Association of arthritis and vitamin D insufficiency with physical disability in Mexican older adults: findings from the Mexican Health and Aging Study

Surveillance and Evaluation of Vitamin D Nutrition and Its Health Impact in Chinese Older Adults

Vitamin D is an essential fat-soluble vitamin for humans and vitamin D deficiency (VDD) affects all age groups, with older adults being at high risk of VDD. A deficiency in vitamin D has been associated with a range of health concerns in older adults, including osteomalacia and osteoporosis. Additionally, there is limited evidence suggesting that VDD may be associated with increased risk of developing cognitive impairment, muscle-wasting disorders, cardiovascular disease, type 2 diabetes mellitus, and mortality. This review synthesizes the latest research advances in China and abroad to provide detailed information on the current status of vitamin D nutritional monitoring, causes of deficiency, health risks, and proposed intake for reducing risk of diet-related noncommunicable diseases in the Chinese older adults.

Beyond the sum of their parts: The combined association of dementia and chronic pain with self-care limitations in older Australians

BACKGROUND

The purpose of this study was to investigate the association between dementia, chronic pain and self-care limitations. Additionally, the study sought to explore the relationship of co-occurring dementia and chronic pain with self-care limitations.

METHODS

Cross-sectional data derived from the Survey of Disability, Ageing and Carers (SDAC) was used to conduct this study. The pooled association between dementia, and chronic pain, with self-care limitations was assessed using ordered logistic regression model. Furthermore, the study also examined the group comparison of interaction effects between co-occurring dementia and chronic pain with self-care limitations.

RESULTS

The ordered logistic regression analysis indicated that people with dementia had significantly higher odds of experiencing greater self-care limitations (adjusted odds ratio [aOR]: 15.12, 95 % confidence interval [CI]: 12.50-18.29) compared to people without dementia. Similarly, chronic pain was independently associated with increased self-care limitations (aOR: 5.98, 95 % CI: 5.49-6.52) compared to people without chronic pain. Additionally, interaction effect analysis revealed that the co-occurrence of dementia and chronic pain substantially heightened the likelihood of self-care limitations (aOR: 66.54, 95 % CI: 52.27-84.69) relative to people without either condition.

CONCLUSIONS

Disability was higher among older Australians with dementia and chronic pain, and this risk can be increased if the two conditions co-exist. A continuous, aligned, and personalised healthcare approach is needed to establish self-care priorities, especially in groups of people with the greatest need.

Mexican Health and Aging Study Biomarker and Genetic Data Profile

The Mexican Health and Aging Study (MHAS) is one of the largest ongoing longitudinal studies of aging in Latin America, with six waves over 20 years. MHAS includes sociodemographic, economic, and health data from a nationally representative sample of adults 50 years and older in urban and rural Mexico. MHAS is designed to study the impact of diseases on adults' health, function, and mortality. As Mexico is experiencing rapid population aging, providing adequate information to study this phenomenon is vital for designing and implementing public policies. The availability of biomarker and genetic data and longitudinal survey data elevates opportunities for research on aging in a low-middle-income country. This manuscript describes the profile of biomarkers and genetic data available in the MHAS study, including sample sizes and sociodemographic characteristics of participants who provided biospecimens for biomarker analyses, emphasizing recent genetic data. The sample size of individuals with anthropometric biomarkers was 2 707 (Wave 1-2001), 2 361 (Wave 2-2003), 2 086 (Wave 3-2012), and 2 051 (2016). Capillary blood samples were collected from 2 063 participants in 2012 (Wave 3) and 1 141 in 2016. Venous blood samples for blood-based biomarkers were collected from 2 003 participants in 2012 (Wave 3) and 752 in 2016. Venous blood samples were also collected for genetic data from 2 010 participants in 2012 (Wave 3) and 750 in 2016. A total of 7 821 participants provided saliva in 2018, and 2 671 provided hair in 2018. From these samples, a total of 7 204 have genome-wide genetic data, 8 600 have apolipoprotein-E genotype data, and 7 156 have genetic ancestry data.

Associations of arthritis with functional disability and depressive symptoms in general US adults: NHANES 1988-1994 and 1999-2018

Objectives

This study aimed to examine the associations of arthritis with functional disability and depressive symptoms among general US adults. Additionally, it explored the relationship between radiographic knee osteoarthritis (assessed by X-ray examination) and functional disability. Above findings seek to highlight the need for comprehensive physical and mental health management in individuals with arthritis.

Methods

We designed a cross-sectional study utilizing multivariable logistic regression models to examine the associations. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were documented in a crude model and three adjusted models. Participants were from the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2018. Arthritis was self-reported or graded by the Kellgren-Lawrence score after an objective X-ray examination. Functional disability included disability in activities of daily living (ADL disability), instrumental activities of daily living (IADL disability), and mobility disability. Depressive symptom was assessed using the Patient Health Questionnaire (PHQ).

Results

We included 22,566 older adults (≥60 years; 10,961 had self-reported arthritis) for functional disability analysis (2377 older adults with data on X-ray examination; 1012 had radiographic knee osteoarthritis) and 32,056 adults (≥20 years; 9175 had self-reported arthritis) for depressive symptom analysis. After controlling for all covariates, self-reported arthritis was associated with ADL disability (odds ratios [OR]: 2.677; 95% confidence interval [CI]: 2.499-2.868), IADL disability (OR: 2.064; 95% CI: 1.940-2.196), and mobility disability (OR: 2.954; 95% CI: 2.778-3.142), and depressive symptom (OR: 2.177; 95% CI: 1.979-2.395). In participants with data on X-ray examination, radiographic knee osteoarthritis was only associated with mobility disability (OR: 1.437; 95% CI: 1.183-1.744).

Conclusions

Self-reported arthritis was associated with ADL disability, IADL disability and mobility disability, and depressive symptoms. Among participants with X-ray data, radiographic knee osteoarthritis was only associated with mobility disability in general US adults. Appropriate managements of both physical and mental health are needed for individuals with arthritis.

Association of Self-Reported Functional Limitations among a National Community-Based Sample of Older United States Adults with Pain: A Cross-Sectional Study

The characteristics of self-reported functional limitations among older United States (US) adults with pain are currently unknown. This cross-sectional study aimed to determine the characteristics associated with functional limitations among non-institutionalized older (≥50 years) US adults with pain using 2017 Medical Expenditure Panel Survey (MEPS) data. Eligible subjects were alive for the calendar year, aged ≥50 years, and experienced pain within the past four weeks. Hierarchical logistic regression models were utilized to determine significant characteristics associated with functional limitations (outcome variable; yes, no). Functional limitations included difficulty with bending, stooping, climbing stairs, grasping objects, lifting, reaching overhead, standing for long periods of time, or walking. Extrapolation of national data values was possible by adjusting for the complex MEPS design. We found approximately 22 million of the 57 million older US adults (≥50 years) who reported pain had a functional limitation in 2017. Characteristics associated with functional limitations included: gender, race, ethnicity, employment status, marital status, pain intensity, physical health, number of chronic conditions, and frequent exercise status. Knowledge of characteristics associated with functional limitations may provide an opportunity to identify and resolve gaps in patient care among this population.

The Association between 25-Hydroxyvitamin D Concentration and Disability Trajectories in Very Old Adults: The Newcastle 85+ Study

Background: Low vitamin D status is common in very old adults which may have adverse consequences for muscle function, a major predictor of disability. Aims: To explore the association between 25-hydroxyvitamin D [25(OH)D] concentrations and disability trajectories in very old adults and to determine whether there is an 'adequate' 25(OH)D concentration which might protect against a faster disability trajectory. Methodology: A total of 775 participants from the Newcastle 85+ Study for who 25(OH)D concentration at baseline was available. Serum 25(OH)D concentrations of <25 nmol/L, 25-50 nmol/L and >50 nmol/L were used as cut-offs to define low, moderate and high vitamin D status, respectively. Disability was defined as difficulty in performing 17 activities of daily living, at baseline, after 18, 36 and 60 months. Results: A three-trajectory model was derived (low-to-mild, mild-to-moderate and moderate-to-severe). In partially adjusted models, participants with 25(OH)D concentrations <25 nmol/L were more likely to have moderate and severe disability trajectories, even after adjusting for sex, living in an institution, season, cognitive status, BMI and vitamin D supplement use. However, this association disappeared after further adjustment for physical activity. Conclusions: Vitamin D status does not appear to influence the trajectories of disability in very old adults.

Biochemical changes associated with temporomandibular disorders

OBJECTIVE

To assess vitamin D, parathyroid hormone, calcitonin, calcium, phosphorus and magnesium levels in patients with versus without temporomandibular disorders (TMDs).

METHODS

This prospective observational study included patients with TMDs and age-matched healthy controls. TMDs were diagnosed via physical and radiologic examination, and serum levels of 25 (OH) vitamin D, parathyroid hormone, calcitonin, calcium, magnesium, and phosphorus were determined. The impact of age, sex and seasonal variations in serum 25 (OH) vitamin D levels was controlled by the inclusion of age, sex and date-matched control patients.

RESULTS

The study included 100 patients, comprising 50 patients with TMDs and 50 control patients. No statistically significant between-group differences were found regarding age or sex. No statistically significant between-group differences were found in terms of serum 25 (OH) vitamin D, calcitonin, calcium, magnesium or phosphorus levels. Parathyroid hormone levels were statistically significantly higher in patients with TMDs versus healthy control patients.

CONCLUSION

In patients with temporomandibular disorders, increased parathyroid hormone levels in response to vitamin D deficiency was significantly more prominent. These data suggest that, in patients with temporomandibular disorders, vitamin D deficiency should be assessed and corrected.

Falls in Mexican older adults aged 60 years and older

BACKGROUND

Falls are a major cause of disability, morbidity, institutionalization, and mortality in older adults.

OBJECTIVES

The purpose of the study was to examine the risk factors for falls among Mexican older adults aged 60 years and older.

METHODS

This study included 6247 participants and their spouse or partner aged 60 years and older from the Mexican Health and Aging Study, an ongoing longitudinal study (2001-2012) conducted in Mexico. Measures included socio-demographics, falls, physical activity, comorbid conditions, pain, vertigo, vision and hearing impairments, urinary incontinence, lower extremity functional limitation, activities of daily living (ADLs), cognitive function, and depressive symptoms.

RESULTS

Mean age was 69.6 years (standard error = 0.18) and 51.8% were female. Forty percent reported one or more falls at baseline. Older age, being female, obesity, arthritis, fractures, stroke, suffering pain, vertigo, lower extremity functional limitations, physical activity, depressive symptoms, urinary incontinence, and ADL disability were significant factors associated with one or more falls over time.

DISCUSSION

Early detection and treatment of the risk factors for falls in this population will help improve the quality of life and reduce medical complications and health care costs.