scholarly journals The Association between Poor Diet Quality, Physical Fatigability and Physical Function in the Oldest-Old from the Geisinger Rural Aging Study

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 41
Author(s):  
Brett Davis ◽  
Yi-Hsuan Liu ◽  
James Stampley ◽  
G. Craig Wood ◽  
Diane C. Mitchell ◽  
...  
Keyword(s):  
Physical Function ◽  
Diet Quality ◽  
Oldest Old ◽  
Healthy Eating Index ◽  
Function Score ◽  
Poor Diet ◽  
Rural Aging ◽  
Physical Function Score ◽  
Aging Study ◽  
Group Sex

More perceived physical fatigability and poor diet quality are associated with impairments in physical function in older adults. However, the degree to which more perceived fatigability explains the association between poor diet quality and low physical function is unknown. We examined this relationship in 122 (66F, 56M) of the oldest-old participants from the Geisinger Rural Aging Study (GRAS). We used 24-h dietary recalls to assess the Healthy Eating Index (HEI), the Pittsburgh Fatigability Scale (PFS, 0–50) to assess perceived physical fatigability, and the PROMIS Physical Function 20a* to assess physical function. We grouped participants into three age categories: 80–84 (n = 51), 85–89 (n = 51), and 90+ (n = 20) years. Multiple linear regression revealed that a lower HEI was associated with higher PFS Physical score after adjusting for age group, sex, body mass index, and the number of medical conditions (p = 0.001). Several macro- and micro-nutrient intakes were also lower in those reporting more (≥15) compared to less (<15) perceived physical fatigability. Mediation analysis revealed that PFS Physical scores explained ~65% (p = 0.001) of the association between HEI total score and PROMIS19 Physical Function score. Poor diet quality may contribute to more perceived physical fatigability, which could exacerbate impairments in the oldest-old’s physical function.

PROMIS Physical Function Score Strongly Correlates With Legacy Outcome Measures in Minimally Invasive Lumbar Microdiscectomy

Spine ◽  
2019 ◽  
Vol 44 (6) ◽  
pp. 442-446 ◽  
Author(s):  
Benjamin Khechen ◽  
Brittany E. Haws ◽  
Dil V. Patel ◽  
Mundeep S. Bawa ◽  
Islam M. Elboghdady ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Physical Function ◽  
Outcome Measures ◽  
Function Score ◽  
Lumbar Microdiscectomy ◽  
Physical Function Score

scholarly journals Comprehensive Assessment of Diet Quality and Risk of Precursors of Early-Onset Colorectal Cancer

2020 ◽  
Author(s):  
Xiaobin Zheng ◽  
Jinhee Hur ◽  
Long H Nguyen ◽  
Jie Liu ◽  
Mingyang Song ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Diet Quality ◽  
Early Onset ◽  
Strong Support ◽  
Healthy Eating Index ◽  
Malignant Potential ◽  
Poor Diet ◽  
Increased Risk

Abstract Background The role of poor diet quality in the rising incidence of colorectal cancer (CRC) diagnosed under age 50 has not been explored. Based on molecular features of early-onset CRC, early-onset adenomas are emerging surrogate endpoints. Methods In a prospective cohort study (Nurses’ Health Study II), we evaluated two empirical dietary patterns (Western and prudent) and three recommendation-based indexes (Dietary Approaches to Stop Hypertension [DASH], Alternative Mediterranean Diet [AMED], and Alternative Healthy Eating Index [AHEI]-2010) with risk of early-onset adenoma overall and by malignant potential (high-risk: ≥1 cm, tubulovillous/villous histology, high-grade dysplasia, or ≥ 3 adenomas), among 29474 women with ≥1 lower endoscopy before age 50 (1991-2011). Multivariable logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results We documented 1157 early-onset adenomas with 375 of high-risk. Western diet was positively, whereas prudent diet, DASH, AMED, and AHEI-2010 were inversely associated with risk of early-onset adenoma. The associations were largely confined to high-risk adenomas (OR [95% CI] for the highest versus lowest quintile: Western = 1.67 [1.18 to 2.37]; prudent = 0.69 [0.48 to 0.98]; DASH = 0.65 [0.45 to 0.93]; AMED = 0.55 [0.38 to 0.79]; AHEI-2010 = 0.71 [0.51 to 1.01]; all P  trend≤.03), driven by those identified in the distal colon and rectum (all P  trend≤.04 except AMED: Ptrend=.14). Conclusion Poor diet quality was associated with an increased risk of early-onset distal and rectal adenomas of high malignant potential. These findings provide preliminary but strong support to the role of diet in early-onset CRC.

scholarly journals How to predict return to work after lumbar discectomy: answers from the NeuroPoint-SD registry

2016 ◽  
Vol 25 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Khoi D. Than ◽  
Jill N. Curran ◽  
Daniel K. Resnick ◽  
Christopher I. Shaffrey ◽  
Zoher Ghogawala ◽  
...  
Keyword(s):  
Return To Work ◽  
Physical Function ◽  
Smoking Status ◽  
Lumbar Discectomy ◽  
Work Status ◽  
Function Score ◽  
Younger Age ◽  
Sf 36 ◽  
Physical Function Score ◽  
Working Status

OBJECTIVE To date, the factors that predict whether a patient returns to work after lumbar discectomy are poorly understood. Information on postoperative work status is important in analyzing the cost-effectiveness of the procedure. METHODS An observational prospective cohort study was completed at 13 academic and community sites (NeuroPoint–Spinal Disorders [NeuroPoint-SD] registry). Patients undergoing single-level lumbar discectomy were included. Variables assessed included age, sex, body mass index (BMI), SF-36 physical function score, Oswestry Disability Index (ODI) score, presence of diabetes, smoking status, systemic illness, workers' compensation status, and preoperative work status. The primary outcome was working status within 3 months after surgery. Stepwise logistic regression analysis was performed to determine which factors were predictive of return to work at 3 months following discectomy. RESULTS There were 127 patients (of 148 total) with data collected 3 months postoperatively. The patients' average age at the time of surgery was 46 ± 1 years, and 66.9% of patients were working 3 months postoperatively. Statistical analyses demonstrated that the patients more likely to return to work were those of younger age (44.5 years vs 50.5 years, p = 0.008), males (55.3% vs 28.6%, p = 0.005), those with higher preoperative SF-36 physical function scores (44.0 vs 30.3, p = 0.002), those with lower preoperative ODI scores (43.8 vs 52.6, p = 0.01), nonsmokers (83.5% vs 66.7%, p = 0.03), and those who were working preoperatively (91.8% vs 26.2%, p < 0.0001). When controlling for patients who were working preoperatively (105 patients), only age was a statistically significant predictor of postoperative return to work (44.1 years vs 51.1 years, p = 0.049). CONCLUSIONS In this cohort of lumbar discectomy patients, preoperative working status was the strongest predictor of postoperative working status 3 months after surgery. Younger age was also a predictor. Factors not influencing return to work in the logistic regression analysis included sex, BMI, SF-36 physical function score, ODI score, presence of diabetes, smoking status, and systemic illness. Clinical trial registration no.: 01220921 (clinicaltrials.gov)

scholarly journals Determinants of Function After Total Knee Arthroplasty

2003 ◽  
Vol 83 (8) ◽  
pp. 696-706 ◽  
Author(s):  
C Allyson Jones ◽  
Donald C Voaklander ◽  
Maria E Suarez-Almazor
Keyword(s):  
Functional Status ◽  
Physical Function ◽  
Short Form ◽  
Study Data ◽  
Walking Distance ◽  
Comorbid Conditions ◽  
Function Score ◽  
Sf 36 ◽  
Physical Function Score ◽  
Total Knee

Abstract Background and Purpose. Decreasing hospital stays for patients with total knee arthroplasties (TKAs) have a direct effect on rehabilitation. The identification of modifiable determinants of postsurgical functional status would help physical therapists plan for discharge from hospitals. The purpose of this study was to identify preoperative determinants of functional status after a TKA. Participants. Using a community-based, prospective cohort study, data were collected from 276 patients who received a primary TKA in a Canadian health care region. Data were collected in the month before surgery and 6 months after surgery. Methods. Function was measured using the function subscale of a disease-specific measure—the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index—and a generic health status measure—the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Independent variables examined included demographic variables (eg, age, sex), medical variables (eg, diagnosis, number of comorbid conditions, ambulatory status), surgical variables (eg, type of implant, number of complications), and knee range of motion. Results. At 6 months after surgery, the average WOMAC physical function score was 70.5 (SD=18.2) and the average SF-36 physical function score was 44.8 (SD=25.3). Using multiple regression analyses, baseline function, walking device, walking distance, and comorbid conditions predicted 6-month function (WOMAC: R2=.20; SF-36 physical function: R2=.27). Discussion and Conclusion. Patients who have lower preoperative function may require more intensive physical therapy intervention because they are less likely to achieve functional outcomes similar to those of patients who have less preoperative dysfunction.

scholarly journals Association Between Intentional Purchase of Local Food Products and Diet Quality Among Adults in Puerto Rico (P04-148-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Abrania Marrero-Hernandez ◽  
Martha Tamez ◽  
Josiemer Mattei
Keyword(s):  
Puerto Rico ◽  
Puerto Rican ◽  
Diet Quality ◽  
Food Environment ◽  
Linear Models ◽  
Local Food ◽  
Food Products ◽  
Healthy Eating Index ◽  
Cross Sectional ◽  
Poor Diet

Abstract Objectives Adults in Puerto Rico have a high prevalence of poor diet quality, behavior that, in other United States territories, has previously been associated with increased access to imported food products. These trends raise the question of whether consumption of local food, which accounts for only 15% of the Puerto Rican food environment, may contribute to healthy dietary intake. We aimed to investigate the association between purposefully purchasing local foods (PPLF) and diet quality in Puerto Rico. Methods The Puerto Rico Assessment of Diet, Lifestyle, and Diseases (PRADLAD) is a 2015 cross-sectional study of 380 adults (35–75y) sampled in San Juan. To assess PPLF, participants were asked, ‘How often do you purposely purchase foods from Puerto Rico (like fruits, vegetables, meat and other products that are produced here rather than being imported)? ’ Diet was assessed through a culturally-adapted food frequency questionnaire, and diet quality was defined using the Alternative Healthy Eating Index-2010 (AHEI). Statistical analysis was conducted among participants with valid dietary data (n = 248). Multivariable generalized linear models tested the association between PPLF and AHEI, adjusted for relevant sociodemographic and behavioral factors. Results Nearly a third (33.9%) of participants reported never/sometimes, 33.5% reported often, and 30.6% reported always PPLF. As compared to never/sometimes PPLF, fully-adjusted mean AHEI scores were 3.56 (P = 0.0383) points higher among those often PPLF and 9.34 (P < 0.0001) points higher among those always PPLF. Compared to never/sometimes PPLF, those who always PPLF had higher fully-adjusted mean component scores for vegetables (P < 0.0001), fruits (P = 0.0002), whole grain (P = 0.0391), nuts and legumes (P = 0.034), trans fat (P = 0.0003), and long-chain (Ω-3) fats (P = 0.002). Conclusions Adults in Puerto Rico who intentionally purchase local products had significantly higher diet quality, especially regarding plant-based foods and healthy fats intake. These findings point to possible dietary benefits associated with improving local food availability. Further research on the Puerto Rican food environment is needed, including potential poor diet quality associated with imported products. Funding Sources Private anonymous donations, Dry Bean Health Research Program Incentive Award, and institutional funds. Supporting Tables, Images and/or Graphs

scholarly journals Consumption of Ultra-Processed Foods and Diet Quality Among U.S. Adults and Children

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 543-543
Author(s):  
Junxiu Liu ◽  
Euridice Steele ◽  
Dimitra Karageorgou ◽  
Renata Micha ◽  
Carlos Monteiro ◽  
...  
Keyword(s):  
Diet Quality ◽  
The United States ◽  
Healthy Eating Index ◽  
Processed Meat ◽  
Processed Foods ◽  
The Third ◽  
Poor Diet ◽  
Adults And Children ◽  
Diet Score ◽  
Score Range

Abstract Objectives Consumption of ultra-processed foods (UPF) has been linked to higher added sugar, sodium, and unhealthful fats, but the association of UPF with overall diet quality is unclear. We investigated how UPF consumption relates to overall diet quality in the U.S. Methods Dietary data were derived from the two most recent cycles of NHANES (2013–2016) including 10,064 adults and 5920 children with one or more 24-hr dietary recalls. UPFs were identified by the degree of processing using the NOVA classification, with total UPF intake (% energy) assessed in quartiles. Diet quality was assessed using the validated American Heart Association (AHA) 2020 continuous primary diet score (range 0–50; based on total fruits/vegetables, whole grains, fish/shellfish, sugar-sweetened beverages, and sodium), AHA secondary diet score (range 0–80; adding nuts/seeds/legumes, processed meat, and saturated fat), and Healthy Eating Index (HEI)-2015 score (range 0–100). Poor diet was defined as &lt; 40% adherence to the AHA primary score. Linear and logistic regressions estimated the relationships between UPF intake and diet quality, accounting for NHANES complex survey design and adjusting for age, sex, race/ethnicity, income, and education. Results Compared to the lowest quartile of UPF consumption (&lt;42.3%E), the multivariable-adjusted AHA primary score was −7.60% (−1.82 points, P &lt; 0.001) lower in the second quartile, −17.9% (−4.31 points, P &lt; 0.001) lower in the third quartile, and −29.3% (−7.04 points, P &lt; 0.001) lower in the highest quartile (&gt;67.8%E). Corresponding values in children were −8.01% (−1.73, P &lt; 0.001), −15.2% (−3.28, P &lt; 0.001), and −29.8% (−6.43, P &lt; 0.001). Compared to the lowest quartile of UPF, adults in the second quartile had 63% higher risk of poor diet quality (multivariable-adjusted OR 1.63; 95% CI 1.35–1.98); in the third quartile, 2.5-fold higher risk (OR, 2.64; 2.13–3.26); and in the highest quartile, nearly 5-fold higher risk (OR 4.85; 3.93–5.97). Corresponding ORs for poor diet quality in children were 1.52 (1.22–1.89), 2.44 (1.94–3.06), and 5.37 (4.16–6.94) across quartiles of UPF, respectively. Findings were similar using the AHA secondary score and HEI-2015 score. Conclusions Higher consumption of UPF associates with substantially lower diet quality in the United States among both adults and children. Funding Sources NIH.

scholarly journals Patient Outcomes Differences Following Ankle Fracture Fixation with or without Ankle Arthroscopy

2020 ◽  
Vol 5 (2) ◽  
pp. 2473011420S0001
Author(s):  
Kenneth S. Smith ◽  
Katherine D. Drexelius ◽  
Shanthan C. Challa ◽  
Daniel K. Moon ◽  
Joshua A. Metzl ◽  
...  
Keyword(s):  
Physical Function ◽  
Ankle Fracture ◽  
Patient Reported Outcomes ◽  
Chart Review ◽  
Ankle Arthroscopy ◽  
P Value ◽  
Function Score ◽  
Patient Reported ◽  
Physical Function Score

Category: Arthroscopy; Ankle; Trauma Introduction/Purpose: Ankle fractures are one of the most common types of fractures, yet there is currently no consensus about how best to treat these patients. The treatment approach typically includes open reduction-internal fixation (ORIF), but not all patients have a good clinical outcome. Intra-articular injuries have been suggested as one potential cause of these sub-optimal outcomes. Use of arthroscopy at the time of surgery is useful in identifying intra-articular lesions in acute ankle fractures, however, there is no evidence that arthroscopic intervention changes the patient’s outcome. Ankle arthroscopy increases the duration and potential complications of anesthesia administration and also increases cost. Our study assesses the clinical impact of arthroscopy accompanying an ankle fracture ORIF, which is essential to promote positive outcomes, while decreasing unnecessary complications and costs. Methods: This is a retrospective chart review. We queried all patients that underwent operative fixation of a bimalleolar or trimalleolar ankle fracture at our institution from January 1, 2014 through November 1, 2018. From this list, we excluded patients less than 18 years old and patients that had concomitant injuries to other body parts that required surgery. In addition, we only included Weber B and Weber C fibula fracture to homogenize the data. We then performed a chart review to extract all demographic data, fracture pattern, surgical procedures performed, tourniquet times, any revision surgeries, arthroscopic findings and any interventions performed due to the arthroscopic portion of the procedure. We then conducted a phone and email survey utilizing the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Short Form and the two question Patient Acceptable Symptom State (PASS). Results: Our study included 213 total patients (142 traditional ORIF, 71 ORIF plus arthroscopy) with an average age of 40 (standard deviation 14.2). The average follow up was 32.4 (13.1) months with a survey follow up rate of 50.7%. The demographic information between the two cohorts was statistically similar. The average tourniquet time for the arthroscopy cohort is 10 minutes longer (89 minutes versus 79 minutes). During the arthroscopy, there was a 28.2% rate of full thickness osteochondral lesions, 33.8% rate of loose bodies, and a 49.2% rate of small cartilage injury not requiring intervention. The mean PROMIS physical function score amongst Weber B fibula fractures was 45.8 and 42.3 in the arthroscopy and non-arthroscopy groups respectively (P value 0.012). In addition, the patient satisfaction rate in Weber B fibula fractures was higher in those patients that underwent arthroscopy as compared to ORIF alone (93.1% versus 75.5%, P value of 0.05). Patients that suffered a tibiotalar joint dislocation at the time of the ankle fracture had a significantly higher PROMIS physical function score (46.6 versus 40.2, P value 0.005) when their surgery included arthroscopy. Conclusion: Ankle arthroscopy at the time of ORIF led to higher mean patient reported outcomes for every tested metric but this reached statistical significance only when looking at the Weber B fibula fractures and ankle dislocations. There was no increase in complication rate and the arthroscopy took only 10 minutes longer on average. [Table: see text]

scholarly journals Longitudinal Changes in Diet Quality over Adulthood and Physical Function in Older Life: Findings from a British Birth Cohort

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1495-1495
Author(s):  
Thanasis Tektonidis ◽  
Shelly Coe ◽  
Patrick Esser ◽  
Jane Maddock ◽  
Sarah Buchanan ◽  
...  
Keyword(s):  
Physical Function ◽  
Diet Quality ◽  
Walking Speed ◽  
Objective Measure ◽  
Dietary Exposure ◽  
Later Life ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Measurement Unit ◽  
Linear Regression Models

Abstract Objectives A healthy diet has been linked to better physical function in older adults but evidence on the role of cumulative dietary exposure is scarce. Sex differences in the relationship are also underexplored. The objective was to explore the longitudinal association of diet quality in adulthood (from 36–64 y), in line with dietary guidelines, and walking speed as an objective measure of later life physical function. Methods Study sample was derived from the Insight 46 (n = 502), a neuroscience sub-study of the longitudinal National Survey of Health and Development, UK. Diet was assessed four times, at age 36 y, 43 y, 53 y and 60–64 y using five-day food diaries, from which the Healthy Eating Index-2015 (HEI) was calculated (0 - low quality, 100 - high quality). Walking speed was estimated in a 10-meter walk test at self-selected pace, using an inertial measurement unit at age 69–71 y. Linear mixed models with random effects and group-based trajectory modeling were used to assess individual and group changes in HEI in adulthood. Multivariable linear regression models with sex as modifier, controlling for multiple characteristics assessed the association between adulthood HEI trajectories and walking speed at 71 y. The final sample was 226 women and 230 men. Results Men and women improved diet quality linearly in adulthood (β: 0.6 HEI/y, 95% CI: 0.5, 0.7). Three linear HEI trajectories were identified (21% “Low” βo: 33, β: 3.6; 59% “Medium” βο: 38, β: 6.1; 20% “High” βο: 52, β: 5.5, P &lt; 0.001). Women had faster increase rates, higher HEI at each age (β: 4 HEI points, 95% CI: 3, 6) and were more likely to belong to the “High” HEI trajectory than men (β: 1.97, P &lt; 0.001). There was no overall association but in women a 10 point increase in predicted HEI trajectory and membership in the “High” vs “Medium”-“Low” HEI trajectories were associated with faster walking speed (β: 0.04 m/s, 95% CI: 0.01, 0.08, β: 0.06 m/s, 95% CI: 0.01, 0.11, respectively). Association was attenuated in multivariable models. No association was observed in men. Conclusions In women, higher diet quality in adulthood was associated with faster walking speed in later life. Achieving and maintaining high diet quality in adulthood is likely of importance to yield benefits in physical function. Funding Sources Medical Research Council UK Alzheimer's Research UK Dementias Platform UK Wolfson Foundation UK CLOSER UK.

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