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Screening recall in older cancer survivors detects differences in balance and mobility. Support Care Cancer 2021; 30:2605-2612. [PMID: 34812954 DOI: 10.1007/s00520-021-06705-9] [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: 05/19/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Cognitive impairments have been reported by up to two-thirds of cancer survivors whose primary cancer did not occur in the central nervous system. Physical impairments as sequelae of cancer-related cognitive impairment (CRCI) have not been well described in previous studies. Furthermore, there is scarcity of literature describing differences among physical performance in those with and without CRCI. The purpose of this study is to examine the differences in physical function of older cancer survivors based on cognitive ability to determine if physical performance differs when different cognitive screening measures are employed. METHODS Adults age 65 + with a history of cancer from the 2010 Health and Retirement Study (n = 1,953) were assigned to groups according to their cognitive ability. Between-group demographic, mobility, and cognitive differences were analyzed using chi-squared and t tests. Recall and orientation were used as cognitive variables, and physical performance outcomes included gait speed, balance, and grip strength. RESULTS Respondents with Low Recall had more impaired balance (semi-tandem, tandem) (p < .05) and slower gait speeds (p < .05). Respondents that were Not-Oriented had slower gait speed (p < .05). Between-group differences in demographics were found by recall and orientation groups. CONCLUSIONS Impairments in balance and gait speed are able to be detected when recall is screened in a population of older cancer survivors. When assessing how physical mobility is related to fall risk, a screen of cognition should go beyond just orientation.
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Hernández B, Voll S, Lewis NA, McCrory C, White A, Stirland L, Kenny RA, Reilly R, Hutton CP, Griffith LE, Kirkland SA, Terrera GM, Hofer SM. Comparisons of disease cluster patterns, prevalence and health factors in the USA, Canada, England and Ireland. BMC Public Health 2021; 21:1674. [PMID: 34526001 PMCID: PMC8442402 DOI: 10.1186/s12889-021-11706-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/29/2021] [Indexed: 12/21/2022] Open
Abstract
Background Identification of those who are most at risk of developing specific patterns of disease across different populations is required for directing public health policy. Here, we contrast prevalence and patterns of cross-national disease incidence, co-occurrence and related risk factors across population samples from the U.S., Canada, England and Ireland. Methods Participants (n = 62,111) were drawn from the US Health and Retirement Study (n = 10,858); the Canadian Longitudinal Study on Ageing (n = 36,647); the English Longitudinal Study of Ageing (n = 7938) and The Irish Longitudinal Study on Ageing (n = 6668). Self-reported lifetime prevalence of 10 medical conditions, predominant clusters of multimorbidity and their specific risk factors were compared across countries using latent class analysis. Results The U.S. had significantly higher prevalence of multimorbid disease patterns and nearly all diseases when compared to the three other countries, even after adjusting for age, sex, BMI, income, employment status, education, alcohol consumption and smoking history. For the U.S. the most at-risk group were younger on average compared to Canada, England and Ireland. Socioeconomic gradients for specific disease combinations were more pronounced for the U.S., Canada and England than they were for Ireland. The rates of obesity trends over the last 50 years align with the prevalence of eight of the 10 diseases examined. While patterns of disease clusters and the risk factors related to each of the disease clusters were similar, the probabilities of the diseases within each cluster differed across countries. Conclusions This information can be used to better understand the complex nature of multimorbidity and identify appropriate prevention and management strategies for treating multimorbidity across countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11706-8.
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Affiliation(s)
- Belinda Hernández
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
| | - Stacey Voll
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, Canada.
| | - Nathan A Lewis
- Department of Psychology, University of Victoria, Victoria, Canada
| | - Cathal McCrory
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
| | - Arthur White
- School of Computer Science and Statistics, Trinity College, The University of Dublin, Dublin, Ireland
| | - Lucy Stirland
- Edinburgh Dementia Prevention and Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St. James's Hospital, Trinity College, The University of Dublin, Dublin, Ireland
| | - Richard Reilly
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.,School of Engineering, Trinity College, The University of Dublin, Dublin, Ireland.,Trinity Centre for Biomedical Engineering, Trinity College, The University of Dublin, Dublin, Ireland
| | - Craig P Hutton
- Division of Medical Sciences, University of Victoria, Victoria, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Susan A Kirkland
- Department of Community Health &Epidemiology and Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Graciela Muniz Terrera
- Edinburgh Dementia Prevention and Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Scott M Hofer
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, Canada.,Department of Psychology, University of Victoria, Victoria, Canada
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Boyle R, Jollans L, Rueda-Delgado LM, Rizzo R, Yener GG, McMorrow JP, Knight SP, Carey D, Robertson IH, Emek-Savaş DD, Stern Y, Kenny RA, Whelan R. Brain-predicted age difference score is related to specific cognitive functions: a multi-site replication analysis. Brain Imaging Behav 2021; 15:327-345. [PMID: 32141032 DOI: 10.1007/s11682-020-00260-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Brain-predicted age difference scores are calculated by subtracting chronological age from 'brain' age, which is estimated using neuroimaging data. Positive scores reflect accelerated ageing and are associated with increased mortality risk and poorer physical function. To date, however, the relationship between brain-predicted age difference scores and specific cognitive functions has not been systematically examined using appropriate statistical methods. First, applying machine learning to 1359 T1-weighted MRI scans, we predicted the relationship between chronological age and voxel-wise grey matter data. This model was then applied to MRI data from three independent datasets, significantly predicting chronological age in each dataset: Dokuz Eylül University (n = 175), the Cognitive Reserve/Reference Ability Neural Network study (n = 380), and The Irish Longitudinal Study on Ageing (n = 487). Each independent dataset had rich neuropsychological data. Brain-predicted age difference scores were significantly negatively correlated with performance on measures of general cognitive status (two datasets); processing speed, visual attention, and cognitive flexibility (three datasets); visual attention and cognitive flexibility (two datasets); and semantic verbal fluency (two datasets). As such, there is firm evidence of correlations between increased brain-predicted age differences and reduced cognitive function in some domains that are implicated in cognitive ageing.
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Affiliation(s)
- Rory Boyle
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Lee Jollans
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, München, Germany
| | - Laura M Rueda-Delgado
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Rossella Rizzo
- Physics Department, University of Calabria, Rende, CS, Italy
| | - Görsev G Yener
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, İzmir, Turkey
- Department of Neurology, Dokuz Eylul University Medical School, İzmir, Turkey
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylul University, İzmir, Turkey
| | - Jason P McMorrow
- Centre for Advanced Medical Imaging, St. James's Hospital, Dublin 8, Ireland
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Silvin P Knight
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin 2, Ireland
| | - Ian H Robertson
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Derya D Emek-Savaş
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, İzmir, Turkey
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
- Department of Psychology, Faculty of Letters, Dokuz Eylul University, İzmir, Turkey
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Rose Anne Kenny
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin 8, Ireland
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
- Global Brain Health Institute, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
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Abstract
The population surviving to old age in sub-Saharan Africa (SSA) is increasing rapidly in consonance with the rest of the world. Nevertheless, the sub-region offers unique challenges to survival across the lifespan. The determinants of health and ageing in SSA are thus likely different from those in higher income countries. The need to explore pressing epidemiological and health service challenges of older people living in SSA in the context of multiple social changes and rapid ageing of the population provided the rationale for the Ibadan Study of Ageing (ISA). This article appraises ISA findings in relation to late-life depression. It concludes that healthcare policies in SSA need to deliberately prioritise the treatment of depression and other mental health problems in late-life in order to stem the neglect of older people's mental health in the region.
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5
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Carthy P, Lyons S, Nolan A. Characterising urban green space density and footpath-accessibility in models of BMI. BMC Public Health 2020; 20:760. [PMID: 32448211 PMCID: PMC7245785 DOI: 10.1186/s12889-020-08853-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 05/05/2020] [Indexed: 11/28/2022] Open
Abstract
Background While exposure to urban green spaces has been associated with various physical health benefits, the evidence linking these spaces to lower BMI, particularly among older people, is mixed. We ask whether footpath availability, generally unobserved in the existing literature, may mediate exposure to urban green space and help explain this volatility in results. The aim of this study is to add to the literature on the association between urban green space and BMI by considering alternative measures of urban green space that incorporate measures of footpath availability. Methods We conduct a cross-sectional study combining data from The Irish Longitudinal Study on Ageing and detailed land use information. We proxy respondents’ exposure to urban green spaces at their residential addresses using street-side and area buffers that take account of the presence of footpaths. Generalised linear models are used to test the association between exposure to several measures of urban green space and BMI. Results Relative to the third quintile, exposure to the lowest quintile of urban green space, as measured within a 1600 m footpath-accessible network buffer, is associated with slightly higher BMI (marginal effect: 0.80; 95% CI: 0.16–1.44). The results, however, are not robust to small changes in how green space is measured and no statistically significant association between urban green spaces and BMI is found under other variants of our regression model. Conclusion The relationship between urban green spaces and BMI among older adults is highly sensitive to the characterisation of local green space. Our results suggest that there are some unobserved factors other than footpath availability that mediate the relationship between urban green spaces and weight status.
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Affiliation(s)
- Philip Carthy
- Economic and Social Research Institute, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, Ireland.,Department of Economics, Trinity College Dublin, Dublin, Ireland
| | - Sean Lyons
- Economic and Social Research Institute, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, Ireland. .,Department of Economics, Trinity College Dublin, Dublin, Ireland.
| | - Anne Nolan
- Economic and Social Research Institute, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, Ireland.,Department of Economics, Trinity College Dublin, Dublin, Ireland.,The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
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6
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Blackwood J, Gore S. Beyond balance and mobility, contributions of cognitive function to falls in older adults with cardiovascular disease. J Frailty Sarcopenia Falls 2020; 4:65-70. [PMID: 32300720 PMCID: PMC7155361 DOI: 10.22540/jfsf-04-065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 11/15/2022] Open
Abstract
Objectives: Older adults with cardiovascular disease (CVD) are at risk for cognitive impairment. Cognitive function is associated with falls in older adults however it is unknown if a relationship exists between cognitive function and falls in CVD. The aim of this study was to examine the contributions of cognitive function on falls in older adults with CVD. Methods: A secondary analysis was performed on data from the Health and Retirement Study cohort 2010 (N=3413) of older adults with CVD. Group assignment was based on falls history (yes/no) within the two years prior to the survey. Demographic (age, education, gender, marital status), physical (strength, balance, physical activity, and mobility) and cognitive (immediate and delayed recall, orientation, semantic verbal fluency, numeracy) information was extracted to characterize the sample. Comparisons between groups were completed for all of these variables. Logistic regression was performed to examine associations between each of the cognitive variables and falls while controlling for age, gender, marital status, education, and BMI. Results: Demographic (age, gender, marital status, and education), physical (grip strength, tandem stance time, and gait speed), and cognitive (orientation, immediate and delayed recall) variables differed by falls history (p<0.05). After controlling for confounding, immediate recall was the only significant predictor of falls (OR=1.09, 95% CI=1.01-1.17) (Nagelkerke R2=0.037, χ2=35.14, p<0.05) with correctly classifying 65.9% of cases. Conclusions: In older adults with CVD, cognitive and physical functions are more impaired in those with a falls history. Screening for cognitive function, specifically immediate recall, should be a part of the management of falls in this population.
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Affiliation(s)
| | - Shweta Gore
- MGH Institute of Health Professions, Boston, MA, USA
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7
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Blackwood J. Cognitive Function and Falls in Older Adults With Type 2 Diabetes Mellitus. J Geriatr Phys Ther 2019; 42:E91-E96. [DOI: 10.1519/jpt.0000000000000209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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8
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Blackwood J. The Influence of Cognitive Function on Balance, Mobility, and Falls in Older Cancer Survivors. REHABILITATION ONCOLOGY 2019. [DOI: 10.1097/01.reo.0000000000000128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Cleary E, McCallion P, McCarron M. Dual sensory impairment among a cohort of older adults living in Ireland: A nested case-control study of the Irish Longitudinal Study on Ageing cohort. HRB Open Res 2018. [DOI: 10.12688/hrbopenres.12861.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Little information is available on the implications of hearing loss, visual impairment and dual sensory impairment among older adults with an intellectual disability (ID) living in Ireland and this paper aims to address the health concerns associated with sensory impairment among this population. Methods: A representative sample of 753 persons aged 40 years and older at all levels of ID and full range of residential circumstances from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) participants were matched with general older population TILDA participants on age, sex and geographic location within Ireland. Demographic data on samples included age, sex, visual impairment (yes/no), hearing impairment (yes/no) and dual sensory impairment (yes/no). For those with intellectual disability (ID) data was also gathered on level of intellectual disability, residence, needing assistance with activities of daily living (ADL) and instrumental activities of daily living, self-rated health, loneliness, doctor’s diagnosis of endocrine disease and of dementia and doctor’s report of two or more chronic health conditions. Bivariate analysis of associations between visual, hearing and dual sensory impairment with the measures of physical and mental health was completed and logistic regression analysis to generate adjusted odds ratios for associations between sensory impairment and physical and mental health conditions. Results: As compared to the matched general population participants, in participants with ID dual sensory impairment was more often associated with poor self-rated health, limitations with two or more ADLs, loneliness and multimorbidity. People with ID were 4.4 times more likely to be multimorbid if they were visually impaired compared with an odds ratio of 2.4 in TILDA participants. Conclusion: Previous studies found significant associations between hearing and visual impairment among older populations. Analysis here also suggests the burden of sensory impairment increases both with ID and then with level of ID
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10
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Castro-Costa E, Lima-Costa MF, de Andrade FB, de Souza PRB, Ferri CP. Cognitive function among older adults: ELSI-Brazil results. Rev Saude Publica 2018; 52Suppl 2:4s. [PMID: 30379286 PMCID: PMC6255422 DOI: 10.11606/s1518-8787.2018052000629] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/18/2018] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate macroregional variations in cognitive function in a national sample representative of the Brazilian population aged 50 years and older. METHODS Data from the baseline of the Longitudinal Study of Brazilian Elderly (ELSI-Brazil), collected between 2015 and 2016, were used. Memory was measured by means of a 10-word list and executive function, by semantic verbal fluency, based on the naming of animals. Gender, age, education, and rural or urban residence were potentially confounding. RESULTS Among the 9,412 ELSI-Brazil participants, 9,085 were included in the analysis; 53.9% were women and the average age was 63.0 (0.42) years. After adjusting for potential confounding variables, average scores for memory and verbal fluency were lower in the Northeast region and higher in the Midwest and Southeast, respectively. In the South region, higher scores were found for immediate and combined memory. In all regions, older participants and those with lower schooling had worse scores for memory and verbal fluency. CONCLUSIONS There are differences in cognitive function among older adults in the different macroregions, independent of age, gender, schooling, and rural or urban residence.
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Affiliation(s)
- Erico Castro-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Paulo Roberto Borges de Souza
- Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil
| | - Cleusa Pinheiro Ferri
- Universidade Federal de São Paulo. Faculdade de Medicina. Departamento de Psicobiologia. São Paulo, SP, Brasil
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11
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Donoghue OA, McGarrigle CA, Foley M, Fagan A, Meaney J, Kenny RA. Cohort Profile Update: The Irish Longitudinal Study on Ageing (TILDA). Int J Epidemiol 2018; 47:1398-1398l. [DOI: 10.1093/ije/dyy163] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Orna A Donoghue
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | | | - Margaret Foley
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Andrew Fagan
- Centre for Advanced Medical Imaging, St James’s Hospital, Dublin, Ireland
| | - James Meaney
- Centre for Advanced Medical Imaging, St James’s Hospital, Dublin, Ireland
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Mercer’s Institute for Successful Ageing (MISA), St James’s Hospital, Dublin, Ireland
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12
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Cassarino M, O'Sullivan V, Kenny RA, Setti A. Disabilities moderate the association between neighbourhood urbanity and cognitive health: Results from the Irish longitudinal study on ageing. Disabil Health J 2018; 11:359-366. [DOI: 10.1016/j.dhjo.2017.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/26/2017] [Accepted: 12/05/2017] [Indexed: 11/26/2022]
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13
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Lee W, Yoon JH, Koo JW, Chang SJ, Roh J, Won JU. Predictors and estimation of risk for early exit from working life by poor health among middle and older aged workers in Korea. Sci Rep 2018; 8:5180. [PMID: 29581459 PMCID: PMC5979952 DOI: 10.1038/s41598-018-23523-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 03/12/2018] [Indexed: 11/23/2022] Open
Abstract
The aims of this study were to investigate the predictors and estimate the risk for early exit from work owing to poor personal health status of the retirees. This study analysed the longitudinal data of 2,708 workers aged more than 45 years old from the Korean Longitudinal Study of Ageing. Multivariate Cox regression analyses were conducted to identify the predictors and to build a prediction model for early exit from work due to poor health. Internal validation was performed using random split, and external validation using the English Longitudinal Study of Ageing. Over the 8-year follow-up, 124 workers exited work early because of poor health. Significant predictors for early exit from work due to poor health included hypertension (hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.01-2.28), abnormal body mass index (HR, 1.60; 95% CI, 1.10-2.35), decreased grasping power index, and perceived health status. The prediction model designed to estimate the risk of unwanted early exit from work because of poor health status showed fair performance in both the internal and external validations. The current study revealed the specific determinants and the possibility of prediction of shortened working life due to poor health status.
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Affiliation(s)
- Wanhyung Lee
- The Institute for Occupational Health, College of Medicine, Yonsei University, Seoul, Korea
- Graduate School of Public Health, College of Medicine, Yonsei University, Seoul, Korea
- Incheon Worker's Health Center, Incheon, Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, College of Medicine, Yonsei University, Seoul, Korea
- Graduate School of Public Health, College of Medicine, Yonsei University, Seoul, Korea
- Incheon Worker's Health Center, Incheon, Korea
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Jung-Wan Koo
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sei-Jin Chang
- Department of Preventive Medicine, Institute Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jaehoon Roh
- The Institute for Occupational Health, College of Medicine, Yonsei University, Seoul, Korea
- Graduate School of Public Health, College of Medicine, Yonsei University, Seoul, Korea
- Incheon Worker's Health Center, Incheon, Korea
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Jong-Uk Won
- The Institute for Occupational Health, College of Medicine, Yonsei University, Seoul, Korea.
- Graduate School of Public Health, College of Medicine, Yonsei University, Seoul, Korea.
- Incheon Worker's Health Center, Incheon, Korea.
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea.
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14
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McCarron M, Cleary E, McCallion P. Health and Health-Care Utilization of the Older Population of Ireland: Comparing the Intellectual Disability Population and the General Population. Res Aging 2017; 39:693-718. [DOI: 10.1177/0164027516684172] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background/Objectives: Largely unresearched are the similarities and differences compared to the general population in the aging of people with an intellectual disability (ID). Data reported here compare the health and health-care utilization of the general aging population in Ireland with those who are aging with ID. Design: Data for comparisons were drawn from the 2010 The Irish Longitudinal Study on Ageing (TILDA) and the Intellectual Disability Supplement (IDS)-TILDA Wave 1 data sets. Setting: TILDA participants were community dwelling only while IDS-TILDA participants were drawn from community and institutional settings. Participants: TILDA consists of a sample of 8,178 individuals aged 50 years and older who were representative of the Irish population. The IDS-TILDA consists of a random sample of 753 persons aged 40 and older. Using age 50 as the initial criterion, 478 persons with ID were matched with TILDA participants on age, sex, and geographic location to create the sample for this comparison. Measurements: Both studies gathered self-reported data on physical and mental health, behavioral health, functional limitations, and health-care utilization. Results: Rates of chronic disease appeared higher overall for people with ID as compared to the general population. There were also age-related differences in the prevalence of diabetes and cancer and different rates of engagement between the two groups in relevant behavioral health activities such as smoking. There were higher utilization levels among IDS-TILDA participants for allied health and general practitioner visits. Conclusion: Different disease trajectories found among IDS-TILDA participants raise concerns. The longitudinal comparison of data for people with ID and for the general population offered a better opportunity for the unique experiences of people with ID to be included in data that inform health planning.
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Affiliation(s)
- Mary McCarron
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Eimear Cleary
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Philip McCallion
- Center for Excellence in Aging and Community Wellness, University at Albany, Albany, NY, USA
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15
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Variations in cognitive abilities across the life course: Cross-sectional evidence from Understanding Society: The UK Household Longitudinal Study. INTELLIGENCE 2016; 59:39-50. [PMID: 27932853 PMCID: PMC5127898 DOI: 10.1016/j.intell.2016.07.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Populations worldwide are aging. Cognitive decline is an important precursor of dementia, illness and death and, even within the normal range, is associated with poorer performance on everyday tasks. However, the impact of age on cognitive function does not always receive the attention it deserves. Methods We have explored cross-sectional associations of age with five cognitive tests (word recall, verbal fluency, subtraction, number sequence, and numerical problem solving) in a large representative sample of over 40,000 men and women aged 16 to 100 living in the UK. Results Women performed better on word recall tests and men had higher scores for subtraction, number sequence and numerical problem solving. However, age-cognition associations were generally similar in both genders. Mean word recall and number sequence scores decreased from early adulthood with steeper declines from the mid-60s onwards Verbal fluency, subtraction and numerical problem solving scores remained stable or increased from early to mid-adulthood, followed by approximately linear declines from around age 60. Performance on all tests was progressively lower in respondents with increasingly worse self-rated health and memory. Age-related declines in word recall, verbal fluency and number sequence started earlier in those with the worst self-rated health. There was no compelling evidence for age dedifferentiation (that the general factor of cognitive ability changes in strength with age). Conclusions We have confirmed previously observed patterns of cognitive aging using a large representative population sample. Cognitive performance by age varies by dimension but all are in decline by age 60. Gender differences in cognitive ability are generally consistent across all ages. Cognitive performance is lower in those with worse self-rated health and memory. Cognitive decline starts earlier in those with fair or poor self-rated health. There is very little evidence for age dedifferentiation of cognitive abilities.
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Prevalence and correlates of physical inactivity in community-dwelling older adults in Ireland. PLoS One 2015; 10:e0118293. [PMID: 25671621 PMCID: PMC4324635 DOI: 10.1371/journal.pone.0118293] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 01/08/2015] [Indexed: 01/01/2023] Open
Abstract
The public health challenges associated with rapid population ageing are likely to be exacerbated by poor physical activity levels. The purpose of this study was to identify correlates of physical inactivity in a population-representative sample of older adults in Ireland. This paper reports a secondary analysis of data from 4892 adults aged 60+ from the Irish Longitudinal Study on Ageing (TILDA). TILDA includes an assessment of the mental and physical health, and social and financial circumstances of participants assessed in a home interview and self-completion questionnaire. Chi squared statistics and forced entry logistic regression were used to identify factors associated with physical inactivity. Females were over twice as likely to be inactive as their male counterparts (Odds Ratio 2.2). Increasing old age was associated with inactivity among males and females. Those who reported above secondary level education, no reported falls in the last year and no fear of falling were less likely to be physically inactive. While older adults who noted poor/fair self-reported health, that they did not look after grandchildren, did not own a car or did not attend a course were also more likely to be inactive than those who reported positively for these items. Gender displayed a strong but often contrasting influence on factors that affect physical activity among older adults. Among females, living alone or in a rural area, retirement, fair/poor emotional health and activity being limited by illness were all significantly associated with inactivity. While cohabiting, being employed and residing in an urban area were related to low levels of activity in males. Our findings identify specific groups of the older Irish population who may be at particular risk of physical inactivity and thereby the associated physiological and psychological hazards. These results can support the development of tailored interventions to promote healthy ageing.
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Korda RJ, Paige E, Yiengprugsawan V, Latz I, Friel S. Income-related inequalities in chronic conditions, physical functioning and psychological distress among older people in Australia: cross-sectional findings from the 45 and up study. BMC Public Health 2014; 14:741. [PMID: 25048295 PMCID: PMC4223589 DOI: 10.1186/1471-2458-14-741] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/09/2014] [Indexed: 11/17/2022] Open
Abstract
Background The burden of chronic disease continues to rise as populations age. There is relatively little published on the socioeconomic distribution of this burden in older people. This study quantifies absolute and relative income-related inequalities in prevalence of chronic diseases, severe physical functioning limitation and high psychological distress in mid-age and older people in Australia. Methods Cross-sectional study of 208,450 participants in the 45 and Up Study, a population-based cohort of men and women aged 45–106 years from New South Wales, Australia. Chronic conditions included self-reported heart disease, diabetes, Parkinson’s disease, cancer and osteoarthritis; physical functioning limitation (severe/not) was measured using Medical Outcomes Study measures and psychological distress (high/not) using the Kessler Psychological Distress Scale. For each outcome, prevalence was estimated in relation to annual household income (6 categories). Prevalence differences (PDs) and ratios (PRs) were generated, comparing the lowest income category (<$20,000) to the highest (≥$70,000), using Poisson regression with robust standard errors, weighted for age, sex and region of residence. Analyses were stratified by age group (45–64, 65–79 and ≥80 years) and sex and adjusted for age and country of birth. Results With few exceptions, there were income gradients in the prevalence of chronic conditions among all age-sex groups, with prevalence decreasing with increasing income. Of the chronic diseases, PDs were highest for diabetes (ranging between 5.69% and 10.36% across age-sex groups) and in women, also for osteoarthritis (5.72% to 8.14%); PRs were highest for osteoarthritis in men aged 45–64 years (4.01), otherwise they were highest for diabetes (1.78 to 3.43). Inequalities were very high for both physical functioning limitation and psychological distress, particularly among those aged 45–64 (PDs between 18.67% and 29.23% and PRs between 4.63 and 16.51). Absolute and relative inequalities tended to decrease with age, but remained relatively high for diabetes and physical functioning in the elderly (≥80 years). Conclusions Significant inequalities in the prevalence of chronic conditions, physical functioning and psychological distress persist into old age. The additional health burden placed on those who are already disadvantaged is likely to become an increasingly important issue in an ageing population.
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Affiliation(s)
- Rosemary J Korda
- National Centre for Epidemiology and Population Health, Australian National University, Canberra ACT 0200, Australia.
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Exploring differences in prevalence of diagnosed, measured and undiagnosed hypertension: the case of Ireland and the United States of America. Int J Public Health 2014; 59:759-67. [DOI: 10.1007/s00038-014-0573-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 05/09/2014] [Accepted: 06/02/2014] [Indexed: 01/13/2023] Open
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