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A pathological convergence theory for non‐communicable diseases 非传染性疾病的病理趋同理论
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-11-05 DOI: 10.1002/agm2.12273
Alicia Padrón‐Monedero
Abstract The current paradigm considers the study of non‐communicable diseases (NCDs), which are the main causes of mortality, as individual disorders. Nevertheless, this conception is being solidly challenged by numerous remarkable studies. The clear fact that the mortality, by virtually all NCDs, tends to cluster at old ages (with the exception of congenital malformations and certain types of cancer, among a few others); makes us intuitive to assume that the common convergence mechanism that exponentially increases mortality by almost all NCDs in older ages is cell aging. Moreover, when we study NCDs, we are not analyzing which disorders cause the mortality of the populations, rather that which disorders kill us before others do, because the aging of the individuals causes inevitably their death by one cause or another. This is not a defeatist perspective, but a challenging and efficient one. These intuitive assumptions have been supported by studies from the pathophysiologic, epidemiologic, and genetic fields, leading to the affirmation that, as NCDs share genetic and pathophysiological mechanisms (derived from mostly the same risk factors), they should no longer be considered independently. Those studies should make us reconsider our current conceptions of studying NCDs as individual disorders, and to hypothesize about a paradigm that would consider most NCDs (cancer, neurological pathologies, cardiovascular diseases, type II diabetes mellitus, chronic respiratory diseases, osteoarthritis, and osteoporosis, among others) different manifestations of the same process: the cell aging.
当前的范式将非传染性疾病(NCDs)作为个体疾病进行研究,这是导致死亡的主要原因。然而,这一观念正受到众多杰出研究的有力挑战。一个明显的事实是,几乎所有非传染性疾病的死亡率都倾向于集中在老年人身上(除了先天性畸形和某些类型的癌症之外);让我们凭直觉假设,几乎所有非传染性疾病在老年人中以指数方式增加死亡率的共同趋同机制是细胞衰老。此外,当我们研究非传染性疾病时,我们不是在分析哪些疾病导致人口死亡,而是分析哪些疾病在其他疾病之前杀死我们,因为个人的衰老不可避免地导致他们因这样或那样的原因死亡。这不是一种失败主义的观点,而是一种挑战和有效的观点。这些直观的假设得到了病理生理学、流行病学和遗传学领域的研究的支持,这些研究证实,由于非传染性疾病具有共同的遗传和病理生理机制(主要来自相同的风险因素),因此不应再单独考虑它们。这些研究应该使我们重新考虑我们目前将非传染性疾病作为个体疾病研究的概念,并假设一种范式,该范式将考虑大多数非传染性疾病(癌症,神经系统疾病,心血管疾病,II型糖尿病,慢性呼吸系统疾病,骨关节炎和骨质疏松症等)同一过程的不同表现:细胞衰老。
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引用次数: 0
Icariin attenuates the calcification of vascular smooth muscle cells through ERαp38MAPK pathway 淫羊藿苷通过ERα - p38MAPK通路减弱血管平滑肌细胞的钙化
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-10-10 DOI: 10.1002/agm2.12267
Jieyu He, Yanjiao Wang, Junkun Zhan, Shuang Li, Yuqing Ni, Wu Huang, Limin Long, Pan Tan, Yi Wang, Youshuo Liu
Abstract Objective To investigate the relationship between icariin and the osteoblastic differentiation of vascular smooth muscle cells (VSMCs) and the signal pathway involved. Methods We applied a universally accepted calcification model of VSMCs induced by β glycerophosphate. Then the VSMCs calcification was observed by treatment with icariin and/or inhibitors of estrogen receptors (ERs) and p38‐mitogen‐activated protein kinase (MAPK) signaling. Results Icariin inhibited osteoblastic differentiation and mineralization of VSMCs due to decreased ALP activity and Runx2 expression. Further study demonstrated that icariin exerted this suppression effect through activating p38‐MAPK but not extracellular‐regulated kinase, JNK or Akt. An inhibitor of p38‐MAPK partially reversed the inhibitory effects of icariin on osteoblastic differentiation. Interestingly, treatment of VSMCs with an ER antagonist ICI182780 and a selective ERα receptor antagonist PPT attenuated icariin‐mediated inhibition effect of VSMCs calcification, associated with suppression of p38‐MAPK phosphorylation. Conclusions Icariin inhibited the osteoblastic differentiation of VSMCs, and that the inhibitory effects were mediated by p38‐MAPK pathways through ERα.
摘要目的探讨淫羊藿苷与血管平滑肌细胞成骨分化的关系及其信号通路。方法采用公认的β甘油磷酸酯诱导VSMCs钙化模型。然后用淫羊精和/或雌激素受体(ERs)和p38 -丝裂原活化蛋白激酶(MAPK)信号抑制剂治疗VSMCs钙化。结果淫羊藿苷通过降低ALP活性和Runx2表达抑制VSMCs成骨分化和矿化。进一步的研究表明淫羊藿苷通过激活p38‐MAPK发挥这种抑制作用,而不是激活细胞外调节激酶、JNK或Akt。p38‐MAPK抑制剂部分逆转了淫羊藿苷对成骨细胞分化的抑制作用。有趣的是,用内质网拮抗剂ICI182780和选择性ERα受体拮抗剂PPT治疗VSMCs,减弱了由鸢尾苷介导的VSMCs钙化抑制作用,这与p38‐MAPK磷酸化的抑制有关。结论淫羊藿苷对VSMCs成骨分化具有抑制作用,其抑制作用可能通过ERα介导p38‐MAPK通路。
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引用次数: 0
LncRNA HOX transcript antisense RNA mediates hyperglycemic‐induced injury in the renal tubular epithelial cell via the miR‐126‐5pAkt axis LncRNA HOX转录反义RNA通过miR‐126‐5pAkt轴介导高血糖诱导的肾小管上皮细胞损伤
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-09-27 DOI: 10.1002/agm2.12266
Qiong Jiang, Ting Yang, Yan Zou, Mingjie He, Qingchun Li, Xiaohui Chen, Aimin Zhong
Abstract Objective: To investigate the involvement of HOX transcript antisense RNA (HOTAIR) in the injury of renal tubular epithelial cells induced by high glucose. Results: In high glucose‐induced HK‐2 cells, the expression of HOTAIR was upregulated, resulting in suppressed cell proliferation. Meanwhile, HOTAIR upregulates the expression of pro‐apoptotic proteins Bax and cleaved caspase‐3, while downregulating the expression of the anti‐apoptotic protein Bcl‐2. Luciferase reporter assays revealed that HOTAIR could target miR‐126‐5p. Additionally, it was found that the PI3K/Akt signaling pathway serves as a downstream target of miR‐126‐5p. Knockdown of HOTAIR relieved apoptosis, whereas further inhibition of miR‐126‐5p led to apoptosis in HK‐2 cells. Conclusions: HOTAIR plays a regulatory role in mediating high glucose‐induced injuries in HK‐2 cells, specifically affecting apoptosis and cell viability, via the miR‐126‐5p/PI3K/Akt signaling pathway.
摘要目的:探讨HOX转录物反义RNA (HOTAIR)在高糖诱导肾小管上皮细胞损伤中的作用。结果:在高糖诱导的HK‐2细胞中,HOTAIR表达上调,抑制细胞增殖。同时,HOTAIR上调促凋亡蛋白Bax和cleaved caspase‐3的表达,下调抗凋亡蛋白Bcl‐2的表达。荧光素酶报告基因检测显示HOTAIR可以靶向miR - 126 - 5p。此外,我们还发现PI3K/Akt信号通路是miR‐126‐5p的下游靶点。HOTAIR的下调减轻了凋亡,而miR - 126 - 5p的进一步抑制导致HK - 2细胞凋亡。结论:HOTAIR通过miR‐126‐5p/PI3K/Akt信号通路,在高糖诱导的HK‐2细胞损伤中发挥调节作用,特别是影响细胞凋亡和细胞活力。
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引用次数: 0
Statistical modeling and estimating number of healthy life years lost and healthy life expectancy in India, 2000–2019 2000-2019年印度健康寿命损失年数和健康预期寿命的统计建模和估计
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-09-27 DOI: 10.1002/agm2.12269
Diptismita Jena, Prafulla Kumar Swain, Manas Ranjan Tripathy, Pravat Kumar Sarangi
Abstract Objective In this study, our objective is to propose various models to estimate healthy life year lost (HLYL) and healthy life expectancy (HLE) in India. Methods The HLYL and HLE were estimated and further these estimates were compared with the direct life table method and the World Health Organization (WHO) method. From the mortality perspective, we have developed a log‐logistic model for estimating the parameter (bx), which is characterized by HLYL. The results were compared with other models, such as the Gompertz and Weibull model. Here, we have also obtained the HLE by subtracting HLYL from the total life expectancy. Results The result shows an increasing trend of HLYL among the male, female, and the total population in India. Conclusion From the log‐logistic model, the HLYL was estimated as 8.79 years, 8.36 years, and 9.38 years for the total, male, and female populations, respectively, in India during 2019.
摘要目的在本研究中,我们的目标是提出各种模型来估计印度的健康寿命年损失(HLYL)和健康预期寿命(HLE)。方法对HLYL和HLE进行估算,并与直接生命表法和世界卫生组织(WHO)方法进行比较。从死亡率的角度,我们建立了一个log - logistic模型来估计参数(bx),该模型具有HLYL的特征。结果与其他模型(如Gompertz和Weibull模型)进行了比较。在这里,我们也通过从总预期寿命中减去HLYL得到了HLE。结果印度男性、女性和总人口中HLYL呈上升趋势。根据对数- logistic模型,2019年印度总人口、男性和女性的寿命寿命分别为8.79年、8.36年和9.38年。
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引用次数: 0
Predictors of real‐world adherence to prescribed home exercise in older patients with a risk of falling: A prospective observational study 一项前瞻性观察性研究:现实世界中有跌倒风险的老年患者坚持处方家庭运动的预测因素
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-09-27 DOI: 10.1002/agm2.12270
Bernadine Teng, Sjaan R. Gomersall, Anna L. Hatton, Asaduzzaman Khan, Sandra G. Brauer
Abstract Objectives Using a multi‐ethnic Asian population, this study assessed adherence to prescribed home exercise programs, explored factors predicting adherence, and evaluated whether home exercise adherence was associated with physical activity. Methods A prospective cohort study was conducted in 68 older adults (aged ≥65 years) from two geriatric outpatient clinics in Singapore, who were receiving tailored home exercises while undergoing 6 weeks of outpatient physical therapy for falls prevention. Adherence was measured as the percentage of prescribed sessions completed. Predictor variables included sociodemographic factors, clinical characteristics, intervention‐specific factors, and physical and psychosocial measures. Multivariable linear regressions were performed to develop a model that best predicted adherence to prescribed exercise. Physical activity levels, measured by accelerometry, were analyzed by cross‐sectional univariate analysis at 6 weeks. Results The mean adherence rate was 65% (SD 34.3%). In the regression model, the number of medications [ B = 0.360, 95% CI (0.098–0.630)], social support for exercising [ B = 0.080, 95% CI (0.015–0.145)], and self‐efficacy for exercising [ B = −0.034, 95% CI (−0.068–0.000)] significantly explained 31% ( R 2 = 0.312) of the variance in exercise adherence. Older adults with better adherence took more steps/day at 6 weeks [ B = 0.001, 95% CI (0.000–0.001)]. Conclusions Low adherence to home exercise programs among older adults in Singapore, emphasizing the need for improvement. Counterintuitively, older adults with more medications, lower exercise self‐efficacy, but with greater social support demonstrated higher adherence. Addressing unmet social support needs is crucial for enhancing adherence rates and reducing fall risks.
摘要目的本研究以多种族亚洲人群为研究对象,评估了家庭锻炼计划的依从性,探讨了预测依从性的因素,并评估了家庭锻炼依从性是否与身体活动有关。方法对来自新加坡两家老年门诊诊所的68名老年人(年龄≥65岁)进行了一项前瞻性队列研究,这些老年人在接受6周门诊物理治疗的同时接受了量身定制的家庭锻炼以预防跌倒。依从性以完成规定疗程的百分比来衡量。预测变量包括社会人口学因素、临床特征、干预特定因素以及生理和心理测量。进行多变量线性回归以建立一个最能预测坚持规定运动的模型。通过加速计测量的身体活动水平,在6周时通过横截面单变量分析进行分析。结果平均依从率为65% (SD为34.3%)。在回归模型中,药物数量[B = 0.360, 95% CI(0.098-0.630)]、运动社会支持[B = 0.080, 95% CI(0.015-0.145)]和运动自我效能[B = - 0.034, 95% CI(- 0.068-0.000)]显著解释了31% (r2 = 0.312)的运动依从性方差。依从性较好的老年人在6周时每天的步数更多[B = 0.001, 95% CI(0.000-0.001)]。结论:新加坡老年人对家庭锻炼计划的依从性较低,强调需要改进。与直觉相反的是,服用更多药物的老年人,运动自我效能感较低,但拥有更多社会支持的老年人表现出更高的依从性。解决未满足的社会支持需求对于提高依从率和减少跌倒风险至关重要。
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引用次数: 0
Vortioxetine usage in an elderly patient with major depressive disorder and accompanied by multiple physical conditions: A case report 沃替西汀在老年抑郁症伴多种身体状况患者中的应用:1例报告
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-09-12 DOI: 10.1002/agm2.12268
Xiaoman Wang, Xiaoqian Ma, Yicheng Long, Guowei Wu
Elderly patients with depressive disorder always have complex and diverse symptoms, and are mostly combined with chronic physical conditions. This case report presents a case of vortioxetine usage in a 67-year-old male patient with major depressive disorder and accompanied by multiple physical conditions. In elderly people, depression mainly affects those with chronic physical diseases. Such as coronary heart disease, hypertension and diabetes. Vortioxetine is a novel antidepressant with multimodal activity that has two different types of pharmacologic targets: serotonin receptors and transporters that have been approved for the treatment of major depressive disorder (MDD).1 Both short-term and long-term clinical trials indicated that vortioxetine is effective and safe in patients with MDD. Other effects include improved cognitive function and quality of life in patients with MDD.2 However, no studies have reported the efficacy of vortioxetine in elderly patients with depression combined with chronic physical diseases so far. We hope that this case can provide some references for the use of antidepressants in the clinical practice. The patient, a 67-year-old male, retired worker, presented with gradual poor mood, decreased interest, and excessive concerns for more than 3 years, and was admitted to the psychiatry department of the second Xiangya hospital on February 24, 2021. The patient reported that following the placement of a heart stent in September 2018, he experienced a gradual onset of symptoms including poor mood, listlessness, decreased interest, hypologia, hypokinesia, preference for solitude, excessive concerns about health, and emotional instability. Besides, the patient often complained of dizziness and poor memory. At first, his self-care ability was fine, thus, his family did not pay attention to him, regarding his conditions as “a bad mood”. Later, he often had negative words and felt that it was meaningless to live. He first went to outpatient clinic in July 2020, and was considered the diagnosis of “depressive state.” He was recommended to take 10 mg qd of escitalopram and 0.5 mg bid of lorazepam. In further consultation in August, he claimed that his mood had improved, but decrease in interest remained significant and he did not care for housework. According to the doctor's advice, escitalopram tablets were increased to 15 mg qd and lorazepam tablets 0.5 mg bid. Since then the patient adhered to medication, but symptoms remained unstable. He switched to 1 tablet of flupentixol-melitracen in September 2020, but the response was still not good. For further treatment, he sought hospitalization on February 24, 2021. Since the onset of the disease, his appetite was fair, and both urination and stool were normal. The patient had a history of coronary atherosclerotic heart disease (CHD) and was implanted with a stent in September 2018. He had been taking aspirin enteric coated tablets 100 mg qd, perindopril tert butylamine tablets 4 m
量表测试:汉密尔顿抑郁量表(HAMD-17项):26分(重度抑郁);汉密尔顿焦虑量表(HAMA): 15分(中度焦虑)。根据患者的病史特点及入院后量表的评估结果,患者符合《精神障碍诊断与统计手册》第5版(DSM-5)的重度抑郁症诊断标准。排除躯体疾病所致精神障碍,心功能未见明显异常,MRI检查。由于没有兴高采烈的病史,排除了双相情感障碍。考虑诊断:1。无精神病性症状的重度抑郁症;2. 冠心病,冠状动脉支架置入术后,NYHA II度;3.前列腺炎。考虑到患者为老年男性,有多种躯体疾病,目前正在服用四种药物,入院后停药,氢溴化氟西汀在2天内由5mg增加至10mg qd,联合盐酸曲唑酮片25 - 50mg qn,奥沙洛西汀由15 - 7.5 mg qn逐渐减少,于1-2周内停药,以改善情绪和睡眠。同时安排心理治疗和经颅磁刺激作为辅助治疗。住院期间血压、血糖等监测结果未见明显异常。经心血管科、泌尿科会诊,继续按指导使用原4种药物(阿司匹林肠溶片100mg qd、培哚普利叔丁胺片4mg qd、琥珀酸美托洛尔半片qd、盐酸坦索罗新缓释胶囊0.2 mg qd)对症治疗。脑MRI显示右侧基底节区空洞梗死,白质病变(Fzekas1级),脑萎缩。肌电检查结果显示足部皮肤交感神经反应异常。经神经科会诊,不需特殊治疗。患者自述服药后无明显不适,症状明显改善,愉悦感,情绪稳定,无明显忧虑,与他人沟通积极。意志活动也增加了,比如在病房里散步和锻炼。住院期间停用奥西泮。2021年3月9日重新进行了HAMD和HAMA测试,得分分别为6分和5分。病人好转后出院。然后,患者坚持服药,并定期进行进一步咨询。之后,他的情绪基本恢复到正常水平。6个月随访后,曲唑酮逐渐停用,氢溴化氟西汀降至5 mg / d。氟西汀氢溴化物已于2022年3月停用。根据2023年6月的随访,患者病情稳定,能够正常生活,在家照顾家务和孩子。老年MDD患者的症状复杂多样,通常伴有多种躯体疾病,包括冠心病、高血压、糖尿病等;因此,患者经常服用多种药物。在临床实践中,需要保证疗效、安全性和耐受性,这就增加了治疗的难度。沃替西汀是一种新型的多模式抗抑郁药物,自2018年在中国上市以来,在临床应用中表现出良好的疗效和高安全性8.3,4根据第二版《中国抑郁症诊疗指南》:《第二版》和加拿大CANMAT等权威指南5、6对于MDD患者,如果用药剂量已足够或已达到个体治疗剂量的最大耐受剂量超过4周,且效果仍不理想,可切换用药。如果另一种机制不同的抗抑郁药仍然不起作用,则可以选择联合用药。通过比较21种抗抑郁药物,以往的研究表明,vortioxetine在治疗心境不良、快感缺乏、兴趣下降、身体不适、疲劳和焦虑等多种MDD症状方面的疗效、可接受性和治疗效果是确定的。7-9既往使用一线选择性5 -羟色胺再摄取抑制剂(SSRIs)或5 -羟色胺去甲肾上腺素多巴胺再摄取抑制剂(SNRIs)抗抑郁药效果不佳的患者,有一半以上改用沃替西汀后可达到康复标准10临床前和临床研究结果表明,与其他抗抑郁药相比,vortioxetine具有5-HT受体调节剂和SERT抑制剂的功能,可直接或间接调节多种神经递质系统,对抑郁症有作用,对认知功能障碍有积极作用。 本病例报告的发表获得了患者的书面知情同意。
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引用次数: 1
Analysis of the incidence of falls and related factors in elderly patients based on comprehensive geriatric assessment 基于老年综合评估的老年患者跌倒发生率及相关因素分析
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-09-04 DOI: 10.1002/agm2.12265
Xun Xiao, Ling Li, Huijuan Yang, Lei Peng, Chunbo Guo, Wei Cui, Shunying Liu, Renhe Yu, Xiangyu Zhang, Mengxi Zhang

Objective

To investigate the incidence of falls in elderly aged 65 years and above among outpatients and inpatients, and to analyze its related factors and identify prevention strategies.

Methods

A retrospective analysis was conducted on 451 patients aged 65 years and above who received comprehensive geriatric assessment in outpatients and inpatients from the Department of Geriatrics in the Second Xiangya Hospital from March 2021 to March 2022. According to whether there had been at least one fall in the past year, the patients were divided into a fall group and a non-fall group. Data were collected from the We-Chat applet of comprehensive geriatric assessment. A t test and chi-square test were performed to compare the difference between the two groups. Logistic regression analysis was then conducted to identify factors associated with falls.

Results

(1) The incidence of falls among the outpatient and inpatient was 28.8%. (2) The rate of light, moderate, and heavy dependence on daily living ability and decreased mobile balance ability were higher in the fall group than those in the non-fall group. The average calf circumference in the fall group was significantly lower than that in the non-fall group. (3) The prevalence of diabetes and eye diseases in the fall group was significantly higher than that in the non-fall group. (4) The percentage of insomnia and suspicious insomnia cases in the fall group was higher than that in the non-fall group. The mean scores for dysphagia, frailty, and incontinence were higher and the mean malnutrition score was lower in the fall group than in the non-fall group. (5) Multiple logistic regression analysis showed that frailty, insomnia, and malnutrition were independent influencing factors of fall (OR = 1.955, 1.652, 10.719, P = 0.044, 0.041, 0.025, respectively).

Conclusions

The incidence of falls among outpatients and inpatients aged 65 years and above is high. Frailty, insomnia, and malnutrition are the main factors influencing falls in these patients.

目的了解65岁及以上老年人门诊和住院患者跌倒的发生情况,分析其相关因素,确定预防策略。方法回顾性分析湘雅第二医院老年科2021年3月至2022年3月接受老年综合评估的65岁及以上门诊和住院患者451例。根据过去一年是否至少有过一次跌倒,将患者分为跌倒组和未跌倒组。数据收集自老年综合评估微信小程序。采用t检验和卡方检验比较两组间差异。然后进行逻辑回归分析以确定与跌倒相关的因素。结果(1)门诊住院患者跌倒发生率为28.8%。(2)跌倒组轻、中、重度日常生活能力依赖率及移动平衡能力下降率均高于非跌倒组。跌倒组的平均小腿围明显低于非跌倒组。(3)跌倒组糖尿病和眼病患病率显著高于非跌倒组。(4)跌倒组失眠及可疑失眠的比例高于非跌倒组。与非跌倒组相比,跌倒组吞咽困难、虚弱和尿失禁的平均得分更高,营养不良的平均得分更低。(5)多元logistic回归分析显示,虚弱、失眠、营养不良是发生跌倒的独立影响因素(OR分别为1.955、1.652、10.719,P分别为0.044、0.041、0.025)。结论65岁及以上老年人门诊和住院患者跌倒发生率较高。虚弱、失眠和营养不良是影响这些患者跌倒的主要因素。
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引用次数: 0
Changing patterns of cancer burden among elderly across Indian states: Evidence from the global burden of disease study 1990–2019 印度各邦老年人癌症负担模式的变化:来自1990-2019年全球疾病负担研究的证据
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-08-21 DOI: 10.1002/agm2.12264
Chandan Kumar Swain, Sourav Padhee, Umakanta Sahoo, Himanshu Sekhar Rout, Prafulla Kumar Swain

Objective

To investigate the trends and patterns of the cancer burden among the elderly in different regions of India at a subnational level.

Methods

Data were extracted from the Global Burden of Disease (GBD) Studies India Compare 2019. Prevalence rate, disability-adjusted life years (DALY), and annual percentage change techniques were used to analyze data.

Results

The three age groups with the highest prevalence of cancer were those aged 60–64 years, 65–69 years, and 70–74 years. In 2019, The prevalence of cancer among the elderly ranged from 7048.815 in Karnataka to 5743.040 in Jharkhand. Kerala has the most significant annual percentage change in the cancer prevalence rate of 0.291 between 1990 and 2019. The highest DALY rate was observed among individuals aged 80–84 years in 2019. That year, the DALY rate among the elderly was 8112.283 in India. The top five cancers with higher DALY rates among the elderly in India in 2019 were tracheal, bronchus, and lung cancer (908.473), colon and rectum cancer (752.961), stomach cancer (707.464), breast cancer (597.881), and lip and oral cavity cancer (557.637).

Conclusion

Elderly individuals demonstrated a higher vulnerable to cancer compared to other age groups. There is a need for state-specific government intervention to minimize the risk of cancer among the elderly due to the heterogeneity in the burden of cancer across Indian states.

目的调查印度不同地区老年人癌症负担的变化趋势和模式。方法数据取自2019年全球疾病负担(GBD)研究印度比较。使用患病率、残疾调整生命年(DALY)和年度百分比变化技术分析数据。结果60 ~ 64岁、65 ~ 69岁和70 ~ 74岁是癌症发病率最高的3个年龄组。2019年,卡纳塔克邦的老年人癌症患病率为7048.815人,贾坎德邦为5743.040人。1990年至2019年期间,喀拉拉邦癌症患病率的年百分比变化最为显著,为0.291。2019年,80-84岁人群的DALY率最高。那一年,印度老年人的DALY比率为8112.283。2019年印度老年人DALY率较高的前五大癌症是气管、支气管和肺癌(908.473)、结肠癌和直肠癌(752.961)、胃癌(707.464)、乳腺癌(597.881)、唇和口腔癌(557.637)。结论与其他年龄组相比,老年人易患癌症。由于印度各邦癌症负担的异质性,有必要对各邦进行具体的政府干预,以尽量减少老年人患癌症的风险。
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引用次数: 0
The prevalence of frailty and its relationship with sociodemographic factors, regional healthcare disparities, and healthcare utilization in the aging population across India 脆弱的患病率及其与社会人口因素的关系,区域医疗保健差距,以及印度老龄化人口的医疗保健利用
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-08-07 DOI: 10.1002/agm2.12263
Sunny Singhal, Sumitabh Singh, Gevesh Chand Dewangan, Sharmistha Dey, Joyita Banerjee, Jinkook Lee, Ashish Datt Upadhyaya, Peifeng Hu, Aparajit Ballav Dey

Objective

To estimate frailty prevalence and its relationship with the socio-economic and regional factors and health care outcomes.

Methods

In this study, participants from the harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) were included. The frailty index (FI) was calculated using a 32-variable deficit model, with a value of ≥ 25% considered as frail. Data on demographic (including caste and religion) and socioeconomic profiles and health care utilization were obtained. The state-wise health index maintained by the government based on various health-related parameters was used to group the participants' residential states into high-, intermediate-, and low-performing states. Multivariable and zero-inflated negative binomial regression was used to assess the relationship of frailty index with sociodemographic characteristics, health index, and health care expenditure or hospitalization.

Results

Among the 3953 eligible participants, the prevalence of frailty was 42.34% (men = 34.99% and women = 49.35%). Compared to high-performing states, intermediate- and low-performing states had a higher proportion of frail individuals (49.7% vs. 46.8% vs. 34.5%, P < 0.001). In the adjusted analysis, frailty was positively associated with age, female sex, rural locality, lower education level, and caste (scheduled caste and other backward classes). After adjusting for the socio-economic profile, FI was inversely associated with the composite health index of a state (P < 0.001). FI was also significantly correlated with total 1-year health care expenditure and hospitalization (P < 0.001 and 0.020, respectively).

Conclusion

There is a high prevalence of frailty among older Indian adults that is associated with sociodemographic factors and regional health care performance. Furthermore, frailty is associated with increased health care utilization and expenditure.

目的了解老年人的脆弱患病率及其与社会经济、地区因素和卫生保健结果的关系。方法本研究纳入了印度纵向衰老研究痴呆统一诊断评估(LASI-DAD)的参与者。虚弱指数(FI)采用32变量赤字模型计算,值≥25%视为虚弱。获得了关于人口统计(包括种姓和宗教)和社会经济概况以及保健利用情况的数据。政府根据各种健康相关参数维持的州健康指数被用来将参与者的居住州分为高、中、低表现州。采用多变量和零膨胀负二项回归评估脆弱指数与社会人口学特征、健康指数、医疗费用或住院治疗的关系。结果3953名符合条件的参与者中,虚弱患病率为42.34%(男性为34.99%,女性为49.35%)。与高绩效州相比,中等和低绩效州的虚弱个体比例更高(49.7% vs. 46.8% vs. 34.5%, P < 0.001)。在调整分析中,脆弱与年龄、女性性别、农村地区、低教育水平和种姓(排期种姓和其他落后阶层)呈正相关。在调整了社会经济状况后,FI与一个州的综合健康指数呈负相关(P < 0.001)。FI与1年总医疗费用和住院率也显著相关(P <分别为0.001和0.020)。结论:印度老年人身体虚弱的患病率较高,这与社会人口因素和地区卫生保健表现有关。此外,体弱多病还与卫生保健的利用和支出增加有关。
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引用次数: 1
Temporal patterns of the burden of Alzheimer's disease and their association with Sociodemographic Index in countries with varying rates of aging 1990–2019 1990-2019年不同老龄化率国家阿尔茨海默病负担的时间模式及其与社会人口指数的关系
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-07-12 DOI: 10.1002/agm2.12260
Majed Ramadan

Objective

To we examine the temporal patterns of the burden of Alzheimer's disease and their association with Sociodemographic Index in countries with varying rates of aging.

Method

Data were obtained from Global Burden of Diseases studies (GBD) 2019 and were used to compare countries with different rates of change in aging population from 1990 to 2019. We collected the data of the age-standardized rates per 100,000 of disability-adjusted life years (DALYs), incidence, prevalence of Alzheimer's disease and other dementias, and the age-specific population rates per 100,000.

Results

Countries with high rates of change in their aging populations had an increase in DALYs, incidence, and prevalence of Alzheimer's disease and other dementias over the last 30 years. Countries with a high rate of change in aging population had a significantly positive association among DALYs, incidence, and prevalence of Alzheimer's disease and other dementias. In contrast, countries with a medium and low rate of change in aging population had negative associations between DALYs and incidence of Alzheimer's disease and other dementias.

Conclusion

This study highlights the significant impact of demographic changes on the burden, prevalence, and incidence of Alzheimer's disease and other dementia. The study also found that robust health care and social systems, as reflected by a higher Sociodemographic Index, can contribute to reducing the burden of Alzheimer's disease and other dementias in medium to low rates of aging populations. The findings underscore the importance of investing in health care and social systems to address the growing burden of these conditions, especially in countries with a high rate of change in the aging population.

目的研究不同老龄化国家阿尔茨海默病负担的时间模式及其与社会人口指数的关系。方法从2019年全球疾病负担研究(GBD)中获取数据,并用于比较1990年至2019年人口老龄化变化率不同的国家。我们收集了每10万人残疾调整生命年(DALYs)的年龄标准化率、阿尔茨海默病和其他痴呆症的发病率、患病率以及每10万人的特定年龄人口率的数据。结果老龄化人口变化率高的国家,在过去30年里,DALYs、阿尔茨海默病和其他痴呆症的发病率和流行率都有所增加。老龄化人口变化率高的国家,DALYs与阿尔茨海默病和其他痴呆症的发病率和患病率之间存在显著正相关。相比之下,人口老龄化变化率中低的国家,DALYs与阿尔茨海默病和其他痴呆症的发病率呈负相关。结论本研究强调了人口变化对阿尔茨海默病和其他痴呆症的负担、患病率和发病率的重要影响。该研究还发现,正如较高的社会人口指数所反映的那样,健全的医疗保健和社会体系有助于减轻老年人口中低比例的阿尔茨海默病和其他痴呆症的负担。研究结果强调了投资于卫生保健和社会系统以解决这些疾病日益加重的负担的重要性,特别是在人口老龄化变化率高的国家。
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引用次数: 0
期刊
Aging Medicine
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