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Lubieniecki P, Lewandowski Ł, Wołyniec M, Połtyn-Zaradna K, Zatońska K, Szuba A. The Dynamics of Cardiovascular Risk-An Analysis of the Prospective Urban Rural Epidemiology (PURE) Poland Cohort Study. J Clin Med 2024; 13:3728. [PMID: 38999293 PMCID: PMC11242048 DOI: 10.3390/jcm13133728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/13/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
Background: The purpose of this study was to analyze the major cardiovascular risk (CVR) factors and their trends in the study population. Methods: The results of subjects in the Polish Prospective Urban and Rural Epidemiological Study (PURE) study group were interpreted. CVR was calculated for each participant according to the Systematic Coronary Risk Evaluation (SCORE2) scale or the Systematic Coronary Risk Evaluation-Older Persons (SCORE2-OP) scale. Data from the beginning of the analysis (2013) and nine years later (2022) were included. In addition, the use of lipid-lowering therapy (LLT) and meeting the low-density lipoprotein cholesterol (LDL-c) target criterion at the beginning and end of the study were analyzed. Results: Patients in the high and very high CVR groups who had abnormal LDL-c results accounted for 64% and 91% of their group in 2013 and 70% and 92% in 2022, respectively. Conclusions: Regardless of age, patients using LLT at the start of the analysis had a greater increase in future CVR, especially if they had lipid abnormalities at the start of the study. This may be due to reverse causality and multimorbidity in these patients, highlighting the importance of appropriate treatment of lipid abnormalities.
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Affiliation(s)
- Paweł Lubieniecki
- Clinical Department of Diabetology and Internal Disease, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Łukasz Lewandowski
- Department of Medical Biochemistry, Wroclaw Medical University, Chalubinskiego 10, 50-368 Wroclaw, Poland
| | - Maria Wołyniec
- Population Health Department, Wroclaw Medical University, 50-345 Wrocław, Poland
| | | | - Katarzyna Zatońska
- Population Health Department, Wroclaw Medical University, 50-345 Wrocław, Poland
- Calisia University, 62-800 Kalisz, Poland
| | - Andrzej Szuba
- Clinical Department of Angiology and Internal Disease, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Benz E, Pinel A, Guillet C, Capel F, Pereira B, De Antonio M, Pouget M, Cruz-Jentoft AJ, Eglseer D, Topinkova E, Barazzoni R, Rivadeneira F, Ikram MA, Steur M, Voortman T, Schoufour JD, Weijs PJM, Boirie Y. Sarcopenia and Sarcopenic Obesity and Mortality Among Older People. JAMA Netw Open 2024; 7:e243604. [PMID: 38526491 DOI: 10.1001/jamanetworkopen.2024.3604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Importance Sarcopenia and obesity are 2 global concerns associated with adverse health outcomes in older people. Evidence on the population-based prevalence of the combination of sarcopenia with obesity (sarcopenic obesity [SO]) and its association with mortality are still limited. Objective To investigate the prevalence of sarcopenia and SO and their association with all-cause mortality. Design, Setting, and Participants This large-scale, population-based cohort study assessed participants from the Rotterdam Study from March 1, 2009, to June 1, 2014. Associations of sarcopenia and SO with all-cause mortality were studied using Kaplan-Meier curves, Cox proportional hazards regression, and accelerated failure time models fitted for sex, age, and body mass index (BMI). Data analysis was performed from January 1 to April 1, 2023. Exposures The prevalence of sarcopenia and SO, measured based on handgrip strength and body composition (BC) (dual-energy x-ray absorptiometry) as recommended by current consensus criteria, with probable sarcopenia defined as having low handgrip strength and confirmed sarcopenia and SO defined as altered BC (high fat percentage and/or low appendicular skeletal muscle index) in addition to low handgrip strength. Main Outcome and Measure The primary outcome was all-cause mortality, collected using linked mortality data from general practitioners and the central municipal records, until October 2022. Results In the total population of 5888 participants (mean [SD] age, 69.5 [9.1] years; mean [SD] BMI, 27.5 [4.3]; 3343 [56.8%] female), 653 (11.1%; 95% CI, 10.3%-11.9%) had probable sarcopenia and 127 (2.2%; 95% CI, 1.8%-2.6%) had confirmed sarcopenia. Sarcopenic obesity with 1 altered component of BC was present in 295 participants (5.0%; 95% CI, 4.4%-5.6%) and with 2 altered components in 44 participants (0.8%; 95% CI, 0.6%-1.0%). An increased risk of all-cause mortality was observed in participants with probable sarcopenia (hazard ratio [HR], 1.29; 95% CI, 1.14-1.47) and confirmed sarcopenia (HR, 1.93; 95% CI, 1.53-2.43). Participants with SO plus 1 altered component of BC (HR, 1.94; 95% CI, 1.60-2.33]) or 2 altered components of BC (HR, 2.84; 95% CI, 1.97-4.11) had a higher risk of mortality than those without SO. Similar results for SO were obtained for participants with a BMI of 27 or greater. Conclusions and Relevance In this study, sarcopenia and SO were found to be prevalent phenotypes in older people and were associated with all-cause mortality. Additional alterations of BC amplified this risk independently of age, sex, and BMI. The use of low muscle strength as a first step of both diagnoses may allow for early identification of individuals at risk for premature mortality.
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Affiliation(s)
- Elizabeth Benz
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alexandre Pinel
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Christelle Guillet
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Frederic Capel
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Bruno Pereira
- Unit of Biostatistics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Marie De Antonio
- Unit of Biostatistics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Melanie Pouget
- Department of Clinical Nutrition, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | | | - Doris Eglseer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Rocco Barazzoni
- Department of Medical, Technological and Translational Sciences, University of Trieste, Ospedale di Cattinara, Trieste, Italy
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marinka Steur
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Josje D Schoufour
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam Public Health Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Yves Boirie
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
- Department of Clinical Nutrition, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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Luchsinger JA, Pang D, Krinsky-McHale SJ, Schupf N, Lee JH, Silverman W, Zigman WB. Obesity, diabetes and their metabolic correlates in middle-aged adults with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:212-222. [PMID: 37899501 PMCID: PMC10872834 DOI: 10.1111/jir.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 09/29/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Obesity in adults without Down syndrome is associated with an adverse metabolic profile including high prevalence of pre-diabetes and diabetes, high levels of insulin, non-high-density lipoprotein (HDL) cholesterol, leptin and high-sensitivity C-reactive protein (hsCRP) and low levels of HDL and adiponectin. We examined whether obesity in middle-aged adults with Down syndrome is also related to an adverse metabolic profile. METHODS This cross-sectional study included 143 adults with Down syndrome, with a mean age of 55.7 ± 5.7 years and 52.5% women. Body mass index (BMI) was classified as underweight (BMI < 18.5 kg/m2 ), normal (BMI 18.5-24.9 kg/m2 ), overweight (BMI 25-29.9 kg/m2 ) and obese (BMI ≥ 30 kg/m2 ). Diabetes was ascertained by history or by haemoglobin A1c (HbA1c) as normal glucose tolerance (HbA1c < 5.7%), pre-diabetes (HbA1c 5.7-6.4%) and diabetes (HbA1c ≥ 6.5%). We measured non-fasting lipids, hsCRP, insulin, adiponectin and leptin. RESULTS The majority of the sample had an overweight (46.9%) or obesity (27.3%) status. However, there was a relatively low prevalence of pre-diabetes (9.8%) and diabetes (6.9%). Overweight and obesity status were not associated with lower HDL and adiponectin and higher insulin, non-HDL cholesterol and hsCRP as expected in adults without Down syndrome. However, overweight and obesity were strongly associated with higher leptin (P < 0.001). CONCLUSIONS The only metabolic correlate of obesity in middle-aged adults with Down syndrome was high leptin levels. Our findings are limited by non-fasting laboratory tests but suggest that middle-aged adults with Down syndrome do not have the adverse metabolic profile related to obesity found in adults without Down syndrome.
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Affiliation(s)
- José A. Luchsinger
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Deborah Pang
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Sharon J. Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Nicole Schupf
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
- Taub Institute, Columbia University Medical Center, New York, NY, USA
| | - Joseph H. Lee
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
- Taub Institute, Columbia University Medical Center, New York, NY, USA
| | | | - Warren B. Zigman
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
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Pellay H, Thomas A, Baillet M, Helmer C, Catheline G, Marmonier C, Samieri C, Féart C. Dairy products and brain structure in French older adults. Br J Nutr 2024; 131:512-520. [PMID: 37694377 PMCID: PMC10784124 DOI: 10.1017/s0007114523001551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 09/12/2023]
Abstract
Among food groups with putative benefits for brain structures, dairy products (DP) have been poorly studied. The sample included participants without dementia from the ancillary brain imaging study of the Three-City cohort who were aged 65+ years, had their DP intake assessed with a FFQ at baseline and underwent an anatomical scan 3 years (n 343) or 9 years (n 195) after completing the dietary survey. The frequencies of consumption of total DP, milk and cheese were not associated with brain structure. Compared with the lowest frequency, the highest frequency of fresh DP (F-DP) consumption (< 0·5 v. > 1·5 times/d) was significantly associated with a lower medial temporal lobe volume (MTLV) (β = -1·09 cm3, 95 % CI - 1·83, -0·36) 9 years later. In this population-based study of older adults, the consumption of F-DP more than 1·5 times/d was associated with a lower MTLV, which is considered an early biomarker of Alzheimer's disease, 9 years later. This original study should be replicated in different settings before conclusions are drawn.
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Affiliation(s)
- Hermine Pellay
- Universty of Bordeaux, INSERM, Bordeaux Population Health, UMR1219, F-33000 Bordeaux, France
- CNIEL, Service Recherche Nutrition-Santé, F-75009 Paris, France
| | - Aline Thomas
- Universty of Bordeaux, INSERM, Bordeaux Population Health, UMR1219, F-33000 Bordeaux, France
| | - Marion Baillet
- Universty of Bordeaux, INSERM, Bordeaux Population Health, UMR1219, F-33000 Bordeaux, France
| | - Catherine Helmer
- Universty of Bordeaux, INSERM, Bordeaux Population Health, UMR1219, F-33000 Bordeaux, France
- Clinical and Epidemiological Research Unit, INSERM CIC1401, F-33000 Bordeaux, France
| | - Gwénaëlle Catheline
- Universty of Bordeaux, CNRS, INCIA, UMR5287, F-33000 Bordeaux, France
- Laboratoire Neuroimagerie et vie quotidienne, EPHE-PSL, F-33000 Bordeaux, France
| | | | - Cécilia Samieri
- Universty of Bordeaux, INSERM, Bordeaux Population Health, UMR1219, F-33000 Bordeaux, France
| | - Catherine Féart
- Universty of Bordeaux, INSERM, Bordeaux Population Health, UMR1219, F-33000 Bordeaux, France
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Lagrandeur J, Putallaz P, Krief H, Büla CJ, Coutaz M. Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective? BMC Geriatr 2023; 23:228. [PMID: 37041477 PMCID: PMC10088129 DOI: 10.1186/s12877-023-03937-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/27/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUNDS To investigate the relationship between obesity and 30-day mortality in a cohort of older hospitalized COVID-19 inpatients. METHODS Included patients were aged 70 years or more; hospitalized in acute geriatric wards between March and December 2020; with a positive PCR for COVID-19; not candidate to intensive care unit admission. Clinical data were collected from patients electronic medical records. Data on 30-day mortality were retrieved from the hospital administrative database. RESULTS Patients included (N = 294) were on average 83.4 ± 6.7 years old, 50.7% were women, and 21.7% were obese (BMI > 30 kg/m2). At 30-day, 85 (28.9%) patients were deceased. Compared to survivors in bivariable analysis, deceased patients were older (84.6 ± 7.6 vs 83.0 ± 6.3 years), more frequently with very complex health status (63.5% vs 39.7%, P < .001), but less frequently obese (13.4% vs 24.9%, P = .033) at admission. Over their stay, deceased patients more frequently (all P < .001) developed radiologic signs of COVID-19 (84.7% vs 58.9%), anorexia (84.7% vs 59.8%), hypernatremia (40.0% vs 10.5%), delirium (74.1% vs 30.1%), and need for oxygen (87.1% vs 46.4%) compared to survivors. In multivariable analysis that controlled for all markers of poor prognosis identified in bivariable analysis, obese patients remain with 64% (adjOR 0.36, 95%CI 0.14-0.95, P = .038) lower odds to be deceased at 30-day than non-obese patients. CONCLUSIONS In this population of older COVID-19 inpatients, an inverse association between obesity and 30-day mortality was observed even after adjusting for all already-known markers of poor prognosis. This result challenges previous observations in younger cohorts and would need to be replicated.
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Affiliation(s)
- Julien Lagrandeur
- Service of Geriatric Medicine, Hospital of Valais, Avenue de La Fusion 27, 1920, Martigny, Switzerland.
| | - Pauline Putallaz
- Service of Geriatric Medicine, Hospital of Valais, Avenue de La Fusion 27, 1920, Martigny, Switzerland
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Hélène Krief
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Christophe J Büla
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Martial Coutaz
- Service of Geriatric Medicine, Hospital of Valais, Avenue de La Fusion 27, 1920, Martigny, Switzerland
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Carr PR, Webb KL, Neumann JT, Thao LTP, Beilin LJ, Ernst ME, Fitzgibbon B, Gasevic D, Nelson MR, Newman AB, Orchard SG, Owen A, Reid CM, Stocks NP, Tonkin AM, Woods RL, McNeil JJ. Associations of body size with all-cause and cause-specific mortality in healthy older adults. Sci Rep 2023; 13:3799. [PMID: 36882434 PMCID: PMC9992380 DOI: 10.1038/s41598-023-29586-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/07/2023] [Indexed: 03/09/2023] Open
Abstract
In the general population, body mass index (BMI) and waist circumference are recognized risk factors for several chronic diseases and all-cause mortality. However, whether these associations are the same for older adults is less clear. The association of baseline BMI and waist circumference with all-cause and cause-specific mortality was investigated in 18,209 Australian and US participants (mean age: 75.1 ± 4.5 years) from the ASPirin in Reducing Events in the Elderly (ASPREE) study, followed up for a median of 6.9 years (IQR: 5.7, 8.0). There were substantially different relationships observed in men and women. In men, the lowest risk of all-cause and cardiovascular mortality was observed with a BMI in the range 25.0-29.9 kg/m2 [HR25-29.9 vs 21-24.9 kg/m2: 0.85; 95% CI, 0.73-1.00] while the highest risk was in those who were underweight [HRBMI <21 kg/m2 vs BMI 21-24.9 kg/m2: 1.82; 95% CI 1.30-2.55], leading to a clear U-shaped relationship. In women, all-cause mortality was highest in those with the lowest BMI leading to a J-shaped relationship (HRBMI <21 kg/m2 vs BMI 21-24.9 kg/m2: 1.64; 95% CI 1.26-2.14). Waist circumference showed a weaker relationship with all-cause mortality in both men and women. There was little evidence of a relationship between either index of body size and subsequent cancer mortality in men or women, while non-cardiovascular non-cancer mortality was higher in underweight participants. For older men, being overweight was found to be associated with a lower risk of all-cause mortality, while among both men and women, a BMI in the underweight category was associated with a higher risk. Waist circumference alone had little association with all-cause or cause-specific mortality risk.Trial registration ASPREE https://ClinicalTrials.gov number NCT01038583.
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Affiliation(s)
- Prudence R Carr
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Katherine L Webb
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Johannes T Neumann
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Department of Cardiology, University Heart & Vascular Centre, Hamburg, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Le T P Thao
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Lawrence J Beilin
- School of Medicine, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Michael E Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy; and, Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
| | - Bernadette Fitzgibbon
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Mark R Nelson
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Anne B Newman
- Centre for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Nigel P Stocks
- Discipline of General Practice, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia
| | - Andrew M Tonkin
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Gray LA, Breeze PR, Williams EA. BMI trajectories, morbidity, and mortality in England: a two-step approach to estimating consequences of changes in BMI. Obesity (Silver Spring) 2022; 30:1898-1907. [PMID: 35920148 PMCID: PMC9546036 DOI: 10.1002/oby.23510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/03/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE BMI is known to have an association with morbidities and mortality. Many studies have argued that identifying health risks using single BMI measures has limitations, particularly in older adults, and that changes in BMI can help to identify risks. This study identifies distinct BMI trajectories and their association with the risks of a range of morbidities and mortality. METHODS The English Longitudinal Study of Aging provides data on BMI, mortality, and morbidities between 1998 and 2015, sampled from adults over 50 years of age. This study uses a growth-mixture model and discrete-time survival analysis, combined using a two-step approach, which is novel in this setting, to the authors' knowledge. RESULTS This study identified four trajectories: "stable overweight," "elevated BMI," "increasing BMI," and "decreasing BMI." No differences in mortality, cancer, or stroke risk were found between these trajectories. BMI trajectories were significantly associated with the risks of diabetes, asthma, arthritis, and heart problems. CONCLUSIONS These results emphasize the importance of looking at change in BMI alongside most recent BMI; BMI trajectories should be considered where possible when assessing health risks. The results suggest that established BMI thresholds should not be used in isolation to identify health risks, particularly in older adults.
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Affiliation(s)
- Laura A. Gray
- Health Economics and Decision Science, School of Health and Related ResearchUniversity of SheffieldSheffieldUK
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
| | - Penny R. Breeze
- Health Economics and Decision Science, School of Health and Related ResearchUniversity of SheffieldSheffieldUK
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
| | - Elizabeth A. Williams
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
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8
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Ramos VF, Silva AF, Picinato-Pirola M. Masticatory function in elderly compared to young adults. Codas 2021; 34:e20200364. [PMID: 34705926 PMCID: PMC9886105 DOI: 10.1590/2317-1782/20212020364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/12/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To characterize the masticatory function of the elderly and to compare total amount of time, masticatory strokes and total mastication score among the elderly and young adults. METHODS It is an observational, cross-sectional and analytical study. A total of 50 individuals participated, 25 elderly (mean age 66 years) and 25 young adults (mean age 22 years). The evaluation of mastication was performed by standardized filming of the usual mastication of a wheat flour biscuit. The masticatory type (alternated bilateral, simultaneous bilateral, preferential unilateral, chronic and anterior), masticatory score, total masticatory time and the total number of masticatory strokes were verified and compared between the elderly and young adults. RESULTS The predominant masticatory pattern in the young adults was the alternated bilateral mastication (52%), while, in the elderly, the simultaneous bilateral mastication predominated (48%). The use of dental prostheses had a significant influence on the total mastication score; elderly presented greater masticatory time and greater amount of masticatory strokes; however, the total masticatory score was lower for this group. CONCLUSION The use of dental prosthesis has a significant influence on masticatory function. When compared to young adults, the elderly had a greater amount of time and masticatory strokes and a lower total mastication score.
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André P, Pais de Barros JP, Mj Merle B, Samieri C, Helmer C, Delcourt C, Féart C. Mediterranean diet and prudent diet are both associated with low circulating esterified 3-hydroxy fatty acids, a proxy of LPS burden, among older adults. Am J Clin Nutr 2021; 114:1080-1091. [PMID: 34036325 DOI: 10.1093/ajcn/nqab126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/29/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND LPS-type endotoxins, naturally found in the gut microbiota, are recognized as triggers of inflammation and emerge as detrimental factors of healthy aging. Nutrition represents a promising strategy to reduce LPS burden, yet little is known about the relation of diet to circulating LPS concentrations. OBJECTIVE The aim was to evaluate the associations between food groups, dietary patterns, and circulating 3-hydroxy fatty acids (3-OH FAs), a proxy of LPS burden. METHODS In a cross-sectional study of 698 French older community-dwelling individuals, 3-OH FA concentrations were measured by LC-tandem MS. Dietary patterns were determined using food-frequency questionnaires. Adherence to a Mediterranean-type diet was computed according to the consumption of 8 food groups (fruits, vegetables, legumes, cereals, fish, olive oil, meat, and dairy products) and alcohol intake (range: 0, low adherence, to 18, high adherence). Three a posteriori dietary patterns were derived from factor analysis: complex carbohydrate (rich in rice, pasta, eggs, poultry, and potatoes), traditional (rich in alcohol, meat, processed meats-cold cuts, and legumes), and prudent (rich in vegetables and fruits and low in cookies) diets. Linear regression models were applied. RESULTS The frequency of consumption of each food group was not associated with 3-OH FA concentrations. Greater adherence to both the Mediterranean diet and the prudent diet were associated with lower circulating 3-OH FAs (β [95% CI] for each additional point of score: -0.12 [-0.22, -0.01] and -0.27 [-0.48, -0.07], respectively). In contrast, greater adherence to the traditional diet was associated with higher concentration of 3-OH FAs (β [95% CI] 0.22 [0.001, 0.46]). The adherence to the complex-carbohydrate diet was not associated with 3-OH FA concentrations. CONCLUSIONS Based on 2 complementary approaches, the identified plant-based dietary patterns were associated with lower 3-OH FA concentrations, and thus a lower LPS burden, which is considered a potent trigger of inflammatory response.
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Affiliation(s)
- Perrine André
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health, U1219, Bordeaux, France
| | | | - Bénédicte Mj Merle
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health, U1219, Bordeaux, France
| | - Cécilia Samieri
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health, U1219, Bordeaux, France
| | - Catherine Helmer
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health, U1219, Bordeaux, France.,INSERM, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux, France
| | - Cécile Delcourt
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health, U1219, Bordeaux, France
| | - Catherine Féart
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health, U1219, Bordeaux, France
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10
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The Association of Healthy Lifestyle Behaviors with Overweight and Obesity among Older Adults from 21 Countries. Nutrients 2021; 13:nu13020315. [PMID: 33499184 PMCID: PMC7911789 DOI: 10.3390/nu13020315] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 12/12/2022] Open
Abstract
This study aimed to analyze the association of healthy lifestyle behaviors with overweight and obesity among Europeans aged 65+ years. Data were from the 2014 European Social Survey, analyzing 21 countries. Five lifestyle behaviors (physical activity, fruit and vegetable consumption, sleep quality, drinking alcohol, and smoking) were analyzed. Binary logistic regressions were performed. A total of 8938 participants (4099 men) 65 years and older, mean age—73.6 (SD: 6.6) presented prevalence of overweight of 42.3% (95% CI: 41.3 to 43.3) and obesity of 20.9% (95% CI: 20.1 to 21.8). Adopting five healthy behaviors was associated with lower odds of obesity (OR = 0.50, 95% CI: 0.39 to 0.63), but not overweight (OR: 0.93; 95% CI: 0.79 to 1.10). Physical activity (≥5 days/week) was the most protective behavior, reducing by 42% the odds of obesity. Sex moderated the association of fruits and vegetables consumption, alcohol use, and smoking with obesity. Strategies aiming to reduce obesity levels in older adults should focus on the promotion of multiple lifestyle health behaviors, particularly physical activity in order to decrease vulnerability risk in old age.
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11
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Kerminen HM, Jäntti PO, Valvanne JNA, Huhtala HSA, Jämsen ERK. Risk factors of readmission after geriatric hospital care: An interRAI-based cohort study in Finland. Arch Gerontol Geriatr 2021; 94:104350. [PMID: 33516078 DOI: 10.1016/j.archger.2021.104350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/02/2021] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify risk factors for readmission after geriatric hospital care. METHODS A retrospective cohort study of 1,167 community-dwelling patients aged ≥70 years who were hospitalised in two geriatric hospitals and discharged to their homes over a three-year period. We combined the results of the interRAI-post acute care instrument (interRAI-PAC) with hospital discharge records. Factors associated with readmissions within 90 days following discharge were analysed using logistic regression analysis. RESULTS The patients' mean age was 84.5 (SD 6.2) years, and 71% (n = 827) were women. The 90-day readmission rate was 29.5%. The risk factors associated with readmission in the univariate analysis were as follows: age, admission from home vs. acute care hospital, Alzheimer's disease, unsteady gait, fatigue, unstable conditions, Activities of Daily Living Hierarchy Scale (ADLH) score, Cognitive Performance Scale (CPS) score, body mass index (BMI), frailty index, bowel incontinence, hearing difficulties, and poor self-rated health. In the multivariable analysis, age of ≥90 years, ADLH ≥1, unsteady gait, BMI <25 or ≥30 kg/m 2 , and frailty remained as risk factors for readmission. Surgical operation during the treatment period was associated with a lower readmission risk. CONCLUSIONS AND IMPLICATIONS InterRAI-PAC performed upon admission to geriatric hospitals revealed patient-related risk factors for readmission. Based on the identified risk factors, we recommend that the patient's functional ability, activities of daily living (ADL) needs, and individual factors underlying ADL disability, as well as nutritional and mobility problems should be carefully addressed and managed during hospitalization to diminish the risk for readmission.
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Affiliation(s)
- Hanna M Kerminen
- Tampere University, Faculty of Medicine and Health Technology, and the Gerontology Research Centre (GEREC), P.O. Box 100, 33014 Tampere University, Finland; Tampere University Hospital, Centre of Geriatrics, Elämänaukio 2, 33520 Tampere, Finland.
| | - Pirkko O Jäntti
- Tampere University, Faculty of Medicine and Health Technology, and the Gerontology Research Centre (GEREC), P.O. Box 100, 33014 Tampere University, Finland
| | - Jaakko N A Valvanne
- Tampere University, Faculty of Medicine and Health Technology, and the Gerontology Research Centre (GEREC), P.O. Box 100, 33014 Tampere University, Finland
| | - Heini S A Huhtala
- Tampere University, Faculty of Social Sciences, P.O. Box 100, 33014, Tampere University, Finland
| | - Esa R K Jämsen
- Tampere University, Faculty of Medicine and Health Technology, and the Gerontology Research Centre (GEREC), P.O. Box 100, 33014 Tampere University, Finland; Tampere University Hospital, Centre of Geriatrics, Elämänaukio 2, 33520 Tampere, Finland
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12
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Tang ML, Zhou YQ, Song AQ, Wang JL, Wan YP, Xu RY. The Relationship between Body Mass Index and Incident Diabetes Mellitus in Chinese Aged Population: A Cohort Study. J Diabetes Res 2021; 2021:5581349. [PMID: 34485532 PMCID: PMC8410436 DOI: 10.1155/2021/5581349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/03/2021] [Accepted: 08/12/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Previous studies reported that overweight older adults had a lower mortality after cardiovascular diseases attack, indicating being thinner might not always be better. However, there is an ongoing debate about what is the optimal range of body mass index (BMI) for the aged population. We aimed to evaluate the value of BMI for the prediction of incident diabetes mellitus (DM) in the Chinese elderly population. METHODS A total number of 6,911 Chinese elderly people (4,110 men and 2,801 women, aged 71 ± 6.0 years) were included in this cohort study. BMI was measured at baseline (Jan 1, 2014, to Dec 31, 2014). All the participants were further classified into six groups: <18.5 kg/m2, 18.5 to <22.5 kg/m2, 22.5 to <25.0 kg/m2, 25.0 to <27.5 kg/m2, 27.5 to <30.0 kg/m2, and ≥30.0 kg/m2. Fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) were annually measured during follow-up (Jan 1, 2015-May 31, 2019). DM was confirmed if either FBG ≥ 7.0 mmol/L or HbA1c ≥ 6.5%. We used the Cox proportional hazard regression model to evaluate the association between BMI and the prediction of incident DM. RESULTS Comparing individuals with a BMI range of 18.5 to <22.5 kg/m2 (reference), the hazard ratio for incident DM was 2.13 (95% CI: 1.54~2.95), 2.14 (95% CI: 1.53~3.00), 3.17 (95% CI: 2.19~4.59), 3.15 (95% CI: 1.94~5.09), and 3.14 (95% CI: 1.94~5.09) for the group with a BMI range of 22.5 to <25.0 kg/m2, 25.0 to <27.5 kg/m2, 27.5 to <30.0 kg/m2, and ≥30.0 kg/m2 after adjusting for baseline age, sex, blood pressure, lipid profiles, and eGFR (P trend < 0.001), after adjusting for the abovementioned confounders. The association tended to be closer in men and young participants, compared with their counterparts. CONCLUSIONS High BMI was associated with a high risk of developing DM in the Chinese aged population. Thus, it is optimal for the aged population to maintain their body weight within a reasonable range to prevent chronic diseases.
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Affiliation(s)
- M. L. Tang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Y. Q. Zhou
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - A. Q. Song
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - J. L. Wang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Y. P. Wan
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - R. Y. Xu
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
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13
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Doorduijn AS, de van der Schueren MAE, van de Rest O, de Leeuw FA, Hendriksen HMA, Teunissen CE, Scheltens P, van der Flier WM, Visser M. Nutritional Status Is Associated With Clinical Progression in Alzheimer's Disease: The NUDAD Project. J Am Med Dir Assoc 2020; 24:638-644.e1. [PMID: 33239240 DOI: 10.1016/j.jamda.2020.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/21/2020] [Accepted: 10/10/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In cognitively normal adults, nutritional parameters are related to cognitive decline and incidence of dementia. Studies on the role of nutrition in predementia stages subjective cognitive decline and mild cognitive impairment, and mild stages of Alzheimer's disease (AD) dementia in a clinical setting are lacking. In the absence of a curative treatment, this evidence is important for targeting nutritional factors to potentially prevent or delay further cognitive decline. Our aim is to investigate associations of nutritional parameters with clinical progression in patients ranging from those who are cognitively normal to those who have AD dementia. DESIGN Longitudinal. SETTING AND PARTICIPANTS Memory clinic, 551 patients (219 with subjective cognitive decline, 135 with mild cognitive impairment, and 197 with AD dementia), mean age 64 ± 8 years. MEASUREMENTS We assessed body mass index, fat-free mass, Mini-Nutritional Assessment, and dietary intake with the Dutch Healthy Diet food frequency questionnaire and the 238-item healthy life in an urban setting (HELIUS) food frequency questionnaire at baseline. Cox proportional hazard models were used to evaluate associations of nutritional parameters with clinical progression. Additional analyses were restricted to patients who were amyloid positive. RESULTS We observed clinical progression in 170 patients (31%) over 2.2 ± 0.9 years. Poorer Mini-Nutritional Assessment score [hazard ratio (95% confidence interval) 1.39 (1.18-1.64)], lower body mass index [1.15 (0.96-1.38)], lower fat-free mass [1.40 (0.93-2.10)], and a less healthy dietary pattern [1.22 (1.01-1.48)] were associated with a higher risk of clinical progression. Similar effect sizes were found in patients who were amyloid positive. CONCLUSIONS AND IMPLICATIONS Poorer nutritional status and a less healthy dietary pattern are associated with a higher risk of clinical progression. This study provides support for investigating whether improving nutritional status can alter the clinical trajectory of AD.
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Affiliation(s)
- Astrid S Doorduijn
- Department of Nutrition and Dietetics, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Marian A E de van der Schueren
- Department of Nutrition and Health, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands; Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Ondine van de Rest
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Francisca A de Leeuw
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Heleen M A Hendriksen
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Epidemiology & Biostatistics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Marjolein Visser
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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14
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Buch A, Magid A, Eldor R, Keinan-Boker L, Ben Haim L, Greenman Y, Stern N. Nutritional profiling of frail and obese, community dwelling older subjects: Results from a national survey. Exp Gerontol 2020; 142:111112. [PMID: 33065229 DOI: 10.1016/j.exger.2020.111112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/09/2020] [Accepted: 10/05/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Less attention has been given to the detection and nutritional status and needs of obese frail/sarcopenic older subjects. The aim of this study was to characterize the nutritional composition in older (≥65 years), frail-prone, obese subjects (defined by either waist circumference [WC] or body mass index [BMI]). METHODS A cross-sectional study with analysis of the national survey "Mabat Zahav". Random sample of 1751 community dwelling Israeli older adults (≥65 years). Eleven nutritional factors formerly linked to frailty were a-priori selected based on the current literature. Data was extracted from a 24-hour dietary recall. Adherence for each nutritional factor was defined using the Dietary Reference Intakes (DRI), and aggregated into a sum score of the overall adherence (ranging from "0" to "11", where "fair" adherence was defined as ≥6; inadequate adherence otherwise). Frailty likelihood was estimated using a validated non-direct model, and associations of nutritional factors with frailty-likelihood in obese vs non-obese individuals were examined. Additionally, a decision tree procedure based on machine learning was applied in order to capture nutritional factors related to frailty, stratified by gender, as well as by WC and/or BMI. RESULTS Overall, the prevalence rates of frailty and pre-frailty were 7.1 and 57.6%, respectively. A "fair nutritional adherence" was less common among frail-prone compared to robust subjects (23.1% vs. 32.1%; p < 0.0001). The intake of most frailty-related nutritional factors did not co-segregate according to the presence of abdominal or BMI-defined obesity. Still, compared to robust normal/overweight subjects, frail-prone obese (by BMI) individuals had a higher rate of inadequate nutritional adherence (odds-ratio 1.842; p < 0.05). Of all 11 nutritional factors, folate in obese women and vitamin A (as retinol) and calcium in non-obese and obese men, respectively, were recognized as the most prominent predictors of frail-prone prevalence by the machine learning process. Although BMI was more closely associated with impaired intake of the 11 selected nutritional components than WC, this association was eliminated when frailty status, low income and education were considered. CONCLUSIONS Frail-prone subjects differed from robust subjects in their nutritional intake. Nutritional inadequacies related to frailty-likelihood were mostly seen among obese women and non-obese men. In the prediction of inadequate adherence to the DRI of 11 nutritional components, obesity is a weaker predictor than frailty, lower education and low income in older Israeli adults.
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Affiliation(s)
- Assaf Buch
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine Tel-Aviv University, Israel; Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel; The Sagol Center for Epigenetics of Aging and Metabolism, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Avi Magid
- The Department of Health System Management, Peres Academic Center, Rehovot, Israel
| | - Roy Eldor
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine Tel-Aviv University, Israel
| | - Lital Keinan-Boker
- School of Public Health, University of Haifa, Haifa, Israel; Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Limor Ben Haim
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Yona Greenman
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine Tel-Aviv University, Israel
| | - Naftali Stern
- The Sackler Faculty of Medicine Tel-Aviv University, Israel; The Sagol Center for Epigenetics of Aging and Metabolism, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
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Ofir O, Buch A, Rouach V, Goldsmith R, Stern N, Monsonego-Ornan E. Association between abdominal obesity and fragility fractures among elderly Israeli women. Aging Clin Exp Res 2020; 32:1459-1467. [PMID: 31522392 DOI: 10.1007/s40520-019-01347-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/03/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Obesity has been traditionally viewed as a protective factor for fractures. Recent studies have challenged this concept, particularly regarding abdominal obesity. We aimed to investigate the association between abdominal obesity, body mass index (BMI) and fragility fractures prevalence in a sample of community-dwelling elderly Israeli women. METHODS The data in this cross-sectional study were based on 'Mabat Zahav'-a survey of a nationally representative sample of elderly Israelis. The study population included 669 women. Data on fragility fractures site and circumstances were self-reported, and height, weight, waist and calf circumferences were measured. Waist circumference (WC) variable was divided into tertiles: < 88 cm, 88-99 cm and > 99 cm. RESULTS Sixty-five women reported fragility fractures (14 hip fractures, 18 vertebral fractures and 39 wrist fractures). Mean age was 73.9 ± 5.9 years, mean BMI was 29.9 ± 5 kg/m2 and mean WC was 93.9 ± 12 cm. While BMI was not associated with osteoporotic fractures, abdominal obesity (WC > 88 cm) was positively associated with fragility fractures, independently of age, smoking, physical activity [middle and high WC tertiles {3.15 (95% CI 1.41-7.02), 2.78 (95% CI 1.05-7.31), respectively}]. CONCLUSIONS Among this sample of elderly women, abdominal obesity was positively associated with fragility fractures, independently of age, smoking, physical activity and BMI. Waist circumference, an easily measured anthropometric indicator, may be useful for assessing the risk of fragility fractures in elderly women, particularly among those with normal or high BMI-a vast population which has been traditionally considered as having lower fracture risk.
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Affiliation(s)
- Orit Ofir
- Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, P.O.B 12, 76100, Rehovot, Israel.
| | - Assaf Buch
- Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, P.O.B 12, 76100, Rehovot, Israel
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, 6 Weizmann St, 64239, Tel-Aviv, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Dr Ya'ackov Klachkin 35 St, 6997801, Tel-Aviv, Israel
| | - Vanessa Rouach
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, 6 Weizmann St, 64239, Tel-Aviv, Israel
| | - Rebecca Goldsmith
- Nutrition Division, Ministry of Health Israel, Yirmiyahu 39 St, Jerusalem, Israel
| | - Naftali Stern
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, 6 Weizmann St, 64239, Tel-Aviv, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Dr Ya'ackov Klachkin 35 St, 6997801, Tel-Aviv, Israel
| | - Efrat Monsonego-Ornan
- Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, P.O.B 12, 76100, Rehovot, Israel
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The impact of obesity on acute pancreatitis outcomes in older patients. Eur Geriatr Med 2020; 11:427-432. [PMID: 32297267 DOI: 10.1007/s41999-020-00305-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Although obesity is an established risk factor for a number of diseases, several epidemiological studies have demonstrated that older obese patients have better survival rates than non-obese old patients in various disease states. In this context, the relationship between obesity and acute pancreatitis outcome in older patients is controversial. Therefore, the authors aimed to investigate the impact of obesity on acute pancreatitis outcomes in older patients. METHODS Patients aged > 65 years who had been hospitalized for acute pancreatitis were retrospectively analyzed. Among them, 190 patients were included. The median age was 73 (68-79) years, and 118 (62.1%) were women. Obesity was assessed according to body mass index, and patients were classified as either obese or non-obese. The primary endpoint of the study was in-hospital major adverse events (major in-hospital complications and death). The secondary endpoints were acute pancreatitis recurrence, 30-day all-cause mortality, and long-term all-cause mortality. RESULTS A total of 77 (40.5%) patients were obese. In-hospital major adverse events were observed in 40 (21.1%) patients. There was no statistical difference in major in-hospital adverse events between the two groups (27 [23.9%] in non-obese patients vs. 13 [16.9%] in obese patients, p = 0.24). Further, the 30-day mortality, long-term survival, and acute pancreatitis recurrence rates were similar (all p > 0.05). The median follow-up time was 18 (0-80) months. CONCLUSION Obesity does not result in higher mortality or complications in older patients with acute pancreatitis. Although the underlying mechanism needs to be elucidated, the deleterious effect of obesity seems to be diminished in older patients.
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Lærum-Onsager E, Brovold T, Bergland A, Pripp AH, Bye A. Associations between health-related quality of life, body mass index, health status and sociodemographic variables in geriatric patients and non-hospitalized older people: A comparative cross-sectional study. Nutr Health 2020; 26:141-150. [PMID: 32297563 DOI: 10.1177/0260106020909047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Data on health-related quality of life (HRQoL) in geriatric patients and non-hospitalized older people are lacking, and the associations among HRQoL, body mass index (BMI) and health status are not sufficiently investigated in these groups. AIM This study aims to describe and compare HRQoL in a sample of geriatric patients and non-hospitalized people >70 years. It further aims to investigate the associations between HRQoL, BMI, health status and sociodemographic variables in geriatric patients and non-hospitalized people >70 years. METHODS This cross-sectional study included 107 geriatric patients and 328 non-hospitalized older people. HRQoL was measured with the 36-Item Short Form Survey (SF-36) and BMI was divided into three classes: underweight (<22 kg/m2), normal weight (22-27 kg/m2) and overweight (>27 kg/m2). RESULTS All SF-36 scores were lower for the geriatric patients than for the non-hospitalized people (p < .001). Underweight (BMI <22 kg/m2) was registered for 43.9% of the geriatric patients and for 13.7% of the non-hospitalized people. No significant associations were found between the SF-36 subscale scores and underweight, but overweight was associated with lower scores on physical functioning (B: -8.7) and vitality (B: -6.8) compared to those with normal BMI (p < .05). The participants with rheumatic diseases, pulmonary diseases, hypertension and digestive diseases had significantly lower scores on most SF-36 scales reflecting physical health. CONCLUSION HRQoL is substantially lower in geriatric patients than in non-hospitalized older people. The negative effects of both overweight and morbidity on HRQoL indicate that it is important to monitor weight and disease symptoms to promote HRQoL in older people, whether hospitalized or non-hospitalized.
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Affiliation(s)
- Ellisiv Lærum-Onsager
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Norway.,Department of Nursing, Lovisenberg Diaconal University College, Norway
| | - Therese Brovold
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Norway
| | - Astrid Bergland
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Norway
| | - Are H Pripp
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Norway.,Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Norway
| | - Asta Bye
- Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital, Norway.,Department of Health, Nutrition and Management, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Norway
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Son KY, Kwon H, Park JH, Joh HK, Hwang SE, Cho SH, Han K, Cho B, Park YG. Association between weight change over a period of 4 years and mortality in Korean older adults. Geriatr Gerontol Int 2020; 20:474-481. [PMID: 32196904 DOI: 10.1111/ggi.13908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/06/2020] [Accepted: 02/28/2020] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to evaluate the association between weight change and mortality in Korean older adults. METHODS We collected data pertaining to National Screening Program participants aged ≥65 years from the Korean National Health Insurance Corporation records during 2005-2011. To this data, we included mortality data, such as the date of death, of these patients (up to and including 2017) from Statistics Korea. We defined weight change as a difference in bodyweight measured in the National Screening Program over a period of 4 years. Cox proportional hazards models were used to evaluate the association between weight change and mortality. RESULTS The study population consisted of 1 100 256 participants, and a total of 46 415 deaths were observed during a mean follow-up period of 3.2 ± 0.8 years (maximum 5.0 years). For 3 531 585 person-year follow up, the mortality rate for stable weight was 10.79 per 1000 person-years (PY). Weight loss increased the mortality rate by 68%, whereas weight gain increased the rate by 10% compared with stable weight (weight loss: mortality rate 20.28 per 1000 PY, adjusted hazard ratio 1.68, 95% confidence interval 1.65-1.72; weight gain: mortality rate 12.86 per 1000 PY, adjusted hazard ratio 1.10, 95% confidence interval 1.07-1.13). However, in subgroup analysis, for participants who were underweight at baseline, current cigarette smokers or heavy alcohol drinkers, weight gain did not increase the mortality rate. CONCLUSIONS In Korean older adults, regardless of the risk factors, both weight loss and weight gain increased the mortality rate compared with stable weight. Geriatr Gerontol Int 2020; 20: 474-481.
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Affiliation(s)
- Ki Young Son
- Department of Family Medicine, Asan Medical Center, Seoul, Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Health Promotion Center, Seoul National University Hospital, Seoul, Korea.,Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Ho Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Health Promotion Center, Seoul National University Hospital, Seoul, Korea.,Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hee-Kyung Joh
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seo Eun Hwang
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Health Promotion Center, Seoul National University Hospital, Seoul, Korea.,Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Su Hwan Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Belong Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Health Promotion Center, Seoul National University Hospital, Seoul, Korea.,Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yong-Gyu Park
- Department of Biostatistics, The Catholic University of Korea College of Medicine, Seoul, Korea
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19
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Banack HR, Bea JW, Stokes A, Kroenke CH, Stefanick ML, Beresford SA, Bird CE, Garcia L, Wallace R, Wild RA, Caan B, Wactawski-Wende J. It's Absolutely Relative: The Effect of Age on the BMI-Mortality Relationship in Postmenopausal Women. Obesity (Silver Spring) 2020; 28:171-177. [PMID: 31799808 PMCID: PMC6989046 DOI: 10.1002/oby.22662] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/27/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The use of relative and absolute effect estimates has important implications for the interpretation of study findings. Likewise, examining additive and multiplicative interaction can lead to differing conclusions about the joint effects of two exposure variables. The aim of this paper is to examine the relationship between BMI and mortality on the relative and absolute scales and investigate interaction between BMI and age. METHODS Data from 68,132 participants in the Women's Health Initiative (WHI) study were used. The risk ratio and risk difference of BMI on mortality were estimated. A product term was also included to examine interaction between BMI and age on the multiplicative scale, and the relative excess risk of interaction was calculated to measure additive interaction. RESULTS Results demonstrated that the mortality risk ratio decreased as women aged, but the mortality risk difference increased as women aged. Evidence of additive and multiplicative interaction between age and BMI was found. CONCLUSIONS In postmenopausal women, the relative mortality risk associated with high BMI decreased with increasing age, but the absolute risk of high BMI increased with increasing age. This indicates the importance of considering the interaction between age and BMI to understand mortality risk in older women.
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Affiliation(s)
- Hailey R Banack
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Jennifer W Bea
- Department of Nutrition Sciences, University of Arizona Cancer Center, University of Arizona, Tucson, Arizona, USA
| | - Andrew Stokes
- Department of Global Health and Center for Global Health and Development, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Marcia L Stefanick
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Shirley A Beresford
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | | | - Lorena Garcia
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Robert Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Robert A Wild
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
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20
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André P, Samieri C, Buisson C, Dartigues JF, Helmer C, Laugerette F, Féart C. Lipopolysaccharide-Binding Protein, Soluble CD14, and the Long-Term Risk of Alzheimer’s Disease: A Nested Case-Control Pilot Study of Older Community Dwellers from the Three-City Cohort. J Alzheimers Dis 2019; 71:751-761. [DOI: 10.3233/jad-190295] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Perrine André
- Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, team Lifelong Exposure Health and Aging, U1219, Bordeaux, France
| | - Cécilia Samieri
- Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, team Lifelong Exposure Health and Aging, U1219, Bordeaux, France
| | - Charline Buisson
- Univ-Lyon, CarMeN laboratory, INRA U1397, Inserm U1060, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France
| | - Jean-François Dartigues
- Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, team Lifelong Exposure Health and Aging, U1219, Bordeaux, France
| | - Catherine Helmer
- INSERM, Clinical Investigation Center – Clinical Epidemiology, Bordeaux, France
| | - Fabienne Laugerette
- Univ-Lyon, CarMeN laboratory, INRA U1397, Inserm U1060, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France
| | - Catherine Féart
- Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, team Lifelong Exposure Health and Aging, U1219, Bordeaux, France
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21
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Avgerinou C, Bhanu C, Walters K, Croker H, Liljas A, Rea J, Bauernfreund Y, Kirby-Barr M, Hopkins J, Appleton A, Kharicha K. Exploring the Views and Dietary Practices of Older People at Risk of Malnutrition and Their Carers: A Qualitative Study. Nutrients 2019; 11:E1281. [PMID: 31195731 PMCID: PMC6627873 DOI: 10.3390/nu11061281] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/10/2019] [Accepted: 06/03/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND While malnutrition is an important cause of morbidity and mortality in older people, it is commonly under-recognised. We know little on the views of community-dwelling older people and their carers regarding the management of malnutrition. The aim of the study was: (a) to explore views and dietary practices of older people at risk of malnutrition and their carers; (b) to identify gaps in knowledge, barriers and facilitators to healthy eating in later life; (c) to explore potential interventions for malnutrition in primary care. METHODS A qualitative study was performed using semi-structured interviews with participants recruited from four general practices and a carers' focus group in London. Community-dwelling people aged ≥75, identified as malnourished or at risk of malnutrition (n = 24), and informal carers of older people (n = 9) were interviewed. Data were analysed using thematic analysis. RESULTS Older people at risk of malnutrition rarely recognise appetite or weight loss as a problem. Commonly held perceptions include that being thin is healthy and 'snacking' is unhealthy. Changes in household composition, physical or mental health conditions and cognitive impairment can lead to inadequate food intake. Most carers demonstrate an awareness of malnutrition, but also a lack of knowledge of what constitutes a nutritious diet. Although older people rarely seek any help, most would value advice from their GP/practice nurse, a dietitian or another trained professional. CONCLUSION Older people at risk of malnutrition and their carers lack knowledge on nutritional requirements in later life but are receptive to intervention. Training for health professionals in delivering tailored dietary advice should be considered.
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Affiliation(s)
- Christina Avgerinou
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Cini Bhanu
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Helen Croker
- Health Behaviour Research Centre, University College London, London WC1E 6BT, UK.
| | - Ann Liljas
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Jennifer Rea
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Yehudit Bauernfreund
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | | | - Jane Hopkins
- Patient and Public Involvement Representative, London, UK.
| | - Amber Appleton
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Kalpa Kharicha
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
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22
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Kim HJ, Min JY, Min KB. Successful Aging and Mortality Risk: The Korean Longitudinal Study of Aging (2006-2014). J Am Med Dir Assoc 2019; 20:1013-1020. [PMID: 30772169 DOI: 10.1016/j.jamda.2018.12.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/07/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of this study is to examine the association of successful aging with mortality and further find gender differences in the effect of components of successful aging on mortality risks. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS A total of 3848 adults aged 65 and older from the Korean Longitudinal Study of Aging (2006-2014) data. MEASURES Successful aging was defined as success in the following 7 components: absence of major disease, no depression, no freedom from disability, high cognitive and physical function, active social engagement, and satisfaction with life. All-cause mortality was measured by death certificate and family interview. RESULTS In both genders, the mortality rate was higher in the older adults who did not achieve successful aging than in their counterparts (men: hazard ratio [HR] = 1.69, 95% confidence interval [CI] 1.18-2.43; and women: HR = 2.37, 95% CI 1.21-4.63). All components of no successful aging were associated with an increased risk of mortality except for no satisfaction with life in females. Mortality rates were predominant in major disease (HR = 1.86, 95% CI 1.54-2.25) and depressive symptoms (HR = 1.62, 95% CI 1.26-2.10) in males, and disability (HR = 2.08, 95% CI 1.68-2.57) and low physical functioning (HR = 2.31, 95% CI 1.79-2.98) were predominant in females. CONCLUSION/IMPLICATION We found that older Koreans who did not achieve successful aging had a higher risk of all-cause mortality than successful agers. There were gender differences in mortality risks across all components of successful aging.
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Affiliation(s)
- Hye-Jin Kim
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jin-Young Min
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
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23
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Zou H, Yin P, Liu L, Liu W, Zhang Z, Yang Y, Li W, Zong Q, Yu X. Body-Weight Fluctuation Was Associated With Increased Risk for Cardiovascular Disease, All-Cause and Cardiovascular Mortality: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2019; 10:728. [PMID: 31787929 PMCID: PMC6856014 DOI: 10.3389/fendo.2019.00728] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/09/2019] [Indexed: 01/05/2023] Open
Abstract
Background: The aim of this study was to evaluate associations between body-weight fluctuation and risk of mortality and cardiovascular diseases (CVD). Methods: PubMed, EMBASE databases and Cochrane Library were searched for cohort studies published up to May 20, 2019, reporting on associations of body-weight fluctuation and mortality from all causes, CVD and cancer, as well as morbidity of CVD and hypertension. Summary relative risks (RRs) were estimated using a random-effects model. Results: Twenty-five eligible publications from 23 studies with 441,199 participants were included. Body-weight fluctuation was associated with increased risk for all-cause mortality (RR, 1.41; 95% confidence interval (CI): 1.27-1.57), CVD mortality (RR, 1.36; 95% CI 1.22-1.52), and morbidity of CVD (RR, 1.49, 95% CI 1.26-1.76) and hypertension (RR, 1.35, 95% CI 1.14-1.61). However, there was no significant association between weight fluctuation and cancer mortality (RR, 1.01; 95% CI 0.90-1.13). No evidence of publication bias was observed (all P > 0.05) except for studies on all-cause mortality (Egger's test, P = 0.001; Begg's test, P = 0.014). Conclusions: Body-weight fluctuation was associated with higher mortality due to all causes and CVD and a higher morbidity of CVD and hypertension.
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Affiliation(s)
- Huajie Zou
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liegang Liu
- Hubei Key Laboratory of Food Nutrition and Safety, Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Wuhan, China
| | - Wenhua Liu
- Medical Translation Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zeqing Zhang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Yang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenjun Li
- Computer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qunchuan Zong
- Department of Orthopedics, The Affiliated Hospital of Qinghai University, Medical College of Qinghai University, Xining, China
| | - Xuefeng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xuefeng Yu
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24
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Crotti G, Gianfagna F, Bonaccio M, Di Castelnuovo A, Costanzo S, Persichillo M, De Curtis A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Body Mass Index and Mortality in Elderly Subjects from the Moli-Sani Study: A Possible Mediation by Low-Grade Inflammation? Immunol Invest 2018; 47:774-789. [PMID: 30422032 DOI: 10.1080/08820139.2018.1538237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The association between obesity and mortality in the elderly remains controversial. To test the association between BMI and mortality, with the hypothesis of a mediation by low-grade inflammation (LGI), a prospective study design (median follow-up 7.8 years) was used on a sample of 4,970 elderly subjects (age ≥ 65 years) from the Moli-sani Study cohort. The association between BMI categories and overall or cause-specific mortality (hazard ratio, HR) was calculated by multivariable Cox regression. Dose-response relationship was tested using restricted cubic splines. Interaction between BMI and LGI, assessed through high-sensitivity C-reactive protein (hs-CRP) and INFLA-score, was also tested. In comparison with normal-weight, overweight was significantly associated with a 20% (adjusted HR = 0.80; 95%CI 0.67-0.95) reduced risk of total mortality, while severe obesity (BMI > 40) with an increased risk (HR = 1.81; 95%CI 1.13-2.93). Cubic spline curves showed a U-shaped relationship between BMI and total mortality (p value for nonlinear relationship = 0.001). Similar results were found for cardio-cerebrovascular and other causes mortality. Hs-CRP and INFLA-score were associated with an increased risk of total mortality in adjusted analyses. Mediation analysis did not show any effect of LGI on the association between BMI and mortality. However, after stratification for LGI under or below the population median, greater LGI increased the risk of mortality in obese elderly more than expected (p for interaction = 0.04). A U-shaped association between BMI and mortality was observed in Italian elderly subjects. While the association was independent of LGI levels, there was a significant interaction between BMI and LGI in increasing mortality risk in obese elderly individuals.
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Affiliation(s)
- Giacomo Crotti
- a Research Center on Public Health, Department of Medicine and Surgery , University of Milano-Bicocca , Monza , Italy
| | - Francesco Gianfagna
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy.,c Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery , University of Insubria , Varese , Italy
| | - Marialaura Bonaccio
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | | | - Simona Costanzo
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | | | - Amalia De Curtis
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | - Chiara Cerletti
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | | | - Giovanni de Gaetano
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | - Licia Iacoviello
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy.,c Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery , University of Insubria , Varese , Italy
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25
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Lv YB, Yuan JQ, Mao C, Gao X, Yin ZX, Kraus VB, Luo JS, Chen HS, Zeng Y, Wang WT, Wang JN, Shi XM. Association of Body Mass Index With Disability in Activities of Daily Living Among Chinese Adults 80 Years of Age or Older. JAMA Netw Open 2018; 1:e181915. [PMID: 30646143 PMCID: PMC6324469 DOI: 10.1001/jamanetworkopen.2018.1915] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Body mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging. OBJECTIVE To examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older. DESIGN, SETTING, AND PARTICIPANTS Data were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese Longitudinal Healthy Longevity Study, a community-based prospective cohort study conducted in 23 provinces of China. The study was initiated in 1998, with follow-up and recruitment of new participants in 2000, 2002, 2005, 2008, 2011, and 2014. MAIN OUTCOMES AND MEASURES Disability in ADL was defined as dependence in eating, toileting, bathing, dressing, indoor activities, and/or continence. RESULTS Among the 16 022 participants, 45.2% were men and 54.8% were women, with a mean (SD) age of 92.2 (7.2) years and a mean (SD) BMI (calculated as weight in kilograms divided by height in meters squared) of 19.3 (3.8). During 70 606 person-years of follow-up, 8113 participants with disability in ADL were identified. Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in ADL: each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL. In comparison with individuals in the fourth quintile for BMI, the adjusted hazard ratio for disability in ADL was 1.38 (95% CI, 1.29-1.48) in the first quintile, 1.37 (95% CI, 1.28-1.47) in the second quintile, 1.11 (95% CI, 1.04-1.19) in the third quintile, and 0.85 (95% CI, 0.79-0.91) in the fifth quintile (P < .001 for trend). When BMI was categorized by Chinese guidelines, the underweight group (BMI <18.5) showed significantly increased risk of disability in ADL (hazard ratio, 1.34; 95% CI, 1.28-1.41) and the overweight or obese group (BMI ≥24.0) showed significantly decreased risk of disability in ADL (hazard ratio, 0.84; 95% CI, 0.78-0.91) compared with the normal weight group (BMI 18.5 to <24.0) (P < .001 for trend). CONCLUSIONS AND RELEVANCE Higher BMI was associated with a lower risk of disability in ADL among Chinese adults age 80 years or older, which suggests that current recommendations for BMI may need to be revisited. More attention should be paid on underweight, rather than overweight or obesity, for the prevention of disability in ADL after age 80 years.
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Affiliation(s)
- Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jin-Qiu Yuan
- Division of Epidemiology, Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, Philadelphia
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Jie-Si Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Shuai Chen
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
- Center for Study of Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Wen-Tao Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiao-Nan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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26
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Visser M, Wijnhoven HAH, Comijs HC, Thomése FGCF, Twisk JWR, Deeg DJH. A Healthy Lifestyle in Old Age and Prospective Change in Four Domains of Functioning. J Aging Health 2018; 31:1297-1314. [PMID: 29809092 PMCID: PMC7322976 DOI: 10.1177/0898264318774430] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The aim of this article is to study the associations between healthy lifestyle in old age and decline in physical, psychological, cognitive, and social functioning. Method: A population-based sample of 3,107 Dutch men and women aged 55 and 85 years (1992/1993; Longitudinal Aging Study Amsterdam) was used with five 3-yeary follow-up examinations. Lifestyle score, based on smoking status, alcohol consumption, physical activity, and body mass index (BMI), ranged from 0 (unhealthy) to 4 (healthy). Outcomes included gait speed, depressive symptoms, cognitive status, and social contacts. Results: Persons with a healthy lifestyle had a 10.6% slower decline in gait speed (0.04 m/s, 95% confidence interval [CI] = [0.03, 0.05]), 10.8% slower increase in depressive symptoms (–1.07 [–1.70, –0.44]), a 1.8% slower decline in cognitive functioning (0.47 [0.23, 0.70]), and a 4.9% slower decline in social contacts (0.58 [0.01, 1.15]) compared with persons with no or one healthy lifestyle factor. Discussion: A healthy lifestyle benefits physical, psychological, cognitive, and social functioning up to very old age.
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Affiliation(s)
- Marjolein Visser
- 1 Vrije Universiteit Amsterdam, The Netherlands.,2 VU University Medical Center, Amsterdam, The Netherlands
| | | | - Hannie C Comijs
- 2 VU University Medical Center, Amsterdam, The Netherlands.,3 GGZ inGeest, Amsterdam, The Netherlands
| | | | - Jos W R Twisk
- 2 VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- 2 VU University Medical Center, Amsterdam, The Netherlands
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27
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Tabue-Teguo M, Grasset L, Avila-Funes JA, Genuer R, Proust-Lima C, Péres K, Féart C, Amieva H, Harmand MGC, Helmer C, Salles N, Rainfray M, Dartigues JF. Prevalence and Co-Occurrence of Geriatric Syndromes in People Aged 75 Years and Older in France: Results From the Bordeaux Three-city Study. J Gerontol A Biol Sci Med Sci 2017; 73:109-116. [PMID: 28541397 DOI: 10.1093/gerona/glx068] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 04/10/2017] [Indexed: 11/13/2022] Open
Abstract
Background Geriatric syndromes (GSs) are often the result of cumulative insults to multiple organ systems and are considered common in older adults. However, their frequency and co-occurrence are not well known in the elderly population. This study aimed to determine the prevalence of several GSs and to analyze the co-occurrence of these syndromes in a general population of elderly individuals. Methods A cross-sectional analysis of 630 adults aged 75 years or older participating in the 10-year follow-up of the Bordeaux sample of the French Three-City Study was conducted. The following 10 GSs were assessed: physical frailty, dementia and cognitive impairment, depressive symptoms, polymedication, social isolation, thinness, falls, dependence, sensory deficit, and incontinence. The prevalence of the 10 GSs was estimated, and multiple correspondence analysis (MCA) models were used to explore the mutual associations between these GSs. Results The mean age of the participants was 83.3 years; 69% were women, and 80.5% [95% confidence interval (CI) = 76.3-82.7] had at least one GS. The most frequent GSs were polymedication (50.6% 95%CI = 46.7-54.5) and falls (43.1% 95%CI = 38.4-46.1). The MCA models identified two major dimensions of the 10 GSs: "Dementia-Dependence-Incontinence" and "Frailty-Depression-Isolation." Conclusions GSs were very common in this French elderly population and were grouped into two major dimensions: the "Dementia-Dependence-Incontinence" and "Frailty-Depression-Isolation."
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Affiliation(s)
- Maturin Tabue-Teguo
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Institut des Maladies Neurodégénératives Clinique, Centre Hospitalier Universitaire de Bordeaux, France.,Centre Hospitalier Villeneuve-sur-Lot, France
| | - Leslie Grasset
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - José Alberto Avila-Funes
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Robin Genuer
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Cecile Proust-Lima
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Karine Péres
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Catherine Féart
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Hélène Amieva
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Institut des Maladies Neurodégénératives Clinique, Centre Hospitalier Universitaire de Bordeaux, France
| | - Magali González-Colaço Harmand
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Catherine Helmer
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Nathalie Salles
- Pôle gérontologie clinique, Centre Hospitalier Universitaire de Bordeaux, France
| | - Muriel Rainfray
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Pôle gérontologie clinique, Centre Hospitalier Universitaire de Bordeaux, France
| | - Jean François Dartigues
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Institut des Maladies Neurodégénératives Clinique, Centre Hospitalier Universitaire de Bordeaux, France
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Strazhesko ID, Tkacheva ON, Akasheva DU, Dudinskaya EN, Plokhova EV, Pykhtina VS, Kruglikova AS, Brailova NV, Sharashkina NV, Kashtanova DA, Isaykina OY, Pokrovskaya MS, Vygodin VA, Ozerova IN, Skvortsov DA, Boytsov SA. Growth Hormone, Insulin-Like Growth Factor-1, Insulin Resistance, and Leukocyte Telomere Length as Determinants of Arterial Aging in Subjects Free of Cardiovascular Diseases. Front Genet 2017; 8:198. [PMID: 29375617 PMCID: PMC5770739 DOI: 10.3389/fgene.2017.00198] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Increased arterial stiffness (AS), intima-media thickness (IMT), and the presence of atherosclerotic plaques (PP) have been considered as important aspects of vascular aging. It is well documented that the cardiovascular system is an important target organ for growth hormone (GH) and insulin-like growth factor (IGF)-1 in humans, and GH /IGF-1 deficiency significantly increases the risk for cardiovascular diseases (CVD). The telomere length of peripheral blood leukocytes (LTL) is a biomarker of cellular senescence and that has been proposed as an independent predictor of (CVD). The aim of this study is to determine the role of GH/IGF-1, LTL and their interaction cardiovascular risk factors (CVRF) in the vascular aging. Methods: The study group included 303 ambulatory participants free of known CVD (104 males and 199 females) with a mean age of 51.8 ± 13.3 years. All subjects had one or more CVRF [age, smoking, arterial hypertension, obesity, dyslipidemia, fasting hyperglycemia, insulin resistance-HOMA (homeostatic model assessment) >2.5, or high glycated hemoglobin]. The study sample was divided into the two groups according to age as "younger" (m ≤ 45 years, f ≤ 55 years) and "older" (m > 45 years, f > 55 years). IMT and PP were determined by ultrasonography, AS was determined by measuring the carotid-femoral pulse wave velocity (c-f PWV) using the SphygmoCor system (AtCor Medical). LTL was determined by PCR. Serum IGF-1 and GH concentrations we measured by immunochemiluminescence analysis. Results: Multiple linear regression analysis with adjustment for CVRF indicated that HOMA, GH, IGF-1, and LTL had an independent relationship with all the arterial wall parameters investigated in the younger group. In the model with c-f PWV as a dependent variable, p < 0.001 for HOMA, p = 0.03 for GH, and p = 0.004 for LTL. In the model with IMT as a dependent variable, p = 0.0001 for HOMA, p = 0.044 for GH, and p = 0.004 for IGF-1. In the model with the number of plaques as a dependent variable, p = 0.0001 for HOMA, and p = 0.045 for IGF-1. In the older group, there were no independent significant associations between GH/IGF-1, LTL, HOMA, and arterial wall characteristics. Conclusions: GH/IGF-1, IR, HOMA, and LTL were the important parameters of arterial aging in younger healthy participants.
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Affiliation(s)
- Irina D Strazhesko
- Department of Clinical Cardiology and Molecular Genetics, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.,Department of Age-associated Diseases, Medical Scientific and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Olga N Tkacheva
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Dariga U Akasheva
- Department of Fundamental and Applied Aspects of Obesity, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Ekaterina N Dudinskaya
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ekaterina V Plokhova
- Department of Cardiology, Federal Scientific and Clinical Center of the Federal Medico-Biological Agency, Moscow, Russia
| | - Valentina S Pykhtina
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Anna S Kruglikova
- Department of Aging and Age-associated Diseases Prevention, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Natalia V Brailova
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Natalia V Sharashkina
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Daria A Kashtanova
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Olesya Y Isaykina
- Department of Primary Prevention of Chronic Non-Communicable Diseases in the Healthcare System, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Mariya S Pokrovskaya
- Biobank, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Vladimir A Vygodin
- Department of Epidemiology of Chronic Non-Communicable Diseases Laboratory of Biostatistics, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Irina N Ozerova
- Department of Biochemical Markers of Chronic Non-Communicable Diseases Research, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Dmitry A Skvortsov
- Department of Chemistry, Lomonosov Moscow State University, Moscow, Russia
| | - Sergey A Boytsov
- National Medical Research Center for Cardiology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
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29
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Morrison VA, McCall L, Muss HB, Jatoi A, Cohen HJ, Cirrincione CT, Ligibel JA, Lafky JM, Hurria A. The impact of actual body weight-based chemotherapy dosing and body size on adverse events and outcome in older patients with breast cancer: Results from Cancer and Leukemia Group B (CALGB) trial 49907 (Alliance A151436). J Geriatr Oncol 2017; 9:228-234. [PMID: 29233548 DOI: 10.1016/j.jgo.2017.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/05/2017] [Accepted: 11/13/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Actual weight-based (AWB) chemotherapy dosing is recommended for obese patients in the 2012 ASCO Clinical Practice Guideline. CALGB 49907, which utilized ABW-based adjuvant chemotherapy dosing, was a phase 3 trial in women age≥65years with early stage breast cancer, providing the opportunity to examine impact of such dosing on toxicities and outcome in older patients with breast cancer. MATERIALS AND METHODS Adverse event data were available for 615 of 633 enrolled patients. Objectives were to assess grade≥3 hematologic/non-hematologic toxicities by treatment arm, age, study entry BSA/BMI, and relapse-free (RFS) and overall survival (OS) by BSA/BMI. RESULTS The 615 patients were sub-grouped by BSA (quartiles) and standard BMI categories, with BMI underweight/normal weight categories combined. Overall, grade≥3 non-hematologic and hematologic toxicities occurred in 39.8% and 28.3% of patients, respectively. There were no significant differences in grade≥3 toxicities among BSA quartiles. However, more grade≥3 hematologic toxicities occurred in the underweight/normal weight BMI subgroup compared to overweight/obese subgroups (p=0.048). Type of chemotherapy and age had no impact on toxicity occurrence by BSA/BMI categories. RFS was superior in the 25th-50th BSA percentile patients in univariate analysis (p=0.042), as was OS in both univariate and multivariate analyses (p=0.007, p=0.009, respectively). No differences in RFS or OS were found by BMI categories. CONCLUSION Obesity was not correlated with adverse relapse or survival outcome, and grade≥3 toxicities were not greater with ABW-based dosing. This supports safety and efficacy of ABW-based dosing as per the 2012 ASCO clinical practice guideline. ClinicalTrials.gov Identifier: NCT00024102 (49907).
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Affiliation(s)
- Vicki A Morrison
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, United States; Division of Infectious Disease, University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, United States.
| | - Linda McCall
- Alliance Statistics and Data Center, Duke University, Durham, NC, United States.
| | - Hyman B Muss
- UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
| | | | - Harvey J Cohen
- Duke University Medical Center, Durham, NC, United States.
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30
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Relationship between body mass and ambulatory blood pressure: comparison with office blood pressure measurement and effect of treatment. J Hum Hypertens 2017; 32:122-128. [PMID: 29203908 PMCID: PMC5826780 DOI: 10.1038/s41371-017-0021-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/08/2017] [Accepted: 10/19/2017] [Indexed: 01/19/2023]
Abstract
Epidemiologic studies assessing the relationship between blood pressure (BP), body mass and cardiovascular events have primarily been based on office BP measurements, and few data are available in the elderly. The aim of the present study was to evaluate the relationship between body mass index (BMI) and BP values obtained by ambulatory blood pressure monitoring (ABPM) as compared to office BP measurements, and the effect of anti-hypertensive treatment on the relationship. The study population consisted of 813 subjects participating in the Cardiovascular Abnormalities and Brain Lesions (CABL) study who underwent 24-hour ABPM. Office BP (mean of 2 measurements) was found to be associated with increasing BMI, for both SBP (p≤0.05) and DBP (p≤0.001). In contrast, there was no association seen of increasing BMI with ABPM parameters in the overall cohort, even after adjusting for age and gender. However, among subjects not on anti-hypertensive treatment, office SBP and DBP measurements were significantly correlated with increasing BMI (p≤0.01) as were daytime SBP and 24-hour SBP, although with a smaller spread across BMI subgroups compared with office readings. In treated hypertensives, there was only a trend toward increasing office DBP and increasing DBP variability with higher BMI. Our results suggest that body mass may be a less significant influence on BP values in the elderly when ABPM rather than office measurements are considered, particularly in patients receiving anti-hypertensive treatment.
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31
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Lacey B, Yeap BB, Golledge J, Lewington S, McCaul KA, Norman PE, Flicker L, Almeida OP, Hankey GJ. Body Mass Index and Vascular Disease in Men Aged 65 Years and Over: HIMS (Health In Men Study). J Am Heart Assoc 2017; 6:JAHA.117.007343. [PMID: 29180456 PMCID: PMC5779044 DOI: 10.1161/jaha.117.007343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Understanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising. METHODS AND RESULTS In this prospective cohort study, 12 203 men (aged ≥65) were recruited in 1996-1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow-up. During a further 8 (SD3) years of follow-up, there were 1136 first-ever major vascular events (nonfatal myocardial infarction, nonfatal stroke, or death from any vascular cause). Cox regression (adjusted for age, education, and smoking) related BMI at recruitment to incidence of major vascular events. At ages 65 to 94, the lowest risk of major vascular events was at ≈ 22.5 to 25 kg/m2. In the higher BMI range (≥25 kg/m2), 5 kg/m2 higher BMI was associated with 33% higher risk of major vascular events (hazard ratio, 1.33 [95% confidence interval, 1.18-1.49]): 24% higher risk of ischemic heart disease (1.24 [1.06-1.46]); 34% higher risk of stroke (1.34 [1.11-1.63]); and 78% higher risk of other vascular death (1.78 [1.32-2.41]). In the lower BMI range, there were fewer events and no strong evidence of an association (hazard ratio per 5 kg/m2 higher BMI, 0.82 [95% confidence interval, 0.61-1.12]). CONCLUSIONS In this population of older men, risk of major vascular events was lowest at ≈ 22.5 to 25 kg/m2. Above this range, BMI was strongly related to incidence of major vascular events, with each 5 kg/m2 higher BMI associated with ≈30% higher risk.
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Affiliation(s)
- Ben Lacey
- Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia .,School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.,Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals, Perth, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia.,The Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia
| | - Sarah Lewington
- MRC Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Kieran A McCaul
- Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia.,School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | - Paul E Norman
- School of Surgery, University of Western Australia, Perth, Australia
| | - Leon Flicker
- Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia.,School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.,Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia
| | - Osvaldo P Almeida
- Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia.,School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.,Department of Neurology, Sir Charles Gairdner Hospital, Perth, Australia
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Silveira EAD, Vieira LL, Jardim TV, Souza JDD. Obesity and its Association with Food Consumption, Diabetes Mellitus, and Acute Myocardial Infarction in the Elderly. Arq Bras Cardiol 2017; 107:509-517. [PMID: 28558083 PMCID: PMC5210454 DOI: 10.5935/abc.20160182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/26/2016] [Indexed: 11/20/2022] Open
Abstract
Background Obesity affects a large part of elderly individuals worldwide and is
considered a risk predictor for the development of chronic diseases such as
cardiac diseases, the leading causes of death in the elderly population. Objective To investigate the prevalence of obesity and associated factors, with
emphasis on the occurrence of other diseases and on food consumption in
elderly individuals treated at the Brazilian Unified Health System (Sistema
Único de Saúde, SUS). Methods Cross-sectional sampling study performed in the city of Goiânia
(Brazil) including elderly individuals (≥ 60 years) receiving primary
care. During home visits, we performed anthropometric measurements and
applied a structured, standardized, and pre-tested questionnaire assessing
socioeconomic, demographic and lifestyle conditions, occurrence of diseases,
and food consumption. We performed multiple Poisson regression analysis
using a hierarchical model and adopting a significance level of 5%. Results We evaluated 418 elderly patients with a mean age of 70.7 ± 7 years.
Their body mass indices had a mean value of 27.0 kg/m2 and were
higher in women than in men (27.4 kg/m2 versus 26.1
kg/m2, respectively, p = 0.017). Obesity had a prevalence of
49.0%, a risk 1.87 times higher between the ages of 60-69 years and 70-79
years, and a rate 1.4 times higher among individuals with more than four
morbidities. On multivariate analysis, the factors associated with obesity
were age 60-69 and 70-79 years, inadequate consumption of whole-wheat grains
and adequate consumption of fruit, musculoskeletal diseases, diabetes
mellitus, and acute myocardial infarction. Conclusions Obesity had a high prevalence in the evaluated elderly population and was
associated with food consumption, musculoskeletal disease, diabetes
mellitus, and acute myocardial infarction.
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Zhou W, Kozikowski A, Pekmezaris R, Lolis J, Tommasulo B, Fishbein J, Wolf-Klein G. Association between Weight Change, Health Outcomes, and Mortality in Older Residents in Long-Term Care. South Med J 2017; 110:459-465. [DOI: 10.14423/smj.0000000000000673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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34
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The Effects of Body Mass Index on Balance, Mobility, and Functional Capacity in Older Adults. TOPICS IN GERIATRIC REHABILITATION 2017. [DOI: 10.1097/tgr.0000000000000144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Lisko I, Tiainen K, Raitanen J, Jylhävä J, Hurme M, Hervonen A, Jylhä M, Stenholm S. Body Mass Index and Waist Circumference as Predictors of Disability in Nonagenarians: The Vitality 90+ Study. J Gerontol A Biol Sci Med Sci 2017; 72:1569-1574. [DOI: 10.1093/gerona/glx032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
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Rodríguez-Fernández JM, Danies E, Martínez-Ortega J, Chen WC. Cognitive Decline, Body Mass Index, and Waist Circumference in Community-Dwelling Elderly Participants. J Geriatr Psychiatry Neurol 2017; 30:67-76. [PMID: 28077009 DOI: 10.1177/0891988716686832] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to explore the association of body mass index (BMI), waist circumference (WC), and BMI and WC changes over time with cognitive decline in a nationally representative sample. METHODS A total of 5239 participants (≥65 years) were followed for 3 years as part of the National Health and Aging Trends Study. Cox proportional hazard regression was applied to model the risk of cognitive decline. RESULTS BMI, after adjusting for WC and main confounders, was associated with reduced risk of cognitive decline (hazard ratio [HR] 0.97 for each unit BMI increase, 0.95-0.99). After stratifying by gender and age, this effect remained significant among females and young elders ≤80 years. A BMI decrease and WC increase >10% over the study period were associated with increased risk of cognitive decline (HR 1.98, 1.16-3.38; HR 1.30, 1.04-1.62, respectively). CONCLUSION In the elderly individuals, lean mass, as measured by BMI adjusted for WC, was associated with reduced risk of cognitive decline. Loss of lean mass and gain of fat mass, as measured by WC adjusted for BMI, were associated with elevated risk of cognitive decline.
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Affiliation(s)
| | - Emily Danies
- 1 Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - José Martínez-Ortega
- 1 Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - William C Chen
- 2 Department of Neurosurgery, University of California, San Francisco, CA, USA
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Peter RS, Nagel G. Sources of heterogeneity in studies of the BMI-mortality association. J Epidemiol 2017; 27:294-297. [PMID: 28256294 PMCID: PMC5463020 DOI: 10.1016/j.je.2016.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 06/29/2016] [Indexed: 12/03/2022] Open
Abstract
Background To date, the amount of heterogeneity among studies of the body mass index-mortality association attributable to differences in the age distribution and length of follow-up has not been quantified. Therefore, we wanted to quantify the amount of heterogeneity attributable to age and follow-up in results of studies on the body mass index-mortality relation. Methods We used optima of the body mass index mortality association reported for 30 populations and performed meta-regression to estimate the amount of heterogeneity attributable to sex, ethnicity, mean age at baseline, percentage smokers, and length of follow-up. Results Ethnicity as single factor accounted for 36% (95% CI, 11–56%) of heterogeneity. Mean age and length of follow-up had an interactive effect and together accounted for 56% (95% CI, 24–74%) of the remaining heterogeneity. Sex did not significantly contribute to the heterogeneity, after controlling for ethnicity, age, and length of follow-up. Conclusions A considerable amount of heterogeneity in studies of the body mass index-mortality association is attributable to ethnicity, age, and length of follow-up. The BMI-mortality association varies considerably between study cohorts. We found ethnicity alone to account for 36% of the heterogeneity. Age and length of follow-up accounted for 56% of the remaining heterogeneity.
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Affiliation(s)
- Raphael Simon Peter
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz, Austria
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Jardim LMSSV, Jardim TV, de Souza WKSB, Pimenta CD, Sousa ALL, Jardim PCBV. Multiprofessional Treatment of High Blood Pressure in Very Elderly Patients. Arq Bras Cardiol 2017; 108:53-59. [PMID: 28146207 PMCID: PMC5245848 DOI: 10.5935/abc.20160196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/29/2016] [Accepted: 09/13/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND As the world population ages, patients older than 80 years, known as very elderly, are more frequently found. There are no studies in this age group aimed at analyzing the multidisciplinary intervention in the treatment of systemic arterial hypertension (SAH) and some comorbidities. OBJECTIVES To assess the effect of a multidisciplinary approach in very elderly hypertensives cared for at a specialized service. METHODS Longitudinal retrospective cohort study in a multidisciplinary service specialized in the SAH treatment in the Brazilian West-Central region. Patients aged 80 years and older by June 2015 were included. Data from the first (V1) and last visit (Vf) were assessed. Anthropometric variables, blood pressure (BP), renal function, pharmacological treatment, lifestyle, comorbidities and cardiovascular events were studied, comparing data from V1 and Vf. Controlled BP was defined as systolic blood pressure (SBP) lower than 140 mm Hg and diastolic blood pressure (DBP) lower than 90 mm Hg. Statistical analyses were performed with SPSSR software, version 21.0. Values of p<0,05 were considered significant. RESULTS Data of 71 patients were assessed with a mean follow-up time of 15,22 years. Their mean age at V1 was 69.2 years, and, at Vf, 84.53 years, and 26.8% of them were males. There was a significant reduction in mean SBP (157.3 x 142.1 mm Hg; p<0.001) and DBP (95.1 x 77.8 mm Hg; p<0.001), with an increase in BP control rates from V1 to Vf (36.6 x 83.1%; p<0.001). The number of antihypertensive drugs used increased (1.49 x 2.85; p<0.001), with an increase in the use of angiotensin-converting enzyme inhibitors (22.5 x 46.5%; p=0.004), angiotensin II receptor blockers (4.2 x 35.2%; p<0.001) and calcium-channel blockers (18.3 x 67.6%; p<0.001). There was a reduction in total cholesterol (217.9 x 191 mg/dL; p<0.001) and LDL-cholesterol (139.6 x 119.0 mg/dL; p<0.001), but worsening of the glomerular filtration rate (62.5 x 45.4 mL/min; p<0.001). CONCLUSION The multidisciplinary intervention in very elderly hypertensives increased BP control rate, with optimization of the pharmacological treatment.
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Affiliation(s)
| | - Thiago Veiga Jardim
- Arterial Hypertension League of the Federal University of
Goiás, Goiânia, GO - Brazil
| | | | - Camila Dutra Pimenta
- Arterial Hypertension League of the Federal University of
Goiás, Goiânia, GO - Brazil
| | - Ana Luiza Lima Sousa
- Arterial Hypertension League of the Federal University of
Goiás, Goiânia, GO - Brazil
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Wu S, Yang YM, Zhu J, Wan HB, Wang J, Zhang H, Shao XH. Impact of Age on the Association Between Body Mass Index and All-Cause Mortality in Patients with Atrial Fibrillation. J Nutr Health Aging 2017; 21:1125-1132. [PMID: 29188871 DOI: 10.1007/s12603-016-0863-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To explore the impact of age on the association between body mass index (BMI) and all-cause mortality in patients with atrial fibrillation (AF). METHODS A total of 1991 patients with AF (69 ± 13 years, 54.9% female) were divided into three age groups: < 65 years, 65-75 years, and > 75 years, and followed for one year. The primary outcome was defined as all-cause mortality, with secondary outcomes including thromboembolism and major bleeding. Cox regression models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Compared to patients aged < 65 years, elder groups had much lower BMI and more comorbidities other than a lower prevalence of valvular heart disease. During one-year follow-up, 277 (13.9%) patients died, 158 (7.9%) underwent thromboembolism events and 26 (1.3%) had major bleeding. Mortality and thromboembolism risk were both notably higher in patients with advanced age (all P values < 0.001). Using normal weight patients as reference, mortality risk was significantly lower in overweight (HR 0.548; 95% CI 0.404-0.744) and obese patients (HR 0.536; 95% CI 0.325-0.883) for the entire cohort, with reduced death risk mainly observed in overweight patients aged 65-75 years (HR 0.285; 95% CI 0.131-0.621) and aged > 75 years (HR 0.686; 95% CI 0.473-0.993), but not in patients aged < 65 years. Continuous analyses of BMI indicated consistent results. CONCLUSION High BMI is associated with reduced mortality rate in patients with AF, and this association is affected by age, with the so-called "obesity paradox" confined to those with advanced age rather than young patients.
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Affiliation(s)
- S Wu
- Yan-min Yang, Emergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China, Tel.: (+86) 10-8839-6294; fax: (+86) 10-8836-4591, E-mail address:
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Abstract
The percentage of older obese adults is on the rise. Many clinicians underestimate the health consequences of obesity in the elderly, citing scarce evidence and concerns that weight loss might be detrimental to the health of older adults. Although overweight and obese elders are not at the same risk for morbidity and mortality as younger individuals, quality of life and function are adversely impacted. Weight loss plans in the elderly should include aerobic activities as well as balance and resistance activities to maintain optimal physical function.
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Affiliation(s)
- Virginia B Kalish
- Department of Family Medicine, National Capital Consortium Family Medicine Residency, Fort Belvoir Community Hospital, 9300 Dewitt Loop, Fort Belvoir, VA 22060, USA.
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41
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Smith J, Easton PS, Saylor BL. Inupiaq Elders study: aspects of aging among male and female elders. Int J Circumpolar Health 2016; 68:182-96. [DOI: 10.3402/ijch.v68i2.18323] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Obesity Paradox in Off-Pump Coronary Artery Bypass Surgery: Does It Benefit the Elderly? Ann Thorac Surg 2016; 102:1974-1980. [DOI: 10.1016/j.athoracsur.2016.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 03/14/2016] [Accepted: 05/02/2016] [Indexed: 11/21/2022]
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43
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Shochat T, Shefer-Hilel G, Zisberg A. Relationships between body mass index and sleep quality and duration in adults 70 years and older. Sleep Health 2016; 2:266-271. [DOI: 10.1016/j.sleh.2016.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 08/31/2016] [Accepted: 09/07/2016] [Indexed: 01/07/2023]
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Krueger PM, Rogers RG, Hummer RA, Boardman JD. Body Mass, Smoking, and Overall and Cause-Specific Mortality Among Older U.S. Adults. Res Aging 2016. [DOI: 10.1177/0164027503258518] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors examine the relationships between body mass, smoking, and overall and cause-specific mortality among U.S. adults aged 60 and older, using data from the National Health Interview Survey linked to the Multiple Cause of Death file and Cox proportional hazard models. The authors find that, compared to those who are normal weight, obese individuals have higher risks of overall, circulatory disease, and diabetes mortality. Furthermore, smoking status suppresses the relationships between obesity and overall, circulatory disease, and cancer mortality, and interacts with lowbody weight to increase mortality risks. Finally, underweight individuals initially face increased risks of death over the follow-up period, although over time their mortality risks diminish to those of normal-weight individuals, likely due to the presence of unobserved illness. Researchers and health practitioners must account for smoking status, body mass, and specific causes of death to understand and improve the health of our increasingly obese elderly population.
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Wilson AR, McAlpine DD. The Effectiveness of Screening for Obesity in Primary Care: Weighing the Evidence. Med Care Res Rev 2016; 63:570-98. [PMID: 16954308 DOI: 10.1177/1077558706290942] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In response to growing alarm about the increase in the prevalence of obesity in the United States, several organizations have recommended that physicians screen their adult patients for this condition and initiate treatment. Screening can be an effective intervention when the condition is grave and prevalent, when an accurate test exists, when effective treatment exists, when the screening program itself does not pose undue risks, and when early detection and treatment improve outcomes. This article critically reviews the evidence supporting these criteria in the case of obesity in adults. It extends previous reviews by assessing the potential impact that uncertainties in the evidence base may have on the effectiveness a screening program. It also examines the feasibility of such a program. We conclude that following the recommendation to screen all adults for obesity is unlikely to improve outcomes.
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Bowman K, Delgado J, Henley WE, Masoli JA, Kos K, Brayne C, Thokala P, Lafortune L, Kuchel GA, Ble A, Melzer D. Obesity in Older People With and Without Conditions Associated With Weight Loss: Follow-up of 955,000 Primary Care Patients. J Gerontol A Biol Sci Med Sci 2016; 72:203-209. [PMID: 27492450 PMCID: PMC5233914 DOI: 10.1093/gerona/glw147] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 07/10/2016] [Indexed: 11/26/2022] Open
Abstract
Background: Moderate obesity in later life may improve survival, prompting calls to revise obesity control policies. However, this obesity paradox may be due to confounding from smoking, diseases causing weight-loss, plus varying follow-up periods. We aimed to estimate body mass index (BMI) associations with mortality, incident type 2 diabetes, and coronary heart disease in older people with and without the above confounders. Methods: Cohort analysis in Clinical Practice Research Datalink primary care, hospital and death certificate electronic medical records in England for ages 60 to more than 85 years. Models were adjusted for age, gender, alcohol use, smoking, calendar year, and socioeconomic status. Results: Overall, BMI 30–34.9 (obesity class 1) was associated with lower overall death rates in all age groups. However, after excluding the specific confounders and follow-up less than 4 years, BMI mortality risk curves at age 65–69 were U-shaped, with raised risks at lower BMIs, a nadir between 23 and 26.9 and steeply rising risks above. In older age groups, mortality nadirs were at modestly higher BMIs (all <30) and risk slopes at higher BMIs were less marked, becoming nonsignificant at age 85 and older. Incidence of diabetes was raised for obesity-1 at all ages and for coronary heart disease to age 84. Conclusions: Obesity is associated with shorter survival plus higher incidence of coronary heart disease and type 2 diabetes in older populations after accounting for the studied confounders, at least to age 84. These results cast doubt on calls to revise obesity control policies based on the claimed risk paradox at older ages.
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Affiliation(s)
- Kirsty Bowman
- Epidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK
| | - João Delgado
- Epidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK
| | - William E Henley
- Health Statistics Group, Institute of Health Research, University of Exeter Medical School, UK
| | - Jane A Masoli
- Epidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK
| | - Katarina Kos
- Diabetes and Obesity Research Group, Institute of Biomedical and Clinical Science, University of Exeter Medical School, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, UK
| | - Praveen Thokala
- School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - Louise Lafortune
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, UK
| | - George A Kuchel
- UConn Center on Aging, University of Connecticut Health Center, Farmington, USA
| | - Alessandro Ble
- Epidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK
| | - David Melzer
- Epidemiology and Public Health, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, UK. .,UConn Center on Aging, University of Connecticut Health Center, Farmington, USA
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Zhang S, Tomata Y, Sugiyama K, Kaiho Y, Honkura K, Watanabe T, Tanji F, Sugawara Y, Tsuji I. Body mass index and the risk of incident functional disability in elderly Japanese: The OHSAKI Cohort 2006 Study. Medicine (Baltimore) 2016; 95:e4452. [PMID: 27495075 PMCID: PMC4979829 DOI: 10.1097/md.0000000000004452] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The relationship between the body mass index (BMI) and the incidence of cause-specific disability remains unclear.We conducted a prospective cohort study of 12,376 Japanese individuals aged ≥65 years who were followed up for 5.7 years. Information on BMI and other lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. BMI was divided into 6 groups (<21, 21-<23, 23-<25, 25-<27[reference], 27-<29 and ≥29). Hazard ratios and 95% confidence intervals for cause-specific disability were estimated using Cox proportional hazards regression models.A U-shaped relationship between BMI and functional disability was observed, with a nadir at 26. The nadir BMI values with the lowest disability risk were 28 for dementia, 25 for stroke, and 23 for joint disease. A low BMI (<23) was a risk factor for disability due to dementia, the HR values (95% CI) being 2.48 (1.70-3.63) for BMI <21 and 2.25 (1.54-3.27) for BMI 21 to <23; a high BMI (≥29) was a risk factor for disability due to joint disease, the HR value (95% CI) being 2.17 (1.40-3.35). There was no significant relationship between BMI and disability due to stroke.The BMI nadirs for cause-specific disability differed: a low BMI (<23) was a risk factor for disability due to dementia, and a high BMI (≥29) was a risk factor for disability due to joint disease. Because BMI values of 23 to <29 did not pose a significantly higher risk for each cause of disability, this range should be regarded as the optimal one for the elderly population.
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Affiliation(s)
- Shu Zhang
- Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan
- Correspondence: Shu Zhang, Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan (e-mail: )
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Qi SF, Zhang B, Wang HJ, Yan J, Du P, Zhang W, Mi YJ, Zhao JJ, Liu DW, Tian QB. Joint effects of age and body mass index on the incidence of hypertension subtypes in the China Health and Nutrition Survey: A cohort study over 22years. Prev Med 2016; 89:23-30. [PMID: 27155441 PMCID: PMC6443580 DOI: 10.1016/j.ypmed.2016.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/28/2016] [Accepted: 05/01/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVES We seek to investigate the joint effects of age and body mass index (BMI) on the incident hypertension subtypes among Chinese adults during 1989-2011. METHODS We investigated the Incidence rates (IRs, per 100person-years) of hypertension subtypes, adjusted relative risks (RRs) and population attributable risk percent (PAR%) of BMI for hypertension, and clarified the age-specific effect of BMI on incident hypertension utilizing a dynamic cohort study from the China Health and Nutrition Survey (CHNS) 1989-2011. RESULTS Normotensive participants (n=53,028) at baseline were included, with mean age was 41.7 (95% CI, 41.6-41.7)years old. During a total of 118,694person years (average was 6.38years) of follow-up, a total of 5208 incident cases of hypertension were documented. The IRs of hypertension were 4.4 (95% CI, 4.3-4.5), which increased gradually by age and BMI (Ptrend<0.001). Compared with those with BMI<22kg/m(2), the RR of hypertension was 3.13 (95% CI, 2.84-3.45) in the group with BMI≥28kg/m(2). The PAR% (BMI>22 vs. BMI<22) for hypertension in Chinese population was 32% (95% CI, 29-34%). Similar trends were observed in all age and BMI groups for both isolated systolic hypertension and systolic-diastolic hypertension, which were mainly affected by age. In contrast, the peak IR of isolated diastolic hypertension was observed in participants aged 30-49years with higher BMIs. CONCLUSIONS The PAR% (IR of BP≥140/90 or treatment for BMI>22 vs. IR for BMI<22) of elevated body weight for hypertension was 32% in Chinese population.
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Affiliation(s)
- Su-Fen Qi
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Hui-Jun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Jing Yan
- Research Center of Electron Microscope, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Pei Du
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Wei Zhang
- Department of Pathology, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Ying-Jun Mi
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Jing-Jing Zhao
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Dian-Wu Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Qing-Bao Tian
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China.
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Abstract
In the last 20 years, many prospective cohort studies have assessed the relationships between food consumption and mortality. Result interpretation is mainly hindered by the limited adjustment for confounders and, to a lesser extent, the small sample sizes. The aim of this study was to investigate the association between dietary habits and all-cause mortality in a multicentre prospective cohort that included non-institutionalised, community-based elderly individuals (Three-City Study). A brief FFQ was administered at baseline. Hazard ratios (HR) and 95 % CI for all-cause mortality were estimated relative to the consumption frequency of several food groups, using Cox proportional hazards models adjusted for sex, centre, socio-demographic characteristics and health status indicators. Among the 8937 participants (mean age: 74·2 years, 60·7 % women), 2016 deaths were recorded during an average follow-up of 9 years. The risk of death was significantly lower among subjects with the highest fruit and vegetable consumption (HR 0·90; 95 % CI 0·82, 0·99, P=0·03) and with regular fish consumption (HR 0·89; 95 % CI 0·81, 0·97, P=0·01). The benefit of olive oil use was found only in women (moderate olive oil use: HR 0·80; 95 % CI 0·68, 0·94, P=0·007; intensive use: HR 0·72; 95 % CI 0·60, 0·85, P=0·0002). Conversely, daily meat consumption increased the mortality risk (HR 1·12; 95 % CI, 1·01, 1·24, P=0·03). No association was found between risk of death and diet diversity and use of various fats. These findings suggest that fruits/vegetables, olive oil and regular fish consumptions have a beneficial effect on the risk of death, independently of the socio-demographic features and the number of medical conditions.
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Corrêa MM, Thumé E, De Oliveira ERA, Tomasi E. Performance of the waist-to-height ratio in identifying obesity and predicting non-communicable diseases in the elderly population: A systematic literature review. Arch Gerontol Geriatr 2016; 65:174-82. [DOI: 10.1016/j.archger.2016.03.021] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 03/17/2016] [Accepted: 03/29/2016] [Indexed: 01/12/2023]
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