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Sasaki T, Nishimoto Y, Hirata T, Abe Y, Hirose N, Takayama M, Takebayashi T, Okano H, Arai Y. Status and physiological significance of circulating adiponectin in the very old and centenarians: an observational study. eLife 2023; 12:e86309. [PMID: 37768324 PMCID: PMC10564453 DOI: 10.7554/elife.86309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/28/2023] [Indexed: 09/29/2023] Open
Abstract
Background High levels of circulating adiponectin are associated with increased insulin sensitivity, low prevalence of diabetes, and low body mass index (BMI); however, high levels of circulating adiponectin are also associated with increased mortality in the 60-70 age group. In this study, we aimed to clarify factors associated with circulating high-molecular-weight (cHMW) adiponectin levels and their association with mortality in the very old (85-89 years of age) and centenarians. Methods The study included 812 (women: 84.4%) for centenarians and 1498 (women: 51.7%) for the very old. The genomic DNA sequence data were obtained by whole-genome sequencing or DNA microarray-imputation methods. Least Absolute Shrinkage and Selection Operator (LASSO) and multivariate regression analyses were used to evaluate cHMW adiponectin characteristics and associated factors. All-cause mortality was analyzed in three quantile groups of cHMW adiponectin levels using Cox regression. Results The cHMW adiponectin levels were increased significantly beyond 100 years of age, were negatively associated with diabetes prevalence, and were associated with SNVs in CDH13 (p=2.21 × 10-22) and ADIPOQ (p=5.72 × 10-7). Multivariate regression analysis revealed that genetic variants, BMI, and high-density lipoprotein cholesterol (HDLC) were the main factors associated with cHMW adiponectin levels in the very old, whereas the BMI showed no association in centenarians. The hazard ratios for all-cause mortality in the intermediate and high cHMW adiponectin groups in very old men were significantly higher rather than those for all-cause mortality in the low-level cHMW adiponectin group, even after adjustment with BMI. In contrast, the hazard ratios for all-cause mortality were significantly higher for high cHMW adiponectin groups in very old women, but were not significant after adjustment with BMI. Conclusions cHMW adiponectin levels increased with age until centenarians, and the contribution of known major factors associated with cHMW adiponectin levels, including BMI and HDLC, varies with age, suggesting that its physiological significance also varies with age in the oldest old. Funding This study was supported by grants from the Ministry of Health, Welfare, and Labour for the Scientific Research Projects for Longevity; a Grant-in-Aid for Scientific Research (No 21590775, 24590898, 15KT0009, 18H03055, 20K20409, 20K07792, 23H03337) from the Japan Society for the Promotion of Science; Keio University Global Research Institute (KGRI), Kanagawa Institute of Industrial Science and Technology (KISTEC), Japan Science and Technology Agency (JST) Research Complex Program "Tonomachi Research Complex" Wellbeing Research Campus: Creating new values through technological and social innovation (JP15667051), the Program for an Integrated Database of Clinical and Genomic Information from the Japan Agency for Medical Research and Development (No. 16kk0205009h001, 17jm0210051h0001, 19dk0207045h0001); the medical-welfare-food-agriculture collaborative consortium project from the Japan Ministry of Agriculture, Forestry, and Fisheries; and the Biobank Japan Program from the Ministry of Education, Culture, Sports, and Technology.
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Affiliation(s)
- Takashi Sasaki
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Yoshinori Nishimoto
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
- Department of Neurology, Keio University, School of Medicine, Tokyo, Japan
| | - Takumi Hirata
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
- Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | | | - Michiyo Takayama
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
- Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Okano
- Department of Physiology, Keio University School of Medicine, Tokyo, Japan
| | - Yasumichi Arai
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
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Marcos-Pérez D, Saenz-Antoñanzas A, Matheu A. Centenarians as models of healthy aging: Example of REST. Ageing Res Rev 2021; 70:101392. [PMID: 34139339 DOI: 10.1016/j.arr.2021.101392] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 01/03/2023]
Abstract
Centenarians are a group of individuals exhibiting extreme longevity, who are characterized by a remarkable compression of morbidity. Therefore, centenarians have been postulated as a model of healthy aging. Different approaches have been used to decipher the biology and genetics of centenarians in order to identify key anti-aging pathways. The majority of studies have taken advantage of blood samples to perform their analysis. Besides, a recent study in human brain samples deciphered the transcription factor REST (Repressor Element-1 Silencing Transcription Factor) as an important player of extreme longevity and cognitive activity. This study goes from human to animal models and revealed that REST acts as an epigenetic regulator of neuronal homeostasis, to control aging and longevity. The aim of this view point is to summarize recent literature describing genetic and epigenetic factors, as well as molecular pathways associated with centenarians and the biology of aging. We will pay particular attention to the impact of REST in centenarians and longevity.
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Affiliation(s)
- Diego Marcos-Pérez
- Biodonostia Health Research Institute, Group of Cellular Oncology, San Sebastián, Spain
| | | | - Ander Matheu
- Biodonostia Health Research Institute, Group of Cellular Oncology, San Sebastián, Spain; CIBER of Frailty and Healthy Aging (CIBERfes), Carlos III Institute, Madrid, Spain; IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.
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Just KS, Tittel SR, Bollheimer C, Naudorf M, Laubner K, Zimny S, Zeyfang A, Hummel M, Stingl JC, Holl RW. Hypoglycemia in Older Adults: Time Trends and Treatment Differences in Patients Aged ≥75 Years With Type 2 Diabetes. J Am Med Dir Assoc 2021; 22:1898-1905.e1. [PMID: 34087226 DOI: 10.1016/j.jamda.2021.05.006] [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: 02/26/2021] [Revised: 04/26/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Hypoglycemia is a potentially life-threatening drug event under antidiabetic treatment. The aim of the study was to examine time trends in severe hypoglycemia in older adults with type 2 diabetes mellitus (T2DM) and antidiabetic treatment. DESIGN Multicenter prospective diabetes patient follow-up registry (DPV). SETTING AND PARTICIPANTS Patients aged ≥75 years with T2DM and documented treatment between 2005 and 2019. METHODS Outcomes of interest were rates of severe hypoglycemia, diabetes therapy, body mass index, HbA1c, and estimated glomerular filtration rate. Time trends of outcomes were analyzed in the whole cohort and compared between age groups (75-<80, 80-<85, ≥85 years). RESULTS A total of 136,931 patients from 188 diabetes centers were included. The adjusted HbA1c decreased from 7.3% (95% confidence interval 7.3-7.4) in 2005 to 7.2% (7.2-7.2) in 2019 (P < .001), with no significant difference between age groups (P = .47). Rates of severe hypoglycemia decreased from 6.7 (6.0-7.4) to 4.1 of 100 person-years (3.7-4.5) (P < .001) in the entire population. Patients aged ≥85 years had constantly lower HbA1c levels compared with younger groups (P < .001). Although severe hypoglycemia decreased the most in the ≥85 age group (P < .001), severe hypoglycemia remained consistently higher in this group compared with the 75 to <80 years group (P < .001). CONCLUSIONS AND IMPLICATIONS During the analyzed time, the risk for severe hypoglycemia decreased. Although drugs with intrinsic risk for hypoglycemia were used less frequently, antidiabetic treatment in older adults should be further improved to continue reducing severe hypoglycemia in this age group, potentially accepting less strict metabolic control and age-specific target ranges.
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Affiliation(s)
- Katja S Just
- Institute of Clinical Pharmacology, University Hospital RWTH Aachen, Aachen, Germany.
| | - Sascha R Tittel
- Ulm University, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | | | | | - Katharina Laubner
- Division of Endocrinology and Diabetology, Department of Medicine II, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Stefan Zimny
- Department of General Internal Medicine, Endocrinology and Diabetology, Helios Clinics, Schwerin, Germany
| | - Andrej Zeyfang
- Ulm University, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany; Clinic of Internal Medicine, Geriatrics, Diabetology and Palliative Medicine, Medius Clinic, Ostfildern, Germany
| | | | - Julia C Stingl
- Institute of Clinical Pharmacology, University Hospital RWTH Aachen, Aachen, Germany
| | - Reinhard W Holl
- Ulm University, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Sasaki T, Abe Y, Takayama M, Adachi T, Okano H, Hirose N, Arai Y. Association among extracellular superoxide dismutase genotype, plasma concentration, and comorbidity in the very old and centenarians. Sci Rep 2021; 11:8539. [PMID: 33879836 PMCID: PMC8058336 DOI: 10.1038/s41598-021-87982-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/07/2021] [Indexed: 12/30/2022] Open
Abstract
Superoxide dismutase 3 (SOD3), an antioxidant enzyme, is known as extracellular SOD (EC-SOD) because it is the predominant form in extracellular fluids. The diversity of plasma EC-SOD concentration is associated with the SOD3 p.R231G missense variant genotype. To clarify the association among SOD3 genotype, plasma EC-SOD concentration, and comorbidity in Oldest Old, we analyzed genome-wide associations with plasma EC-SOD concentration and associations between EC-SOD concentration and medical history classified by the SOD3 genotype in the Very Old (85–99 years old, n = 505) and Centenarians (over 100 years old, n = 595). The results revealed that SOD3 p.R231G was the most significant variant associated with plasma EC-SOD concentration. Although no significant difference was observed in medical histories between the SOD3 p.R231G variant non-carriers and carriers, higher EC-SOD concentration in plasma of SOD3 p.R231G variant non-carriers was associated with a high odds ratio for chronic kidney disease (OR = 2.70, 95% CI = 1.98–3.72) and low odds ratio for diabetes mellitus (DM) (OR = 0.61, 95% CI = 0.39–0.95). Comparison with 11 plasma biomarkers for age-related disease showed that plasma EC-SOD concentration correlated with adiponectin and estimated glomerular filtration rate with creatinine correction; therefore, we deduced that EC-SOD co-operates with adiponectin and possesses beneficial functions for DM in the Oldest Old.
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Affiliation(s)
- Takashi Sasaki
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Michiyo Takayama
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuo Adachi
- Department of Biomedical Pharmaceutics, Laboratory of Clinical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan
| | - Hideyuki Okano
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Physiology, Keio University School of Medicine, Tokyo, Japan
| | - Nobuyoshi Hirose
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Barak Y, Leitch S, Glue P. The Great Escape. Centenarians' exceptional health. Aging Clin Exp Res 2021; 33:513-520. [PMID: 32488471 DOI: 10.1007/s40520-020-01552-w] [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: 03/04/2020] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Centenarians escapers are those who reached 100 years of age without the diagnosis of any of the common age-related diseases and exploring their characteristics will inform about successful ageing. No previous study has examined centenarians free of common chronic diseases amongst New Zealand centenarians. METHODS Retrospective observational cross-sectional review of a national dataset determining the prevalence of depression, dementia, diabetes and hypertension, smoking, physical activity and social relationships among older adults (aged 60-99 years) and centenarians. Participants were all older New Zealanders living independently in the community who completed the international Residential Assessment Instrument-Home Care (interRAI-HC) assessment during the study's 5-year period (July 2013-June 2018). RESULTS The assessments of 292 centenarians (mean age 101.03, SD 1.27 years) and 103,377 elderly (mean age 81.7, SD 5.7 years) were analysed. Compared to the elderly, centenarians were more likely to be female (74.7%, compared with 59.3% elderly, p < 0.001). Centenarians free of common chronic diseases did not differ from other centenarians on any of the analysed variables. Reduction in smoking rates and steady high rates of social engagement were associated with reaching a centenarian status free of common chronic diseases compared with older adults. CONCLUSIONS Not smoking and being socially engaged throughout older age were associated with being a centenarian free of common chronic diseases. This study adds to our understanding the complexities of attaining exceptional longevity.
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Stefánsson BV, Heerspink HJL, Wheeler DC, Sjöström CD, Greasley PJ, Sartipy P, Cain V, Correa-Rotter R. Correction of anemia by dapagliflozin in patients with type 2 diabetes. J Diabetes Complications 2020; 34:107729. [PMID: 32948397 DOI: 10.1016/j.jdiacomp.2020.107729] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/22/2022]
Abstract
AIMS Anemia is common in type 2 diabetes (T2D), particularly in patients with kidney impairment, and often goes unrecognized. Dapagliflozin treatment increases hemoglobin and serum erythropoietin levels. We investigated the effect of dapagliflozin 10-mg/day on hemoglobin in T2D patients with and without anemia. METHODS Data from 5325 patients from 14 placebo-controlled, dapagliflozin-treatment studies of at least 24-weeks duration were pooled. Dapagliflozin's effects (vs. placebo) on hemoglobin, serum albumin, estimated glomerular filtration rate (eGFR), systolic blood pressure, body weight, and safety in patients with and without anemia were evaluated. RESULTS At baseline, 13% of all T2D patients and 28% of those with chronic kidney disease (eGFR <60 mL/min/1.73 m2) had anemia. Hemoglobin increased continuously to at least week 8 and was sustained throughout 24-weeks follow-up in dapagliflozin-treated patients. Serum albumin increased in dapagliflozin-treated patients at week 4 and remained stable thereafter. Dapagliflozin was well tolerated and corrected anemia in 52% of patients with anemia at baseline (placebo: 26%). Incidences of new-onset anemia were lower in dapagliflozin-treated (2.3%) versus placebo-treated (6.5%) patients. CONCLUSIONS Treatment with dapagliflozin can correct and prevent anemia in T2D patients. A gradual increase in hemoglobin beyond week 4 may indicate an erythropoiesis-stimulating effect of sodium-glucose cotransporter 2 inhibition.
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Affiliation(s)
- Bergur V Stefánsson
- Late-stage Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Hiddo J L Heerspink
- Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, the Netherlands; George Institute for Global Health, Sydney, Australia
| | - David C Wheeler
- George Institute for Global Health, Sydney, Australia; Department of Renal Medicine, University College London, London, United Kingdom
| | - C David Sjöström
- Late-stage Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Peter J Greasley
- Research and Early Development, Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Peter Sartipy
- Late-stage Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden; Systems Biology Research Center, School of Bioscience, University of Skövde, Skövde, Sweden
| | - Valerie Cain
- Bogier Clinical and IT Solutions, Raleigh, NC, United States
| | - Ricardo Correa-Rotter
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Liu M, Yang S, Wang S, Zhao Y, Zhu Q, Ning C, He Y. Distribution of blood glucose and prevalence of diabetes among centenarians and oldest-old in China: based on the China Hainan Centenarian Cohort Study and China Hainan Oldest-old Cohort Study. Endocrine 2020; 70:314-322. [PMID: 32643047 DOI: 10.1007/s12020-020-02403-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/24/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE There was little data on the distribution of blood glucose levels and diabetes prevalence for centenarians and the oldest-old. The aim of this study is to analyzed the distribution of blood glucose and diabetes prevalence for centenarians and oldest-old in China: Based on the China Hainan Centenarian Cohort Study (CHCCS) and China Hainan Oldest-old Cohort Study (CHOCS). DESIGN A cross-sectional study. SETTING AND PARTICIPANTS A total of 1002 centenarians and 798 oldest-old were enrolled from 18 cities and counties in Hainan Province (one of the longevity provinces) from 2016-2018. MEASURES The fasting blood glucose was tested and prevalence of diabetes was calculated. RESULTS The average age of centenarians was 102.77 ± 2.55 years old, 82.0% were women. The average age of the oldest-old was 84.99 ± 4.01 years old, 59.9% were women. The average blood glucose of centenarians was 5.12 ± 1.44 and 4.80 ± 1.27 mmol/L, and more than 70% were between 3.00 mmol/L and 5.99 mmol/L. There was no statistical difference between different genders and age groups. A total of 9.5% of centenarians had diabetes and 8.1% had IFG. A total of 11.4% of the oldest-old had diabetes and 4.4% had IFG. Abdominal obesity and TG levels may be associated with diabetes prevalence. The corresponding ORs were 1.517(1.083-2.125) and 1.473(1.089-1.943) respectively of abdominal obesity among centenarians and the oldest-old respectively, and corresponding ORs 1.182(1.081-1.316) and 1.162(1.009-1.699) respectively of abdominal obesity among centenarians and the oldest-old respectively CONCLUSIONS AND IMPLICATIONS: In summary, the results based on CHCCS with the largest sample among centenarians and CHOCS showed that the blood glucose level and the prevalence of diabetes were at a lower level than those of adults or younger elderly. The results provide new evidence for target level of blood glucose control in those older elderly.
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Affiliation(s)
- Miao Liu
- Department of Statistics and Epidemiology, Graduate School of Medical School of Chinese PLA General Hospital, 100853, Beijing, China.
- Institute of Geriatrics and Beijing Key Laboratory of Normal Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center of Chinese PLA General Hospital, 100853, Beijing, China.
| | - Shanshan Yang
- Institute of Geriatrics and Beijing Key Laboratory of Normal Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center of Chinese PLA General Hospital, 100853, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics and Beijing Key Laboratory of Normal Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center of Chinese PLA General Hospital, 100853, Beijing, China
| | - Yali Zhao
- Central Laboratory, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Qiao Zhu
- Central Laboratory, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Chaoxue Ning
- Central Laboratory, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Yao He
- Institute of Geriatrics and Beijing Key Laboratory of Normal Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center of Chinese PLA General Hospital, 100853, Beijing, China.
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Viswanathan M, Ranjit Mohan A, Ranjit U, Prasanna Kumar G, Philips R, Saravanan J, Ulagamathesan V, Ganesan US, Kumaradas GV, Rajendran AK, Thangarajan R, Rajendra P, Coimbatore Subramanian SR. Clinical Profile of Elderly Patients (Over 90 Years) with Type 2 Diabetes Seen at a Diabetes Center in South India. Diabetes Technol Ther 2020; 22:79-84. [PMID: 31638436 DOI: 10.1089/dia.2019.0219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: The current life expectancy in India is <70 years. Type 2 diabetes mellitus (T2DM) is known to reduce life expectancy by 6-8 years. Hence elderly people with T2DM in India would be rare. We report on the clinical profile of Asian Indian patients with T2DM who lived beyond 90 years of age and compared them with T2DM patients aged 50 to 60 years. Methods: From the diabetes electronic medical records of >470,000 diabetes patients, we identified T2DM patients who had lived ≥90 years and compared them with those in the 50-60 years age group, matched for gender and duration of diabetes. Clinical data included age at last visit, age at diagnosis, duration of diabetes, family history, smoking and alcohol, details of medications, body mass index (BMI), and blood pressure. Biochemical data included fasting and postprandial plasma glucose, glycated hemoglobin, fasting and stimulated C-peptide levels, lipid profile, and renal function studies. Assessment of retinopathy, nephropathy, neuropathy, coronary artery disease (CAD), and peripheral vascular disease (PVD) was also done. Results: A total of 325 T2DM patients aged ≥90 years and 278 T2DM patients aged between 50 and 60 years were selected for the study. Patients aged ≥90 years had higher systolic blood pressure (P < 0.001) and lower BMI (P < 0.001) than those between 50 and 60 years. Prevalence of retinopathy (29.7% vs. 53.5%) and macroalbuminuria (3.7% vs. 16.0%) was lower in the ≥90 years T2DM patients than in the 50-60 years age group. However, prevalence of neuropathy (89.8% vs. 50.8%), PVD (13.5% vs. 2.0%), and CAD (60.3% vs. 32.0%) was higher among the ≥90 years patients. Eighty-five percent of the T2DM aged ≥90 years were on oral hypoglycemic agents (OHAs), (of whom 64.9% were on sulfonylurea), 12% were on insulin, and 3% on diet alone. Among the 50-60 years old, 87.8% were on OHAs and 12.2% on insulin. Conclusions: This is the first report on the clinical profile of Asian Indians with T2DM aged ≥90 years, and significant differences are seen in their clinical profile compared with younger T2DM patients.
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Affiliation(s)
- Mohan Viswanathan
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
- Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control and IDF Centre of Excellence in Diabetes Care, Chennai, India
| | - Anjana Ranjit Mohan
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
- Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control and IDF Centre of Excellence in Diabetes Care, Chennai, India
| | - Unnikrishnan Ranjit
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
- Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control and IDF Centre of Excellence in Diabetes Care, Chennai, India
| | - Gupta Prasanna Kumar
- Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control and IDF Centre of Excellence in Diabetes Care, Chennai, India
| | - Routary Philips
- Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control and IDF Centre of Excellence in Diabetes Care, Chennai, India
| | - Jebarani Saravanan
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Venkatesan Ulagamathesan
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Uma Sankari Ganesan
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Gini Venisha Kumaradas
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Ashok Kumar Rajendran
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
| | | | - Pradeepa Rajendra
- Madras Diabetes Research Foundation, ICMR Center for Advanced Research on Diabetes, Chennai, India
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Hussain S, Habib A, Najmi AK. Anemia prevalence and its impact on health-related quality of life in Indian diabetic kidney disease patients: Evidence from a cross-sectional study. J Evid Based Med 2019; 12:243-252. [PMID: 31769220 DOI: 10.1111/jebm.12367] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/13/2019] [Accepted: 11/03/2019] [Indexed: 01/10/2023]
Abstract
AIM The aim of the study was to determine the prevalence, predictors of anemia, and its impact on health-related quality of life among diabetic kidney disease (DKD) patients. METHODS Patients with a confirmed diagnosis of type 2 diabetes mellitus (T2DM), and had any stages of CKD (stages I to IV), based on their estimated glomerular filtration rate (eGFR) were enrolled in the study. Anemia was defined using the World Health Organization (WHO) criteria and quality of life was assessed using the EQ-5D scale. All the statistical analysis was performed using SAS v9.4. RESULTS A total of 323 patients completed the study. The mean ± SD age of patients was 56 ± 11.25 years, and 51.7% were female. Mean duration of diabetes was 9.6 ± 4.57 years. A total of 227 (70.27%) had anemia as per the WHO criteria. Linear association was observed between the eGFR and hemoglobin. After controlling for the possible confounders in multivariate logistic regression analysis, older age (odds ratio [OR]: 2.46 [95% CI: 1.16 to 5.28], P = .021), diabetes duration (OR: 1.53 [95% CI: 1.04 to 2.25], P = .022), and CKD stage III (OR: 3.63 [95% CI: 0.99 to 13.32], P = .004) were found to be significantly associated with the anemia. Consistently lower EQ-5D index values were observed for the anemic group. CONCLUSION This study reported a high prevalence of anemia and impaired quality of life among DKD patients. Routine screening of anemia can be the most preventive measure to deal with this burdening co-morbid condition.
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Affiliation(s)
- Salman Hussain
- Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Anwar Habib
- Department of Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Abul Kalam Najmi
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
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Gellert P, von Berenberg P, Zahn T, Neuwirth J, Kuhlmey A, Dräger D. Multimorbidity Profiles in German Centenarians: A Latent Class Analysis of Health Insurance Data. J Aging Health 2017; 31:580-594. [PMID: 29254430 DOI: 10.1177/0898264317737894] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Multimorbidity in centenarians is common; although investigations of the prevalence of morbidity in centenarians are accumulating, research on profiles of co-occurrence of morbidities is still sparse. Our aim was to explore profiles of comorbidities in centenarians. METHOD Health insurance data from 1,121 centenarians comprising inpatient and outpatient diagnoses from the past 5 years (2009-2013) were analyzed using latent class analysis with adjustments for sex, age, hospitalization, and long-term care. RESULTS Four distinct comorbidity profiles emerged from the data: 36% of centenarians were categorized as "age-associated"; 18% had a variety of comorbidities but were not diabetic were labeled "multimorbid without diabetes"; 9% were labeled "multimorbid with diabetes"; and 36% "low morbidity." CONCLUSION Patterns of comorbidities describe the complexity of geriatric multimorbidity more appropriately than an approach focused on a single disease. The profiles described by this specific research may inform clinicians and health care planners for the oldest old.
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Wendell CR, Zonderman AB, Katzel LI, Rosenberger WF, Plamadeala VV, Hosey MM, Waldstein SR. Nonlinear associations between plasma cholesterol levels and neuropsychological function. Neuropsychology 2016; 30:980-987. [PMID: 27280580 DOI: 10.1037/neu0000298] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Although both high and low levels of total and low-density lipoprotein (LDL) cholesterol have been associated with poor neuropsychological function, little research has examined nonlinear effects. We examined quadratic relations of cholesterol to performance on a comprehensive neuropsychological battery. METHOD Participants were 190 older adults (53% men, ages 54-83) free of major medical, neurologic, and psychiatric disease. Measures of fasting plasma total and high-density lipoprotein (HDL) cholesterol were assayed, and LDL cholesterol was calculated. Participants completed neuropsychological measures of attention, executive function, memory, visuospatial judgment, and manual speed and dexterity. Multiple regression analyses examined cholesterol levels as quadratic predictors of each measure of cognitive performance, with age (dichotomized as <70 vs. 70+) as an effect modifier. RESULTS A significant quadratic effect of Total Cholesterol² × Age was identified for Logical Memory II (b = -.0013, p = .039), such that the 70+ group performed best at high and low levels of total cholesterol than at midrange total cholesterol (U-shaped) and the <70 group performed worse at high and low levels of total cholesterol than at midrange total cholesterol (inverted U shape). Similarly, significant U- and J-shaped effects of LDL Cholesterol² × Age were identified for Visual Reproduction II (b = -.0020, p = .026) and log of the Trail Making Test, Part B (b = .0001, p = .044). Quadratic associations between HDL cholesterol and cognitive performance were nonsignificant. CONCLUSIONS Results indicate differential associations between cholesterol and neuropsychological function across different ages and domains of function. High and low total and LDL cholesterol may confer both risk and benefit for suboptimal cognitive function at different ages. (PsycINFO Database Record
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Affiliation(s)
| | - Alan B Zonderman
- Intramural Research Program, National Institute on Aging, National Institutes of Health
| | - Leslie I Katzel
- Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine
| | | | | | - Megan M Hosey
- Department of Psychology, University of Maryland, Baltimore County
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Chmielewski P, Borysławski K, Chmielowiec K, Chmielowiec J. Longitudinal and cross-sectional changes with age in selected anthropometric and physiological traits in hospitalized adults: an insight from the Polish Longitudinal Study of Aging (PLSA). ANTHROPOLOGICAL REVIEW 2015. [DOI: 10.1515/anre-2015-0025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Longitudinal studies of aging concerning individuals with comparable lifestyle, diet, health profile, socioeconomic status, and income remain extraordinarily rare. The purposes of our ongoing project are as follows: (i) to collect extensive data on biological and medical aspects of aging in the Polish population, (ii) to determine factors affecting the rate and course of aging, (iii) to understand how aging unfolds as a dynamic and malleable process in ontogeny, and (iv) to find novel predictors of longevity. Our investigation followed 142 physically healthy asylum inmates, including 68 males and 74 females, for at least 25 years from the age of 45 years onward. Cross-sectional assessment involved 225 inmates, including 113 males and 112 females. All the patients lived for a very long time under similar and good environmental conditions at the hospital in Cibórz, Lubuskie Province. They maintained virtually the same daily schedule and lifestyle. The rate and direction of changes with age in selected anthropometric and physiological traits were determined using ANOVA, t-test, and regression analysis. There were sex differences in the rate and pattern of age-related changes in certain characteristics such as relative weight, red blood cell count, monocyte count, thymol turbidity value, systolic blood pressure, and body temperature. Body weight, the body mass index (BMI), and total bilirubin level increased with advancing age, while body height decreased with age in both sexes. In conclusion, the aging process was associated with many regressive alterations in biological traits in both sexes but the rate and pattern of these changes depended on biological factors such as age and sex. There were only few characteristics which did not change significantly during the period under study. On the basis of comparison between the pattern of longitudinal changes with aging and the pattern of cross-sectional changes with age in the analyzed traits, we were able to predict which pattern of changes is associated with longer lifespan.
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Affiliation(s)
- Piotr Chmielewski
- Department of Anatomy, Faculty of Medicine, Wrocław Medical University, T. Chałubińskiego 6a, 50-368 Wrocław
| | - Krzysztof Borysławski
- Department of Anthropology, Institute of Biology, Wrocław University of Environmental and Life Sciences
| | - Krzysztof Chmielowiec
- Regional Psychiatric Hospital for People with Mental Disorders, Cibórz, Lubuskie Province, Poland
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Hazra NC, Dregan A, Jackson S, Gulliford MC. Differences in Health at Age 100 According to Sex: Population-Based Cohort Study of Centenarians Using Electronic Health Records. J Am Geriatr Soc 2015; 63:1331-7. [PMID: 26096699 PMCID: PMC4745036 DOI: 10.1111/jgs.13484] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To use primary care electronic health records (EHRs) to evaluate the health of men and women at age 100. DESIGN Population-based cohort study. SETTING Primary care database in the United Kingdom, 1990-2013. PARTICIPANTS Individuals reaching the age of 100 between 1990 and 2013 (N = 11,084, n = 8,982 women, n = 2,102 men). MEASUREMENTS Main categories of morbidity and an index of multiple morbidities, geriatric syndromes and an index of multiple impairments, cardiovascular risk factors. RESULTS The number of new female centenarians per year increased from 16 per 100,000 in 1990-94 to 25 per 100,000 in 2010-13 (P < .001) and of male centenarians from four per 100,000 to six per 100,000 (P = .06). The most prevalent morbidities at the age of 100 were musculoskeletal diseases, disorders of the senses, and digestive diseases. Women had greater multiple morbidity than men (odds ratio (OR) = 1.64, 95% confidence interval (CI) = 1.42-1.89, P < .001). Geriatric syndromes, including falls, fractures, hearing and vision impairment, and dementia, were frequent; 30% of women and 49% of men had no recorded geriatric syndromes. Women had greater likelihood of having multiple geriatric syndromes (OR = 2.14, 95% CI = 1.90-2.41, P < .001). CONCLUSION Fewer men than women reach the age of 100, but male centenarians have lower morbidity and fewer geriatric syndromes than women. Research using EHRs offers opportunities to understand the epidemiology of aging and improve care of the oldest old.
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Affiliation(s)
- Nisha C Hazra
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - Alex Dregan
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - Stephen Jackson
- Department of Clinical Gerontology, King's College Hospital, London, UK
| | - Martin C Gulliford
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
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Trevest K, Treadway H, Hawkins-van der Cingel G, Bailey C, Abdelhafiz AH. Prevalence and determinants of anemia in older people with diabetes attending an outpatient clinic: a cross-sectional audit. Clin Diabetes 2014; 32:158-62. [PMID: 25646941 PMCID: PMC4220597 DOI: 10.2337/diaclin.32.4.158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This cross-sectional audit investigates the prevalence and determinants of anemia in older people with diabetes attending an outpatient clinic. Anemia was found to be highly prevalent, affecting 59% of patients. Older age and longer duration of diabetes were the main predictors of anemia, whereas the presence of chronic kidney disease was a mediator rather than a direct cause.
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