients who were followed for cognitive testing, 61 died and 21 were medically untestable. Five patients refused testing and tests were not administered to 30 patients. A total of 883 patients completed the MMSE at 3 months post-surgery. Based on the raw MMSE scores, the median score for the severely impaired patients was 20 (IQR: 16-22), 26 (IQR: 25-27) for mildly impaired patients, and 29 (IQR: 29-30) for cognitively normal patients. Gender, and race were found to be statistically significant (p<.05) predictors after controlling for age and education. Baseline Rankin Score and the occurrence of a leakage or rupture during surgery were also predictive of cognitive status. The World Federation of Neurosurgical Societies Score, the Fisher’s SAH Score, and aneurysm size and location were not found to be statistically significant. Conclusion: Patients with surgical treatment for subarachnoid hemorrhage share several demographic risk factors associated with cognitive changes in the general public, but have additional neurological risk factors associated with SAH and aneurysm procedures.

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Potentially modifiable factors associated with agitation and aggression in Alzheimer’s disease: results of the ICTUS study

International Psychogeriatrics ◽

10.1017/s1041610218001990 ◽

2019 ◽

Vol 31 (10) ◽

pp. 1509-1516 ◽

Cited By ~ 2

Author(s):

Adelaide de Mauleon ◽

Maria Soto ◽

Pierre Jean Ousset ◽

Fati Nourhashemi ◽

Benoit Lepage ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Affective Disorder ◽

Positive Impact ◽

Neuropsychiatric Symptoms ◽

Cognitive Status ◽

Community Dwelling ◽

Factors Associated ◽

Modifiable Factors ◽

The Impact

ABSTRACTObjectives:To study potentially modifiable factors associated with the severity of agitation or aggression (A/A) symptoms among Alzheimer’s disease (AD) patients.Design:Data from the Impact of Cholinergic Treatment Use (ICTUS) study, European longitudinal prospective observational study.Setting:Community dwelling outpatients included in 29 European memory clinics.Participants:1375 participants with probable AD (Mini-Mental State Examination score of 10–26) with an informal caregiver.Measurements:At baseline and twice yearly over the two-year follow-up, patients underwent comprehensive clinical and neuropsychological assessments: sociodemographic data, cognitive status, functional impairment, and assessment of neuropsychiatric symptoms based on Neuro-Psychiatric Inventory (NPI). The ZARIT scale assessed the caregiver’s burden. The variable of interest was the severity of the item of A/A of the NPI. To study factors associated to the severity of A/A symptoms six months later, a multivariate mixed regression model was used.Results:Frequency of A/A symptom varied from 30% to 34% at each visit. Two factors were found to be independently associated with the severity of A/A: (1) the presence of affective disorder (anxiety, depression, and/or irritability) that increased the severity of the A/A by 0.89 point (coefficient:0.89; 95% Confidence Interval (CI) = [0.48,1.30], p < 0.001), and (2) a severe caregiver burden that increased the severity of the A/A by 1.08 point (coefficient:1.08; 95% CI = [0.69,1.47], p < 0.001).Conclusion:Research should evaluate whether the identification and treatment of an affective disorder along with the evaluation and optimal management of the caregiver would have a positive impact on the course of A/A in mild to moderate AD patients.

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The Impact of Anemia on Mortality, Cognition and Function in a Racially Diverse Community-Dwelling Elderly Population.

Blood ◽

10.1182/blood.v104.11.1627.1627 ◽

2004 ◽

Vol 104 (11) ◽

pp. 1627-1627

Author(s):

Susan Denny ◽

Maragatha Kuchibhatla ◽

Harvey Jay Cohen

Keyword(s):

Disease Status ◽

The Elderly ◽

Epidemiologic Studies ◽

Cognitive Status ◽

Community Dwelling ◽

Mild Anemia ◽

Age Related ◽

Definition Of ◽

And Function ◽

The Impact

Abstract The WHO definition of anemia, Hgb<12g/dL (W) and <13g/dL (M) is largely based on studies in younger populations. As our population is aging it is important to explore the impact of varying Hgb levels on mortality and function in representative populations of older persons. The Duke Established Populations for Epidemiologic Studies for the Elderly (EPESE) is a random household sample, over sampled for African Americans (AA), initiated in 1986. In 1992 we obtained Hgb levels for 1744 subjects age >71 and evaluated functional and cognitive status at baseline and 4 years later, and mortality for 8 years. Using WHO criteria, the prevalence of anemia was 24%. It was age related; 17% (65–74), 25% (75–79), 32% (>80) p<.0001, but not gender related. There was a strong racial difference, 33.6% AA, 13.8% Caucasians (p=<.0001) with an odds ratio, adjusted for age, education, renal insufficiency and comorbidity of 3.0 (95%CI 2.3 – 3.9) Baseline functional status was worse in anemic subjects (p<.0001) but cognition was not (p=.06). The risk ratio for 8 year mortality was 1.7 (95% CI 1.5, 2.0) for anemic subjects (p=.0001). This did not differ by gender nor, despite the increased prevalence, by race (RR AA: caucasian = 0.85; 95% CI 0.6–1.2). Assessing survival by Hgb level, a nonlinear relationship was seen, with highest % survival between 13–14 g/dL for women (p<.0001) and 14–15g/dL for men (p=.09). Using the WHO standard as reference, controlling for baseline characteristics, women with Hgb 10–11 g/dL had higher mortality (RR 2.1, 95% CI. 1.5 –3.1) but with 11–12 g/dL did not. Similarly men with Hgb 10–11 g/dL had increased mortality (RR2.0, 95% CI 1.1, 3.7). In women there was a progressively greater decline in function at 4 years with each decrement of Hgb level from 16 to 10g/dL, but not in men. Both women and men with mild anemia (11–12 g/dL and 10–11g/dL respectively) had greater decreases in cognition than those at higher levels (p=.01). Thus in an elderly community based population, anemia is significantly more common in AA independent of disease status, and is independently associated with increased mortality over eight years for both races and genders, and with declines in function and cognition most prominently in women. Further investigation of the etiology of these relationships is warranted.

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Limbic-predominant age-related TDP-43 encephalopathy, ADNC pathology, and cognitive decline in aging

Neurology ◽

10.1212/wnl.0000000000010454 ◽

2020 ◽

Vol 95 (14) ◽

pp. e1951-e1962

Author(s):

Alifiya Kapasi ◽

Lei Yu ◽

Patricia A. Boyle ◽

Lisa L. Barnes ◽

David A. Bennett ◽

...

Keyword(s):

Alzheimer Disease ◽

Cognitive Decline ◽

Late Life ◽

Cognitive Testing ◽

Mixed Effect ◽

Mixed Effect Models ◽

Age Related ◽

Global Cognition ◽

Rate Of Decline ◽

The Impact

ObjectiveTo examine the impact of 3 pathologic groups, pure limbic-predominant age-related transactive response DNA-binding protein 43 encephalopathy (LATE) neuropathologic changes (NC), pure Alzheimer disease neuropathologic change (ADNC), and mixed ADNC with LATE-NC, on late-life cognitive decline.MethodsData came from 1,356 community-based older persons who completed detailed annual cognitive testing and systematic neuropathologic examination at autopsy to identify LATE-NC, ADNC, and other age-related pathologies. Persons were categorized into (0) a group without a pathologic diagnosis of LATE or ADNC (n = 378), (1) LATE-NC without ADNC (n = 91), (2) ADNC without LATE-NC (n = 535), and (3) mixed ADNC with LATE-NC (n = 352). We used mixed-effect models to examine the group associations with rate of decline in global cognition and 5 cognitive domains and then examined whether age modified associations.ResultsCompared to those without LATE-NC or ADNC, those with pure LATE-NC had a faster decline in global cognition (p = 0.025) and episodic memory (p = 0.002); however, compared to persons with pure ADNC, those with pure LATE-NC showed a slower decline. Those with mixed ADNC with LATE-NC showed the fastest decline compared to those with either pathology alone. Persons ≥90 years of age with mixed ADNC with LATE-NC had slower cognitive decline compared to those ≤89 years of age.ConclusionPersons with pure LATE-NC follow a slower trajectory compared to those with pure ADNC. Those with mixed LATE/ADNC have a steeper decline than individuals with either pathology alone. In addition, age may modify the effect of pathology on cognitive decline. These findings have important implications for the development of biomarkers and prognosis for late-life cognitive decline.Classification of evidenceThis study provides Class I evidence that LATE-NC and Alzheimer disease pathologic changes are associated with different trajectories of late-life cognitive decline.

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Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) Practices of Sports Medicine Professionals

Journal of Athletic Training ◽

10.4085/1062-6050-44.6.639 ◽

2009 ◽

Vol 44 (6) ◽

pp. 639-644 ◽

Cited By ~ 82

Author(s):

Tracey Covassin ◽

Robert J. Elbin ◽

Jennifer L. Stiller-Ostrowski ◽

Anthony P. Kontos

Keyword(s):

Sports Medicine ◽

Online Survey ◽

Cognitive Status ◽

Cognitive Testing ◽

Return To Play ◽

Soccer Players ◽

Neurocognitive Testing ◽

Certified Athletic Trainers ◽

Baseline Testing ◽

The Impact

Abstract Context: Computerized neurocognitive testing is becoming popular among clinicians evaluating sport-related concussions across all levels of sport. Baseline neurocognitive testing has been recommended to provide more accurate representation of the preconcussion cognitive status of individual athletes. However, little is known about the use of baseline neurocognitive testing in concussion assessment and management. Objective: To examine implementation and practice trends of sports medicine professionals using baseline neurocognitive testing at the high school and collegiate levels. Design: Quantitative survey research. Setting: Online survey. Patients or Other Participants: Certified athletic trainers (ATs) from approximately 1209 US institutions listed on the ImPACT Web site were recruited. A total of 399 ATs completed the survey, for a response return rate of 32.7%. Main Outcome Measure(s): Survey questions addressed educational level, years of certification, employment setting, percentage of athletes baseline tested, and accuracy of baseline tests. Other items addressed postconcussive neurocognitive testing protocols and scenarios for return-to-play decisions based on neurocognitive testing. Results: Nearly all ATs (94.7%) administered baseline computerized neurocognitive testing to their athletes. However, only 51.9% examined these baseline tests for validity. The majority of ATs indicated that they administer baseline neurocognitive tests most frequently to football players (88.4%), followed by women's soccer players (78.8%) and men's soccer players (71.2%). Nearly all respondents (95.5%) stated that they would not return a symptomatic athlete to play if the athlete's neurocognitive scores were back to baseline. However, when asked if they would return an athlete who is symptom free but who scores below his or her baseline, 86.5% responded no, 9.8% responded yes, and 3.8% indicated that it depended on the importance of the competition. Conclusions: The use of baseline testing, baseline testing readministration, and postconcussion protocols among ATs is increasing. However, the ATs in this study reported that they relied more on symptoms than on neurocognitive test scores when making return-to-play decisions.

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COVID-19 scenarios for comparing the effectiveness of age-specific vaccination regimes, exemplified for the city of Aschaffenburg (Germany)

10.1101/2021.08.31.21262915 ◽

2021 ◽

Author(s):

Tobias Krebs ◽

Holger von Jouanne-Diedrich ◽

Michael J Moeckel

Keyword(s):

Local Population ◽

Age Groups ◽

The Elderly ◽

Strong Increase ◽

Published Data ◽

Model Parameters ◽

Agent Based ◽

The Past ◽

The Impact ◽

The City

Purpose of this report: The purpose of this rapid communication is to illustrate the effectiveness of different vaccination regimes for controlling the number of severe and critical COVID-19 cases in the city of Aschaffenburg, Germany. Our results show that, despite numerous vaccinations in the past, further vaccinations are necessary to immunize the population and to keep the number of severe and critical cases low in the coming months. Considering that not all people can or want to receive vaccination, we compare different age-specific vaccination approaches. Applied Methods: We use the agent-based epidemiological simulator Covasim for discussing the impact of different vaccination strategies. We calibrate it to reproduce the historical course of the COVID-19 pandemic in the city of Aschaffenburg, Germany; for this, we model and integrate numerous public health interventions imposed on the local population. As for some of the political actions rigorous quantification is currently not available, we fit those unknown (free) model parameters to published data on the measured epidemiological dynamics. Then we calculate the state of immunization of the population, gained through infections and vaccinations, at any time in the past, including models for time-dependent immunity decay that have been made available in Covasim. Finally, we define and compare scenar-ios of different vaccination regimes, especially with regard to vaccinating adolescents and providing booster vaccinations to the elderly. Key message: Without further vaccinations, we expect a strong increase in severe and critical cases. In order to restrict their growth our simulations suggest that in all considered cases vaccinations of unvaccinated people is more effective than booster vaccinations for already fully vaccinated people. This applies even to vaccinations of young people who are not themselves at high risk of developing severe or critical illness. We attribute this observation to the fact that immunization of adolescents indirectly protects vulnerable age groups by preventing the spread of the virus more ef-fectively than further immunizing other age groups. This indicates that with the pandemic ongoing, strategies focussed on minimizing individual health risks by vaccinations may no longer coincide with those needed to minimize the num-ber of severe and critical cases.

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Prevalence and factors associated with frailty in hospitalized older Patients

10.21203/rs.2.13463/v2 ◽

2020 ◽

Author(s):

Sonia HAMMAMI ◽

Amira Zarrouk ◽

Cecile Piron ◽

Ioana Almas ◽

Nabil Sakly ◽

...

Keyword(s):

Cognitive Abilities ◽

Nutritional Assessment ◽

Complete Blood Count ◽

Strong Association ◽

Mini Nutritional Assessment ◽

The Elderly ◽

Cognitive Status ◽

Related Disorder ◽

Factors Associated ◽

Age Related

Abstract Background: Frailty is a multidimensional syndrome that leads to an increase of an age-related disorder of several physiological systems, and cognitive abilities decline. The aim of this study was to evaluate the prevalence of frailty among older persons in Belgium and we examined the factors associated with frailty with a principal focus en cognitive, dietary status, and inflammatory parameters Methods: A total of 124 participants (90 women, 34 men; age: mean ± SD: 85.9 ± 5.5 years) were studied, recruited from the Geriatrics department, Belgium. Nutritional, cognitive status and physical activity were assessed using Mini Mental State Examination score (MMSE), Mini Nutritional Assessment score (MNA), and Katz score, respectively. Frailty syndrome was evaluated using the modified Short Emergency Geriatric Assessment (SEGA) score. Medication and medical history were recorded. Analyzed biochemical parameters included C-reactive protein (CRP), complete blood count, blood creatinine, vitamin D level, and serum protein electrophoresis. According to SEGA score, participants were divided into non-frail (n=19), frail (n=25) and severely frail patients (n= 80). Results: The SEGA score was inversely correlated with MMSE, MNA and Katz score. SEGA score was negatively correlated to albumin levels (r = -0.30; p<0.001) and positively correlated to CRP, polypharmacy and age(r = 0.28, r = 0.37, r = 0.33 and p<0.01 respectively) . Logistic regression showed a strong association between frailty, Katz score, dementia, polypharmacy and living in nursing home. Conclusion : Our results provide useful information for understanding mechanisms of frailty. This will help to develop preventive strategies for the elderly at the pre-frailty stage.

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Physical, nutritional and psychological states interfere with health related quality of life of institutionalized elderly

10.21203/rs.2.13460/v2 ◽

2020 ◽

Author(s):

Ilky Pollansky Silva e Farias ◽

Luiza Almeida Souto Montenegro ◽

Rayssa Lucena Wanderley ◽

Jannerson Cesar Xavier de Pontes ◽

Antonio Carlos Pereira ◽

...

Keyword(s):

Quality Of Life ◽

Cognitive Status ◽

Capital City ◽

Health Related Quality ◽

Institutionalized Elderly ◽

Factors Associated ◽

Related Quality ◽

Health Related ◽

The Impact

Abstract Purpose Nursing home elders experience many problems that may influence their quality of life, in example of cognitive, mental, nutritional and physical disabilities. Concerning about elders’ wellbeing may help them living with dignity. This study aimed to investigate factors associated with Health-Related Quality of Life (HRQoL) of institutionalized elders in a capital city of Brazilian Northeast. Methods A cross-sectional study was conducted with 193 institutionalized elders living in the metropolitan region of João Pessoa (Brazil). The following variables were tested regarding their association with the elders’ HRQoL: Socio-demographic characteristics; Performance of daily-living activities, Frailty status, Cognitive status, Nutritional status, Self-perception of oral health and Depression status. Hierarchical multiple linear and logistic regressions analyses were performed in order to assess the impact of each independent variable on HRQoL, considering a significance level of 5%. Results The mean (SD) and the median of HRQoL of institutionalized elders were 62.69(15.24) and 62, respectively. Elderly were mostly (72.02%) female, being those with 80 years and over the more frequent (54.92%). Dependence on daily activities (OR=2.06, 95%CI=1.32-3.23), frailty (OR=1.68, 95%CI=1.15-2.45) and depression (OR=2.22, 95%CI=1.51-3.27) were statistically associated with poor HRQoL (p<0.05). Other variables have no significance within the adjusted model. Conclusions Dependent, frail and depressed institutionalized elderly presented a greater chance to have a worse HRQoL. It is necessary to plan and implement actions that would reduce the factors associated with the low quality of life of institutionalized elderly.

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