<p>I have read with great interest the Xiao et al. study examining retrospectively the incidence of falls and related factors in outpatient and inpatient elderly sample (<i>n</i> = 451) aged 65 years and above.<span><sup>1</sup></span> Key factors considered in the study were pain and other comorbidities, such as frailty and osteoarthritis.<span><sup>1</sup></span> Although the findings have great merits and add to the body of literature, there are some limitations that should have been addressed or reported in the study.</p><p>Whereas Xiao et al. data indicate that the association between pain and fall is not statistically significant, this finding was not explicitly presented in the article. More importantly, it is astounding that the study found pain had no impact on the incidence of falls, despite the clear link between pain and falls in older adults in the literature. For example, a 2014 systematic review and meta-analysis by Stubbs et al.<span><sup>2</sup></span> found that pain was associated with a higher risk of falls, where half (50.5%) of older adults with pain reported at least one fall over a 12-month period. A more recent systematic review found that multisite pain is associated with an increased risk of future falls risk in community-dwelling older people.<span><sup>3</sup></span> Further, it is well recognized that chronic pain is highly prevalent and disabling in older adults with and without dementia, but it is often an underestimated clinical problem in this population.<span><sup>4</sup></span> Given that the data in the Xiao et al. study did not involve the pathological state of “chronic pain,” and the latter differs from the concept of pain within 4 weeks, the authors cannot be assertive in concluding that pain had no impact on the incidence of falls. Clearly, the status, duration, and type of pain (e.g., acute nociceptive pain vs. persistent pain) may have influenced these findings and, therefore, the definition of pain should have been further clarified or operationalized in the Xiao et al. study. Moreover, the limitations of the study should have been mentioned that the findings were only applicable to this operational definition of pain.</p><p>The sample in the Xiao et al. study included older adults with mild and moderate dementia, whose pain reporting in some may be unreliable or inadequate. Further, the Mini-Mental State Examination instrument was listed in the methodology, but cognition scores were not reported for the sample. Thus, how did the authors ascertain intact cognition and communication skills in the sample? That is, how was the self-reporting capacity of the sample confirmed? If not, why was this not reported in the limitations?</p><p>Given that no difference in pain was detected between the fall and nonfall groups by the digital pain drawings instrument and this instrument was not validated in people with dementia, these issues raise the question whether the instrument was sensitive enough to detect any di
{"title":"Pain is underestimated in older adults with risk of falls","authors":"Mustafa Atee","doi":"10.1002/agm2.12283","DOIUrl":"https://doi.org/10.1002/agm2.12283","url":null,"abstract":"<p>I have read with great interest the Xiao et al. study examining retrospectively the incidence of falls and related factors in outpatient and inpatient elderly sample (<i>n</i> = 451) aged 65 years and above.<span><sup>1</sup></span> Key factors considered in the study were pain and other comorbidities, such as frailty and osteoarthritis.<span><sup>1</sup></span> Although the findings have great merits and add to the body of literature, there are some limitations that should have been addressed or reported in the study.</p><p>Whereas Xiao et al. data indicate that the association between pain and fall is not statistically significant, this finding was not explicitly presented in the article. More importantly, it is astounding that the study found pain had no impact on the incidence of falls, despite the clear link between pain and falls in older adults in the literature. For example, a 2014 systematic review and meta-analysis by Stubbs et al.<span><sup>2</sup></span> found that pain was associated with a higher risk of falls, where half (50.5%) of older adults with pain reported at least one fall over a 12-month period. A more recent systematic review found that multisite pain is associated with an increased risk of future falls risk in community-dwelling older people.<span><sup>3</sup></span> Further, it is well recognized that chronic pain is highly prevalent and disabling in older adults with and without dementia, but it is often an underestimated clinical problem in this population.<span><sup>4</sup></span> Given that the data in the Xiao et al. study did not involve the pathological state of “chronic pain,” and the latter differs from the concept of pain within 4 weeks, the authors cannot be assertive in concluding that pain had no impact on the incidence of falls. Clearly, the status, duration, and type of pain (e.g., acute nociceptive pain vs. persistent pain) may have influenced these findings and, therefore, the definition of pain should have been further clarified or operationalized in the Xiao et al. study. Moreover, the limitations of the study should have been mentioned that the findings were only applicable to this operational definition of pain.</p><p>The sample in the Xiao et al. study included older adults with mild and moderate dementia, whose pain reporting in some may be unreliable or inadequate. Further, the Mini-Mental State Examination instrument was listed in the methodology, but cognition scores were not reported for the sample. Thus, how did the authors ascertain intact cognition and communication skills in the sample? That is, how was the self-reporting capacity of the sample confirmed? If not, why was this not reported in the limitations?</p><p>Given that no difference in pain was detected between the fall and nonfall groups by the digital pain drawings instrument and this instrument was not validated in people with dementia, these issues raise the question whether the instrument was sensitive enough to detect any di","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 1","pages":"136-137"},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140340268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to describe temporal trends of thyroid cancer (ThC) from 2010 to 2019, in Asian countries by geographical region and sociodemographic index, compared with global data.Annual case data and age‐standardized rates (ASRs) of epidemiological indicators of ThC cancer data were collected from the 2019 Global Burden of Disease (GBD) study from 2010 to 2019 in 49 countries and territories in Asia. The relative difference (%) between years was used to show comparative variations of ASRs for the indicators studied. The female/male ratio was calculated by dividing female ASRs by male ASRs. Also, these rates were compared between the age group ≥70 years old and younger age groups.In 2019, more than 50% of ThC cases and deaths occurred in Asian countries. A total of 53% of ThC patients lived in Asia and more than 60% of the global burden of ThC was imposed on Asian countries. From 2010 to 2019, incidences, deaths, prevalence cases, and DALYs number of ThC cancer increased over 1.28‐, 1.26‐, 1.3‐, and 1.2‐fold, in Asia, respectively. During this period, the age‐standardized incidence rate (ASIR) and the age‐standardized prevalence rate (ASPR) of ThC cancer increased by 5% and 8%, respectively, while the age‐standardized death rate (ASDR) and the age‐standardized DALYs rate (DALYs ASR) of ThC cancer decreased by 6% and 4%, respectively. These trends are different from what happens in other continents. In 2019, age‐specific incidence, death, prevalence, and DALY cases of ThC cancer were peaking at 50–54, 75–79, 50–54, and 55–59 years, respectively. In 2019, the highest ASIR and ASPR of ThC cancer was observed in high‐income Asia Pacific countries and the highest ASDR and DALYs ASR in Southeast Asia countries. Only high‐income Asia Pacific countries experienced a decreasing trend in ASIR and ASPR from 2010 to 2019. ASDR and DALYs ASR have the highest decreasing trend in high‐income Asia Pacific. In 2019, among high SDI Asian countries, the Republic of Korea had the highest ASIR and ASPR, and Brunei Darussalam had the highest ASDR and DALYs ASR. The highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer was found in Lebanon and Malaysia (high‐middle SDIs), Vietnam (middle SDIs), and Cambodia and Palestine (low‐middle SDIs). Among low SDI Asian countries, Pakistan had the highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer. All indicators for most countries were higher in women than men.More than half of the burden of thyroid cancer is imposed on the residents of the Asian continent. Although the incidence and prevalence of this cancer in Asian countries is lower than that of the world, America, and Europe, the highest rate of death from thyroid cancer occurs in Asia and they witness the highest burden of the disease. Therefore, it seems that implementing early detection strategies and increasing access to treatment facilities in Asia is one of the necessities of thyroid cancer control in its residents.
本研究旨在描述2010年至2019年亚洲各国甲状腺癌（ThC）按地理区域和社会人口指数划分的时间趋势，并与全球数据进行比较。从2019年全球疾病负担（GBD）研究中收集了2010年至2019年亚洲49个国家和地区甲状腺癌流行病学指标的年度病例数据和年龄标准化率（ASRs）。不同年份之间的相对差异（%）用于显示所研究指标的 ASRs 比较变化。女性/男性比率是用女性 ASR 除以男性 ASR 计算得出的。此外，还比较了≥70岁年龄组和更年轻年龄组之间的这些比率。2019年，50%以上的肺结核病例和死亡病例发生在亚洲国家。共有53%的肺结核患者生活在亚洲，全球60%以上的肺结核负担由亚洲国家承担。从 2010 年到 2019 年，亚洲的 ThC 癌症发病率、死亡人数、流行病例数和残疾调整生命年数分别增长了 1.28 倍、1.26 倍、1.3 倍和 1.2 倍。在此期间，THC 癌的年龄标准化发病率（ASIR）和年龄标准化患病率（ASPR）分别上升了 5%和 8%，而年龄标准化死亡率（ASDR）和年龄标准化残疾调整寿命年数（DALYs ASR）则分别下降了 6%和 4%。这些趋势与其他大洲的情况不同。2019年，特定年龄的肺癌发病率、死亡率、患病率和残疾调整寿命率分别在50-54岁、75-79岁、50-54岁和55-59岁达到峰值。2019 年，高收入亚太国家的 ThC 癌症 ASIR 和 ASPR 最高，东南亚国家的 ASDR 和 DALYs ASR 最高。从 2010 年到 2019 年，只有高收入亚太国家的 ASIR 和 ASPR 呈下降趋势。亚太地区高收入国家的 ASDR 和 DALYs ASR 下降趋势最高。2019 年，在 SDI 高的亚洲国家中，大韩民国的 ASIR 和 ASPR 最高，文莱达鲁萨兰国的 ASDR 和 DALYs ASR 最高。黎巴嫩和马来西亚（中高 SDIs）、越南（中 SDIs）以及柬埔寨和巴勒斯坦（中低 SDIs）的肺癌 ASIR、ASDR、ASPR 和 DALYs ASR 最高。在 SDI 较低的亚洲国家中，巴基斯坦的肺癌 ASIR、ASDR、ASPR 和 DALY ASR 最高。大多数国家的所有指标都是女性高于男性。虽然亚洲国家的甲状腺癌发病率和流行率低于世界、美洲和欧洲，但亚洲的甲状腺癌死亡率最高，疾病负担也最重。由此看来，在亚洲实施早期检测策略并增加治疗设施的可及性，是亚洲居民控制甲状腺癌的必要条件之一。
{"title":"Temporal trends of thyroid cancer between 2010 and 2019 in Asian countries by geographical region and SDI, comparison with global data","authors":"Fatemeh Rezaei, Afrooz Mazidimoradi, Zahra Pasokh, Seyed Parsa Dehghani, L. Allahqoli, Hamid Salehiniya","doi":"10.1002/agm2.12277","DOIUrl":"https://doi.org/10.1002/agm2.12277","url":null,"abstract":"This study aims to describe temporal trends of thyroid cancer (ThC) from 2010 to 2019, in Asian countries by geographical region and sociodemographic index, compared with global data.Annual case data and age‐standardized rates (ASRs) of epidemiological indicators of ThC cancer data were collected from the 2019 Global Burden of Disease (GBD) study from 2010 to 2019 in 49 countries and territories in Asia. The relative difference (%) between years was used to show comparative variations of ASRs for the indicators studied. The female/male ratio was calculated by dividing female ASRs by male ASRs. Also, these rates were compared between the age group ≥70 years old and younger age groups.In 2019, more than 50% of ThC cases and deaths occurred in Asian countries. A total of 53% of ThC patients lived in Asia and more than 60% of the global burden of ThC was imposed on Asian countries. From 2010 to 2019, incidences, deaths, prevalence cases, and DALYs number of ThC cancer increased over 1.28‐, 1.26‐, 1.3‐, and 1.2‐fold, in Asia, respectively. During this period, the age‐standardized incidence rate (ASIR) and the age‐standardized prevalence rate (ASPR) of ThC cancer increased by 5% and 8%, respectively, while the age‐standardized death rate (ASDR) and the age‐standardized DALYs rate (DALYs ASR) of ThC cancer decreased by 6% and 4%, respectively. These trends are different from what happens in other continents. In 2019, age‐specific incidence, death, prevalence, and DALY cases of ThC cancer were peaking at 50–54, 75–79, 50–54, and 55–59 years, respectively. In 2019, the highest ASIR and ASPR of ThC cancer was observed in high‐income Asia Pacific countries and the highest ASDR and DALYs ASR in Southeast Asia countries. Only high‐income Asia Pacific countries experienced a decreasing trend in ASIR and ASPR from 2010 to 2019. ASDR and DALYs ASR have the highest decreasing trend in high‐income Asia Pacific. In 2019, among high SDI Asian countries, the Republic of Korea had the highest ASIR and ASPR, and Brunei Darussalam had the highest ASDR and DALYs ASR. The highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer was found in Lebanon and Malaysia (high‐middle SDIs), Vietnam (middle SDIs), and Cambodia and Palestine (low‐middle SDIs). Among low SDI Asian countries, Pakistan had the highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer. All indicators for most countries were higher in women than men.More than half of the burden of thyroid cancer is imposed on the residents of the Asian continent. Although the incidence and prevalence of this cancer in Asian countries is lower than that of the world, America, and Europe, the highest rate of death from thyroid cancer occurs in Asia and they witness the highest burden of the disease. Therefore, it seems that implementing early detection strategies and increasing access to treatment facilities in Asia is one of the necessities of thyroid cancer control in its residents.","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"5 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139440000","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}
{"title":"Geriatric frailty determinants in India","authors":"Jorge Luis Passarelli, Hanadi Al Hamad","doi":"10.1002/agm2.12275","DOIUrl":"https://doi.org/10.1002/agm2.12275","url":null,"abstract":"","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"6 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139438843","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}
Cell growth involves cell division. This stops after reaching a certain limit. Some cells become inactive and unable to undergo apoptosis (programmed cell death). These cells accumulate at sites of tissue damage or disease, thus accelerating aging. They are called senescent cells. Therapeutic interventions that can either eliminate senescent cells (senolytics) or suppress their harmful effects (senomorphics) have been developed. Senescence (aging) is caused by the inter‐ and intramolecular interactions between the domains of forkhead (FHD) and transactivation (TAD), as well as C‐terminal region 3 (CR3) and DNA binding (DBD). On the other hand, anti‐senescent/senolytic (anti‐aging) activities are achieved by disrupting these interactions with CR3‐ and forkhead box protein O4 (FOXO4)‐based peptides, such as ES2 and DRI, respectively. In this study, we use a computerized procedure based on digital signal processing to systematically analyze the inter‐molecular interactions between senolytics and their targets.Informational spectrum method (ISM) is engaged.We obtained the sequences of the peptides from the interacting proteins of CR3 and FOXO4 and evaluated their ability to disrupt the inter‐molecular interactions between FOXO4 and DRI and CR3 and BDB, which are responsible for senescence (aging). Our results show that the peptides have different degrees of senolytic (anti‐aging) activity, depending on their affinity for CR3 and BDB, or FOXO4 and DRI. We found that enhanced senescence 2 (ES2) has a higher affinity for CR3 and BDB than FOXO4 and DRI, and that the interaction between CR3 and BDB is crucial for aging. Therefore, ES2 and other CR3‐based peptides are more potent senolytics than FOXO4‐based peptides. Our findings are consistent with previous studies and reveal new insights into the mechanisms of senescence and senolytics. ES2 is considered the best senolytic candidate, as it is 3–7 times more effective than DRI. We verified that ES2 has a weaker interaction with FOXO4 than CR3. However, the performance of DRI has been noted to depend on its intramolecular interactions and stability. Hence, intramolecular analyses using the digital signal processing‐based technique has become very vital and will follow.CR3‐based peptides are promising candidates for senolytic therapy. Senolytics are linear chains of amino acids that can target and eliminate senescent cells, which are cells that have stopped dividing and contribute to aging and age‐related diseases. By using this proposed, novel computerized technique that is based on digital signal processing, senolytics can be easily analyzed and optimized for their effectiveness and safety. This provides a more rational approach to enhancing our longevity and well‐being by offering interventions that can delay or reverse aging and insights that can advance the field of gerontology. This procedure also will compliment other approaches such as molecular stimulation, etc.
{"title":"Bioinformatics procedure for investigating senolytic (anti‐aging) agents: A digital signal processing technique","authors":"Norbert Nwankwo, Ignatius Okafor","doi":"10.1002/agm2.12274","DOIUrl":"https://doi.org/10.1002/agm2.12274","url":null,"abstract":"Cell growth involves cell division. This stops after reaching a certain limit. Some cells become inactive and unable to undergo apoptosis (programmed cell death). These cells accumulate at sites of tissue damage or disease, thus accelerating aging. They are called senescent cells. Therapeutic interventions that can either eliminate senescent cells (senolytics) or suppress their harmful effects (senomorphics) have been developed. Senescence (aging) is caused by the inter‐ and intramolecular interactions between the domains of forkhead (FHD) and transactivation (TAD), as well as C‐terminal region 3 (CR3) and DNA binding (DBD). On the other hand, anti‐senescent/senolytic (anti‐aging) activities are achieved by disrupting these interactions with CR3‐ and forkhead box protein O4 (FOXO4)‐based peptides, such as ES2 and DRI, respectively. In this study, we use a computerized procedure based on digital signal processing to systematically analyze the inter‐molecular interactions between senolytics and their targets.Informational spectrum method (ISM) is engaged.We obtained the sequences of the peptides from the interacting proteins of CR3 and FOXO4 and evaluated their ability to disrupt the inter‐molecular interactions between FOXO4 and DRI and CR3 and BDB, which are responsible for senescence (aging). Our results show that the peptides have different degrees of senolytic (anti‐aging) activity, depending on their affinity for CR3 and BDB, or FOXO4 and DRI. We found that enhanced senescence 2 (ES2) has a higher affinity for CR3 and BDB than FOXO4 and DRI, and that the interaction between CR3 and BDB is crucial for aging. Therefore, ES2 and other CR3‐based peptides are more potent senolytics than FOXO4‐based peptides. Our findings are consistent with previous studies and reveal new insights into the mechanisms of senescence and senolytics. ES2 is considered the best senolytic candidate, as it is 3–7 times more effective than DRI. We verified that ES2 has a weaker interaction with FOXO4 than CR3. However, the performance of DRI has been noted to depend on its intramolecular interactions and stability. Hence, intramolecular analyses using the digital signal processing‐based technique has become very vital and will follow.CR3‐based peptides are promising candidates for senolytic therapy. Senolytics are linear chains of amino acids that can target and eliminate senescent cells, which are cells that have stopped dividing and contribute to aging and age‐related diseases. By using this proposed, novel computerized technique that is based on digital signal processing, senolytics can be easily analyzed and optimized for their effectiveness and safety. This provides a more rational approach to enhancing our longevity and well‐being by offering interventions that can delay or reverse aging and insights that can advance the field of gerontology. This procedure also will compliment other approaches such as molecular stimulation, etc.","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"54 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139447567","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}
Laura Carrick, Brett Doleman, Joshua Wall, Amanda Gates, Jon N. Lund, John P. Williams, Bethan E. Phillips
<div> <section> <h3> Objectives</h3> <p>Cardiorespiratory fitness (CRF) declines with advancing and has also, independent of age, been shown to be predictive of all-cause mortality, morbidity, and poor clinical outcomes. In relation to the older patient, there is a particular wealth of evidence highlighting the relationship between low CRF and poor surgical outcomes. Cardiopulmonary exercise testing (CPET) is accepted as the gold-standard measure of CRF. However, this form of assessment has significant personnel and equipment demands and is not feasible for those with certain age-associated physical limitations, including joint and cardiovascular comorbidities. As such, alternative ways to assess the CRF of older patients are very much needed.</p> </section> <section> <h3> Methods</h3> <p>Sixty-four participants (45% female) with a median age of 74 (65–90) years were recruited to this study via community-based advertisements. All participants completed three tests of physical function: (1) a step-box test; (2) handgrip strength dynamometry; and (3) a CPET on a cycle ergometer; and also had their muscle architecture (vastus lateralis) assessed by B-mode ultrasonography to provide measures of muscle thickness, pennation angle, and fascicle length. Multivariate linear regression was then used to ascertain bedside predictors of CPET parameters from the alternative measures of physical function and demographic (age, gender, body mass index (BMI)) data.</p> </section> <section> <h3> Results</h3> <p>There was no significant association between ultrasound-assessed parameters of muscle architecture and measures of CRF. VO<sub>2peak</sub> was predicted to some extent from fast step time during the step-box test, gender, and BMI, leading to a model that achieved an <i>R</i><sup>2</sup> of 0.40 (<i>p</i> < 0.001). Further, in aiming to develop a model with minimal assessment demands (i.e., using handgrip dynamometry rather than the step-box test), replacing fast step time with non-dominant HGS led to a model which achieved an <i>R</i><sup>2</sup> of 0.36 (<i>p</i> < 0.001). Non-dominant handgrip strength combined with the step-box test parameter of fast step time and BMI delivered the most predictive model for VO<sub>2peak</sub> with an <i>R</i><sup>2</sup> of 0.45 (<i>p</i> < 0.001).</p> </section> <section> <h3> Conclusions</h3> <p>Our findings show that simple-to-ascertain patient characteristics and bedside assessments of physical function are able to predict CPET-derived CRF. Combined with gender and BMI, both handgrip strength and fast step time
{"title":"Exploring the utility of bedside tests for predicting cardiorespiratory fitness in older adults","authors":"Laura Carrick, Brett Doleman, Joshua Wall, Amanda Gates, Jon N. Lund, John P. Williams, Bethan E. Phillips","doi":"10.1002/agm2.12280","DOIUrl":"https://doi.org/10.1002/agm2.12280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cardiorespiratory fitness (CRF) declines with advancing and has also, independent of age, been shown to be predictive of all-cause mortality, morbidity, and poor clinical outcomes. In relation to the older patient, there is a particular wealth of evidence highlighting the relationship between low CRF and poor surgical outcomes. Cardiopulmonary exercise testing (CPET) is accepted as the gold-standard measure of CRF. However, this form of assessment has significant personnel and equipment demands and is not feasible for those with certain age-associated physical limitations, including joint and cardiovascular comorbidities. As such, alternative ways to assess the CRF of older patients are very much needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-four participants (45% female) with a median age of 74 (65–90) years were recruited to this study via community-based advertisements. All participants completed three tests of physical function: (1) a step-box test; (2) handgrip strength dynamometry; and (3) a CPET on a cycle ergometer; and also had their muscle architecture (vastus lateralis) assessed by B-mode ultrasonography to provide measures of muscle thickness, pennation angle, and fascicle length. Multivariate linear regression was then used to ascertain bedside predictors of CPET parameters from the alternative measures of physical function and demographic (age, gender, body mass index (BMI)) data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no significant association between ultrasound-assessed parameters of muscle architecture and measures of CRF. VO<sub>2peak</sub> was predicted to some extent from fast step time during the step-box test, gender, and BMI, leading to a model that achieved an <i>R</i><sup>2</sup> of 0.40 (<i>p</i> < 0.001). Further, in aiming to develop a model with minimal assessment demands (i.e., using handgrip dynamometry rather than the step-box test), replacing fast step time with non-dominant HGS led to a model which achieved an <i>R</i><sup>2</sup> of 0.36 (<i>p</i> < 0.001). Non-dominant handgrip strength combined with the step-box test parameter of fast step time and BMI delivered the most predictive model for VO<sub>2peak</sub> with an <i>R</i><sup>2</sup> of 0.45 (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings show that simple-to-ascertain patient characteristics and bedside assessments of physical function are able to predict CPET-derived CRF. Combined with gender and BMI, both handgrip strength and fast step time","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 1","pages":"60-66"},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140340507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Xie, Kiran Kancherla, Sashiruben Chandramohan, N. Braidy, E. K. W. Chan, Ying‐Hua Xu, Daniel K. Y. Chan
It is now recognized that blood brain barrier (BBB) leakage occurs in cerebral small vascular disease (CSVD) and plays a significant role in the pathophysiology of vascular dementia. We hypothesized that genetic polymorphisms of junctional adhesion molecule‐A (JAM‐A) (which may result in compromised structure of tight junction proteins that form the BBB) in combination with cerebrovascular risk factors hypertension, lipid disorders, and type 2 diabetes may result in BBB leakage and increase the individual's risk of CSVD‐related dementia.In this case–control study, 97 controls with a mean Mini‐Mental State Exam (MMSE) score of 29 and 38 CSVD‐related vascular dementia participants (mean MMSE score of 19) were recruited. Bloods were collected for the analysis of two common single nucleotide polymorphisms (SNPs) of the JAM‐A genotypes rs790056 and rs2481084 using real‐time polymerase chain reaction (PCR) assay. Medical history of hypertension, hyperlipidemia, and diabetes was collected for all participants.Polymorphisms of genotype JAM‐A SNP rs790056 showed statistically significant result when the subgroup with hyperlipidemia was analyzed (OR = 3.130, p = 0.042 for TC + CC genotypes with hyperlipidaemia vs controls). Similar result was found with diabetes (OR = 4.670, p = 0.031 for TC + CC genotypes vs controls). No significant result was found with hypertension. Borderline results of statistical significance were found for JAM‐A SNP rs2481084 with hyperlipidemia (OR = 3.210, p = 0.054 for TC + CC genotypes vs controls) and with diabetes (OR = 3.620, p = 0.069 for TC + CC genotypes vs controls) but not for hypertension. The borderline results might have been due to lack of statistical power because of small sample size.These results lend further support that cerebrovascular risk factors interact with genetic polymorphisms of BBB proteins to increase the risk of vascular dementia.
{"title":"Involvement of single nucleotide polymorphisms of junction adhesion molecule with small vessel vascular dementia","authors":"Peter Xie, Kiran Kancherla, Sashiruben Chandramohan, N. Braidy, E. K. W. Chan, Ying‐Hua Xu, Daniel K. Y. Chan","doi":"10.1002/agm2.12278","DOIUrl":"https://doi.org/10.1002/agm2.12278","url":null,"abstract":"It is now recognized that blood brain barrier (BBB) leakage occurs in cerebral small vascular disease (CSVD) and plays a significant role in the pathophysiology of vascular dementia. We hypothesized that genetic polymorphisms of junctional adhesion molecule‐A (JAM‐A) (which may result in compromised structure of tight junction proteins that form the BBB) in combination with cerebrovascular risk factors hypertension, lipid disorders, and type 2 diabetes may result in BBB leakage and increase the individual's risk of CSVD‐related dementia.In this case–control study, 97 controls with a mean Mini‐Mental State Exam (MMSE) score of 29 and 38 CSVD‐related vascular dementia participants (mean MMSE score of 19) were recruited. Bloods were collected for the analysis of two common single nucleotide polymorphisms (SNPs) of the JAM‐A genotypes rs790056 and rs2481084 using real‐time polymerase chain reaction (PCR) assay. Medical history of hypertension, hyperlipidemia, and diabetes was collected for all participants.Polymorphisms of genotype JAM‐A SNP rs790056 showed statistically significant result when the subgroup with hyperlipidemia was analyzed (OR = 3.130, p = 0.042 for TC + CC genotypes with hyperlipidaemia vs controls). Similar result was found with diabetes (OR = 4.670, p = 0.031 for TC + CC genotypes vs controls). No significant result was found with hypertension. Borderline results of statistical significance were found for JAM‐A SNP rs2481084 with hyperlipidemia (OR = 3.210, p = 0.054 for TC + CC genotypes vs controls) and with diabetes (OR = 3.620, p = 0.069 for TC + CC genotypes vs controls) but not for hypertension. The borderline results might have been due to lack of statistical power because of small sample size.These results lend further support that cerebrovascular risk factors interact with genetic polymorphisms of BBB proteins to increase the risk of vascular dementia.","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"300 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160758","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}
Increased depression severity has been linked to cognitive impairment (CI). Importantly, CI is a known risk factor for impaired balance and falls. Therefore, this study aims to explore the relationship between CI and neuromuscular functions and secondarily it aims to find out if CI is a potential predictor for neuromuscular functions deficits in depressed elderly.Eighty‐four depressed elderly participated in the study. Assessment for CI symptoms were done using Mini Mental Status Examination (MMSE) in subjects having confirmed depression. Neuromuscular functions such as balance confidence, static and dynamic balance, functional mobility, and fall risk were subjectively assessed using Activities‐specific Balance Confidence (ABC) Scale, Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, and Performance Oriented Mobility Assessment (POMA), respectively.Pearson's analysis revealed that there was moderate positive linear‐correlation between MMSE and BBS (R = 0.382, p = <0.001) and between MMSE and ABC (R = 0.229, p = 0.036*). Further, regression analysis (R2) revealed that MMSE significantly predicted the neuromuscular functions using BBS [F(1, 82) = 14.013, p < 0.001, with an R2 of 0.146] and ABC [F(1, 82) = 4.545, p= 0.036*, with an R2 of 0.053].Results of this study points to an impaired CI as a possible factor in development of neuromuscular function impairment in depressed elderly.
抑郁症严重程度的增加与认知障碍（CI）有关。重要的是，CI 是导致平衡受损和跌倒的已知风险因素。因此，本研究旨在探讨 CI 与神经肌肉功能之间的关系，其次还旨在了解 CI 是否是抑郁老人神经肌肉功能缺陷的潜在预测因素。84 名抑郁症老人参加了这项研究，研究人员使用迷你精神状态检查（MMSE）对确诊抑郁症的受试者进行了 CI 症状评估。皮尔逊分析显示，MMSE与BBS（R = 0.382，P = <0.001）、MMSE与ABC（R = 0.229，P = 0.036*）之间存在中度正线性相关。此外，回归分析（R2）显示，MMSE能显著预测BBS[F（1，82）=14.013，p＜0.001，R2为0.146]和ABC[F（1，82）=4.545，p= 0.036*，R2为0.053]的神经肌肉功能。
{"title":"Association of impaired cognitive function with balance confidence, static balance, dynamic balance, functional mobility, and risk of falls in older adults with depression","authors":"Zainab Khan, A. Saif, Neera Chaudhry, A. Parveen","doi":"10.1002/agm2.12276","DOIUrl":"https://doi.org/10.1002/agm2.12276","url":null,"abstract":"Increased depression severity has been linked to cognitive impairment (CI). Importantly, CI is a known risk factor for impaired balance and falls. Therefore, this study aims to explore the relationship between CI and neuromuscular functions and secondarily it aims to find out if CI is a potential predictor for neuromuscular functions deficits in depressed elderly.Eighty‐four depressed elderly participated in the study. Assessment for CI symptoms were done using Mini Mental Status Examination (MMSE) in subjects having confirmed depression. Neuromuscular functions such as balance confidence, static and dynamic balance, functional mobility, and fall risk were subjectively assessed using Activities‐specific Balance Confidence (ABC) Scale, Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, and Performance Oriented Mobility Assessment (POMA), respectively.Pearson's analysis revealed that there was moderate positive linear‐correlation between MMSE and BBS (R = 0.382, p = <0.001) and between MMSE and ABC (R = 0.229, p = 0.036*). Further, regression analysis (R2) revealed that MMSE significantly predicted the neuromuscular functions using BBS [F(1, 82) = 14.013, p < 0.001, with an R2 of 0.146] and ABC [F(1, 82) = 4.545, p= 0.036*, with an R2 of 0.053].Results of this study points to an impaired CI as a possible factor in development of neuromuscular function impairment in depressed elderly.","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"116 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138959712","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}
Yijiong Yang, Stacy A. Drake, Jing Wang, Gordon C. Shen, Hongyu Miao, Robert O. Morgan, Xianglin L. Du, David R. Lairson
Introduction
Addressing femoral neck fractures resulting from ground-level falls in older adults with Alzheimer's disease (AD) involves a personalized treatment plan. There is considerable ongoing debate concerning the relative advantages and disadvantages of surgical treatment (internal fixation or arthroplasty) vs nonoperative treatment for femoral neck fractures in older persons with AD.
Methods
This retrospective cohort study compared the mortality, hazard ratio, and survival rate between operative and nonoperative treatments, controlling for patients' demographic information and baseline health status. The study population consisted of Optum beneficiaries diagnosed with AD who experienced an initial femoral neck fracture claim between January 1, 2012, and December 31, 2017. Kaplan–Meier survival curves were applied to compare the treatment groups' post-fracture survival rates and mortality. Cox regression was used to examine the survival period by controlling the covariates.
Results
Out of the 4157 patients with AD with femoral neck fractures, 59.8% were women (n = 2487). The median age was 81 years. The 1-year survival rate for nonoperative treatment (70.19%) was lower than that for internal fixation (75.27%) and arthroplasty treatment (82.32%). Compared with the nonoperative group, arthroplasty surgical treatment had significant lower hazard risk of death (arthroplasty hazard ratio: 0.850, 95% CI: 0.728–0.991, P < 0.05).
Discussion
The findings suggest that the operative treatment group experiences higher survival rates and lower mortality rates than the nonoperative group. This paper provides insights into treatment outcomes of older adults with AD receiving medical care for femoral neck fractures.
{"title":"Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study","authors":"Yijiong Yang, Stacy A. Drake, Jing Wang, Gordon C. Shen, Hongyu Miao, Robert O. Morgan, Xianglin L. Du, David R. Lairson","doi":"10.1002/agm2.12279","DOIUrl":"10.1002/agm2.12279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Addressing femoral neck fractures resulting from ground-level falls in older adults with Alzheimer's disease (AD) involves a personalized treatment plan. There is considerable ongoing debate concerning the relative advantages and disadvantages of surgical treatment (internal fixation or arthroplasty) vs nonoperative treatment for femoral neck fractures in older persons with AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study compared the mortality, hazard ratio, and survival rate between operative and nonoperative treatments, controlling for patients' demographic information and baseline health status. The study population consisted of Optum beneficiaries diagnosed with AD who experienced an initial femoral neck fracture claim between January 1, 2012, and December 31, 2017. Kaplan–Meier survival curves were applied to compare the treatment groups' post-fracture survival rates and mortality. Cox regression was used to examine the survival period by controlling the covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of the 4157 patients with AD with femoral neck fractures, 59.8% were women (n = 2487). The median age was 81 years. The 1-year survival rate for nonoperative treatment (70.19%) was lower than that for internal fixation (75.27%) and arthroplasty treatment (82.32%). Compared with the nonoperative group, arthroplasty surgical treatment had significant lower hazard risk of death (arthroplasty hazard ratio: 0.850, 95% CI: 0.728–0.991, <i>P</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings suggest that the operative treatment group experiences higher survival rates and lower mortality rates than the nonoperative group. This paper provides insights into treatment outcomes of older adults with AD receiving medical care for femoral neck fractures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 1","pages":"52-59"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138961087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective The primary aim of this study was to evaluate the influence of targeted interventions, administered through comprehensive geriatric assessments on the incidence of hospitalization‐related complications among older adults diagnosed with pulmonary diseases. Methods A retrospective analysis of medical records encompassed individuals aged 75 years and older who were admitted to a lung center during the period spanning from March to June 2023. These admissions occurred in a context where standardized geriatric management protocols were systematically implemented. This study's scope extended to assessing the prevalence of hospital‐related complications, encompassing delirium and pressure ulcers. A rigorous multivariate logistic regression analysis was conducted to discern and characterize associated factors. Results The integration of comprehensive geriatric assessment yielded a substantial reduction in in‐hospital complications among the cohort of 118 patients (mean age : 82.1 ± 5.6 years, 44.5% women). The incidence of delirium decreased from 53.3% to 21.8% [odds ratio (OR): 0.246, 95% confidence interval (CI): 0.134–0.450, p < 0.001], whereas the presence of pressure ulcers decreased from 43.9% to 25% (OR: 0.395, 95% CI: 0.217–0.715, p < 0.001). The multivariate analysis uncovered independent associations between delirium and variables including community‐acquired pneumonia (OR: 4.417, 95% CI : 1.574–12.395, p = 0.005), severe disability (OR: 2.981, 95% CI: 1.140–7.798, p = 0.026), and hearing loss (OR: 3.219, 95% CI : 1.260–8.170, p = 0.014). Prolonged hospital stays emerged as the sole factor significantly associated with pressure ulcers (OR: 1.071, 95% CI: 1.033–1.109). Furthermore, an intricate bidirectional relationship was evident between delirium and pressure ulcers (OR: 7.158, 95% CI: 2.962–17.300, p < 0.01). Conclusion In conjunction with its consequent interventions, geriatric evaluation assumes a pivotal role in ameliorating adverse outcomes stemming from hospitalization among older adults afflicted with pulmonary ailments. This role gains particular salience among subpopulations characterized by heightened susceptibility, such as individuals coping with hearing loss and severe disability.
摘要目的本研究的主要目的是通过综合老年病学评估评估针对性干预措施对诊断为肺部疾病的老年人住院相关并发症发生率的影响。方法回顾性分析2023年3月至6月期间在肺科中心住院的75岁及以上患者的医疗记录。这些入院是在标准化老年管理协议系统实施的背景下发生的。本研究的范围扩展到评估医院相关并发症的患病率，包括谵妄和压疮。进行了严格的多变量逻辑回归分析，以辨别和表征相关因素。结果综合老年病学评估使118例患者(平均年龄:82.1±5.6岁，44.5%为女性)的院内并发症显著减少。谵妄的发生率从53.3%下降到21.8%[优势比(OR): 0.246, 95%可信区间(CI): 0.134-0.450, p <0.001]，而压疮的发生率从43.9%降至25% (OR: 0.395, 95% CI: 0.217-0.715, p <0.001)。多变量分析揭示了谵妄与社区获得性肺炎(OR: 4.417, 95% CI: 1.574-12.395, p = 0.005)、严重残疾(OR: 2.981, 95% CI: 1.140-7.798, p = 0.026)和听力损失(OR: 3.219, 95% CI: 1.260-8.170, p = 0.014)等变量之间的独立关联。延长住院时间是与压疮显著相关的唯一因素(OR: 1.071, 95% CI: 1.033-1.109)。此外，谵妄和压疮之间明显存在复杂的双向关系(OR: 7.158, 95% CI: 2.962-17.300, p <0.01)。结论:结合随后的干预措施，老年评估在改善肺部疾病老年人住院治疗的不良后果方面起着关键作用。这一作用在易感性较高的亚群体中尤其突出，例如听力损失和严重残疾的个体。
{"title":"Geriatric care‐related outcomes in patients 75 years and older admitted to a pulmonary disease center and predictors for hospital‐related complications","authors":"Daniela Josefina Cataneo‐Piña, Celia Gabriela Hernández‐Favela, Lidia Aurora Mondragón‐Posadas, Citlalic Torres Nuñez","doi":"10.1002/agm2.12271","DOIUrl":"https://doi.org/10.1002/agm2.12271","url":null,"abstract":"Abstract Objective The primary aim of this study was to evaluate the influence of targeted interventions, administered through comprehensive geriatric assessments on the incidence of hospitalization‐related complications among older adults diagnosed with pulmonary diseases. Methods A retrospective analysis of medical records encompassed individuals aged 75 years and older who were admitted to a lung center during the period spanning from March to June 2023. These admissions occurred in a context where standardized geriatric management protocols were systematically implemented. This study's scope extended to assessing the prevalence of hospital‐related complications, encompassing delirium and pressure ulcers. A rigorous multivariate logistic regression analysis was conducted to discern and characterize associated factors. Results The integration of comprehensive geriatric assessment yielded a substantial reduction in in‐hospital complications among the cohort of 118 patients (mean age : 82.1 ± 5.6 years, 44.5% women). The incidence of delirium decreased from 53.3% to 21.8% [odds ratio (OR): 0.246, 95% confidence interval (CI): 0.134–0.450, p < 0.001], whereas the presence of pressure ulcers decreased from 43.9% to 25% (OR: 0.395, 95% CI: 0.217–0.715, p < 0.001). The multivariate analysis uncovered independent associations between delirium and variables including community‐acquired pneumonia (OR: 4.417, 95% CI : 1.574–12.395, p = 0.005), severe disability (OR: 2.981, 95% CI: 1.140–7.798, p = 0.026), and hearing loss (OR: 3.219, 95% CI : 1.260–8.170, p = 0.014). Prolonged hospital stays emerged as the sole factor significantly associated with pressure ulcers (OR: 1.071, 95% CI: 1.033–1.109). Furthermore, an intricate bidirectional relationship was evident between delirium and pressure ulcers (OR: 7.158, 95% CI: 2.962–17.300, p < 0.01). Conclusion In conjunction with its consequent interventions, geriatric evaluation assumes a pivotal role in ameliorating adverse outcomes stemming from hospitalization among older adults afflicted with pulmonary ailments. This role gains particular salience among subpopulations characterized by heightened susceptibility, such as individuals coping with hearing loss and severe disability.","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"12 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038496","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}
Suhas Seshadri, Orly Morgan, Alana Moore, Shivangi Parmar, Julie Schnur, Guy Montgomery, Armen Henderson, Joshua Laban
Abstract Objective To assess prevalence of elevated blood pressure readings, rates of established hypertension diagnosis, and blood pressure control medication prescription rates in a cohort of older people experiencing unsheltered homelessness presenting to a Street Medicine clinic in Miami‐Dade County, Florida. In addition, we will compare outcomes found in the study cohort to that of the general population. Methods Demographic information, clinical history, blood pressure control medication prescription, and blood pressure measurements were taken by a Street Medicine team of medical providers. The team routinely provides medical evaluations and care for people experiencing unsheltered homelessness who reside in rough sleeper tent encampments located on the street. Clinical information and vitals were recorded in REDCap. De‐identified data from patients 65 years and above were downloaded and compared to a general population data set—the Centers for Disease Control National Health and Nutrition Examination Survey (CDC NHANES) 2017–2020 Pre‐pandemic cohort. Data analysis was performed using R Studio version 4.3.2. Results Blood pressure was reported in 120 distinct interactions with older people experiencing homelessness. Compared to the age‐matched NHANES data, older people experiencing unsheltered homelessness were at significantly increased relative risk for elevated blood pressure within the range of Stage 1 Hypertension ( RR : 3.914, 95% CI : 2.560–5.892, P < 0.001), and within range of Stage 2 Hypertension ( RR : 5.550, 95% CI : 4.272–7.210, P < 0.001). According to NHANES, 49.6% of adults over 60 with diagnosed hypertension receive treatment. Of study participants, 69% of those with elevated blood pressure had previously received a diagnosis of hypertension and 15.9% on medication to control blood pressure. Conclusion Our cohort of older people experiencing unsheltered homelessness had higher rates of elevated blood pressure and reduced rates of hypertension diagnosis and treatment as compared to the general population. Older people experiencing unsheltered homelessness are a growing population, and future research should seek to evaluate and understand older adult care vulnerabilities, including chronic disease management, to improve health outcomes for those who are aging, hypertensive, and unhoused.
摘要目的评估在佛罗里达州迈阿密-戴德县街头医学诊所就诊的一群无家可归的老年人中血压读数升高的患病率、高血压确诊率和血压控制药物处方率。此外，我们将比较研究队列与普通人群的结果。方法由医务人员组成的街头医疗队采集人口统计资料、临床病史、血压控制用药处方及血压测量数据。该小组定期为露宿街头的露宿帐篷营地的无家可归者提供医疗评估和护理。在REDCap中记录临床信息和生命体征。下载65岁及以上患者的识别数据，并将其与一般人群数据集(疾病控制中心国家健康和营养检查调查(CDC NHANES) 2017-2020年大流行前队列)进行比较。使用R Studio 4.3.2版本进行数据分析。结果:在与无家可归的老年人的120种不同的互动中，报告了血压。与年龄匹配的NHANES数据相比，经历无庇护无家可归的老年人在1期高血压范围内血压升高的相对风险显著增加(RR: 3.914, 95% CI: 2.560-5.892, P <0.001)，在2期高血压范围内(RR: 5.550, 95% CI: 4.272-7.210, P <0.001)。根据NHANES的数据，60岁以上的高血压患者中有49.6%接受了治疗。在研究参与者中，69%的血压升高的人以前接受过高血压诊断，15.9%的人服用过药物来控制血压。结论:与一般人群相比，我们研究的无家可归的老年人血压升高的比例更高，高血压诊断和治疗的比例更低。无家可归的老年人越来越多，未来的研究应寻求评估和了解老年人护理的脆弱性，包括慢性病管理，以改善老年人、高血压患者和无家可归者的健康状况。
{"title":"Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of <scp>Miami‐Dade</scp> County","authors":"Suhas Seshadri, Orly Morgan, Alana Moore, Shivangi Parmar, Julie Schnur, Guy Montgomery, Armen Henderson, Joshua Laban","doi":"10.1002/agm2.12272","DOIUrl":"https://doi.org/10.1002/agm2.12272","url":null,"abstract":"Abstract Objective To assess prevalence of elevated blood pressure readings, rates of established hypertension diagnosis, and blood pressure control medication prescription rates in a cohort of older people experiencing unsheltered homelessness presenting to a Street Medicine clinic in Miami‐Dade County, Florida. In addition, we will compare outcomes found in the study cohort to that of the general population. Methods Demographic information, clinical history, blood pressure control medication prescription, and blood pressure measurements were taken by a Street Medicine team of medical providers. The team routinely provides medical evaluations and care for people experiencing unsheltered homelessness who reside in rough sleeper tent encampments located on the street. Clinical information and vitals were recorded in REDCap. De‐identified data from patients 65 years and above were downloaded and compared to a general population data set—the Centers for Disease Control National Health and Nutrition Examination Survey (CDC NHANES) 2017–2020 Pre‐pandemic cohort. Data analysis was performed using R Studio version 4.3.2. Results Blood pressure was reported in 120 distinct interactions with older people experiencing homelessness. Compared to the age‐matched NHANES data, older people experiencing unsheltered homelessness were at significantly increased relative risk for elevated blood pressure within the range of Stage 1 Hypertension ( RR : 3.914, 95% CI : 2.560–5.892, P < 0.001), and within range of Stage 2 Hypertension ( RR : 5.550, 95% CI : 4.272–7.210, P < 0.001). According to NHANES, 49.6% of adults over 60 with diagnosed hypertension receive treatment. Of study participants, 69% of those with elevated blood pressure had previously received a diagnosis of hypertension and 15.9% on medication to control blood pressure. Conclusion Our cohort of older people experiencing unsheltered homelessness had higher rates of elevated blood pressure and reduced rates of hypertension diagnosis and treatment as compared to the general population. Older people experiencing unsheltered homelessness are a growing population, and future research should seek to evaluate and understand older adult care vulnerabilities, including chronic disease management, to improve health outcomes for those who are aging, hypertensive, and unhoused.","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"220 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135476378","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：