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Wizgier D, Meng Y, Das A, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Ribeiro RV, Shivappa N, Hébert JR, Hirani V. The association of dietary antioxidants and the inflammatory potential of the diet with poor physical function and disability in older Australian men: the Concord Health and Ageing in Men Project. Br J Nutr 2024; 131:1528-1539. [PMID: 38220224 PMCID: PMC11043910 DOI: 10.1017/s0007114524000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/18/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
Our objective was to evaluate the association of antioxidant intake and the inflammatory potential of the diet with functional decline in older men. A diet history questionnaire was used to collect dietary intake data from men aged ≥ 75 years (n 794) participating in the Concord Health and Aging in Men Project cohort study. Intake of vitamins A, C, E and Zn were compared with the Australian Nutrient Reference Values to determine adequacy. The Energy-adjusted Dietary Inflammatory Index (E-DIITM) was used to assess the inflammatory potential of the diet. Physical performance data were collected via handgrip strength and walking speed tests, and activities of daily living (ADL) and instrumental activities of daily living (IADL) questionnaires, at baseline and 3-year follow-up (n 616). Logistic regression analysis was used to identify associations between diet and incident poor physical function and disability. Both poor antioxidant intake and high E-DII scores at baseline were significantly associated with poor grip strength and ADL disability at 3-year follow-up. No significant associations with walking speed or IADL disability were observed. Individual micronutrient analysis revealed a significant association between the lowest two quartiles of vitamin C intake and poor grip strength. The lowest quartiles of intake for vitamins A, C, E and Zn were significantly associated with incident ADL disability. The study observed that poor antioxidant and anti-inflammatory food intake were associated with odds of developing disability and declining muscle strength in older men. Further interventional research is necessary to clarify the causality of these associations.
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Affiliation(s)
- Daniela Wizgier
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Ying Meng
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Arpita Das
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW2006, Australia
| | - Fiona Blyth
- School of Public Health, University of Sydney, Sydney, NSW2006, Australia
| | - David G. Le Couteur
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - David J. Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - Louise M. Waite
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
| | - Rosilene V. Ribeiro
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- School of Life and Environmental Science (SoLES), University of Sydney, Sydney, NSW, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
| | - Vasant Hirani
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
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Tran MH, van Zwieten A, Kiely KM, Blyth FM, Naganathan V, Le Couteur DG, Handelsman DJ, Seibel MJ, Waite LM, Cumming RG, Khalatbari-Soltani S. Intra-generational social mobility and mortality among older men in the Concord Health and Ageing in Men Project: A cohort study. SSM Popul Health 2024; 25:101581. [PMID: 38264197 PMCID: PMC10803938 DOI: 10.1016/j.ssmph.2023.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/16/2023] [Accepted: 12/06/2023] [Indexed: 01/25/2024] Open
Abstract
Objectives We examined associations between intra-generational social mobility (reflected in life-course socioeconomic trajectories) and mortality, among older men. Methods Data came from a prospective Australian community-based cohort of older men. Social mobility was defined by socioeconomic indicators from three points in the life-course: educational attainment (late adolescence-early adulthood), occupation (mid-life), and current sources of income (older age). We defined indicators of social mobility trajectory (6 categories; reflecting the direction of social mobility) and social mobility status (2 categories; mobile or non-mobile). We used Cox regression to examine associations with mortality, adjusting for age, country of birth, and living arrangement. Results We followed 1568 men (mean age 76.8, SD 5.4) for a mean duration of 9.1 years, with 797 deaths recorded. Moving upward was the predominant social mobility trajectory (36.0%), followed by mixed trajectories (25.1%), downward (15.1%), stable low (12.2%), stable high (7.6%), and stable middle (4.0%). Men with downward (Hazard ratio 1.58, 95% CI 1.13 to 2.19) and stable low socioeconomic trajectories (1.77, 1.25 to 2.50) had higher mortality risks than men with stable high socioeconomic trajectories, while men with upward trajectories had similar risks to those with stable high trajectories. 76.2% of the participants were classified as having mobile status; no associations were evident between binary social mobility status and mortality. Discussions These findings suggest cumulative and persistent exposure to disadvantaged socioeconomic conditions across the life-course, rather than social mobility, is associated with increased mortality. For each stage of the life-course, addressing socioeconomic disadvantage may reduce inequities in mortality.
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Affiliation(s)
- Minh-Hoang Tran
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- NTT Hi-Tech Institute, Nguyen Tat Thanh University, HCMC, Viet Nam
| | - Anita van Zwieten
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Kim M. Kiely
- Ageing Futures Institute, University of New South Wales (UNSW), Sydney, (NSW), Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
- School of Health and Society and School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, (NSW), Australia
| | - Fiona M. Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
- Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - David G. Le Couteur
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - David J. Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Markus J. Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Louise M. Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
- Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - Robert G. Cumming
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Saman Khalatbari-Soltani
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
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Luong R, Ribeiro R, Naganathan V, Blyth F, Waite LM, Handelsman DJ, Le Couteur DG, Seibel MJ, Hirani V. Empirically derived dietary patterns are associated with major adverse cardiovascular events, all-cause mortality, and congestive cardiac failure in older men: The Concord Health and Ageing in Men Project. J Nutr Health Aging 2024; 28:100020. [PMID: 38388114 DOI: 10.1016/j.jnha.2023.100020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/10/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Diet is associated with major adverse cardiovascular events (MACE). OBJECTIVE We evaluated the associations between empirically derived dietary patterns and MACE. DESIGN Prospective cohort study. SETTING The Concord Health and Ageing in Men Project, Sydney, Australia. PARTICIPANTS 539 community-dwelling older Australian men aged 75 years and older. METHODS Men underwent dietary assessment using a validated dietitian-administered diet history questionnaire. Cox regression analyses were conducted between MACE and the three dietary patterns identified from factor analysis. Five-point MACE comprised of all-cause mortality, myocardial infarction (MI), congestive cardiac failure (CCF), coronary revascularisation, and/or ischaemic stroke. Four-point MACE included the four endpoints of MI, CCF, coronary revascularisation, and/or ischaemic stroke, and excluded all-cause mortality. RESULTS At a median of 5.3 (IQR 4.6-6.3) years of follow-up, the incidences were: five-point MACE 31.2% (n = 168); four-point MACE excluding all-cause mortality 17.8% (n = 96); all-cause mortality 20.1% (n = 111); CCF 11.3% (n = 61); MI 3.7% (n = 20); stroke 3.2% (n = 17); and coronary revascularisation 3.1% (n = 15). In fully adjusted analyses, compared to the bottom tertile, the middle tertile of 'vegetables-legumes-seafood' dietary pattern was associated with reduced five-point MACE (HR 0.67 [95% CI: 0.45, 0.99, P = .047]), and CCF (HR 0.31 [95% CI: 0.15, 0.65, P = .002]), whilst the middle tertile of 'wholegrains-milk-other fruits' dietary pattern was associated with increased five-point MACE (HR 1.78 [95% CI: 1.17, 2.70, P = .007]), four-point MACE (HR 1.92 [95% CI: 1.12, 3.30, P = .018]), and CCF (HR 2.33 [95% CI: 1.17, 4.65, P = .016]). For the 'discretionary-starchy vegetables-processed meats' dietary pattern, a higher score was associated with increased five-point MACE (HR 1.33 [95% CI: 1.09, 1.62, P = .004]), and all-cause mortality (HR 1.63 [95% CI: 1.26, 2.12, P < .001]), and compared to the bottom tertile, the top tertile was associated with increased all-cause mortality (HR 2.26 [95% CI: 1.27, 4.00, P = .005]). CONCLUSION Older men may benefit from consuming a 'vegetables-legumes-seafood' dietary pattern rather than 'discretionary-starchy vegetables-processed meats' and 'wholegrains-milk-other fruits' dietary patterns for the prevention of MACE.
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Affiliation(s)
- Rebecca Luong
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia.
| | - Rosilene Ribeiro
- Charles Perkins Centre, The University of Sydney, NSW, Australia; School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - Fiona Blyth
- ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; School of Public Health, The University of Sydney, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia; Andrology Department, Concord Hospital, Concord, NSW, Australia
| | - David G Le Couteur
- Charles Perkins Centre, The University of Sydney, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
| | - Markus J Seibel
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
| | - Vasant Hirani
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia; Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
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Luong R, Ribeiro R, Naganathan V, Blyth F, Waite LM, Handelsman DJ, Le Couteur DG, Seibel MJ, Hirani V. Cross-sectional and longitudinal associations between empirically derived dietary patterns and frailty among older men: The Concord Health and Ageing in Men Project. J Nutr Health Aging 2024; 28:100021. [PMID: 38267155 DOI: 10.1016/j.jnha.2023.100021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/30/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Diet may be associated with frailty. OBJECTIVE We aimed to evaluate the associations between empirically derived dietary patterns and frailty in older men. DESIGN Prospective cohort study. SETTING The Concord Health and Ageing in Men Project, Sydney, Australia. PARTICIPANTS 785 community-dwelling older Australian men aged 75 years and older. METHODS Men underwent dietary assessment using a validated dietitian-administered diet history questionnaire. Factor analysis identified three dietary patterns. Multinomial logistic regression was conducted between frailty and dietary patterns for cross-sectional analyses and longitudinal analyses over a 3-year follow-up. Frailty was defined by the Fried frailty phenotype. RESULTS Of the 785 men, pre-frailty was prevalent in 47.1% (n = 370), and frailty in 8.3% (n = 65). In fully adjusted cross-sectional analyses, the top tertile and a higher 'vegetables-legumes-seafood' dietary pattern score were associated with reduced prevalence of frailty (OR 0.34 [95% CI: 0.12, 0.93, P = .036]) and OR 0.50 [95% CI: 0.30, 0.83, P = .007] respectively). The top tertile of the 'discretionary-starchy vegetables-processed meats' dietary pattern was also associated cross-sectionally with increased prevalence of pre-frailty (OR 1.75 [95% CI: 1.08, 2.83, P = .022]). Of the 296 robust men in fully adjusted longitudinal analyses, the incidence of pre-frailty was 52.4% (n = 155), and frailty was 5.4% (n = 16) over a 3-year follow-up. The middle tertile of the 'vegetables-legumes-seafood' dietary pattern had a non-significant trend towards reduced incident pre-frailty (OR 0.52 [95% CI: 0.27, 1.00, P = .050]). CONCLUSION Consumption of a 'vegetables-legumes-seafood' dietary pattern appears to be less favoured by frail older men.
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Affiliation(s)
- Rebecca Luong
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia.
| | - Rosilene Ribeiro
- Charles Perkins Centre, The University of Sydney, NSW, Australia; School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - Fiona Blyth
- ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; School of Public Health, The University of Sydney, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia; Andrology Department, Concord Hospital, Concord, NSW, Australia
| | - David G Le Couteur
- Charles Perkins Centre, The University of Sydney, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
| | - Markus J Seibel
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
| | - Vasant Hirani
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia; Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
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Wright FAC, Shu ECC, Cumming RG, Naganathan V, Blyth FM, Hirani V, Le Couteur DG, Handelsman DJ, Seibel MJ, Waite LM, Stanaway FF. Oral health-related quality of life of older Australian men. Community Dent Oral Epidemiol 2023; 51:767-777. [PMID: 35561045 DOI: 10.1111/cdoe.12754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 02/16/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aims of this study were to assess oral health-related quality of life (OHRQoL) in a cohort of older Australian men and explore the association between their general health conditions, socio-demographic factors and OHRQoL. METHODS The Concord Health and Ageing in Men Project (CHAMP) is a cohort study of the health of a representative sample of Australian men, initiated in 2005-2006 with an initial sample of 1705 men 70 years or over. Participants completed a self-administered health and socio-demographic questionnaire and attended an interview and clinical assessment at baseline and each of three follow-up assessments. Information on oral health and responses to the Oral Health Impact Profile (OHIP-14) were collected in the 4th follow-up in which 778 men completed the OHIP-14 questionnaire and 614 men had a dental assessment. The prevalence of oral health impact was defined as a response of fairly often or very often to one or more of the OHIP-14 questions. Mean OHIP-14 scores were calculated for the 14 questions and used as the dependent variable in the regression analyses. Zero-inflated Poisson regression was used to estimate prevalence rate ratios (PRR). RESULTS Only 10% of men presented oral health impacts. In multivariate regression modelling, being born in Italy/Greece (PRR: 2.16, 95% CI: 1.93-2.42) or in other countries (PRR: 2.12, 95% CI: 1.89-2.38), having poor self-rated general health (PRR: 1.38, 95% CI: 1.24-1.53), having poor mental wellbeing (PRR: 1.14, 95% CI: 1.04-1.24), having ≥6 depressive symptoms (PRR: 1.18, 95% CI: 1.05-1.32), being a current smoker (PRR: 1.34, 95% CI: 1.06-1.70) and having more decayed tooth surfaces (PRR:1.01, 95% CI: 1.00-1.02) were associated with higher impact scores. CONCLUSIONS Overall, older Australian men exhibit good oral health-related quality of life. The inter-relationship between perceptions of general health and well-being, health and oral health variables and social background supports policy objectives of closer integration of general health and oral health services for older Australian men.
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Affiliation(s)
- Fredrick Alan Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Ellie C-C Shu
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Robert G Cumming
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Repatriation General Hospital, University of Sydney, Concord, New South Wales, Australia
| | - Markus J Seibel
- Concord Clinical School, University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Fiona F Stanaway
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
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Scott D, Blyth F, Naganathan V, Le Couteur DG, Handelsman DJ, Waite LM, Hirani V. Sarcopenia prevalence and functional outcomes in older men with obesity: Comparing the use of the EWGSOP2 sarcopenia versus ESPEN-EASO sarcopenic obesity consensus definitions. Clin Nutr 2023; 42:1610-1618. [PMID: 37481869 DOI: 10.1016/j.clnu.2023.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND & AIMS The potential for older adults with obesity to also have sarcopenia, and the health consequences of 'sarcopenic obesity', may be underappreciated by health professionals. The primary aim of this secondary analysis of a prospective cohort study of older men was to explore the prevalence and functional outcomes of sarcopenic obesity based on different consensus definitions. METHODS 1416 community-dwelling men aged ≥70 years were classified into sarcopenia categories according to the European Working Group on Sarcopenia in Older People (EWGSOP2) definition, and sarcopenic obesity categories according to the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity (ESPEN-EASO) definition. Descriptive analyses determined prevalence of sarcopenia in obese and non-obese older men. Multivariable analyses compared associations with functional outcomes including activity of daily living (ADL) and instrumental activity of daily living (IADL) disability and 12-month incident falls. RESULTS According to the EWGSOP2 definition, 12.6% of men had confirmed sarcopenia but only 0.3% of men had sarcopenia and obesity (BMI ≥30 kg/m2). Conversely, 9.6% of men had sarcopenic obesity according to the ESPEN-EASO definition. Notably, no men with a BMI ≥32 kg/m2 were classified as having EWGSOP2-confirmed sarcopenia, despite the fact that 60.8% of all men with BMI ≥32 kg/m2 had low muscle strength. Due to low numbers (N = 4) of obese older men with EWGSOP2-confirmed sarcopenia, associations with functional outcomes were not assessed. Men with sarcopenic obesity according to the ESPEN-EASO definition had significantly lower hand grip strength, higher chair-stands time and slower gait speed (all P < 0.05), increased odds for ADL (odds ratio: 5.02, 95% CI: 1.85-13.58) and IADL (2.18, 1.38-3.45) disability, and higher 12-month incident falls rates (incident rate ratio: 1.59, 95% CI: 1.03-2.44) than men with neither sarcopenia nor obesity. CONCLUSION Low muscle strength is common in older men with obesity, but the prevalence of sarcopenia is likely to be underestimated when the EWGSOP2 operational definition is applied in this population. The ESPEN-EASO operational definition of sarcopenic obesity appears to provide a valid approach for identifying older men with obesity who are at risk of poor functional outcomes related to sarcopenia.
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Affiliation(s)
- David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Fiona Blyth
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
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Kiely KM, Khalatbari-Soltani S, Blyth FM, Naganathan V, Handelsman DJ, Waite LM, Le Couteur DG, Mortby ME, Cumming RG, Anstey KJ. Mixed Evidence of an Association between Self-Rated Hearing Difficulties and Falls: Prospective Analysis of Two Longitudinal Studies. Gerontology 2023; 69:98-108. [PMID: 35598592 DOI: 10.1159/000524311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/21/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION This study aimed to assess the extent to which a single item of self-reported hearing difficulties is associated with future risk of falling among community-dwelling older adults. METHODS We used data from two Australian population-based cohorts: three waves from the PATH Through Life study (PATH; n = 2,048, 51% men, age 66.5 ± 1.5 SD years) and three waves from the Concord Health and Ageing in Men Project (CHAMP; n = 1,448, 100% men with mean age 77.3 ± 5.3 SD years). Hearing difficulties were recorded on a four-point ordinal scale in PATH and on a dichotomous scale in CHAMP. The number of falls in the past 12 months was reported at each wave in both studies. In CHAMP, incident falls were also ascertained by triannual telephone call cycles for up to four years. Multivariable-adjusted random intercept negative binomial regression models were used to estimate the association between self-reported hearing difficulties and number of falls reported at the following wave or 4-monthly follow-ups. RESULTS In PATH, self-reported hearing difficulties were associated with a higher rate of falls at follow-up (incidence rate ratio = 1.15, 95% CI = 1.03-1.27 per a one-level increase in self-reported hearing difficulties), after adjusting for sociodemographic characteristics, health behaviours, physical functioning, balance, mental health, medical conditions, and medications. There were no significant associations between hearing difficulties and the rate of falls based on either repeated survey or 4-monthly follow-ups in CHAMP. CONCLUSION Though we find mixed results, findings from PATH data indicate an ordinal measure of self-reported hearing loss may be predictive of falls incidence in young-old adults. However, the null findings in the male-only CHAMP preclude firm conclusions of a link between hearing loss and falls risk.
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Affiliation(s)
- Kim M Kiely
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.,The School of Psychology, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia
| | - Saman Khalatbari-Soltani
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Vasikaran Naganathan
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Moyra E Mortby
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.,The School of Psychology, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia
| | - Robert G Cumming
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.,The School of Psychology, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia
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8
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Luong R, Ribeiro RV, Rangan A, Naganathan V, Blyth F, Waite LM, Handelsman DJ, Le Couteur DG, Seibel MJ, Hirani V. Haem Iron Intake Is Associated with Increased Major Adverse Cardiovascular Events, All-Cause Mortality, Congestive Cardiac Failure, and Coronary Revascularisation in Older Men: The Concord Health and Ageing in Men Project. J Nutr Health Aging 2023; 27:559-570. [PMID: 37498103 DOI: 10.1007/s12603-023-1945-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/22/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Nutritional intake can influence major adverse cardiovascular events (MACE). Dietary iron is found in two forms: haem-iron (HI) only found in animal sources and non-haem iron (NHI) present mostly in plant sources. OBJECTIVE We evaluated the associations between dietary iron intakes with MACE and iron status biomarkers. DESIGN Prospective cohort study. SETTING The Concord Health and Ageing in Men Project, Sydney, Australia. PARTICIPANTS 539 community-dwelling older Australian men aged 75 years and older. METHODS Men underwent nutritional assessment using a validated diet history questionnaire. Entries were converted to food groups and nutrients. The dietary calculation was used to derive HI and NHI intakes from total iron intakes. Analyses of iron intakes with iron status biomarkers were conducted using linear regression, and with MACE and individual endpoints were conducted using Cox regression. Five-point MACE comprised of all-cause mortality, myocardial infarction (MI), congestive cardiac failure (CCF), coronary revascularisation, and/or ischaemic stroke. Four-point MACE included the four endpoints of MI, CCF, coronary revascularisation, and/or ischaemic stroke, and excluded all-cause mortality. RESULTS At a median of 5.3 (4.6 - 6.3) years follow-up, the incidences were: 31.2% (n = 168) five-point MACE, 17.8% (n = 96) four-point MACE excluding all-cause mortality, 20.1% (n = 111) all-cause mortality, 11.3% (n = 61) CCF, and 3.1% (n = 15) coronary revascularisation. In adjusted analyses, higher HI intake (per 1mg increment) was associated with increased five-point MACE (HR: 1.45 [95% CI: 1.16, 1.80, P = .001]), four-point MACE excluding all-cause mortality (HR: 1.64 [95% CI: 1.26, 2.15, P <.001]), all-cause mortality (HR: 1.51 [95% CI: 1.15, 1.99, P = .003]), CCF (HR: 2.08 [95% CI: 1.45, 2.98, P <.001]), and coronary revascularisation (HR: 1.89 [95% CI: 1.15, 3.10, P = .012]). Compared with the bottom tertile of NHI intake, the middle tertile of NHI intake was associated with reduced risk of all-cause mortality (HR: 0.56 [95% CI: 0.33, 0.96, P = .035]). Total iron intake was not associated with MACE and individual endpoints. Dietary iron intakes were not associated with serum iron and haemoglobin. CONCLUSION Higher haem iron intake was independently associated with increased risks of five-point MACE, four-point MACE excluding all-cause mortality, all-cause mortality, CCF, and coronary revascularisation in older men over 5 years.
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Affiliation(s)
- R Luong
- Rebecca Luong, Level 4, Charles Perkins Centre D17, University of Sydney, NSW 2006, Australia,
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Lin AG, Shaheen N, Ganda K, Cullen J, Waite LM, Seibel MJ. Improving osteoporosis treatment rates in inpatients admitted with hip fracture: A healthcare improvement initiative in a tertiary referral hospital. Aging Med (Milton) 2022; 5:264-271. [PMID: 36606266 PMCID: PMC9805288 DOI: 10.1002/agm2.12229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 11/16/2022] Open
Abstract
Objective This healthcare improvement initiative was designed to increase inpatient osteoporosis treatment after hip fracture. Methods A new protocol was developed by Geriatric Medicine and Endocrinology departments at a tertiary care hospital in Sydney. Its aim was to standardize assessment and treatment of osteoporosis in patients admitted with hip fracture. Eligible inpatients would receive intravenous zoledronic acid during their admission. A 6-month sample of hip fracture patients admitted after the protocol's implementation was compared to a group admitted before. Data collected included demographics, biochemistry, treatment rates, adverse effects, and admission survival. Results There was a considerable increase in osteoporosis treatment after introducing the protocol. Before the protocol's introduction, none of 36 eligible patients received treatment. After the intervention 79% (23 out of 29) of eligible patients were treated.All treated patients had renal function and serum calcium levels checked post-infusion with no adverse outcomes. Eight patients developed flu-like symptoms within 24 h of the infusion. There were no instances of arrhythmias, ocular inflammation, or death. The cost per patient treated was AUD $87. Conclusion Adopting a standardized protocol for osteoporosis treatment in patients admitted for hip fracture was effective in improving treatment rates whilst being relatively safe and inexpensive.
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Affiliation(s)
- Andrew Gan Lin
- Department of EndocrinologyConcord HospitalConcordNew South WalesAustralia
| | - Nargis Shaheen
- Centre for Education and Research on Ageing (CERA), Department of Geriatric MedicineConcord HospitalConcordNew South WalesAustralia
| | - Kirtan Ganda
- Department of EndocrinologyConcord HospitalConcordNew South WalesAustralia,Concord Clinical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - John Cullen
- Centre for Education and Research on Ageing (CERA), Department of Geriatric MedicineConcord HospitalConcordNew South WalesAustralia,Concord Clinical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Louise M. Waite
- Centre for Education and Research on Ageing (CERA), Department of Geriatric MedicineConcord HospitalConcordNew South WalesAustralia,Concord Clinical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Markus J. Seibel
- Department of EndocrinologyConcord HospitalConcordNew South WalesAustralia,Concord Clinical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
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10
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Vardy JL, Pond GR, Cysique LA, Gates TM, Lagopoulos J, Renton C, Waite LM, Tannock IF, Dhillon HM. Lack of cognitive impairment in long-term survivors of colorectal cancer. Support Care Cancer 2022; 30:6123-6133. [PMID: 35420329 PMCID: PMC9135780 DOI: 10.1007/s00520-022-07008-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/23/2022] [Indexed: 11/24/2022]
Abstract
Background Our longitudinal study reported cognitive impairment in 43% of people following diagnosis of localised colorectal cancer (CRC) versus 15% in healthy controls (p < 0.001) and 50% versus 13% 1–2 years later (p < 0.001). Here we evaluate cognitive function and neuroimaging in a subgroup at long-term follow-up. Patients and methods Cancer-free Australian participants in the study, and controls, completed cognitive and functional assessments. Neuroimaging was optional. Blood tests included inflammatory markers, clotting factors, sex hormones and apolipoprotein E genotype. The primary endpoint was demographically and practice effect-corrected cognitive scores comparing CRC survivors with controls over time examined using a linear mixed model, adjusted for baseline performance. Secondary endpoints included cognitive impairment rate using the Global Deficit Score [GDS > 0.5], Functional Deficit Score, blood results and neuroimaging. Results The study included 25 CRC survivors (60% men, median age 72) at mean 9 years after baseline (9 received adjuvant chemotherapy) and 25 controls (44% men, median age 68) at mean 6 years after baseline. There were no significant differences in cognitive scores or proportion with cognitive impairment (16 vs. 8%) between survivors and controls and no evidence of accelerated ageing in CRC survivors. Baseline cognitive performance predicted for subsequent cognitive function. There were no differences in functional tests or blood tests between groups. In 18 participants undergoing neuroimaging, 10 CRC survivors had higher myoinositol levels than 8 controls, and lower volume in the right amygdala and caudate and left hippocampal regions. Conclusions There was no difference in cognitive capacity and function between CRC survivors and controls 6–12 years after diagnosis. Differences in neuroimaging require confirmation in a larger sample. Highlights • No evidence of long term cognitive impairment in colorectal cancer survivors compared to controls 6–12 years after diagnosis • No evidence of accelerated cognitive ageing in colorectal cancer survivors • No evidence of long-term functional impairment in colorectal cancer survivors Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-07008-3.
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Affiliation(s)
- Janette L Vardy
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia. .,Concord Cancer Centre, Concord Repatriation General Hospital, Hospital Rd, Concord, Sydney, NSW 2137, Australia. .,Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia.
| | | | - Lucette A Cysique
- School of Psychology, University of New South Wales, Randwick, Australia.,St. Vincent's Hospital Applied Medical Research Centre, Sydney, Australia
| | - Thomas M Gates
- School of Psychology, University of New South Wales, Randwick, Australia.,St. Vincent's Hospital Applied Medical Research Centre, Sydney, Australia
| | - Jim Lagopoulos
- Brain Mind Research Institute, University of Sydney, Sydney, Australia.,Sunshine Coast Mind & Neuroscience, Thompson Institute, University of Sunshine Coast, Birtinya, Australia
| | - Corrinne Renton
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
| | - Louise M Waite
- Concord Repatriation General Hospital, Sydney, Australia
| | - Ian F Tannock
- Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Haryana M Dhillon
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
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11
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Xu P, Blyth FM, Naganathan V, Cumming RG, Handelsman DJ, Seibel MJ, Le Couteur DG, Waite LM, Khalatbari-Soltani S. Socioeconomic Inequalities in Elective and Nonelective Hospitalizations in Older Men. JAMA Netw Open 2022; 5:e226398. [PMID: 35389499 PMCID: PMC8990350 DOI: 10.1001/jamanetworkopen.2022.6398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
IMPORTANCE Among older adults, there is limited and inconsistent evidence on the association between socioeconomic position (SEP) and elective and nonelective hospitalization. OBJECTIVE To evaluate the association between SEP and all-cause and cause-specific elective and nonelective hospitalization and hospital length of stay among older men. DESIGN, SETTING, AND PARTICIPANTS This population-based, prospective cohort study used data from the Concord Health and Aging in Men Project (CHAMP). CHAMP recruited 1705 men aged 70 years or older between January 28, 2005, and June 4, 2007, in Sydney, Australia. Data were analyzed from February 1 to September 30, 2021. EXPOSURES Indicators of SEP, including education (university degree certificate, diploma or no postschool qualifications), occupation (professionals and managers; small employers and self-employed; or lower clerical, service, sales workers, skilled, and unskilled workers), and source of income (other sources of income than government pension, reliance on government pensions and other sources of income, or reliant solely on a government pension), and a cumulative SEP score (tertiles) as SEP indicators; 3-level variables present high, intermediate, and low SEP. MAIN OUTCOMES AND MEASURES All-cause and cause-specific elective and nonelective hospitalizations, number of hospitalizations, and length of stay were the study outcomes, ascertained through data linkage. Associations were quantified using competing-risks survival regression and negative binomial regression. RESULTS A total of 1566 men (mean [SD] age, 76.8 [5.4] years) were included. During a mean (SD) 9.07 (3.53) years of follow-up, 1067 men had at least 1 elective hospitalization, and 1255 men had at least 1 nonelective hospitalization. No associations were found between SEP and elective hospitalizations. Being in the lowest tertile for educational level (subhazard ratio [SHR], 1.32; 95% CI, 1.11-1.58), occupational position (SHR, 1.30; 95% CI, 1.12-1.50), sources of income (SHR, 1.33; 95% CI, 1.17-1.52), and cumulative SEP tertile groups (SHR, 1.45; 95% CI, 1.24-1.68) were all associated with having at least 1 nonelective hospitalization compared with those in the highest tertiles. Significant associations were found between being in the lowest SEP groups and increased numbers and longer length of stay of nonelective hospitalizations. CONCLUSIONS AND RELEVANCE In this prospective cohort study, low SEP was inversely associated with nonelective hospitalizations but not elective hospitalization in older men in Australia. These findings point to the existence of socioeconomic inequalities in health care use, indicative of a need to take action to reduce these inequalities.
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Affiliation(s)
- Peiyao Xu
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Fiona M. Blyth
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
- ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Ageing and Alzheimer’s Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - Robert G. Cumming
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
- ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
| | - David J. Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Markus J. Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - David G. Le Couteur
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Ageing and Alzheimer’s Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Louise M. Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Ageing and Alzheimer’s Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - Saman Khalatbari-Soltani
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
- ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
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12
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Luong R, Ribeiro RV, Rangan A, Naganathan V, Blyth F, Waite LM, Handelsman DJ, Cumming RG, Le Couteur DG, Hirani V. Changes in dietary total and non-haem iron intake is associated with incident frailty in older men: The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2022; 77:1853-1865. [PMID: 35352124 PMCID: PMC9434472 DOI: 10.1093/gerona/glac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background Nutritional intake could influence the development of frailty. The aim was to evaluate the associations between dietary iron intakes and changes in dietary iron intakes with frailty. Methods Cross-sectional analyses involved 785 men with Fried frailty phenotype (FP) and 758 men with Rockwood frailty index (FI) data aged 75 years and older at nutrition assessment from the Concord Health and Ageing in Men Project prospective cohort study. Of these, 563 men who were FP robust or prefrail, and 432 men who were FI nonfrail were included in the longitudinal analyses for more than 3 years. Dietary intake was assessed at both timepoints using a validated diet history questionnaire. The dietary calculation was used to derive heme iron and nonheme iron intakes from total iron intakes. The associations were evaluated through binary logistic regression. Results Incidence of FP frailty was 15.3% (n = 86). In longitudinal analyses, maintaining total iron intakes (medium tertile −2.61–0.81 mg/d), increases in total iron and nonheme iron intakes (high tertiles ≥0.82 mg/d and ≥0.80 mg/d), and changes in nonheme iron intake (1 mg increment) were associated with reduced risks of incident FP frailty (OR: 0.47 [95% confindence interval (CI): 0.24, 0.93, p = .031], OR 0.48 [95% CI: 0.23, 0.99, p = .048], OR 0.41 [95% CI: 0.20, 0.88, p = .022], and OR 0.89 [95% CI: 0.82, 0.98, p = .017]). Conclusion Maintaining or increases in total dietary iron and increases or changes in dietary nonheme iron intakes more than 3 years were associated with reduced incidence of FP frailty in older men.
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Affiliation(s)
- Rebecca Luong
- Charles Perkins Centre, The University of Sydney, NSW, Australia.,Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia
| | - Rosilene V Ribeiro
- Charles Perkins Centre, The University of Sydney, NSW, Australia.,School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, NSW, Australia
| | - Anna Rangan
- Charles Perkins Centre, The University of Sydney, NSW, Australia.,Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia.,Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - Fiona Blyth
- ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia.,School of Public Health, The University of Sydney, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia.,Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, The University of Sydney and Concord Hospital, Concord, NSW, Australia
| | - Robert G Cumming
- ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia.,School of Public Health, The University of Sydney, NSW, Australia
| | - David G Le Couteur
- Charles Perkins Centre, The University of Sydney, NSW, Australia.,ANZAC Research Institute, The University of Sydney and Concord Hospital, Concord, NSW, Australia
| | - Vasant Hirani
- Charles Perkins Centre, The University of Sydney, NSW, Australia.,Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia.,ANZAC Research Institute, The University of Sydney and Concord Hospital, Concord, NSW, Australia
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13
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Wu H, Mach J, Gnjidic D, Naganathan V, Blyth FM, Waite LM, Handelsman DJ, Le Couteur DG, Hilmer SN. Comparing Effects of Polypharmacy on Inflammatory Profiles in Older Adults and Mice: Implications for Translational Ageing Research. J Gerontol A Biol Sci Med Sci 2022; 77:1295-1303. [PMID: 35299251 PMCID: PMC9255679 DOI: 10.1093/gerona/glac061] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Indexed: 11/14/2022] Open
Abstract
Aging and multimorbidity are associated with inflammation. Polypharmacy is common in older people with multimorbidity. Given the potential for interactions between polypharmacy and inflammation, the relationship between inflammation and polypharmacy were studied in older adults with multimorbidity and in healthy aging mice. A cross-sectional analysis of data from the 5-year wave of the Concord Health and Ageing in Men Project, a population-based study of community-dwelling men aged ≥70 years. Serum concentrations of 27 cytokines were measured using a multiplex immunoassay. Associations between polypharmacy (≥5 medications) and cytokines were evaluated using multivariable linear regression adjusting for age, frailty, comorbidities, and individual drug classes. Interaction between polypharmacy and Drug Burden Index (DBI―drugs with anticholinergic and sedative effects) was analyzed. Effects of polypharmacy and DBI on serum levels of 23 cytokines were determined in aging male mice treated with chronic polypharmacy or control. Compared to the nonpolypharmacy group (n = 495), CHAMP participants with polypharmacy (n = 409) had significantly higher concentrations of IL-8, IL-6, CCL3, Eotaxin, IL-1ra, IL-1β, IP-10, and lower concentrations of anti-inflammatory cytokine IL-4. In fully-adjusted multivariable models, polypharmacy was positively associated with concentrations of IL-8 and CCL3. There were no significant differences in inflammatory profiles between control and polypharmacy-treated mice. The relationship was not influenced by DBI in men or in mice. Inflammatory markers associated with polypharmacy in older adults were not seen in healthy aged mice administered polypharmacy, and may be related to underlying diseases. The polypharmacy mouse model provides opportunities for mechanistic investigations in translational research.
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Affiliation(s)
- Harry Wu
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - John Mach
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Danijela Gnjidic
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing (CERA), Department of Geriatric Medicine, Concord Hospital, Concord, New South Wales, Australia.,Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Concord, New South Wales, Australia
| | - Fiona M Blyth
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Concord, New South Wales, Australia.,School of Public Health, ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing (CERA), Department of Geriatric Medicine, Concord Hospital, Concord, New South Wales, Australia.,Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Concord, New South Wales, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital and ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - David G Le Couteur
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing (CERA), Department of Geriatric Medicine, Concord Hospital, Concord, New South Wales, Australia.,Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Concord, New South Wales, Australia.,ANZAC Research Institute, Ageing and Alzheimer's Institute (AAAI), University of Sydney, Concord, New South Wales, Australia
| | - Sarah N Hilmer
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, St Leonards, New South Wales, Australia
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14
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Gnanenthiran S, Ng AC, Cumming RG, Brieger DB, Le Couteur DG, Waite LM, Seibel M, Handelsman DJ, Naganathan V, Kritharides L, Blyth FM. Hemoglobin, Frailty and Long-Term Cardiovascular Events in Community-Dwelling Older Men Aged ≥70 years. Can J Cardiol 2022; 38:745-753. [DOI: 10.1016/j.cjca.2022.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/11/2022] [Accepted: 01/23/2022] [Indexed: 12/11/2022] Open
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Ischia L, Naganathan V, Waite LM, Le Couteur DG, Thillainadesan J. COVID-19 and geriatric medicine in Australia and New Zealand. Australas J Ageing 2021; 41:301-308. [PMID: 34904362 DOI: 10.1111/ajag.13027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/12/2021] [Accepted: 10/28/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To investigate geriatricians' views about issues facing geriatric medicine, and the preparedness of the health-care system during the COVID-19 pandemic. METHODS An online survey of heads of geriatric medicine departments in hospitals in Australia and New Zealand undertaken in May 2020. RESULTS The majority of hospitals had admitted one or more patients with suspected COVID-19. Most geriatricians believed their hospital was 'adequately' or 'well prepared' for the pandemic. Inpatient capacity increased to manage acute, post-acute and rehabilitative care of older patients with COVID-19. Non-inpatient services for older people were reduced and telehealth-instituted widely. Increases in work hours, on-call and staffing levels were reported. Geriatricians voiced major concerns about the preparedness of residential aged care facilities to manage the pandemic. CONCLUSIONS The COVID-19 pandemic impacted on geriatricians and the provision of geriatric medicine services. Many issues that subsequently affected older people were predicted in advance.
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Affiliation(s)
- Liesl Ischia
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Concord, Sydney, New South Wales, Australia
| | - Louise M Waite
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Concord, Sydney, New South Wales, Australia
| | - David G Le Couteur
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Concord, Sydney, New South Wales, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Janani Thillainadesan
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Concord, Sydney, New South Wales, Australia
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16
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Das A, Cumming R, Naganathan V, Blyth F, Couteur DGL, Handelsman DJ, Waite LM, Ribeiro RVR, Simpson SJ, Hirani V. Associations between dietary intake of total protein and sources of protein (plant vs. animal) and risk of all-cause and cause-specific mortality in older Australian men: The Concord Health and Ageing in Men Project. J Hum Nutr Diet 2021; 35:845-860. [PMID: 34806230 DOI: 10.1111/jhn.12965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The association between dietary protein intake and the risk of mortality is still controversial. The present study aimed to examine the associations between dietary total, animal and plant protein intake and all-cause and cause-specific mortality. METHODS Community-dwelling men aged ≥ 70 years were recruited from local government areas surrounding Concord Hospital in Sydney, New South Wales for the Concord Health and Ageing in Men Project (CHAMP). The research dietitian administered a standardised validated diet history questionnaire to capture baseline dietary intake. In total, 794 men participated in a detailed diet history interview at the third wave. Adequacy of protein intake was assessed by comparing participant intake with the Nutrient Reference Values. Total protein intake was categorised into quintiles. Sources of protein were also captured. Mortality was ascertained through the New South Wales death registry. Cox proportional hazard models were used to assess the association between dietary total, animal and plant protein intake and risk of mortality. RESULTS The mean age of the CHAMP men was 81 years. In total, 162 men died during a median follow-up of 3.7 years. Of these, 54 (33.3%) and 49 (30.2%) men died due to cancer and cardiovascular disease, respectively. There were U-shaped associations between protein intake and all-cause and cancer mortality. In multiple adjusted analysis, the second (hazard ratio [HR] = 0.38; 95% confidence interval [CI] = 0.18-0.82) and third (HR = 0.36; 95% CI = 0.16-0.82) quintiles of protein intakes were significantly associated with reduced risk of all-cause and only second quintile (HR = 0.47; 95% CI = 0.10-0.93) of protein intake was significantly associated with cancer mortality. Each serve increase in animal protein was significantly associated with 12% (HR = 1.12; 95% CI = 1.00-1.26) and 23% (HR = 1.23; 95% CI = 1.02-1.49) increased risk of all-cause mortality and cancer mortality respectively. Conversely, each serve increase in plant protein intake was significantly associated with 25% (HR = 0.75; 95% CI 0.61-0.92) and 28% (HR = 0.72; 95% CI = 0.53-0.97) reduced risk of all-cause and cancer mortality, respectively. No such associations were observed for cardiovascular disease mortality. CONCLUSIONS Both second and third quintiles of total protein intake were associated with reduced all-cause and cancer mortality. Plant protein was inversely associated with all-cause and cancer mortality, whereas animal protein intake was positively associated with mortality.
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Affiliation(s)
- Arpita Das
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, NSW, Australia
| | - Robert Cumming
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, NSW, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, NSW, Australia.,School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Vasikaran Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, NSW, Australia
| | - Fiona Blyth
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, NSW, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, NSW, Australia
| | - Rosilene V R Ribeiro
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Stephen J Simpson
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Vasant Hirani
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, NSW, Australia
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17
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Khalatbari-Soltani S, Blyth FM, Naganathan V, Le Couteur DG, Handelsman DJ, Seibel MJ, Hirani V, Wright FAC, Waite LM, Cumming RG. Cohort Profile update: The Concord Health and Ageing in Men Project (CHAMP). Int J Epidemiol 2021; 51:31-32h. [PMID: 34601611 DOI: 10.1093/ije/dyab171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Saman Khalatbari-Soltani
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, NSW, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, NSW, Australia
| | - Fiona M Blyth
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, NSW, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, NSW, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - Markus J Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - Vasant Hirani
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - F A Clive Wright
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - Louise M Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - Robert G Cumming
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, NSW, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, NSW, Australia
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18
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Khalatbari-Soltani S, Stanaway F, Sherrington C, Blyth FM, Naganathan V, Handelsman DJ, Seibel MJ, Waite LM, Le Couteur DG, Cumming RG. The Prospective Association Between Socioeconomic Status and Falls Among Community-Dwelling Older Men. J Gerontol A Biol Sci Med Sci 2021; 76:1821-1828. [PMID: 33537735 DOI: 10.1093/gerona/glab038] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) has been suggested as a risk factor for falls but the few prospective studies to test this have had mixed results. We evaluated the prospective association between SES and falls in the Concord Health and Ageing in Men Project (CHAMP). METHODS CHAMP is a population-based prospective cohort study of men aged ≥70 years in Sydney, Australia. Incident falls were ascertained by triannual telephone calls for up to 4 years. SES was assessed with 4 indicators (education, occupation, source of income, home ownership) and cumulative SES score. We tested for interaction between SES indicators and country of birth and conducted stratified analyses. RESULTS We evaluated 1624 men (mean age: 77.3 ± 5.4 years). During a mean ± SD follow-up of 42.6 ± 8.7 months, 766 (47%) participants reported ≥1 incident falls. In nonstratified analyses, there were no associations between SES indicators and falls. In stratified analyses, falls rates were higher among Australian-born men with less formal education (incidence rate ratio [IRR] 1.66, 95% confidence interval [CI] 1.16-2.37, compared with those with more education) and those with low occupational position (1.45; 1.09-1.93). However, among men born in non-main English-speaking countries the rate of falls was lower among those with low educational level and no associations were evident for occupational position. CONCLUSIONS Lower educational level and occupational position predicted a higher falls rate in Australian-born men; the opposite relationship was evident for educational level among migrants born in non-main English-speaking countries. Further studies should test these relationships in different populations and settings and evaluate targeted interventions.
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Affiliation(s)
- Saman Khalatbari-Soltani
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Australia
| | - Fiona Stanaway
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia
| | - Cathie Sherrington
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.,Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Australia
| | - Fiona M Blyth
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Australia
| | - Markus J Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Australia
| | - Louise M Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, New South Wales, Australia
| | - Robert G Cumming
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Australia
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19
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Scott D, Blyth F, Naganathan V, Le Couteur DG, Handelsman DJ, Seibel MJ, Waite LM, Hirani V. Prospective associations of chronic and intrusive pain with sarcopenia and physical disability amongst older Australian men: The Concord Health and Ageing in Men Project. Exp Gerontol 2021; 153:111501. [PMID: 34314842 DOI: 10.1016/j.exger.2021.111501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Associations of chronic and intrusive pain with sarcopenia and disability in older men are unclear. METHODS 1452 community-dwelling men aged ≥70 years self-reported chronic pain (pain every day for ≥3 months) and intrusive pain (pain interfering with normal activities in the last 4 weeks) at baseline and five years later, and were classified as having no, prevalent (baseline only), incident (follow-up only) or persistent (both baseline and follow-up) pain. Appendicular lean mass (ALM), hand grip strength and gait speed were assessed. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP2) and Sarcopenia Diagnosis and Outcomes Consortium (SDOC) definitions. Activity of daily living (ADL) and instrumental activity of daily living (IADL) impairment were assessed by questionnaires. RESULTS Approximately 11% of men reported both chronic and intrusive pain. Gait speed, but not ALM or hand grip strength, significantly mediated the relationship of chronic pain and intrusive pain with ADL and IADL disability by 12-57%. Over five years, incident (odds ratio: 1.84; 95% CI: 1.10-3.10) and persistent (3.02; 1.55-5.88) intrusive pain, and persistent chronic pain (2.29; 1.30-4.04), were associated with increased likelihood of incident sarcopenia (SDOC). Incident and persistent intrusive pain were associated with incident ADL (1.91; 1.04-3.52 and 3.78; 1.90-7.51, respectively) and IADL (2.98; 1.81-4.90 and 4.63; 2.22-9.65, respectively) impairment. CONCLUSIONS Older men with incident and persistent intrusive pain have increased risk for incident sarcopenia and disability over five years. The association of pain with disability appears to be mediated by gait speed.
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Affiliation(s)
- David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Fiona Blyth
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, Dept of Endocrinology & Metabolism, Concord Hospital, The University of Sydney, New South Wales, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
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20
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Le Couteur DG, Handelsman DJ, Stanaway F, Waite LM, Blyth FM, Naganathan V, Cumming RG, Hirani V. Sarcopenic Obesity and Amino Acids: Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2021; 76:1000-1004. [PMID: 33709116 DOI: 10.1093/gerona/glab076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Indexed: 11/14/2022] Open
Abstract
Although characteristic changes in amino acid concentrations occur in obesity and sarcopenia, amino acids concentrations have not been reported in sarcopenic obesity. We studied n = 831 men aged 75 years and older from the 5-year follow-up of the Concord Health and Ageing in Men Project. Sarcopenia was defined using the Foundation of the National Institutes of Health criteria and obesity was defined as >30% fat mass. There were 31 men (3.7%) who had sarcopenic obesity. Branched chain amino acids were elevated in the obese (but not sarcopenic) group (n = 348) but reduced in both the sarcopenic (but not obese) (n = 44) and the sarcopenic obese groups. Apart from this, most of the amino acid concentrations were between those for the obese and the sarcopenic groups. Yet despite low concentrations of branched chain amino acids, the sarcopenic obese group had indications of insulin resistance and diabetes mellitus (fasting glucose and insulin concentrations, homeostatic model assessment, and percentage of participants taking diabetes medications) that were similar to the obese group. In summary, sarcopenic obese participants did not have a unique amino acid signature. In obesity, elevated branched chain amino acids are not a prerequisite for insulin resistance and diabetes if obesity is associated with sarcopenia.
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Affiliation(s)
- David G Le Couteur
- Centre of Education and Research on Ageing, Ageing and Alzheimers Institute, University of Sydney and Concord Hospital, New South Wales, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Fiona Stanaway
- School of Public Health, University of Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre of Education and Research on Ageing, Ageing and Alzheimers Institute, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Fiona M Blyth
- School of Public Health, University of Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre of Education and Research on Ageing, Ageing and Alzheimers Institute, University of Sydney and Concord Hospital, New South Wales, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, New South Wales, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, University of Sydney, New South Wales, Australia
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21
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Krishnan A, Waite LM, Stanaway FF. Representation of racial and ethnic minority groups in cohort studies evaluating risk factors for dementia: protocol for a scoping review. BMJ Open 2021; 11:e044404. [PMID: 33986050 PMCID: PMC8126304 DOI: 10.1136/bmjopen-2020-044404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Available evidence suggests that some racial/ethnic minority populations may be disproportionately burdened by dementia. Cohort studies are an important tool for defining and understanding the causes behind these racial and ethnic inequalities. However, ethnic minority populations may be more likely to be excluded from such research. Therefore, the aim of this study is to systematically investigate and quantify racial and ethnic minority representation in dementia risk factor research. METHODS AND ANALYSIS The elements of this protocol have been designed in accordance with the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols which are specifically applicable to scoping review protocols. We will include population-based cohort studies looking at risk factors for dementia incidence in our review and assess the representation of racial and ethnic minority populations in these studies. We will use multiple strategies to identify relevant studies, including a systematic search of the following electronic databases: MEDLINE (Ovid SP), Embase (Ovid SP) and Scopus. Two review authors will independently perform title and abstract screening, full-text screening and data extraction. Included cohort studies will be evaluated using a comprehensive framework to assess racial/ethnic minority representation. Logistic regression will also be performed to describe associations between cohort study characteristics and outcomes related to racial and ethnic minority representation. ETHICS AND DISSEMINATION Formal ethical approval is not required to conduct this review as no primary data are to be collected. The final results of this scoping review will be disseminated through publication in peer-reviewed journals and conference presentations.
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Affiliation(s)
- Arjun Krishnan
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Louise M Waite
- Faculty of Medicine and Health, The University of Sydney Concord Clinical School, Sydney, New South Wales, Australia
- The University of Sydney Centre for Education and Research on Ageing, Sydney, New South Wales, Australia
| | - Fiona F Stanaway
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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22
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Takehara S, Hirani V, Wright FAC, Naganathan V, Blyth FM, Le Couteur DG, Waite LM, Seibel MJ, Handelsman DJ, Cumming RG. Appetite, oral health and weight loss in community-dwelling older men: an observational study from the Concord Health and Ageing in Men Project (CHAMP). BMC Geriatr 2021; 21:255. [PMID: 33863274 PMCID: PMC8052725 DOI: 10.1186/s12877-021-02169-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background Unintended weight loss and the reduction in appetite are common phenomenon among older people. Reduced appetite has been linked to medication related reductions in saliva production, reduced taste ability and poor oral health. Poor appetite can result in reduced nutrient intake ensuing weight loss. It is possible that poor appetite is a mediating step on the causal pathway between oral health and weight loss. This study investigates whether poor oral health and loss of appetite are related to weight loss. Methods This is an observational study where data were obtained from the Concord Health and Ageing in Men Project (CHAMP). Information on socio-demographics, appetite and health related behavior was collected by self-completed questionnaire. Intraoral assessment was conducted by calibrated oral health therapists. Height and weight were measured by trained staff. Regression analysis investigated associations between oral health and appetite as risk factors for weight loss. Results Participants included 542 community dwelling older males. 99 older men (18.3%) experienced 5% or more weight loss over 3 years. Men who lost weight from baseline had lower BMI and lower body weight, had higher prevalence of frailty and depression, reported poorer appetite, and had fewer teeth (13.8 ± 9.5) than those who did not lose weight (16.3 ± 9.3). Before adjustment, the prevalence ratio (PR) for weight loss was 1.76 (95% Confidence Interval (CI), 1.19–2.59) for participants with 0–19 natural teeth present compared to those with 20 or more teeth. When adding appetite and other variables to the model, the PR for number of teeth and weight loss was unchanged: 1.78 (95% CI, 1.06–3.00). The mediation analysis showed that the indirect effect of appetite on the association between number of natural teeth on weight loss was not found to be significant. Conclusion This study found that number of natural teeth present and appetite are independently related to weight change among elderly men in Australia. Tooth loss can increase the risk of swallowing difficulty leading to change in food preference, avoidance of foods and a decrease in energy intake. Our study showed the importance of oral health interventions to encourage maintenance of 20 or more natural teeth in older people.
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Affiliation(s)
- Sachiko Takehara
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia. .,Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - F A Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Fiona M Blyth
- Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Markus J Seibel
- Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,ANZAC Research Institute, The University of Sydney, Concord Hospital, Sydney, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, The University of Sydney, Concord Hospital, Sydney, NSW, Australia
| | - Robert G Cumming
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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Das A, Cumming RG, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Ribeiro RVR, Simpson SJ, Hirani V. Dietary and supplemental antioxidant intake and risk of major adverse cardiovascular events in older men: The concord health and ageing in men project. Nutr Metab Cardiovasc Dis 2021; 31:1102-1112. [PMID: 33549432 DOI: 10.1016/j.numecd.2020.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS The role of antioxidant intake in cardiovascular disease remains inconclusive. This study evaluates the association between antioxidant intake and the risk of major adverse cardiovascular events (MACE) among older Australian men. METHODS AND RESULTS 794 men aged ≥75 years participated in the 3rd wave of the Concord Health and Ageing in Men Project. Dietary adequacy of antioxidant intake was assessed by comparing participants' intake of vitamins A, E, C and zinc to the Nutrient Reference Values (NRV) for Australia. Attainment of NRVs of antioxidants was categorised into a dichotomised variable 'inadequate' (meeting≤2 of 4 antioxidants) or 'adequate' (meeting≥3 of 4 antioxidants). The usage of antioxidant supplements was assessed. The outcome measure was MACE. The composite MACE endpoint was defined as having one of the following: death, myocardial infarction, ischemic stroke, congestive cardiac failure (CCF), and revascularization during the period of observation. There was no significant association between dietary (HR: 1.03, 95% CI: 0.71, 1.48) or supplemental antioxidant intake (HR: 1.10, 95% CI: 0.75, 1.63) and overall MACE. However, a significant association was observed between inadequate antioxidant intake and CCF (HR: 1.32; 95% CI: 1.16, 1.50). The lowest quartile of zinc intake (<11.00 mg/d) was significantly associated with CCF (HR 2.36; 95% CI: 1.04, 5.34). None of the other antioxidants were significantly associated with CCF or other MACE components. CONCLUSION Inadequate dietary antioxidant intake, particularly zinc, is associated with increased risk of CCF in older Australian men but not associated with overall MACE.
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Affiliation(s)
- Arpita Das
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Australia.
| | - Robert G Cumming
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia; Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Australia; School of Public Health, University of Sydney, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - Fiona Blyth
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia; Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - Rosilene V R Ribeiro
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Stephen J Simpson
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Vasant Hirani
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, Australia; ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia; Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
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24
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Ng CA, Scott D, Seibel MJ, Cumming RG, Naganathan V, Blyth FM, Le Couteur DG, Waite LM, Handelsman DJ, Hirani V. Higher-Impact Physical Activity Is Associated With Maintenance of Bone Mineral Density But Not Reduced Incident Falls or Fractures in Older Men: The Concord Health and Aging in Men Project. J Bone Miner Res 2021; 36:662-672. [PMID: 33278306 DOI: 10.1002/jbmr.4228] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/15/2020] [Accepted: 11/28/2020] [Indexed: 12/20/2022]
Abstract
High-impact physical activities with bone strains of high magnitude and frequency may benefit bone health. This study aimed to investigate the longitudinal associations between changes in loading intensities and application rates, estimated from self-reported physical activity, with bone mineral density (BMD) changes over 5 years and also with incident falls over 2 years and long-term incident fractures in community-dwelling older men. A total of 1599 men (mean age 76.8 ± 5.4 years) from the Concord Health and Aging in Men Project (CHAMP) were assessed at baseline (2005-2007) and at 2- and 5-year follow-up. At each time point, hip and lumbar spine BMD were measured by dual-energy X-ray absorptiometry, and physical activity energy expenditure over the past week was self-reported via the Physical Activity Scale for the Elderly (PASE) questionnaire. Sum effective load ratings (ELRs) and peak force were estimated from the PASE questionnaire, reflecting the total and highest loading intensity and application rate of physical activities, respectively. Participants were contacted every 4 months over 2 years to self-report falls and over 6.0 ± 2.2 years for fractures. Hip fractures were ascertained by data linkage for 8.9 ± 3.6 years. Compared with sum ELR and PASE scores, peak force demonstrated the greatest standardized effect size for BMD maintenance at the spine (β = 9.77 mg/cm2 ), total hip (β = 14.14 mg/cm2 ), and femoral neck (β = 13.72 mg/cm2 ) after adjustment for covariates, including PASE components (all p < .01). Only PASE scores were significantly associated with reduced falls risk (standardized incident rate ratio = 0.90, 95% confidence interval 0.81-1.00, p = .04). All physical activity measures were significantly associated with reduced incident fractures in univariate analyses, but none remained significant after multivariable adjustments. Older men who engaged in physical activity of high and rapid impact maintained higher BMD, while higher energy expenditure was associated with reduced falls risk. Coupling traditional physical activity data with bone loading estimates may improve understanding of the relationships between physical activity and bone health. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Carrie-Anne Ng
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.,Department of Medicine at Western Health, The University of Melbourne, Sunshine, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, The University of Sydney, Sydney, Australia
| | - Robert G Cumming
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia.,The ARC Centre of Excellence in Population Ageing Research, University of Sydney, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia.,ANZAC Research Institute and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital and ANZAC Research Institute, University of Sydney, Sydney, Australia
| | - Vasant Hirani
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia.,School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
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25
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Mesinovic J, Scott D, Seibel MJ, Cumming RG, Naganathan V, Blyth FM, Le Couteur DG, Waite LM, Handelsman DJ, Hirani V. Risk Factors for Incident Falls and Fractures in Older Men With and Without Type 2 Diabetes Mellitus: The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2021; 76:1090-1100. [PMID: 33649759 DOI: 10.1093/gerona/glab062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) increases falls and fracture risk. Our objective was to compare incidence and risk factors for falls and fractures in community-dwelling older men with and without T2DM. METHODS A total of 1705 men (471 with T2DM; 1234 without T2DM) aged ≥70 years were assessed at baseline. Men were contacted every 4 months for 6.0 ± 2.2 years to ascertain incident falls and fractures, with the latter being confirmed by radiographic reports. Hip fractures were ascertained via data linkage (follow-up: 8.8 ± 3.6 years). Risk factors for falls and fractures included physical activity and function, body composition, medications, and vision measures. RESULTS Men with T2DM had similar fall (incident rate ratio [IRR]: 0.92 [95% confidence interval {CI}: 0.70, 1.12], n = 1246) and fracture rates (hazard ratio [HR]: 0.86 [95% CI: 0.56, 1.32], n = 1326) compared to men without T2DM after adjustment for significant risk factors. In men with T2DM, depression (IRR: 1.87 [95% CI: 1.05, 3.34], n = 333), sulphonylurea usage (IRR: 2.07 [95% CI: 1.30, 3.27]) and a greater number of prescription medications (IRR: 1.13 [95% CI: 1.03, 1.24]) were independently associated with increased fall rates, and higher total hip bone mineral density was independently associated with lower fracture rates (HR: 0.63 [95% CI: 0.47, 0.86], n = 351). Interaction terms demonstrated that better contrast sensitivity was independently associated with lower fracture rates (HR: 0.14 [95% CI: 0.02, 0.87]) in men with T2DM compared to men without T2DM. CONCLUSION Fall and fracture rates were similar in men with and without T2DM after adjusting for significant risk factors. Vision assessments including contrast sensitivity measures may improve fracture prediction in older men with T2DM.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.,Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, and Department of Endocrinology and Metabolism, Concord Hospital, The University of Sydney, New South Wales, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia.,The Australian Research Council Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
| | - Fiona M Blyth
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia.,ANZAC Research Institute and Charles Perkins Centre, University of Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney, Concord Hospital, New South Wales, Australia
| | - Vasant Hirani
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia.,School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, New South Wales, Australia
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26
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Le Couteur DG, Ribeiro R, Senior A, Hsu B, Hirani V, Blyth FM, Waite LM, Simpson SJ, Naganathan V, Cumming RG, Handelsman DJ. Branched Chain Amino Acids, Cardiometabolic Risk Factors and Outcomes in Older Men: The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2021; 75:1805-1810. [PMID: 31428789 DOI: 10.1093/gerona/glz192] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Indexed: 11/12/2022] Open
Abstract
Increased blood levels of branched chain amino acids (BCAAs) have been associated with cardiometabolic risk factors. Here, we studied 918 community-dwelling older men to determine the relationship between BCAAs and other amino acids with cardiometabolic risk factors, major cardiovascular endpoints (MACE), and mortality. BCAAs had robust associations with many adverse metabolic risk factors (increased glucose, insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), triglycerides; decreased high-density lipoprotein cholesterol). However, paradoxically, participants with lower levels of BCAAs had greater mortality and MACE possibly because increasing age and frailty, both of which were associated with lower BCAA levels, are powerful risk factors for these outcomes in older people. Overall, amino acids that were lowest in frail subjects (BCAAs, α-aminobutyric acid [AABA], histidine, lysine, methionine, threonine, tyrosine) were inversely associated with mortality and MACE. In conclusion, BCAAs are biomarkers for important outcomes in older people including cardiometabolic risk factors, frailty, and mortality. In old age, frailty becomes a dominant risk factor for MACE and mortality.
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Affiliation(s)
- David G Le Couteur
- Ageing and Alzheimers Institute and Centre for Education and Research on Ageing, Concord Hospital, Australia.,ANZAC Research Institute, Concord, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Rosilene Ribeiro
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Alistair Senior
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Benjumin Hsu
- Centre for Big Data Research in Health, University of New South Wales, Kensington, Australia
| | - Vasant Hirani
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Fiona M Blyth
- Ageing and Alzheimers Institute and Centre for Education and Research on Ageing, Concord Hospital, Australia.,School of Public Health, University of Sydney, Camperdown, Australia
| | - Louise M Waite
- Ageing and Alzheimers Institute and Centre for Education and Research on Ageing, Concord Hospital, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Vasikaran Naganathan
- Ageing and Alzheimers Institute and Centre for Education and Research on Ageing, Concord Hospital, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Camperdown, Australia
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27
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Takehara S, Wright FAC, Naganathan V, Hirani V, Blyth FM, Couteur DGL, Waite LM, Seibel MJ, Handelsman DJ, Cumming RG. A Cross-Sectional Study of Perceived Dental Treatment Needs and Oral Health Status in Community-Dwelling Older Australian Men: The Concord Health and Ageing in Men Project. Int Dent J 2021; 71:224-232. [PMID: 34024332 PMCID: PMC9275195 DOI: 10.1111/idj.12623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Assessing perceived needs for dental treatment is important in understanding and predicting people's health behaviours. The purpose of this study is to examine older men's perceptions regarding dental treatment needs, and to investigate the disparity between perceived needs and the actual oral health of a population of community-dwelling older Australians. Methods Using cross-sectional data from the 4th wave of the Concord Health and Ageing in Men Project, logistic regression analysis of perceived needs for dental treatment was conducted for 596 men aged 78 and over, with functional tooth units (FTUs), number of decayed tooth surfaces, and periodontitis as independent variables. Results Thirty-six percent (n = 216) of the participants believed they required some form of dental treatment. The remaining participants did not perceive a need for treatment, yet 65.3% objectively required prosthodontic or restorative care. The regression model showed men with lower FTUs were significantly more likely to report a perceived need for dental treatment than those with 12 FTUs [0–6 FTUs: adjusted odds ratio (OR) 2.58, 95% CI 1.28–5.20; 7–11 FTUs: adjusted OR 2.43, 95% CI 1.16–5.10]. However, neither the number of decayed tooth surfaces nor the existence of periodontitis was associated with perceived dental treatment needs. Conclusions Most older men viewed their oral health positively, and the majority of those with objectively assessed needs, did not perceive themselves as requiring dental treatment. Loss of FTUs appears to alert participants to seek treatment, but not the presence of dental caries or periodontitis.
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Affiliation(s)
- Sachiko Takehara
- Centre for Education and Research on Ageing, Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia; Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
| | - F A Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia; Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia; Ageing and Alzheimer's Institute, Aged Chronic Care and Rehabilitation, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia; Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia; Ageing and Alzheimer's Institute, Aged Chronic Care and Rehabilitation, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Fiona M Blyth
- Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia; Ageing and Alzheimer's Institute, Aged Chronic Care and Rehabilitation, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Louise M Waite
- Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia; Ageing and Alzheimer's Institute, Aged Chronic Care and Rehabilitation, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Markus J Seibel
- Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia; ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, NSW, Australia
| | - Robert G Cumming
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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Khalatbari-Soltani S, Cumming RG, Chomik R, Blyth FM, Naganathan V, Handelsman DJ, Le Couteur DG, Waite LM, Stanaway F. The association between home ownership and the health of older men: Cross-sectional analysis of the Australian Concord Health and Ageing in Men Project. Australas J Ageing 2021; 40:e199-e206. [PMID: 33492753 DOI: 10.1111/ajag.12896] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the association between home ownership and health in older men. METHODS Cross-sectional analysis of 909 community-dwelling Australian men (mean age: 81.3 ± 4.6) from the Concord Health and Ageing in Men Project (CHAMP, 2012-2013). We considered self-rated health, frailty status, multimorbidity, and anxiety and depressive symptoms which identify different dimensions of health. RESULTS Most participants were owner-occupiers (89.7%). In age- and country of birth-adjusted analyses, not being an owner-occupier was associated with an increased likelihood of depressive symptoms [prevalence ratio: 1.82, 95% confidence intervals 1.17 to 2.84]. There were no associations between home ownership and other health conditions. CONCLUSION Lack of home ownership was associated with a higher prevalence of depressive symptoms, largely explained by poorer social support. Thus, targeting mental health programs at older divorced or separated men who do not own their own home could be an appropriate community-based intervention.
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Affiliation(s)
- Saman Khalatbari-Soltani
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
| | - Robert G Cumming
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
| | - Rafal Chomik
- ARC Centre of Excellence in Population Ageing Research, Australian School of Business, The University of New South Wales, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Louise M Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - Fiona Stanaway
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
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Scott D, Hirani V, Waite LM, Blyth F, Le Couteur DG, Cumming R, Jones G. Letter to the Editor: 'Giant' Claims Require Strong Evidence: A Comment on 'Osteosarcopenia: A Geriatric Giant of the XXI Century'. J Nutr Health Aging 2021; 25:946-947. [PMID: 34409977 DOI: 10.1007/s12603-021-1659-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D Scott
- Associate Professor David Scott, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia 3125, , Telephone: +61 3 9246 8438
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30
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Stanaway FF, Blyth FM, Naganathan V, Le Couteur DG, Ribeiro R, Hirani V, Waite LM, Handelsman DJ, Seibel MJ, Cumming RG. Mortality Paradox of Older Italian-Born Men in Australia: The Concord Health and Ageing in Men Project. J Immigr Minor Health 2020; 22:102-109. [PMID: 30840179 DOI: 10.1007/s10903-019-00874-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Italian migrants are one of the largest groups of older migrants in Australia. Past research has found lower mortality rates in Italian migrants but it is unclear if this persists into older age. Data came from 334 Italian-born and 849 Australian-born men aged 70 years and over participating in a longitudinal study of men's ageing. Male Italian migrants were more likely to smoke, be overweight, and have lower socio-economic status (SES). They also had higher morbidity from diabetes, chronic pain, dementia and depressive symptoms but lower morbidity from heart disease and cancer. There was no age-adjusted mortality difference. However, adjusting for SES, lifestyle and morbidity differences revealed a 25% lower mortality rate (adjusted HR = 0.75; 95% CI 0.57, 0.98) in Italian-born men. Compared to their Australian-born counterparts, older Italian-born men have a lower mortality than expected considering their lower SES, higher smoking and higher morbidity.
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Affiliation(s)
- Fiona F Stanaway
- Sydney School of Public Health, Sydney University, Edward Ford Building, Camperdown, NSW, 2006, Australia.
| | - Fiona M Blyth
- Concord Clinical School, Concord Hospital, Concord, NSW, 2139, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
| | - Rosilene Ribeiro
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
- School of Life and Environmental Science, Charles Perkins Centre, Sydney University, Camperdown, 2006, NSW, Australia
| | - Vasant Hirani
- School of Life and Environmental Science, Charles Perkins Centre, Sydney University, Camperdown, 2006, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Hospital, Sydney University, Concord, 2139, NSW, Australia
| | - Markus J Seibel
- School of Life and Environmental Science, Charles Perkins Centre, Sydney University, Camperdown, 2006, NSW, Australia
| | - Robert G Cumming
- Sydney School of Public Health, Sydney University, Edward Ford Building, Camperdown, NSW, 2006, Australia
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
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Khalatbari-Soltani S, Stanaway F, Cvejic E, Blyth FM, Naganathan V, Handelsman DJ, Le Couteur DG, Seibel MJ, Waite LM, Cumming RG. Contribution of psychosocial factors to socioeconomic inequalities in mortality among older Australian men: a population-based cohort study. Int J Equity Health 2020; 19:177. [PMID: 33028353 PMCID: PMC7539396 DOI: 10.1186/s12939-020-01277-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Among older people, the extent to which psychosocial factors explain socioeconomic inequalities in mortality is debated. We aimed to investigate the potential mediating effect of psychosocial factors on socioeconomic inequalities in mortality. METHODS We used data from a prospective population-based cohort (the Concord Health and Ageing in Men Project; baseline recruitment in 2005-2007), in Sydney, Australia. The main outcomes were all-cause and cause-specific mortality. Socioeconomic status (SES; educational attainment, occupational position, source of income, housing tenure, and a cumulative SES score) was assessed at baseline. Measures of structural and functional social support, as well as depressive and anxiety symptoms were assessed three times during follow-ups. Associations were quantified using Cox regression. Mediation was calculated using "change-in-estimate method". RESULTS 1522 men (mean age at baseline: 77·4 ± 5·5 years) were included in the analyses with a mean (SD) follow-up time of 9·0 (3·6) years for all-cause and 8·0 (2·8) years for cause-specific mortality. At baseline, psychosocial measures displayed marked social patterning. Being unmarried, living alone, low social interactions, and elevated depressive symptoms were associated with higher risk of all-cause and cardiovascular disease (CVD) mortality. Psychosocial factors explained 35% of SES inequalities in all-cause mortality, 29% in CVD mortality, 12% in cancer mortality, and 39% in non-CVD, non-cancer mortality. CONCLUSION Psychosocial factors may account for up to one-third of SES inequalities in deaths from all and specific causes (except cancer mortality). Our findings suggest that interventional studies targeting social relationships and/or psychological distress in older men aiming to reduce socioeconomic inequalities in mortality are warranted.
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Affiliation(s)
- Saman Khalatbari-Soltani
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia.
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, Australia.
| | - Fiona Stanaway
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Erin Cvejic
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, New South Wales, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Markus J Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Louise M Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Robert G Cumming
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia.
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, Australia.
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
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Le Couteur DG, Stanaway F, Waite LM, Cullen J, Lindley RI, Blyth FM, Naganathan V, Cumming RG, Handelsman DJ. Apolipoprotein E and Health in Older Men: The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2020; 75:1858-1862. [PMID: 32342099 DOI: 10.1093/gerona/glaa105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Indexed: 11/12/2022] Open
Abstract
APOE genotype has been associated with various age-related outcomes including Alzheimer's disease, frailty, and mortality. In this study, the relationship between health, particularly cognitive function, and APOE was investigated in older men from the Concord Health and Ageing in Men Project (n = 1,616; age 76.9 ± 5.5 years [range 70-97 years]; Australia). Baseline characteristics and survival up to 12 years were determined. Frailty was measured using Cardiovascular Health study (CHS) criteria and Rockwood frailty index, and cognition using Mini-Mental State Examination (MMSE) and Addenbrookes Cognitive Examination. APOE ε4 was less common in the oldest men and those born in Mediterranean countries. APOE ε2 was beneficially associated with cholesterol, creatinine, gamma-glutamyl transaminase, glucose, and HDL cholesterol while APOE ε4 was adversely associated with cholesterol and albumin. APOE ε4 was associated with a clinical diagnosis of Alzheimer's disease when adjusted for age and region of birth (ε4 homozygotes Odds ratio (OR) 7.0; ε4 heterozygotes OR 2.4, p < .05), and APOE ε2 had a small positive association with cognition. On multivariate regression, overall cognitive function in the entire cohort was associated with age, country of birth, education, and frailty (all p < .001). APOE was not associated with frailty or survival. In conclusion, age and region of birth influenced distribution of APOE genotype in older men. Although APOE ε4 was associated with Alzheimer's disease, overall cognitive function in the cohort was associated more strongly with frailty than APOE genotype.
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Affiliation(s)
- David G Le Couteur
- Centre of Education and Research on Ageing, Ageing and Alzheimer's Institute, University of Sydney and Concord Hospital, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Australia
| | - Fiona Stanaway
- School of Public Health, University of Sydney, Australia
| | - Louise M Waite
- Centre of Education and Research on Ageing, Ageing and Alzheimer's Institute, University of Sydney and Concord Hospital, Australia
| | - John Cullen
- Centre of Education and Research on Ageing, Ageing and Alzheimer's Institute, University of Sydney and Concord Hospital, Australia
| | - Richard I Lindley
- Westmead Applied Research Centre, University of Sydney, and the George Institute for Global Health, Australia
| | - Fiona M Blyth
- School of Public Health, University of Sydney, Australia
| | - Vasi Naganathan
- Centre of Education and Research on Ageing, Ageing and Alzheimer's Institute, University of Sydney and Concord Hospital, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Australia
| | | | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Australia
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Das A, Cumming RG, Naganathan V, Blyth F, Ribeiro RV, Le Couteur DG, Handelsman DJ, Waite LM, Simpson SJ, Hirani V. Prospective Associations Between Dietary Antioxidant Intake and Frailty in Older Australian Men: The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2020; 75:348-356. [PMID: 30955034 DOI: 10.1093/gerona/glz054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The objective of the study is to evaluate the prospective associations between antioxidant intake and incident frailty among older Australian men aged ≥75 years. METHODS Seven hundred and ninety-four men participated in a detailed diet history interview at the Concord Health and Ageing in Men Project (CHAMP) study third wave (considered baseline nutrition here) and 781 men participated at the fourth wave (considered 3-year follow-up here). The main outcome measurement was incident frailty at 3-year follow-up, using the Cardiovascular Health Study definition. Dietary adequacy of antioxidant intake was assessed by comparing participants' median intakes of four dietary antioxidants (vitamin A, E, C, and zinc) to the nutrient reference values (NRVs). Attainment of the NRVs was incorporated into a dichotomized variable "poor" (meeting ≤2 antioxidants) or "good" (meeting ≥3 antioxidants) as the independent variable using the cut-point method. Also, intakes of each individual dietary antioxidant at baseline nutrition were categorized into quartiles. Analyses were performed using multinomial logistic regression. RESULTS Incidence of pre-frailty was 53.0% and frailty was 6.4% at 3-year follow-up. Poor dietary antioxidant intake (meeting ≤2) at baseline nutrition was associated with incident frailty at 3-year follow-up in unadjusted (OR: 2.59 [95% CI: 1.47, 4.59, p = .001]) and adjusted (OR: 2.46 [95% CI: 1.10, 5.51, p = .03]) analyses. The lowest quartile of vitamin E intake (<7.08 mg/d) was significantly associated with incident frailty (OR: 2.46 [95% CI: 1.01, 6.00, p = .05]). CONCLUSIONS Poor antioxidant intake, particularly vitamin E, is a plausible factor associated with incident frailty among older men. This supports the need for clinical trials of diets rich in antioxidants or possibly low-dose antioxidant supplements, for prevention of frailty.
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Affiliation(s)
- Arpita Das
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, New South Wales.,ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales
| | - Robert G Cumming
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales.,ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales.,School of Public Health, University of Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales
| | - Fiona Blyth
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales
| | - Rosilene V Ribeiro
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, New South Wales
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales
| | - Stephen J Simpson
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, New South Wales
| | - Vasant Hirani
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, New South Wales.,ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales
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Scott D, Seibel MJ, Cumming R, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Hsu B, Waite LM, Hirani V. Comparison of clinical risk factors for incident fracture in obese and non-obese community-dwelling older men. Bone 2020; 137:115433. [PMID: 32422298 DOI: 10.1016/j.bone.2020.115433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/30/2020] [Accepted: 05/13/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Obese older adults have higher bone mineral density (BMD), but other characteristics of obesity may predispose these individuals to fracture. We aimed to compare clinical risk factors for incident fracture in obese and non-obese older men. METHODS Body mass index (BMI) and body fat percentage were assessed at baseline by anthropometry and dual-energy X-ray absorptiometry, respectively, in 1625 community-dwelling men aged ≥70 years. Categories for non-obese and obese were <30 kg/m2and ≥30 kg/m2 for BMI, and <30% and ≥30% for body fat percentage. Sociodemographic, medical, physical function and blood biochemistry parameters were collected at baseline. Self-reported incident fractures of any type and cause (excluding pathological fractures and fractures of hands, fingers, feet, toes and the skull) were confirmed by radiographic reports and recorded up to 9 years. Hip fractures were followed for 14 years using data linkage. RESULTS Prevalence of obesity was 27% according to BMI and 44% according to body fat percentage. There were no differences in incidence of any fracture between non-obese and obese men by BMI (10.7 vs 9.3%, respectively; P > 0.05) or body fat percentage (10.2 vs 10.6%, respectively; P > 0.05). Significant interactions were observed demonstrating that dementia increased hazard for incident any and hip fracture in non-obese men (adjusted hazard ratio 7.08; 95% CI 3.27-15.36 and 8.36; 3.13-22.31, respectively) but not obese men. Past-year falls increased hazard for any fracture in obese men (2.86; 95% CI 1.60-5.10) but not non-obese men while higher luteinizing hormone concentrations reduced hazard for hip fracture in obese men (0.91; 0.85-0.97 per IU/L) but not non-obese men. CONCLUSIONS In community-dwelling older men, obesity does not protect against incident fracture. Assessments of falls history and gonadotrophin levels, in addition to established clinical risk factors for fracture, may contribute to improvements in fracture prediction in obese older men.
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Affiliation(s)
- David Scott
- School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia; School of Exercise and Nutrition Sciences and Institute for Physical Activity and Nutrition (IPAN), Faculty of Health, Deakin University, Burwood, Victoria, Australia.
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, and Dept of Endocrinology & Metabolism, Concord Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | - Robert Cumming
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia; Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Fiona Blyth
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Benjumin Hsu
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Vasant Hirani
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
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35
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Khalatbari-Soltani S, Blyth FM, Naganathan V, Handelsman DJ, Le Couteur DG, Seibel MJ, Waite LM, Cvejic E, Cumming RG. Socioeconomic status, health-related behaviours, and death among older people: the Concord health and aging in men project prospective cohort study. BMC Geriatr 2020; 20:261. [PMID: 32727399 PMCID: PMC7391572 DOI: 10.1186/s12877-020-01648-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background Conflicting evidence exists regarding the association of socioeconomic status (SES) with mortality among older people and little is known about the mechanisms underlying this association. We investigated the association of SES with mortality among older Australian men. We also investigated potential mediating effects of health-related behaviours in SES-mortality associations. Methods We used data from a prospective population-based cohort (the Concord Health and Aging in Men Project), in Sydney, Australia. The main outcomes were all-cause and cause-specific mortality. Educational attainment, occupational position, source of income, housing tenure, and a cumulative SES score were assessed at baseline. Longitudinally assessed alcohol consumption, smoking, physical activity, and body mass index were investigated as potential mediators. Associations were quantified using Cox regression. Results We evaluated 1527 men (mean age: 77.4 ± 5.5 years). During a mean follow-up time of 9.0 years, 783 deaths occurred. For deaths from all causes, the adjusted hazard ratio (HR) for the lowest tertile of cumulative SES score versus the highest tertile was 1.44 (95% CI 1.21 to 1.70); the corresponding sub-HRs were 1.35 (0.96 to 1.89) for cardiovascular disease (CVD) mortality; 1.58 (1.15 to 2.18) for cancer mortality, and 1.86 (1.36 to 2.56) for non-CVD, non-cancer mortality. SES-mortality associations were attenuated by 11–25% after adjustment for mediating health-related behaviours. Conclusion Low SES is associated with increased mortality in older Australian men and health-related behaviours accounted for less than one-fourth of these associations. Further research is needed to fully understand the mechanisms underlying SES inequalities in mortality among older people.
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Affiliation(s)
- Saman Khalatbari-Soltani
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia. .,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, Australia.
| | - Fiona M Blyth
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Markus J Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Louise M Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Erin Cvejic
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Robert G Cumming
- The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia. .,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, Australia. .,Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
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Teng C, Loy CT, Sellars M, Pond D, Latt MD, Waite LM, Sinka V, Logeman C, Tong A. Making Decisions About Long-Term Institutional Care Placement Among People With Dementia and Their Caregivers: Systematic Review of Qualitative Studies. Gerontologist 2020; 60:e329-e346. [PMID: 31141133 DOI: 10.1093/geront/gnz046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES People with dementia become increasingly dependent on others for care as cognition declines. Decision making about placement of people with dementia into long-term institutional care can be emotionally complex. The objective of this review is to describe experiences and perspectives of people with dementia and their family caregivers in making decisions about institutional care placement. RESEARCH DESIGN AND METHODS MEDLINE, Embase, PsycINFO, and CINAHL were searched from inception to August 2018. Thematic synthesis was used to analyze results. RESULTS We included 42 studies involving 123 people with dementia and 705 family caregivers from 12 countries. We identified five themes: ensuring safety (avoiding injury due to frailty, protecting against dangerous behaviors, preventing aggressive encounters), reaching breaking point (insufferable burden of caregiving, needs exceeding capabilities, intensifying family conflict, loneliness and isolation, straining under additional responsibilities, making extreme personal sacrifices), vulnerability in lacking support (ill-prepared for crisis, unable to access professional expertise, unpredictable prognostic trajectory, uncertainty navigating health care services, pressured by limited placement opportunities, high cost of placement, resenting loss of autonomy), avoiding guilt of abandonment (sharing accountability, mitigating against disagreement and stigma, reluctance to relinquish caregiving, seeking approval), and seeking reassurance and validation (preserving personhood and former identity, empowerment through engagement, assurance of care quality, acceptance from other care residents). DISCUSSION AND IMPLICATIONS People with dementia and family caregivers feel vulnerable, disempowered, and guilty in decision making about institutionalization. Person-centered communication and support strategies that foster confidence and reassurance are needed to assist people with dementia and caregivers to make decisions about placement into long-term institutional care settings.
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Affiliation(s)
- Claris Teng
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia
| | - Clement T Loy
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia
| | - Marcus Sellars
- Advance Care Planning Australia, Austin Health, Melbourne.,Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Dimity Pond
- School of Medicine and Public Health (General Practice), University of Newcastle, Australia
| | - Mark D Latt
- Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, New South Wales, Australia
| | - Victoria Sinka
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia
| | - Charlotte Logeman
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia
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Takehara S, Wright FAC, Waite LM, Naganathan V, Hirani V, Blyth FM, Le Couteur DG, Seibel MJ, Handelsman DJ, Cumming RG. Oral health and cognitive status in the Concord Health and Ageing in Men Project: A cross-sectional study in community-dwelling older Australian men. Gerodontology 2020; 37:353-360. [PMID: 32227607 DOI: 10.1111/ger.12469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 02/10/2020] [Accepted: 03/06/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several studies have examined the relationship between cognition and oral health in older populations. To further understand this relationship, we examined the associations between cognitive function, chewing capacity and the number of teeth present in community-dwelling older males in Australia. METHODS Data were obtained from cross-sectional analysis of fourth wave of the Concord Health and Ageing in Men Project (CHAMP). Participants were 369 community-dwelling males aged 78 years or over. Cognitive function was measured utilising the Mini-Mental State Examination (MMSE). Chewing capacity was determined on ability to chew food items of different textures, and oral health data were collected. Ordinal regression was used to analyse associations between MMSE (four categories) and chewing capacity and number of natural teeth present. RESULTS Overall, 67.5% of participants reported that they could chew all 11 listed food items. Participants with fewer than 20 teeth were statistically significantly more likely to have cognitive impairment (unadjusted odds ratio (OR) 1.87; 95% confidence interval (CI) 1.25-2.79, adjusted OR 1.62; 95% CI 1.07-2.43). Participants with limited chewing capacity were also more likely to have cognitive impairment (unadjusted OR 1.91; 95% CI 1.25-2.94, adjusted OR 1.61; 95% CI 1.03-2.49). CONCLUSIONS This study suggests either that older men with fewer than 20 natural teeth and those with limited chewing capacity are more likely to have an associated cognitive impairment or that those with cognitive impairment are more likely to have fewer teeth and limited chewing capacity. Further longitudinal studies should clarify these relationships.
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Affiliation(s)
- Sachiko Takehara
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Concord, NSW, Australia.,Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Fredrick A Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Fiona M Blyth
- Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Concord, NSW, Australia.,Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia.,Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Markus J Seibel
- Concord Clinical School, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Hospital, The University of Sydney, Sydney, NSW, Australia
| | - Robert G Cumming
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Concord, NSW, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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38
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Hsu B, Hirani V, Cumming RG, Naganathan V, Blyth FM, Wright FC, Waite LM, Seibel MJ, Handelsman DJ, Le Couteur DG. Cross-Sectional and Longitudinal Relationships Between Inflammatory Biomarkers and Frailty in Community-dwelling Older Men: The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2020; 74:835-841. [PMID: 28977375 DOI: 10.1093/gerona/glx142] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/17/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Previous studies demonstrated associations between IL-6 and frailty, but associations between a wide range of cytokines, chemokines, and growth factors with prevalent and incident frailty has not been studied. METHODS Community-dwelling men aged more than 75 enrolled in the 5-year and 8-year follow-up of the CHAMP study were assessed. Twenty-seven inflammatory biomarkers were measured using the Bio-Plex Pro Human Cytokine 27-plex Assay kit at 5-year follow-up. Frailty was determined using the Fried frailty phenotype (FP) and Rockwood frailty index (FI) at both time-points. Age, body mass index, smoking, alcohol, and comorbidity were also assessed. RESULTS In cross-sectional analysis of the 5-year follow-up, the unadjusted odds ratio (OR) for frail versus robust evaluated by the FP showed significant associations for IL-6 (OR: 1.56, 95% confidence interval [CI]: 1.23-1.98) and IL-8 (OR: 1.28, 95% CI: 1.00-1.63). IL-6 remained significantly associated in the age-adjusted (OR: 1.58, 95% CI: 1.21-2.05) and multivariable-adjusted model (OR: 1.54, 95% CI: 1.16-2.05). No associations were observed between pre-frail versus robust. In longitudinal unadjusted analysis, IL-8 (OR: 1.32, 95% CI: 1.03-1.70) and IP-10 (OR: 1.32, 95% CI: 1.03-1.70) at 5-year predicted incident frailty at 8-year follow-up. IL-8 remained longitudinally associated with incident frailty after age (OR: 1.34, 95% CI: 1.03-1.75) but not multivariable (OR: 1.20, 95% CI: 0.98-1.70) adjustment. Similar results were seen using the FI. None of the other biomarkers had significant associations with incident frailty. CONCLUSIONS Our findings suggest that IL-6 and IL-8 may be cross-sectionally associated with frailty and that all measured inflammatory biomarkers were not causally related to frailty. Together with previous studies, the results suggest that frailty is specifically linked to IL-6 and IL-8 rather than simply representing a nonspecific pan-inflammatory condition.
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Affiliation(s)
- Benjumin Hsu
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.,Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Australia
| | - Vasant Hirani
- Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Australia.,Charles Perkins Centre, University of Sydney, New South Wales, Australia
| | - Robert G Cumming
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.,Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Australia.,School of Public Health, University of Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Fiona M Blyth
- Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Fredrick C Wright
- Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Louise M Waite
- Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia
| | - Markus J Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.,Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.,Charles Perkins Centre, University of Sydney, New South Wales, Australia
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Scott D, Seibel M, Cumming R, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Hirani V. Does Combined Osteopenia/Osteoporosis and Sarcopenia Confer Greater Risk of Falls and Fracture Than Either Condition Alone in Older Men? The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2020; 74:827-834. [PMID: 30032209 DOI: 10.1093/gerona/gly162] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND It is unclear whether older men with osteopenia/osteoporosis and sarcopenia (so-called osteosarcopenia) are at greater risk of falls and fractures than those with either condition alone. METHODS One thousand five hundred seventy-five community-dwelling men aged ≥70 years had appendicular lean mass, total hip and lumbar spine bone mineral density determined by dual-energy x-ray absorptiometry, and completed hand grip strength and gait speed tests. Osteopenia/osteoporosis was defined as a T-score at any site ≤-1.0 SD. Sarcopenia was defined using the European Working Group on Sarcopenia algorithm. Participants were contacted every 4 months for 6 ± 2 years to ascertain incident fractures (confirmed by radiographic reports) and for 2 years for incident falls. RESULTS Prevalence of osteosarcopenia was 8%, while 34% of participants had osteopenia/osteoporosis alone and 7% had sarcopenia alone. Men with osteosarcopenia had significantly increased fall (incidence rate ratio: 1.41; 95% confidence interval [CI]: 1.02 to 1.95) and fracture risk (hazard ratio: 1.87; 95% CI: 1.07 to 3.26) compared with men with neither osteopenia/osteoporosis nor sarcopenia. There was no statistical interaction between osteopenia/osteoporosis and sarcopenia, and falls and fracture risk were not different for osteosarcopenia compared with either condition alone (all p > .05). CONCLUSIONS Community-dwelling older men with combined osteopenia/osteoporosis and sarcopenia do not have increased falls and fracture risk compared with those with either condition. Further research is required to clarify whether the term "osteosarcopenia" has any meaning above and beyond either term alone and therefore potential clinical utility for falls and fracture prediction.
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Affiliation(s)
- David Scott
- School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Australian Institute for Musculoskeletal Science, Department of Medicine-Western Health, The University of Melbourne, St Albans, Victoria, Australia
| | - Markus Seibel
- Bone Research Program, ANZAC Research Institute, University of Sydney, New South Wales, Australia.,Department of Endocrinology and Metabolism, Concord Hospital, University of Sydney, New South Wales, Australia
| | - Robert Cumming
- School of Public Health, University of Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Australia.,The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Australia
| | - Fiona Blyth
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney, New South Wales, Australia.,Charles Perkins Centre, University of Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney, New South Wales, Australia.,Department of Andrology, Concord Hospital, University of Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Australia
| | - Vasant Hirani
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Australia.,School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, New South Wales, Australia
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Cervo MMC, Scott D, Seibel MJ, Cumming RG, Naganathan V, Blyth FM, Le Couteur DG, Handelsman DJ, Ribeiro RV, Waite LM, Shivappa N, Hebert JR, Hirani V. Proinflammatory Diet Increases Circulating Inflammatory Biomarkers and Falls Risk in Community-Dwelling Older Men. J Nutr 2020; 150:373-381. [PMID: 31665502 DOI: 10.1093/jn/nxz256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/03/2019] [Accepted: 09/26/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The relations between diet, chronic inflammation, and musculoskeletal health are unclear, especially among older men. OBJECTIVE This study aimed to determine associations of the Dietary Inflammatory Index (DII) with inflammatory biomarkers, musculoskeletal health, and falls risk in community-dwelling older men. METHODS The cross-sectional analysis included 794 community-dwelling men, mean age 81.1 ± 4.5 y, who participated in the 5-y follow-up of the Concord Health and Aging in Men Project. Of these, 616 were seen again 3 y later for the longitudinal analysis. Energy-adjusted DII (E-DII) was calculated from a validated diet history questionnaire. Bone mineral density (BMD) was measured using DXA. Twenty-four inflammatory biomarkers were analyzed. Incident falls over 3 y were determined through telephone interviews every 4 mo. Multiple regression, linear mixed effects models, negative binomial regression, and mediation analysis were utilized in this study. RESULTS A higher E-DII score (indicating a more proinflammatory diet) was associated with higher concentrations of IL-6 (β: 0.028 pg/mL; 95% CI: 0.003, 0.053), IL-7 (β: 0.020 pg/mL; 95% CI: 0.002, 0.037), and TNF-α (β: 0.027 pg/mL; 95% CI: 0.003, 0.051). A higher E-DII score was also associated with lower appendicular lean mass adjusted for BMI (ALMBMI) (β: -0.006 kg/m2; 95% CI: -0.010, -0.001). For every unit increase in E-DII (range: -4.91 to +3.66 units), incident falls rates increased by 13% (incidence rate ratio: 1.13; 95% CI: 1.05, 1.21) over 3 y. Mediation analysis showed that the association between E-DII and 3-y incident falls was influenced by the concentrations of IL-7 by 24%. There was no association between E-DII and BMD. CONCLUSIONS Consumption of a proinflammatory diet was associated with increased concentrations of IL-6, IL-7, and TNF-α; increased falls risk; and lower ALMBMI in community-dwelling older men. The association between incident falls and E-DII was partly mediated by concentrations of IL-7.
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Affiliation(s)
- Mavil May C Cervo
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School-Western Campus, The University of Melbourne, St Albans, Victoria, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, and Department of Endocrinology and Metabolism, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Aging and Alzheimer's Institute, Concord Hospital, Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research, University of Sydney, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Aging and Alzheimer's Institute, Concord Hospital, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Aging and Alzheimer's Institute, Concord Hospital, Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research, University of Sydney, Sydney, New South Wales, Australia.,ANZAC Research Institute and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Rosilene V Ribeiro
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - James R Hebert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - Vasant Hirani
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Aging Research, University of Sydney, Sydney, New South Wales, Australia.,School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
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Wright FAC, Takehara S, Stanaway FF, Naganathan V, Blyth FM, Hirani V, Le Couteur DG, Handelsman DJ, Waite LM, Seibel MJ, Cumming RG. Associations between oral health and depressive symptoms: Findings from the Concord Health and Ageing in Men Project. Australas J Ageing 2020; 39:e306-e314. [PMID: 31943668 DOI: 10.1111/ajag.12763] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/04/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate whether poorer oral health, tooth loss and lower usage of dental services are associated with depressive symptoms in older Australian men. METHODS Cross-sectional study of data collected from participants of the Concord Health and Ageing in Men Project. Depressive symptoms were evaluated by the Geriatric Depression Scale. Chewing capacity was estimated by ability to chew 11 food items. RESULTS The prevalence of depressive symptoms was 17.5%. Self-evaluated oral health, chewing capacity and the number of natural and decayed teeth were associated with depressive symptoms. After adjusting for multiple confounders, chewing capacity (PR 1.93; 95% CI 1.34-2.79) and decayed teeth (PR 1.68; 95% CI 1.03-2.75) maintained a significant association with depressive symptoms. CONCLUSION The direction of causality between oral health and depression is unclear; however, oral health may contribute to depression in older Australian men and depressive symptoms may limit chewing capacity and be aggravated by untreated dental decay.
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Affiliation(s)
- Fredrick A Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, Sydney, NSW, Australia.,The Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Sachiko Takehara
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, Sydney, NSW, Australia.,The Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Fiona F Stanaway
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, Sydney, NSW, Australia.,The Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Fiona M Blyth
- Concord Clinical School, Concord Repatriation and General Hospital, The University of Sydney, Concord, NSW, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, Sydney, NSW, Australia.,The Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Repatriation General Hospital, The University of Sydney, Concord, NSW, Australia
| | - Louise M Waite
- Department of Geriatric Medicine and Rehabilitation Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Markus J Seibel
- Concord Clinical School, Concord Repatriation and General Hospital, The University of Sydney, Concord, NSW, Australia
| | - Robert G Cumming
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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42
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Hsu B, Naganathan V, Blyth FM, Hirani V, Le Couteur DG, Waite LM, Seibel MJ, Handelsman DJ, Cumming RG. Frailty and Cause-Specific Hospitalizations in Community-Dwelling Older Men. J Nutr Health Aging 2020; 24:563-569. [PMID: 32510107 DOI: 10.1007/s12603-020-1352-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The types of medical conditions leading to hospitalization in frail older people have not been investigated. The objectives were to evaluate associations between frailty and (a) risk of all-cause and cause-specific hospitalization, and (b) rate of all-cause and cause-specific hospitalizations. DESIGN, SETTING AND PARTICIPANTS Community-dwelling men aged 70+ years in the Concord Health and Ageing in Men Project (CHAMP) were assessed for frailty at baseline (2005-2007, n=1705). MEASUREMENTS Frailty was determined by both the Fried frailty phenotype (FP) and the Rockwood frailty index (FI). Non-elective and elective hospitalization data were accessed from the New South Wales (NSW) Admitted Patient Data Collection and mortality from the NSW Deaths Registry for the period 2005-2017. Causes of hospitalization were categorized using ICD-10 classification of principal diagnoses based on organ system involved into 14 major categories. RESULTS Nearly 80% of CHAMP men had at least one non-elective hospitalization and 63% had an elective hospitalization over a 9-year follow-up. Men with FP frailty were twice as likely to have a non-elective hospitalization (HR: 1.98, 95%CI: 1.61-2.44) and a greater number of non-elective hospitalizations (IRR: 1.44, 95%CI: 1.22-1.70). Similar relationships were found between FI frailty and non-elective hospitalizations. Men with frailty (either FP or FI) were more likely to have at least one non-elective hospitalization for 13 of the 14 cause-related admissions. In contrast, frailty was only associated with 3 cause-related elective hospitalizations. Men with frailty were also more likely to have an increased number of non-elective hospitalizations for all 14 causes, but only for 6 causes of elective hospitalizations. CONCLUSIONS Our findings suggest frailty increases the risk and number of non-elective hospitalizations in older men for a wide range of cause. Strategies on early identification of frailty, followed by appropriate preventative strategies to lower the risk of non-elective hospital admissions are warranted.
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Affiliation(s)
- B Hsu
- Benjumin Hsu, Centre for Big Data Research in Health, UNSW Sydney, New South Wales, Australia 2052. E-mail:
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Valdez E, Wright FAC, Naganathan V, Milledge K, Blyth FM, Hirani V, Le Couteur DG, Handelsman DJ, Waite LM, Cumming RG. Frailty and oral health: Findings from the Concord Health and Ageing in Men Project. Gerodontology 2019; 37:28-37. [DOI: 10.1111/ger.12438] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Eduardo Valdez
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Fredrick A. Clive Wright
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Kate Milledge
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- School of Public Health Sydney Medical School The University of Sydney Sydney NSW Australia
| | - Fiona M. Blyth
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Concord Clinical School Concord Repatriation and General Hospital The University of Sydney Concord NSW Australia
| | - Vasant Hirani
- Charles Perkins Centre School of Life and Environmental Sciences The University of Sydney Sydney NSW Australia
| | - David G. Le Couteur
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - David J. Handelsman
- ANZAC Research Institute Concord Repatriation General Hospital The University of Sydney Concord NSW Australia
| | - Louise M. Waite
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Robert G. Cumming
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- School of Public Health Sydney Medical School The University of Sydney Sydney NSW Australia
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Ribeiro RV, Solon-Biet SM, Pulpitel T, Senior AM, Cogger VC, Clark X, O'Sullivan J, Koay YC, Hirani V, Blyth FM, Seibel MJ, Waite LM, Naganathan V, Cumming RG, Handelsman DJ, Simpson SJ, Le Couteur DG. Of Older Mice and Men: Branched-Chain Amino Acids and Body Composition. Nutrients 2019; 11:E1882. [PMID: 31412601 PMCID: PMC6723310 DOI: 10.3390/nu11081882] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 01/02/2023] Open
Abstract
Protein and branched-chain amino acid (BCAA) intake are associated with changes in circulating BCAAs and influence metabolic health in humans and rodents. However, the relationship between BCAAs and body composition in both species is unclear, with many studies questioning the translatability of preclinical findings to humans. Here, we assessed and directly compared the relationship between circulating BCAAs, body composition, and intake in older mice and men. Body weight and body fat were positively associated with circulating BCAA levels in both mouse and human, which remained significant after adjustments for age, physical activity, number of morbidities, smoking status, and source of income in the human cohort. Macronutrient intakes were similarly associated with circulating BCAA levels; however, the relationship between protein intake and BCAAs were more pronounced in the mice. These findings indicate that the relationship between circulating BCAAs, body composition, and intakes are comparable in both species, suggesting that the mouse is an effective model for examining the effects of BCAAs on body composition in older humans.
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Affiliation(s)
- Rosilene V Ribeiro
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia.
| | - Samantha M Solon-Biet
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia.
- Sydney Medical School, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia.
| | - Tamara Pulpitel
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
| | - Alistair M Senior
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
| | - Victoria C Cogger
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
- Sydney Medical School, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia
| | - Ximonie Clark
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
| | - John O'Sullivan
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
- Heart Research Institute, The University of Sydney, Sydney 2006, Australia
| | - Yen Chin Koay
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
- Heart Research Institute, The University of Sydney, Sydney 2006, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Kensington 2033, Australia
| | - Fiona M Blyth
- Concord Clinical School, Faculty of Health and Medicine, The University of Sydney, Concord 2139, Australia
| | - Markus J Seibel
- Sydney Medical School, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia
- Concord Clinical School, Faculty of Health and Medicine, The University of Sydney, Concord 2139, Australia
- ANZAC Research Institute, The University of Sydney, Concord 2139, Australia
| | - Louise M Waite
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Kensington 2033, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Health and Medicine, The University of Sydney, Concord 2139, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Sydney 2006, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Kensington 2033, Australia
| | - David J Handelsman
- ANZAC Research Institute, The University of Sydney, Concord 2139, Australia
| | - Stephen J Simpson
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
| | - David G Le Couteur
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
- Charles Perkins Centre, Camperdown, The University of Sydney, Sydney 2006, Australia
- Sydney Medical School, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia
- Ageing and Alzheimers Institute, Concord Hospital, University of Sydney, Concord 2139, Australia
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Scott D, Seibel MJ, Cumming R, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Hsu B, Waite LM, Hirani V. Associations of Body Composition Trajectories with Bone Mineral Density, Muscle Function, Falls, and Fractures in Older Men: The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci 2019; 75:939-945. [DOI: 10.1093/gerona/glz184] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
Weight loss increases fracture risk in older adults. We aimed to determine associations of 2-year body composition trajectories with subsequent falls and fractures in older men.
Methods
We measured appendicular lean mass (ALM) and total fat mass (FM) by dual-energy X-ray absorptiometry at baseline and Year 2 in 1,326 community-dwelling men aged ≥70 and older. Body composition trajectories were determined from residuals of a linear regression of change in ALM on change in FM (higher values indicate maintenance of ALM over FM), and a categorical variable for change in ALM and FM (did not lose [≥−5% change] versus lost [<−5% change]). Bone mineral density (BMD), hand grip strength, and gait speed were assessed at Years 2 and 5. After Year 2, incident fractures (confirmed by radiographical reports) and falls were recorded for 6.8 years.
Results
Compared with men who did not lose ALM or FM, men who did not lose ALM but lost FM, and men who lost both ALM and FM, had reduced falls (−24% and −34%, respectively; both p < .05). Men who lost ALM but did not lose FM had increased falls (incidence rate ratio = 1.73; 95% CI 1.37–2.18). ALM/FM change residuals were associated with improved lumbar spine BMD (B = 0.007; 95% CI 0.002–0.012 g/cm2 per SD increase) and gait speed (0.015; 0.001–0.029 m/s), and reduced hip fractures (hazard ratio = 0.68; 95% CI 0.47–0.99).
Conclusions
Fracture risk may be increased in older men who lose higher ALM relative to FM. Weight loss interventions for obese older men should target maintenance of lean mass.
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Affiliation(s)
- David Scott
- School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School – Western Campus, The University of Melbourne, St Albans, Victoria, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, and Department of Endocrinology & Metabolism, Concord Hospital, University of Sydney, New South Wales, Australia
| | - Robert Cumming
- School of Public Health, University of Sydney, New South Wales, Australia
- Centre for Education and Research on Ageing and Alzheimer’s Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
- The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing and Alzheimer’s Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
| | - Fiona Blyth
- Centre for Education and Research on Ageing and Alzheimer’s Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing and Alzheimer’s Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
- ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Australia
| | - Benjumin Hsu
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing and Alzheimer’s Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
| | - Vasant Hirani
- Centre for Education and Research on Ageing and Alzheimer’s Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, Concord Hospital, University of Sydney, New South Wales, Australia
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, New South Wales, Australia
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46
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Teng C, Loy C, Sellars M, Pond D, Latt M, Waite LM, Logeman C, Sinka V, Tong A. P3-512: MAKING DECISIONS ABOUT LONG-TERM INSTITUTIONAL CARE PLACEMENT AMONG PEOPLE WITH DEMENTIA AND THEIR CAREGIVERS: SYSTEMATIC REVIEW OF QUALITATIVE STUDIES. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Claris Teng
- Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
| | - Clement Loy
- Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
| | - Marcus Sellars
- Advance Care Planning Australia; Melbourne VIC Australia
- Sydney Medical School; University of Sydney; Sydney NSW Australia
| | - Dimity Pond
- The University of Newcastle; Newcastle Australia
| | - Mark Latt
- Sydney Medical School; University of Sydney; Sydney NSW Australia
| | - Louise M. Waite
- Centre for Education and Research on Ageing, Concord Hospital; The University of Sydney; Sydney Australia
| | - Charlotte Logeman
- Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
| | - Victoria Sinka
- Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
- Centre for Kidney Research; The Children's Hospital at Westmead; Westmead NSW Australia
| | - Allison Tong
- Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
- Centre for Kidney Research; The Children's Hospital at Westmead; Westmead NSW Australia
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47
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Shu CC, Hsu B, Cumming RG, Blyth FM, Waite LM, Le Couteur DG, Handelsman DJ, Naganathan V. Caregiving and all-cause mortality in older men 2005-15: the Concord Health and Ageing in Men Project. Age Ageing 2019; 48:571-576. [PMID: 31028375 DOI: 10.1093/ageing/afz039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/02/2019] [Accepted: 04/02/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND while both negative and positive impacts of caregiving on health have been reported, findings regarding caregiver's mortality may be biased by the lack of consideration of changes in their health and caregiving status during follow-up. This study examines the impact of caregiving on the risk of death in older men, allowing for caregiving-transition by individuals and adjusting for changes over time in their health status. METHODS data from 1639 men age ≥70 years old from the Concord Health and Ageing in Men Project (CHAMP) were collected between baseline (2005-07), 2-year and 5-year follow-up and linked to death records up to 30 September 2015. A time-varying Cox proportional hazards model was used to examine the risk of death from caregiving between 2005 and 2015, adjusting for baseline education, history of myocardial infarction, congestive heart failure, and risk factors which may change over time (age, income, self-rated overall health, number of morbidities, physical disability, depression and anxiety). RESULTS the average follow-up was 7.39 years (SD = 2.95) with 495 deaths observed. There was no significant difference in all-cause mortality between caregivers and non-caregivers in the multivariable model (HR: 0.95, 95% CI: 0.67-1.32, P = 0.73). CONCLUSIONS this study addressed the dynamic caregiving role and covariates which has been rarely considered in the literature. While there is concern that when older people take on a caring role their health suffers, we found no difference in mortality between older male caregivers and non-caregivers when we accounted for transitions in their caregiving status.
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Affiliation(s)
- Chen-Chun Shu
- Centre for Education and Research on Ageing, University of Sydney and Concord Clinical School, Sydney, Australia
| | - Benjumin Hsu
- Centre for Education and Research on Ageing, University of Sydney and Concord Clinical School, Sydney, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- School of Public health, University of Sydney, Sydney, Australia
| | - Robert G Cumming
- Centre for Education and Research on Ageing, University of Sydney and Concord Clinical School, Sydney, Australia
- School of Public health, University of Sydney, Sydney, Australia
- ARC Centre of Excellence in Population Ageing Research, Sydney, Australia
| | - Fiona M Blyth
- Centre for Education and Research on Ageing, University of Sydney and Concord Clinical School, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, University of Sydney and Concord Clinical School, Sydney, Australia
- Ageing and Alzheimer’s Institute, Concord Hospital, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, University of Sydney and Concord Clinical School, Sydney, Australia
- Ageing and Alzheimer’s Institute, Concord Hospital, Sydney, Australia
| | | | - Vasi Naganathan
- Centre for Education and Research on Ageing, University of Sydney and Concord Clinical School, Sydney, Australia
- Ageing and Alzheimer’s Institute, Concord Hospital, Sydney, Australia
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48
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Toyama T, van den Broek-Best O, Ohkuma T, Handelsman D, Waite LM, Seibel MJ, Cumming R, Naganathan V, Sherrington C, Hirani V, Wang AY. Associations of Impaired Renal Function With Declines in Muscle Strength and Muscle Function in Older Men: Findings From the CHAMP Study. J Gerontol A Biol Sci Med Sci 2019; 74:1812-1820. [DOI: 10.1093/gerona/glz100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Advanced kidney disease is associated with reduced muscle strength and physical performance. However, associations between early stages of renal impairment and physical outcomes are unclear.
Methods
The Concord Health and Ageing in Men Project is a prospective study of 1,705 community-dwelling men aged 70 years and older. Participants with estimated glomerular filtration rate (eGFR) more than 30 mL/min/1.73 m2 were included and further divided into four eGFR categories. Physical parameters including grip strength, gait speed, appendicular lean mass (ALM, a sum of skeletal mass of arms and legs), ALM adjusted for body mass index (ALMBMI), and muscle function (measured using grip strength divided by arm lean mass) were assessed at both baseline and 5-year follow-up. Associations between kidney function and changes in physical parameters were analyzed using linear and logistic regression models.
Results
Our study included 789 men with a median age of 75 years and median eGFR of 72 mL/min/1.73 m2 at baseline. Over 5 years, grip strength, gait speed, ALMBMI, and muscle function all declined in the whole cohort, compared with baseline. The multivariable analyses showed that poorer renal function was associated with more rapid declines in grip strength, gait speed, and muscle function in participants with mild-to-moderate renal impairment (GFR category stage G3, eGFR < 60 mL/min/1.73 m2) (p = .01, p < .01, p = .02, respectively) but less so in those with eGFR more than 60 mL/min/1.73 m2, whereas eGFR category did not have a significant impact on declines in ALMBMI. These results remained unchanged with or without adjustment for age.
Conclusions
In community-dwelling older men, mild-to-moderate renal impairment at baseline was associated with declines in grip strength, gait speed, and muscle function over time despite preservation of muscle mass.
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Affiliation(s)
- Tadashi Toyama
- Renal and Metabolic Division, The George Institute for Global Health, University of New South Wales (UNSW), Australia
- Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan
| | | | - Toshiaki Ohkuma
- Renal and Metabolic Division, The George Institute for Global Health, University of New South Wales (UNSW), Australia
| | - David Handelsman
- Department of Andrology, Concord Hospital, ANZAC Research Institute, University of Sydney, New South Wales
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, Department of Endocrinology and Metabolism, Concord Hospital, University of Sydney, New South Wales
| | - Robert Cumming
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales
- Sydney School of Public Health, University of Sydney, New South Wales
- The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales
| | | | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, New South Wales
| | - Amanda Y Wang
- Renal and Metabolic Division, The George Institute for Global Health, University of New South Wales (UNSW), Australia
- Department of Nephrology, Concord General Repatriation Hospital, New South Wales, Australia
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49
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Tran J, Wright F, Takara S, Shu CC, Chu SY, Naganathan V, Hirani V, Blyth FM, Le Couteur DG, Waite LM, Handelsman DJ, Seibel MJ, Milledge KL, Cumming RG. Oral health behaviours of older Australian men: the Concord Health and Ageing in Men Project. Aust Dent J 2019; 64:246-255. [PMID: 30972755 DOI: 10.1111/adj.12694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Concord Health and Ageing in Men Project (CHAMP) is a cohort study of the health of a representative sample of older Australian men. The aim of this paper is to describe the oral health behaviours and dental service use of CHAMP participants and explore associations between oral health behaviours with and general health status. METHOD Information collected related to socio-demographics, general health, oral health service-use and oral health behaviours. Key general health conditions were ascertained from the health questionnaire and included physical capacity and cognitive status. RESULTS Fifty-seven percent of the men reported visiting a dental provider at least once or more a year and 56.7% did so for a "dental check-up". Of those with some natural teeth, 59.3% claimed to brush their teeth at least twice or more a day. Most men (96%) used a standard fluoride toothpaste. Few participants used dental floss, tooth picks or mouth-rinses to supplement oral hygiene. Cognitive status and self-rated general health were associated with dental visiting patterns and toothbrushing behaviour. CONCLUSIONS Most older men in CHAMP perform favourable oral health behaviours. Smoking behaviour is associated with less favourable dental visiting patterns, and cognitive status with toothbrushing behaviour.
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Affiliation(s)
- J Tran
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Fac Wright
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - S Takara
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Department of Oral Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - C-C Shu
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Sk-Y Chu
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - V Naganathan
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Ageing and Alzheimer's Institute, Geriatric Medicine and Rehabilitation, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - V Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - F M Blyth
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, New South Wales, Australia
| | - D G Le Couteur
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - L M Waite
- Centre for Education and Research and Ageing, Concord Clinical School and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - D J Handelsman
- ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - M J Seibel
- Concord Clinical School, Concord Repatriation General Hospital, University of Sydney, Concord, New South Wales, Australia
| | - K L Milledge
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - R G Cumming
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
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50
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Wright FAC, Law GG, Milledge KL, Chu SKY, Hsu B, Valdez E, Naganathan V, Hirani V, Blyth FM, LeCouteur DG, Waite LM, Handelsman DJ, Seibel MJ, Cumming RG. Chewing function, general health and the dentition of older Australian men: The Concord Health and Ageing in Men Project. Community Dent Oral Epidemiol 2018; 47:134-141. [DOI: 10.1111/cdoe.12435] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/19/2018] [Accepted: 10/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Fredrick A. C. Wright
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
| | - Garry G. Law
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
| | - Kate L. Milledge
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
- School of Public Health; Sydney Medical School; University of Sydney; Sydney New South Wales Australia
| | - Steven K.-Y. Chu
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
| | - Benjumin Hsu
- Centre for Big Data Research; University of New South Wales; Sydney New South Wales Australia
- ANZAC Research Institute; Concord Repatriation General Hospital; University of Sydney; Concord New South Wales Australia
| | - Eduardo Valdez
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
- Department of Geriatric Medicine; Concord Repatriation General Hospital; Concord New South Wales Australia
- Ageing and Alzheimer's Institute; Geriatric Medicine and Rehabilitative Medicine; Concord Repatriation and General Hospital; Concord New South Wales Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences; Charles Perkins Centre; University of Sydney; New South Wales Australia
| | - Fiona M. Blyth
- Concord Clinical School; Concord Repatriation General Hospital; University of Sydney; Concord New South Wales Australia
| | - David G. LeCouteur
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
- Department of Geriatric Medicine; Concord Repatriation General Hospital; Concord New South Wales Australia
- Ageing and Alzheimer's Institute; Geriatric Medicine and Rehabilitative Medicine; Concord Repatriation and General Hospital; Concord New South Wales Australia
| | - Louise M. Waite
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
- Department of Geriatric Medicine; Concord Repatriation General Hospital; Concord New South Wales Australia
- Ageing and Alzheimer's Institute; Geriatric Medicine and Rehabilitative Medicine; Concord Repatriation and General Hospital; Concord New South Wales Australia
- Concord Clinical School; Concord Repatriation General Hospital; University of Sydney; Concord New South Wales Australia
| | - David J. Handelsman
- ANZAC Research Institute; Concord Repatriation General Hospital; University of Sydney; Concord New South Wales Australia
| | - Markus J. Seibel
- Concord Clinical School; Concord Repatriation General Hospital; University of Sydney; Concord New South Wales Australia
| | - Robert G. Cumming
- Centre for Education and Research on Ageing; Concord Clinical School; Sydney Local Health District; Concord Repatriation General Hospital; Concord New South Wales Australia
- School of Public Health; Sydney Medical School; University of Sydney; Sydney New South Wales Australia
- School of Life and Environmental Sciences; Charles Perkins Centre; University of Sydney; New South Wales Australia
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