Afsaneh Mohammadnejad, Juulia Jylhävä, Marianne Ewertz, Jesper Ryg, Jacob v B Hjelmborg, Angéline Galvin
Background While age is an important risk factor for both cancer and frailty, it is unclear whether cancer itself increases the risk of frailty. We aimed to assess the association between cancer and frailty in a longitudinal cohort of older Danish twins, taking familial effect into account. Methods Using the Danish Cancer Registry, cancer cases were identified among participants aged 70 and over in the Longitudinal Study of Aging Danish Twins (LSADT). Frailty was evaluated over 10 years of follow-up using the frailty index (FI) and defined as FI > 0.21. Stratified Cox regressions were performed on discordant twin pairs (pairs where one twin had incident cancer and the other was cancer-free), and on all LSADT individual twins (twin pairs and singletons) with no history of cancer. Results Among the 72 discordant pairs (n=144, median age at inclusion=75) included in the study, the median FI at inclusion was 0.08 for both cancer twins and cancer-free co-twins. From the stratified Cox regression, twins with cancer had an increased hazard of developing frailty (HR=3.67, 95%CI=1.02,13.14) compared to their cancer-free co-twins. The analyses on individual twins (n=4,027) provided similar results, showing an increased hazard of frailty in individuals with cancer (HR=2.57, 95%CI= 1.77,3.74) compared to those without cancer. Conclusions We showed a higher risk of becoming frail following a cancer diagnosis in both discordant twin pairs and individual twins. These findings support the importance of monitoring of frailty in older adults with cancer through geriatric assessments and implementation of frailty interventions.
{"title":"Is cancer associated with frailty? Results from a longitudinal study of old Danish twins","authors":"Afsaneh Mohammadnejad, Juulia Jylhävä, Marianne Ewertz, Jesper Ryg, Jacob v B Hjelmborg, Angéline Galvin","doi":"10.1093/gerona/glae225","DOIUrl":"https://doi.org/10.1093/gerona/glae225","url":null,"abstract":"Background While age is an important risk factor for both cancer and frailty, it is unclear whether cancer itself increases the risk of frailty. We aimed to assess the association between cancer and frailty in a longitudinal cohort of older Danish twins, taking familial effect into account. Methods Using the Danish Cancer Registry, cancer cases were identified among participants aged 70 and over in the Longitudinal Study of Aging Danish Twins (LSADT). Frailty was evaluated over 10 years of follow-up using the frailty index (FI) and defined as FI > 0.21. Stratified Cox regressions were performed on discordant twin pairs (pairs where one twin had incident cancer and the other was cancer-free), and on all LSADT individual twins (twin pairs and singletons) with no history of cancer. Results Among the 72 discordant pairs (n=144, median age at inclusion=75) included in the study, the median FI at inclusion was 0.08 for both cancer twins and cancer-free co-twins. From the stratified Cox regression, twins with cancer had an increased hazard of developing frailty (HR=3.67, 95%CI=1.02,13.14) compared to their cancer-free co-twins. The analyses on individual twins (n=4,027) provided similar results, showing an increased hazard of frailty in individuals with cancer (HR=2.57, 95%CI= 1.77,3.74) compared to those without cancer. Conclusions We showed a higher risk of becoming frail following a cancer diagnosis in both discordant twin pairs and individual twins. These findings support the importance of monitoring of frailty in older adults with cancer through geriatric assessments and implementation of frailty interventions.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aldis H Petriceks, Lawrence J Appel, Edgar R Miller, Christine M Mitchell, Jennifer A Schrack, Amal A Wanigatunga, Erin D Michos, Robert H Christenson, Heather Rebuck, Stephen P Juraschek
Background Orthostatic hypotension is associated with cardiovascular disease. It remains unclear if low standing blood pressure or high seated blood pressure is responsible for this association. We compared associations of orthostatic hypotension and hypertension with high-sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide. Methods We performed a secondary analysis of the Study to Understand Fall Reduction and Vitamin D in You (STURDY), a randomized controlled trial funded by the National Institute on Aging, between July 2015 and May 2019. Participants were community-dwelling adults, 70 years or older. Blood tests for high-sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide were drawn at visits concurrent with blood pressure measurements. Secondary analysis occurred in 2023. We determined associations between blood pressure phenotypes and cardiac biomarkers. Results Of 674 participants (mean age 76.5 ± 5.4 years, 43% female, 17.2% Black race), 29.1% had prior cardiovascular disease. Participants with seated hypertension had 10.1% greater high-sensitivity cardiac troponin I (95% CI = 3.8, 16.9) and 11.0% greater N-terminal pro-B-type natriuretic peptide (4.0, 18.6) than those without seated hypertension. Participants with standing hypertension had 8.6% (2.7, 14.9) greater high-sensitivity cardiac troponin I and 11.8% greater N-terminal pro-B-type natriuretic peptide (5.1, 18.9) than those without standing hypertension. Hypotensive phenotypes were not associated with either biomarker. Conclusions Both seated and standing hypertension were associated with greater high-sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide, but hypotensive phenotypes were not. Hypoperfusion may not be the principal mechanism behind subclinical cardiac injury among older adults with orthostatic hypotension.
背景 直立性低血压与心血管疾病有关。目前仍不清楚是站立时血压低还是坐位时血压高导致了这种关联。我们比较了正性低血压和高血压与高敏心肌肌钙蛋白 I 和 N 端前 B 型利钠肽的关系。方法 我们在 2015 年 7 月至 2019 年 5 月期间对美国国家老龄化研究所资助的随机对照试验 "减少跌倒和您体内的维生素 D 研究"（STURDY）进行了二次分析。参与者为 70 岁或以上居住在社区的成年人。在就诊时抽血检测高敏心肌肌钙蛋白 I 和 N 端前 B 型钠尿肽，同时测量血压。二次分析于 2023 年进行。我们确定了血压表型与心脏生物标志物之间的关联。结果 在 674 名参与者（平均年龄 76.5 ± 5.4 岁，43% 为女性，17.2% 为黑人）中，29.1% 曾患有心血管疾病。与非坐位高血压患者相比，坐位高血压患者的高敏心肌肌钙蛋白 I（95% CI = 3.8，16.9）和 N 端前 B 型钠尿肽（4.0，18.6）分别高出 10.1%和 11.0%。与没有站立性高血压的人相比，站立性高血压患者的高敏心肌肌钙蛋白 I 高出 8.6% (2.7, 14.9)，N-末端前 B 型钠尿肽高出 11.8% (5.1, 18.9)。低血压表型与这两种生物标志物均无关联。结论 坐位高血压和站立高血压都与高敏心肌肌钙蛋白 I 和 N 端前-B 型钠尿肽增加有关，但低血压表型与之无关。低灌注可能不是患有正性低血压的老年人亚临床心脏损伤的主要机制。
{"title":"Associations of Hypertension and Orthostatic Hypotension with Subclinical Cardiovascular Disease","authors":"Aldis H Petriceks, Lawrence J Appel, Edgar R Miller, Christine M Mitchell, Jennifer A Schrack, Amal A Wanigatunga, Erin D Michos, Robert H Christenson, Heather Rebuck, Stephen P Juraschek","doi":"10.1093/gerona/glae234","DOIUrl":"https://doi.org/10.1093/gerona/glae234","url":null,"abstract":"Background Orthostatic hypotension is associated with cardiovascular disease. It remains unclear if low standing blood pressure or high seated blood pressure is responsible for this association. We compared associations of orthostatic hypotension and hypertension with high-sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide. Methods We performed a secondary analysis of the Study to Understand Fall Reduction and Vitamin D in You (STURDY), a randomized controlled trial funded by the National Institute on Aging, between July 2015 and May 2019. Participants were community-dwelling adults, 70 years or older. Blood tests for high-sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide were drawn at visits concurrent with blood pressure measurements. Secondary analysis occurred in 2023. We determined associations between blood pressure phenotypes and cardiac biomarkers. Results Of 674 participants (mean age 76.5 ± 5.4 years, 43% female, 17.2% Black race), 29.1% had prior cardiovascular disease. Participants with seated hypertension had 10.1% greater high-sensitivity cardiac troponin I (95% CI = 3.8, 16.9) and 11.0% greater N-terminal pro-B-type natriuretic peptide (4.0, 18.6) than those without seated hypertension. Participants with standing hypertension had 8.6% (2.7, 14.9) greater high-sensitivity cardiac troponin I and 11.8% greater N-terminal pro-B-type natriuretic peptide (5.1, 18.9) than those without standing hypertension. Hypotensive phenotypes were not associated with either biomarker. Conclusions Both seated and standing hypertension were associated with greater high-sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide, but hypotensive phenotypes were not. Hypoperfusion may not be the principal mechanism behind subclinical cardiac injury among older adults with orthostatic hypotension.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maddison L Mellow, Dorothea Dumuid, Alexandra Wade, Timothy Olds, Ty Stanford, Hannah Keage, Montana Hunter, Nicholas Ware, Felicity M Simpson, Frini Karayanidis, Ashleigh E Smith
BACKGROUND Each day is made up of a composition of ‘time-use behaviours’. These can be classified by their intensity (e.g., light or moderate-vigorous physical activity (PA)) or domain (e.g., chores, socialising). Intensity-based time-use behaviours are linked with cognitive function and cardiometabolic health in older adults, but it is unknown whether these relationships differ depending on the domain (or type/context) of behaviour. METHODS This study included 397 older adults (65.5 ± 3.0 years, 69% female, 16.0 ± 3.0 years education) from Adelaide and Newcastle, Australia. Time-use behaviours were recorded using the Multimedia Activity Recall for Children and Adults (MARCA), cognitive function was measured using the Addenbrooke’s Cognitive Examination III (ACE-III) and Cambridge Neuropsychological Test Automated Battery (CANTAB), and systolic and diastolic blood pressure, total cholesterol and waist-hip ratio were also recorded. Two 24-hr time-use compositions were derived from each participant’s MARCA, including a four-part intensity composition (sleep, sedentary behaviour, light and moderate-vigorous PA) and an eight-part domain composition (Sleep, Self-Care, Chores, Screen Time, Quiet Time, Household Administration, Sport/Exercise, and Social). RESULTS Linear regressions found significant associations between the domain composition and both ACE-III (p=0.010) and waist-hip ratio (p=0.009), and between the intensity composition and waist-hip ratio (p=0.025). Isotemporal substitution modelling demonstrated that the domains of sedentary behaviours and PA impacted their associations with ACE-III, whilst any PA appeared beneficial for waist-hip ratio. CONCLUSIONS Findings suggest the domain of behaviour should be considered when aiming to support cognitive function, whereas for cardiometabolic health, it appears sufficient to promote any type of PA
{"title":"Should we work smarter or harder for our health? A comparison of intensity and domain-based time-use compositions and their associations with cognitive and cardiometabolic health","authors":"Maddison L Mellow, Dorothea Dumuid, Alexandra Wade, Timothy Olds, Ty Stanford, Hannah Keage, Montana Hunter, Nicholas Ware, Felicity M Simpson, Frini Karayanidis, Ashleigh E Smith","doi":"10.1093/gerona/glae233","DOIUrl":"https://doi.org/10.1093/gerona/glae233","url":null,"abstract":"BACKGROUND Each day is made up of a composition of ‘time-use behaviours’. These can be classified by their intensity (e.g., light or moderate-vigorous physical activity (PA)) or domain (e.g., chores, socialising). Intensity-based time-use behaviours are linked with cognitive function and cardiometabolic health in older adults, but it is unknown whether these relationships differ depending on the domain (or type/context) of behaviour. METHODS This study included 397 older adults (65.5 ± 3.0 years, 69% female, 16.0 ± 3.0 years education) from Adelaide and Newcastle, Australia. Time-use behaviours were recorded using the Multimedia Activity Recall for Children and Adults (MARCA), cognitive function was measured using the Addenbrooke’s Cognitive Examination III (ACE-III) and Cambridge Neuropsychological Test Automated Battery (CANTAB), and systolic and diastolic blood pressure, total cholesterol and waist-hip ratio were also recorded. Two 24-hr time-use compositions were derived from each participant’s MARCA, including a four-part intensity composition (sleep, sedentary behaviour, light and moderate-vigorous PA) and an eight-part domain composition (Sleep, Self-Care, Chores, Screen Time, Quiet Time, Household Administration, Sport/Exercise, and Social). RESULTS Linear regressions found significant associations between the domain composition and both ACE-III (p=0.010) and waist-hip ratio (p=0.009), and between the intensity composition and waist-hip ratio (p=0.025). Isotemporal substitution modelling demonstrated that the domains of sedentary behaviours and PA impacted their associations with ACE-III, whilst any PA appeared beneficial for waist-hip ratio. CONCLUSIONS Findings suggest the domain of behaviour should be considered when aiming to support cognitive function, whereas for cardiometabolic health, it appears sufficient to promote any type of PA","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meng-Hua Tao, Chun-Hui Lin, Mei Lu, Stuart C Gordon
Background Chronic hepatitis C virus (HCV) infection is associated with early onset of chronic diseases, and increased risk of chronic disorders. Chronic viral infections have been linked to accelerated biological aging based on epigenetic clocks. In this study, we aimed to investigate the association between HCV infection and clinical measures of biological aging among 8,306 adults participating the 2015-2018 waves of the National Health and Nutrition Examination Survey (NHANES). Methods NHANES 2015-2018 participants aged 20 years and older who had complete data on clinical blood markers and HCV related tests were included in the current study. We estimated biological age using two approaches including Phenotypic Age (PhenoAge) and allostatic load (AL) score based on nine clinical biomarkers. Results After adjusting for demographic and other confounding factors, HCV antibody-positivity was associated with advanced PhenoAge (β = 2.43, 95% confidence interval (CI), 1.51-3.35), compared with HCV antibody-negativity. Additionally, both active HCV infection (HCV RNA (+)) and resolved infection were associated with greater PhenoAge acceleration. The positive association with AL score was not statistically significant. We did not observe any significant interactions of potential effect modifiers, including smoking and use of drug/ needle injection, with HCV infection on measures of biological aging. Conclusions Our findings suggest that HCV infection is independently associated with biological aging measured by phenotypic age in the US general population. Further studies are warranted to confirm the findings.
{"title":"Accelerated Phenotypic Aging Associated with Hepatitis C Infection: Results from the U.S. National Health and Nutrition Examination Surveys 2015-2018","authors":"Meng-Hua Tao, Chun-Hui Lin, Mei Lu, Stuart C Gordon","doi":"10.1093/gerona/glae232","DOIUrl":"https://doi.org/10.1093/gerona/glae232","url":null,"abstract":"Background Chronic hepatitis C virus (HCV) infection is associated with early onset of chronic diseases, and increased risk of chronic disorders. Chronic viral infections have been linked to accelerated biological aging based on epigenetic clocks. In this study, we aimed to investigate the association between HCV infection and clinical measures of biological aging among 8,306 adults participating the 2015-2018 waves of the National Health and Nutrition Examination Survey (NHANES). Methods NHANES 2015-2018 participants aged 20 years and older who had complete data on clinical blood markers and HCV related tests were included in the current study. We estimated biological age using two approaches including Phenotypic Age (PhenoAge) and allostatic load (AL) score based on nine clinical biomarkers. Results After adjusting for demographic and other confounding factors, HCV antibody-positivity was associated with advanced PhenoAge (β = 2.43, 95% confidence interval (CI), 1.51-3.35), compared with HCV antibody-negativity. Additionally, both active HCV infection (HCV RNA (+)) and resolved infection were associated with greater PhenoAge acceleration. The positive association with AL score was not statistically significant. We did not observe any significant interactions of potential effect modifiers, including smoking and use of drug/ needle injection, with HCV infection on measures of biological aging. Conclusions Our findings suggest that HCV infection is independently associated with biological aging measured by phenotypic age in the US general population. Further studies are warranted to confirm the findings.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
So Yeon Jeon, Hee Won Yang, Bo Ran Son, Jimin Baek, Jeong Lan Kim
Background The caregiving burden of the spousal caregivers (SCGs) to individuals with cognitive impairment poses public health challenges with adverse psychosocial and physiological effects. However, few studies have investigated the neurobiological impact of caregiving, particularly through the investigation of neuroinflammation and neurodegeneration. Methods Using data from a longitudinal cohort at Chungnam National University Hospital, the relationship between caregiving burden, neuroinflammation and neurodegeneration was examined in 38 older adult couples over a 16-month period. Caregiving burden was assessed through a multifaceted approach. For factors related to the care recipient, we assessed cognitive function and neuropsychiatric symptoms. Factors regarding the SCGs included the measurement of perceived depression. Glial fibrillary acidic protein (GFAP) was used as a plasma biomarker for neuroinflammation and neurofilament light chain (NfL) for neurodegeneration. Regression analyses were adjusted for age, sex, apolipoprotein E status, follow-up interval, vascular risk factors, and physical activity. Results Changes in depression among SCGs were significantly correlated with increased GFAP levels (p = 0.003), indicating that greater depressive symptoms during caregiving are associated with increased neuroinflammation. In contrast, no significant correlations were found between changes in cognitive function or neuropsychiatric symptoms in care recipients and the plasma biomarker levels of SCGs. Additionally, there was no significant association between changes in depression and NfL levels in SCGs. Conclusions The psychological stress experienced by SCGs while caring for partners with cognitive impairment actively contributes to neuroinflammation, a well-known risk factor for various diseases. This study emphasizes the need to address psychological stress experienced by older adult caregivers.
{"title":"Caregiving-Related Depression Increases Neuroinflammation in Spousal Caregivers to Individuals with Cognitive Impairment: A Longitudinal Study","authors":"So Yeon Jeon, Hee Won Yang, Bo Ran Son, Jimin Baek, Jeong Lan Kim","doi":"10.1093/gerona/glae235","DOIUrl":"https://doi.org/10.1093/gerona/glae235","url":null,"abstract":"Background The caregiving burden of the spousal caregivers (SCGs) to individuals with cognitive impairment poses public health challenges with adverse psychosocial and physiological effects. However, few studies have investigated the neurobiological impact of caregiving, particularly through the investigation of neuroinflammation and neurodegeneration. Methods Using data from a longitudinal cohort at Chungnam National University Hospital, the relationship between caregiving burden, neuroinflammation and neurodegeneration was examined in 38 older adult couples over a 16-month period. Caregiving burden was assessed through a multifaceted approach. For factors related to the care recipient, we assessed cognitive function and neuropsychiatric symptoms. Factors regarding the SCGs included the measurement of perceived depression. Glial fibrillary acidic protein (GFAP) was used as a plasma biomarker for neuroinflammation and neurofilament light chain (NfL) for neurodegeneration. Regression analyses were adjusted for age, sex, apolipoprotein E status, follow-up interval, vascular risk factors, and physical activity. Results Changes in depression among SCGs were significantly correlated with increased GFAP levels (p = 0.003), indicating that greater depressive symptoms during caregiving are associated with increased neuroinflammation. In contrast, no significant correlations were found between changes in cognitive function or neuropsychiatric symptoms in care recipients and the plasma biomarker levels of SCGs. Additionally, there was no significant association between changes in depression and NfL levels in SCGs. Conclusions The psychological stress experienced by SCGs while caring for partners with cognitive impairment actively contributes to neuroinflammation, a well-known risk factor for various diseases. This study emphasizes the need to address psychological stress experienced by older adult caregivers.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"333 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shuojia Wang, Chengyuan Yu, Jing Zhu, Pengfei Zhao, Nana Jin, Lixin Cheng, Lin Kang
Background There is limited knowledge about the effect of leisure activities on cognitive decline related to different multimorbidity patterns. The study aimed to examine the role of leisure activities in the association between multimorbidity patterns and cognitive function. Methods We conducted a community-based cohort study based on the 2002-2018 Chinese Longitudinal Health Longevity Survey (CLHLS). Multimorbidity patterns were examined by exploratory factor analysis. Multivariable linear and logistic regression models were used to assess the associations between multimorbidity, leisure activities and cognitive function. Results The study included 14,093 older adults. Those with specific multimorbidity patterns had lower MMSE scores. Compared to individuals with cardio-metabolic and sensory patterns who frequently engaged in activities such as housework, garden work, and watching TV/listening to the radio, those who participated in these activities less regularly had lower MMSE scores. Furthermore, a higher frequency change of participation and a greater variety of leisure activities were associated with better cognitive function. Conclusions The older individuals with multimorbidity are associated with lower MMSE scores, while those who participated in more leisure activities had higher cognitive function. Diverse, and frequent leisure activities may help delay cognitive decline in Chinese older adults with different multimorbidities.
{"title":"Multimorbidity patterns, leisure activities, and cognitive function: A population-based longitudinal study","authors":"Shuojia Wang, Chengyuan Yu, Jing Zhu, Pengfei Zhao, Nana Jin, Lixin Cheng, Lin Kang","doi":"10.1093/gerona/glae231","DOIUrl":"https://doi.org/10.1093/gerona/glae231","url":null,"abstract":"Background There is limited knowledge about the effect of leisure activities on cognitive decline related to different multimorbidity patterns. The study aimed to examine the role of leisure activities in the association between multimorbidity patterns and cognitive function. Methods We conducted a community-based cohort study based on the 2002-2018 Chinese Longitudinal Health Longevity Survey (CLHLS). Multimorbidity patterns were examined by exploratory factor analysis. Multivariable linear and logistic regression models were used to assess the associations between multimorbidity, leisure activities and cognitive function. Results The study included 14,093 older adults. Those with specific multimorbidity patterns had lower MMSE scores. Compared to individuals with cardio-metabolic and sensory patterns who frequently engaged in activities such as housework, garden work, and watching TV/listening to the radio, those who participated in these activities less regularly had lower MMSE scores. Furthermore, a higher frequency change of participation and a greater variety of leisure activities were associated with better cognitive function. Conclusions The older individuals with multimorbidity are associated with lower MMSE scores, while those who participated in more leisure activities had higher cognitive function. Diverse, and frequent leisure activities may help delay cognitive decline in Chinese older adults with different multimorbidities.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Feifan Zhao, Zhentao Wang, Zaichao Wu, Xueling Wang, Yun Li, Yunge Gao, Kun Han, Qiongfei Yu, Cai Wu, Jie Chen, Dan Zhao, Keqing Dong, Yan Qian, Xuanyi Wu, Ying Chen, Hao Wu
Background Hearing loss and lifestyle factors have been associated with cognitive impairment. We aimed to explore the joint association of combined healthy lifestyle factors and hearing loss with cognitive impairment, which has been scarcely studied. Methods This baseline study used data from the CHOICE-Cohort study (Chinese Hearing Solution for Improvement of Cognition in Elders). Hearing loss was assessed by the better-ear pure-tone average (BPTA). A composite healthy lifestyle score was built based on never smoking, never drinking, regular physical activity, and balanced diet. Cognitive impairment was diagnosed by the Mini-Mental State Examination (MMSE) score of less than 24. Results We included 17057 participants aged 60 years or older in China (mean age 69.8 [SD 6.2] years, 55.7% female). Among the participants, 48.3% (n=8234) had mild hearing loss, and 25.8% (n=4395) had moderate or greater hearing loss. The proportion of participants with healthy lifestyle scores of 0-1, 2, 3, and 4 was 14.9% (n=2539), 29.3% (n=5000), 37.4% (n=6386), and 18.4% (n=3132), respectively. 29.6% (n=5057) participants had cognitive impairment. When compared to those with normal hearing and healthy lifestyle (scores of 3-4), participants with hearing loss plus unhealthy lifestyle (scores of 0-2) exhibited approximately twofold increased risk of cognitive impairment (OR=1.92, 95% CI 1.70-2.18). Conversely, the risk was greatly attenuated by adherence to healthy lifestyle in individuals with hearing loss (OR=1.57, 95% CI 1.40-1.76). Conclusions Our findings demonstrated adherence to a broad range of healthy lifestyle factors was associated with a significantly lower risk of cognitive impairment among participants with hearing loss.
{"title":"Joint Association of Combined Healthy Lifestyle Factors and Hearing Loss with Cognitive Impairment in China","authors":"Feifan Zhao, Zhentao Wang, Zaichao Wu, Xueling Wang, Yun Li, Yunge Gao, Kun Han, Qiongfei Yu, Cai Wu, Jie Chen, Dan Zhao, Keqing Dong, Yan Qian, Xuanyi Wu, Ying Chen, Hao Wu","doi":"10.1093/gerona/glae226","DOIUrl":"https://doi.org/10.1093/gerona/glae226","url":null,"abstract":"Background Hearing loss and lifestyle factors have been associated with cognitive impairment. We aimed to explore the joint association of combined healthy lifestyle factors and hearing loss with cognitive impairment, which has been scarcely studied. Methods This baseline study used data from the CHOICE-Cohort study (Chinese Hearing Solution for Improvement of Cognition in Elders). Hearing loss was assessed by the better-ear pure-tone average (BPTA). A composite healthy lifestyle score was built based on never smoking, never drinking, regular physical activity, and balanced diet. Cognitive impairment was diagnosed by the Mini-Mental State Examination (MMSE) score of less than 24. Results We included 17057 participants aged 60 years or older in China (mean age 69.8 [SD 6.2] years, 55.7% female). Among the participants, 48.3% (n=8234) had mild hearing loss, and 25.8% (n=4395) had moderate or greater hearing loss. The proportion of participants with healthy lifestyle scores of 0-1, 2, 3, and 4 was 14.9% (n=2539), 29.3% (n=5000), 37.4% (n=6386), and 18.4% (n=3132), respectively. 29.6% (n=5057) participants had cognitive impairment. When compared to those with normal hearing and healthy lifestyle (scores of 3-4), participants with hearing loss plus unhealthy lifestyle (scores of 0-2) exhibited approximately twofold increased risk of cognitive impairment (OR=1.92, 95% CI 1.70-2.18). Conversely, the risk was greatly attenuated by adherence to healthy lifestyle in individuals with hearing loss (OR=1.57, 95% CI 1.40-1.76). Conclusions Our findings demonstrated adherence to a broad range of healthy lifestyle factors was associated with a significantly lower risk of cognitive impairment among participants with hearing loss.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yingliang Wei, Tingjing Zhang, Haochen Wang, Jianbang Su, Minghao Yu, Yashu Liu, Lunhao Bai, Yang Xia
Background Few studies have explored the association between stair climbing and osteoarthritis (OA) to determine whether the former is a protective or risk factor for the latter. This study prospectively evaluated the associations among stair climbing, genetic susceptibility, and their interaction with the risk of incident hip/knee OA. Methods The cohort analyses included 398,939 participants from the UK Biobank. Stair climbing was assessed using a questionnaire. Genetic risk scores (GRSs) consisting of 70, 83, and 87 single-nucleotide polymorphisms for hip, knee, and hip/knee OA were constructed. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations among stair climbing, genetic predisposition, and hip and/or knee OA risk. Results After 3,621,735 person-years of follow-up, 31,940 patients developed OA. Stair climbing was positively associated with incident hip/knee (P for trend<0.001) and knee (P for trend<0.0001) OA but not hip OA. After adjustments, compared with no stair climbing, climbing >150 steps/day was associated with a higher risk of hip/knee OA (HR, 1.08; 95% CI, 1.03–1.12) and knee OA (HR, 1.13; 95% CI, 1.06–1.20). Although no significant interaction between stair climbing and the GRS of OA risk was found, the above associations were only significant in participants with middle and high GRSs. Conclusion A higher frequency of stair climbing was positively associated with the risk of knee OA but not hip OA, highlighting the importance of avoiding frequent stair climbing in preventing knee OA, especially in genetically predisposed individuals.
背景很少有研究探讨爬楼梯与骨关节炎（OA）之间的关系，以确定前者是后者的保护因素还是风险因素。本研究前瞻性地评估了爬楼梯、遗传易感性及其相互作用与髋/膝关节 OA 发病风险之间的关系。方法 该队列分析包括英国生物库中的 398,939 名参与者。通过问卷对爬楼梯情况进行评估。构建了由 70、83 和 87 个单核苷酸多态性组成的髋关节、膝关节和髋/膝关节 OA 遗传风险评分（GRS）。采用 Cox 比例危险回归模型估算爬楼梯、遗传易感性和髋关节和/或膝关节 OA 风险之间的危险比 (HR) 和 95% 置信区间 (CI)。结果 经过 3,621,735 人年的随访，31,940 名患者出现了 OA。爬楼梯与髋关节/膝关节（趋势P<0.001）和膝关节（趋势P<0.0001）OA的发生呈正相关，但与髋关节OA无关。经调整后，与不爬楼梯相比，每天爬>150步与髋/膝关节OA（HR，1.08；95% CI，1.03-1.12）和膝关节OA（HR，1.13；95% CI，1.06-1.20）的风险较高有关。虽然爬楼梯与 OA 风险 GRS 之间没有发现明显的交互作用，但上述关联仅在中高 GRS 参与者中具有显著性。结论 爬楼梯的频率越高，患膝关节OA的风险就越高，而患髋关节OA的风险就越低。
{"title":"Stair Climbing, Genetic Predisposition, and the Risk of Hip/Knee Osteoarthritis","authors":"Yingliang Wei, Tingjing Zhang, Haochen Wang, Jianbang Su, Minghao Yu, Yashu Liu, Lunhao Bai, Yang Xia","doi":"10.1093/gerona/glae223","DOIUrl":"https://doi.org/10.1093/gerona/glae223","url":null,"abstract":"Background Few studies have explored the association between stair climbing and osteoarthritis (OA) to determine whether the former is a protective or risk factor for the latter. This study prospectively evaluated the associations among stair climbing, genetic susceptibility, and their interaction with the risk of incident hip/knee OA. Methods The cohort analyses included 398,939 participants from the UK Biobank. Stair climbing was assessed using a questionnaire. Genetic risk scores (GRSs) consisting of 70, 83, and 87 single-nucleotide polymorphisms for hip, knee, and hip/knee OA were constructed. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations among stair climbing, genetic predisposition, and hip and/or knee OA risk. Results After 3,621,735 person-years of follow-up, 31,940 patients developed OA. Stair climbing was positively associated with incident hip/knee (P for trend&lt;0.001) and knee (P for trend&lt;0.0001) OA but not hip OA. After adjustments, compared with no stair climbing, climbing &gt;150 steps/day was associated with a higher risk of hip/knee OA (HR, 1.08; 95% CI, 1.03–1.12) and knee OA (HR, 1.13; 95% CI, 1.06–1.20). Although no significant interaction between stair climbing and the GRS of OA risk was found, the above associations were only significant in participants with middle and high GRSs. Conclusion A higher frequency of stair climbing was positively associated with the risk of knee OA but not hip OA, highlighting the importance of avoiding frequent stair climbing in preventing knee OA, especially in genetically predisposed individuals.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary Louise Pomeroy, Mfon Umoh, Yiqing Qian, Gilbert Gimm, Katherine A Ornstein, Thomas K M Cudjoe
Background Social isolation is a well-known risk factor for poor health outcomes, including incident dementia, yet its associations with outcomes among persons living with dementia is understudied. We examined the association between social isolation and hospitalization among a nationally representative sample of older adults with and without dementia. Methods This observational cohort study included 5,533 community-dwelling Medicare beneficiaries from the 2015 and 2016 National Health and Aging Trends Study (NHATS). Using multivariable logistic regression analyses, we examined associations between social isolation and hospitalization in the following year, examining differences by dementia status. Social isolation was measured using a 4-item typology. Dementia was identified using a pre-specified classification in NHATS. Results 20.7% of older adults were socially isolated. Social isolation was more prevalent among persons with dementia (35.4%) than among those without dementia (19.0%) (p < .001). Among persons with dementia, social isolation was associated with 1.68 greater odds of hospitalization (CI: 1.23‒2.28), translating into a 9% average increase in the predicted probability of hospitalization for persons with dementia who were socially isolated compared to those who were not (p = 0.001). In the combined sample that included persons with and without dementia, there was a significant moderation effect of dementia on the association between social isolation and hospitalization (OR: 1.70; CI: 1.19‒2.43). Conclusions For persons with dementia, social isolation is prevalent and associated with greater odds of subsequent hospitalization. Efforts to reduce acute healthcare utilization should explore ways to bolster social connection to improve health outcomes among persons with dementia.
{"title":"Social Isolation and Hospitalization in Community-dwelling Older Adults by Dementia Status","authors":"Mary Louise Pomeroy, Mfon Umoh, Yiqing Qian, Gilbert Gimm, Katherine A Ornstein, Thomas K M Cudjoe","doi":"10.1093/gerona/glae224","DOIUrl":"https://doi.org/10.1093/gerona/glae224","url":null,"abstract":"Background Social isolation is a well-known risk factor for poor health outcomes, including incident dementia, yet its associations with outcomes among persons living with dementia is understudied. We examined the association between social isolation and hospitalization among a nationally representative sample of older adults with and without dementia. Methods This observational cohort study included 5,533 community-dwelling Medicare beneficiaries from the 2015 and 2016 National Health and Aging Trends Study (NHATS). Using multivariable logistic regression analyses, we examined associations between social isolation and hospitalization in the following year, examining differences by dementia status. Social isolation was measured using a 4-item typology. Dementia was identified using a pre-specified classification in NHATS. Results 20.7% of older adults were socially isolated. Social isolation was more prevalent among persons with dementia (35.4%) than among those without dementia (19.0%) (p &lt; .001). Among persons with dementia, social isolation was associated with 1.68 greater odds of hospitalization (CI: 1.23‒2.28), translating into a 9% average increase in the predicted probability of hospitalization for persons with dementia who were socially isolated compared to those who were not (p = 0.001). In the combined sample that included persons with and without dementia, there was a significant moderation effect of dementia on the association between social isolation and hospitalization (OR: 1.70; CI: 1.19‒2.43). Conclusions For persons with dementia, social isolation is prevalent and associated with greater odds of subsequent hospitalization. Efforts to reduce acute healthcare utilization should explore ways to bolster social connection to improve health outcomes among persons with dementia.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing Sun, Grace L Ditzenberger, Todd T Brown, Susan Langan, Hsing-Yu Hsu, Derek Ng, Frank J Palella, Jordan E Lake, Lawrence A Kingsley, Susan L Koletar, Wendy Post, Kristine M Erlandson
Background People with HIV (PWH) experience faster physical decline than those without HIV (PWoH), despite antiretroviral therapy. We compared skeletal muscle density and area and their relationship with physical function among PWH and PWoH. Methods Quantitative computed tomography (CT) scans were performed at the L4-L5 spinal region and the thigh to evaluate muscle groups in Multicenter AIDS Cohort (MACS) participants at baseline. Using exploratory factor analysis, we summarized aggregated muscle measures based on factor loadings. Longitudinal associations between muscle area and density with gait speed and grip strength were examined using multivariable linear regression models with generalized estimating equations, adjusting for demographics, HIV serostatus, and other health metrics. Results We included 798 men (61% of PWH). The median age was 54 years (IQR: 49-59), 61% were White, 32% Black, and 10% Hispanic. Among them, 22% had a BMI over 30 kg/m2, and 14% had diabetes. Two factors emerged from the factor analysis explaining 55.9% of variance. Factor 1 (explained 32.5% of variance) encompassed all density measures. Factor 2 (explained 23.4% of variance) encompassed all area measures. Associations between muscle density and gait speed were more pronounced with aggregated measures than with individual ones. Specifically, each unit increase in overall muscle density correlated with a 0.028 meter/second increase in gait speed (95% confidence interval [CI]: 0.017, 0.038, p<0.01). Grip strength was associated with aggregated measures of both muscle density and area, with overall muscle density associated with a 1.88 kg increase in grip strength (95% CI: 1.29, 2.46, p<0.01), and overall muscle area with a 1.60 kg increase (95% CI: 1.02, 2.19, p<0.01). Conclusions Aggregated muscle density and area measurements were significantly associated with physical function. These correlations underscore the importance of interventions to enhance skeletal muscle to improve healthy aging for PWH and PWoH.
{"title":"Muscle Quality And Physical Function In Men With And Without Hiv","authors":"Jing Sun, Grace L Ditzenberger, Todd T Brown, Susan Langan, Hsing-Yu Hsu, Derek Ng, Frank J Palella, Jordan E Lake, Lawrence A Kingsley, Susan L Koletar, Wendy Post, Kristine M Erlandson","doi":"10.1093/gerona/glae229","DOIUrl":"https://doi.org/10.1093/gerona/glae229","url":null,"abstract":"Background People with HIV (PWH) experience faster physical decline than those without HIV (PWoH), despite antiretroviral therapy. We compared skeletal muscle density and area and their relationship with physical function among PWH and PWoH. Methods Quantitative computed tomography (CT) scans were performed at the L4-L5 spinal region and the thigh to evaluate muscle groups in Multicenter AIDS Cohort (MACS) participants at baseline. Using exploratory factor analysis, we summarized aggregated muscle measures based on factor loadings. Longitudinal associations between muscle area and density with gait speed and grip strength were examined using multivariable linear regression models with generalized estimating equations, adjusting for demographics, HIV serostatus, and other health metrics. Results We included 798 men (61% of PWH). The median age was 54 years (IQR: 49-59), 61% were White, 32% Black, and 10% Hispanic. Among them, 22% had a BMI over 30 kg/m2, and 14% had diabetes. Two factors emerged from the factor analysis explaining 55.9% of variance. Factor 1 (explained 32.5% of variance) encompassed all density measures. Factor 2 (explained 23.4% of variance) encompassed all area measures. Associations between muscle density and gait speed were more pronounced with aggregated measures than with individual ones. Specifically, each unit increase in overall muscle density correlated with a 0.028 meter/second increase in gait speed (95% confidence interval [CI]: 0.017, 0.038, p&lt;0.01). Grip strength was associated with aggregated measures of both muscle density and area, with overall muscle density associated with a 1.88 kg increase in grip strength (95% CI: 1.29, 2.46, p&lt;0.01), and overall muscle area with a 1.60 kg increase (95% CI: 1.02, 2.19, p&lt;0.01). Conclusions Aggregated muscle density and area measurements were significantly associated with physical function. These correlations underscore the importance of interventions to enhance skeletal muscle to improve healthy aging for PWH and PWoH.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142236865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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