Greater short-term weight loss in women 20-45 versus 55-65 years of age following bariatric surgery.

PubMed

Ochner, Christopher N; Teixeira, Julio; Geary, Nori; Asarian, Lori

2013-10-01

Whether and how sex and age affect bariatric-surgery outcome is poorly understood. Estrogens regulate body composition in women and animals, and increase weight loss in a rodent model of gastric bypass, suggesting that premenopausal women may lose more weight following bariatric surgery. One thousand three hundred fifty-six female gastric-bypass or gastric-banding patients were retrospectively grouped as 20-45 years old (presumptively premenopausal; n = 1,199) and 55-65 years old (presumptively postmenopausal; n = 157). Mixed-model ANCOVA followed by Bonferroni-corrected t tests were used to categorically test the effect of age on percent excess body weight loss (%EBWL) at 1 and 2 years post-surgery, controlling for preoperative EBW and surgery type. Age effects were also tested dimensionally in all women and in 289 male patients. Twenty- to forty-five-year-old women showed greater %EBWL 1 and 2 years post-surgery than 55-65-year-old women (p's < 0.0005). No age effect was detected in 20-25- vs. 30-35-, 30-35- vs. 40-45-, or 20-25- vs. 40-45-year-old women (p's > 0.2) This age effect was detected only after gastric banding, with 20-45-year-old women losing ∼7 kg more than 55-65-year-old women after 2 years. Dimensional analysis confirmed a significant inverse effect of age on bariatric surgery outcome in women, but did not detect any effect in men. Results indicate that 55-65-year-old women lose less weight than 20-45-year-old women in the initial 2 years after bariatric surgery, especially gastric banding; this may be mediated by age- or menopause-associated changes in physical activity, energy expenditure, or energy intake.

Risk factors for mortality before age 18 years in cystic fibrosis.

PubMed

McColley, Susanna A; Schechter, Michael S; Morgan, Wayne J; Pasta, David J; Craib, Marcia L; Konstan, Michael W

2017-07-01

Understanding early-life risk factors for childhood death in cystic fibrosis (CF) is important for clinical care, including the identification of effective interventions. Data from the Epidemiologic Study of Cystic Fibrosis (ESCF) collected 1994-2005 were linked with the Cystic Fibrosis Foundation Patient Registry (CFFPR) demographic and mortality data from 2013. Inclusion criteria were ≥1 visit annually at age 3-5 years and ≥1 FEV 1 measurement at age 6-8 years. Demographic data, nutritional parameters, pulmonary signs and symptoms, microbiology, and FEV 1 were evaluated as risk factors for death before age 18 years. Multivariable Cox proportional hazards regression was used to model the simultaneous effects of risk factors associated with death before age 18 years. Among 5365 patients enrolled in ESCF who met inclusion criteria, 3880 (72%) were linked to the CFFPR. Among these, 191 (5.7%) died before age 18 years; median age at death was 13.4 ± 3.1 years. Multivariable regression showed clubbing, crackles, female sex, unknown CFTR genotype, minority race or ethnicity, Medicaid insurance (a proxy of low socioeconomic status), Pseudomonas aeruginosa on 2 or more cultures, and weight-for-age <50th percentile were significant risk factors for death regardless of inclusion of FEV 1 at age 6-8 years in the model. We identified multiple risk factors for childhood death of patients with CF, all of which remained important after incorporating FEV 1 at age 6-8 years. Among the factors identified were the presence of clubbing or crackles at age 3-5 years, signs which are not routinely collected in registries. © 2017 Wiley Periodicals, Inc.

Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of ...

MedlinePlus

... Share Compartir Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily ... 2010, the age-adjusted percentage of adults aged 18 years or older with diagnosed diabetes performing daily ...

[Acute poisoning in patients over 65 years of age].

PubMed

Miranda Arto, P; Ferrer Dufol, A; Ruiz Ruiz, F J; Menao Guillén, S; Civeira Murillo, E

2014-01-01

There are few Spanish studies on acute poisoning in the elderly despite the associated risk factors of this group of patients. Retrospective descriptive study of acute poisonings treated in the Emergency Service of the University Hospital of Zaragoza from 1995 to 2009 on patients 65 years old or older. A total of 762 patients were selected in the study (4.74% of all acute poisonings) with a mean age of 74.16 (SD ± 6) years. Ingestion was the major route of exposure (85%) and alcohol overdose (28,7%) was the most frequent type of poisoning. A trend was also observed showing a lower emetic treatment and gastric lavage and an increase in activated charcoal. Benzodiazepines (14.3%) and toxic household products (11%) with caustic properties were also the main toxics found in the study. Acute poisonings in the elderly required more hospitalizations, have a higher mortality and more autolytic attempts which result in death.

Adolescent conduct problems and premature mortality: follow-up to age 65 years in a national birth cohort.

PubMed

Maughan, B; Stafford, M; Shah, I; Kuh, D

2014-04-01

Severe youth antisocial behaviour has been associated with increased risk of premature mortality in high-risk samples for many years, and some evidence now points to similar effects in representative samples. We set out to assess the prospective association between adolescent conduct problems and premature mortality in a population-based sample of men and women followed to the age of 65 years. A total of 4158 members of the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort) were assessed for conduct problems at the ages of 13 and 15 years. Follow-up to the age of 65 years via the UK National Health Service Central Register provided data on date and cause of death. Dimensional measures of teacher-rated adolescent conduct problems were associated with increased hazards of death from cardiovascular disease by the age of 65 years in men [hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.04-1.32], and of all-cause and cancer mortality by the age of 65 years in women (all-cause HR 1.16, 95% CI 1.07-1.25). Adjustment for childhood cognition and family social class did little to attenuate these risks. Adolescent conduct problems were not associated with increased risks of unnatural/substance-related deaths in men or women in this representative sample. Whereas previous studies of high-risk delinquent or offender samples have highlighted increased risks of unnatural and alcohol- or substance abuse-related deaths in early adulthood, we found marked differences in mortality risk from other causes emerging later in the life course among women as well as men.

Associations of work and health-related characteristics with intention to continue working after the age of 65 years.

PubMed

ten Have, Margreet; van Dorsselaer, Saskia; de Graaf, Ron

2015-02-01

This study examines the association of work and health-related characteristics with the intention to continue working after the age of 65 years. Data were from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative population survey, including 1854 employees aged 45-64 years; 29.0% reported the intention to continue working after 65 years. Lower education, more adverse psychosocial working conditions and any physical disorder were negatively associated with this intention. Mental disorders were not associated. These findings highlight the importance of favourable working conditions and good physical health in relation to employees' intention to continue working after 65 years. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Can maintaining cognitive function at 65 years old predict successful ageing 6 years later? The PROOF study.

PubMed

Castro-Lionard, Karine; Thomas-Antérion, Catherine; Crawford-Achour, Emilie; Rouch, Isabelle; Trombert-Paviot, Béatrice; Barthélémy, Jean-Claude; Laurent, Bernard; Roche, Frédéric; Gonthier, Régis

2011-03-01

preservation of cognitive abilities is required to have a good quality of life. The predictive value of cognitive functioning at 65 years old on successful ageing 6 years later is not established. nine hundred and seventy-six questionnaires were sent by mail to a sample of healthy and voluntary French pensioners. Successful ageing was defined through health status and well-being. Cognitive abilities had been assessed 6 years earlier according to an objective method (Free and Cued Selective Recall Reminding Test (FCSRT), the Benton visual retention test and the similarities subtest of the Wechsler Adult Intelligence Scale-Revised) and a subjective one (Goldberg's anxiety scale, Mac Nair's scale and a Visual Analogue Scale to evaluate memory abilities change in the last 5 years). six hundred and eighty-six questionnaires could be analysed. The mean age was 72.9 ± 1.2 years old with 59% of women and 99% lived at home. Well-being was negatively correlated with the FCSRT (r = -0.08, P = 0.0318) but positively related with the Benton (r = 0.09, P = 0.0125) and the similarities tests (r = 0.09, P = 0.0118). There is a negative correlation between anxious and cognitive complaints measured at baseline, and successful ageing indicators 6 years later. preservation of cognitive abilities at the age of retirement can predict a successful ageing 6 years later. ClinicalTrials.gov Identifier: NCT00759304.

[Health-related quality of life evaluation of elderly aged 65 years and over living at home].

PubMed

Jalenques, I; Auclair, C; Rondepierre, F; Gerbaud, L; Tourtauchaux, R

2015-06-01

To assess health-related quality of life in French adults aged 65 years and over, living at home, with a specific self-administered questionnaire, the LEIPAD, cross-culturally adapted in French. Elderly completed socio-demographic and medical questionnaires, a questionnaire about negative life events during the last 12 months and the LEIPAD. Data of 195 subjects (mean age: 72.6 years, men: 56.5%) were analyzed. The response rates to the LEIPAD scales were superior to 90%. Elderly reported on the whole a good health-related quality of life. Age had a negative effect on quality on life, which deteriorates over years. Age was correlated to the scales "Physical function", "Self-care", "Cognitive functioning" and "Sexual functioning". Elderly hospitalized in the last year had worse quality of life with a significant difference for "Physical function" scale. The number of health problems was positively correlated to "Physical function" scale. Elderly declaring at least one health problem had worse quality of life for this scale. Problems in couple, materials and financial problems had also negative effects on health-related quality of life. Our study highlights a good health-related quality of life for the majority of these adults aged 65 years and over, as well as the negative effect of age, health, couple, materials and financial problems on their quality of life. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review.

PubMed

Silva, Bruno Mota; Cartucho, António; Sarmento, Marco; Moura, Nuno

2017-04-28

The objective of this study was to analyze current evidence regarding surgical management of rotator cuff tears in patients of 65 years of age and above. Our hypothesis was that surgical repair of rotator cuff tears, in patients older than 65 years, conveys good outcome scores. We have not found a similar systematic review in current literature. Medline®, PubMed, Scopus, and the Cochrane Register of Controlled Trials were searched from January 1999 unto December 2015 for studies, regardless of language, including the words 'rotator cuff' and '65 years' or '70 years'. Inclusion criteria were studies (level I to IV) that reported clinical outcomes in patients older than 65 years, having undertaken surgical repair of a symptomatic rotator cuff tears. Arthroscopic, mini open and open techniques were included. Exclusion criteria were: studies with patients younger than 65 years, studies that did not use validated outcome evaluation scores as primary assessment tools and those with follow up under one year. This work followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines. Data abstracted included patient demographics, tear pattern, surgical procedures, clinical and repair results. Outcome scores were converted to percentages, allowing comparison of data between studies. After deep analysis, 14 studies met the inclusion criteria: 11 level IV studies, 1 level III study and 2 level II studies. Seven studies found statistically significant outcome improvements between pre and postoperative evaluations. All studies reported good or excellent surgical outcomes. Better results would probably be achieved if all studies had rigorous and homogeneous patient selection criteria, but the fact is, that even though this was not the case, the clinical scores remained favorable, and with statistically significant outcome improvement in all studies with prospectively collected data. Based on current literature, rotator cuff repair

Long-term safety and tolerability of saxagliptin add-on therapy in older patients (aged ≥65 years) with type 2 diabetes

PubMed Central

Iqbal, Nayyar; Allen, Elsie; Öhman, Peter

2014-01-01

Background Treatment decisions for older patients with type 2 diabetes mellitus must balance glycemic control and adverse event risk. The objective of this study was to evaluate the long-term safety and tolerability of saxagliptin 5 mg as add-on therapy to common antihyperglycemic drugs in patients aged ≥65 years and <65 years. Methods Pooled adverse event data from three placebo-controlled trials of 76–206 weeks’ duration in older (≥65 years) and younger (<65 years) patients receiving saxagliptin 5 mg or matching placebo added to metformin, glyburide, or a thiazolidinedione were analyzed. Measurements were calculated from day of first dose to specified event or last dose and included time at risk for adverse events, treatment-related adverse events, serious adverse events, adverse events leading to discontinuation, and events of special interest. Weighted incidence rates (number of events/total time) and incidence rate ratios (saxagliptin/placebo) with 95% confidence intervals were calculated (Mantel-Haenszel test). Results A total of 205 older (mean age 69 years; saxagliptin, n=99; placebo, n=106) and 1,055 younger (mean age 52 years; saxagliptin, n=531; placebo, n=524) patients were assessed. Regardless of age category, the adverse event incidence rates were generally similar between treatments, with confidence intervals for incidence rate ratios bridging 1. Treatment-related adverse events occurred in 36 older patients receiving saxagliptin versus 32 receiving placebo (incidence rate 34.1 versus 27.1 per 100 person-years) and in 150 younger patients in both treatment groups (incidence rate 24.0 versus 27.8 per 100 person-years). With saxagliptin versus placebo, serious adverse events occurred in eight versus 14 older (incidence rate 5.7 versus 9.9 per 100 person-years) and 49 versus 44 younger patients (incidence rate 6.5 versus 6.6 per 100 person-years). There were two deaths (one patient ≥65 years) with saxagliptin and six (none aged ≥65 years

Long-term safety and tolerability of saxagliptin add-on therapy in older patients (aged ≥ 65 years) with type 2 diabetes.

PubMed

Iqbal, Nayyar; Allen, Elsie; Öhman, Peter

2014-01-01

Treatment decisions for older patients with type 2 diabetes mellitus must balance glycemic control and adverse event risk. The objective of this study was to evaluate the long-term safety and tolerability of saxagliptin 5 mg as add-on therapy to common antihyperglycemic drugs in patients aged ≥ 65 years and <65 years. Pooled adverse event data from three placebo-controlled trials of 76-206 weeks' duration in older (≥ 65 years) and younger (<65 years) patients receiving saxagliptin 5 mg or matching placebo added to metformin, glyburide, or a thiazolidinedione were analyzed. Measurements were calculated from day of first dose to specified event or last dose and included time at risk for adverse events, treatment-related adverse events, serious adverse events, adverse events leading to discontinuation, and events of special interest. Weighted incidence rates (number of events/total time) and incidence rate ratios (saxagliptin/placebo) with 95% confidence intervals were calculated (Mantel-Haenszel test). A total of 205 older (mean age 69 years; saxagliptin, n=99; placebo, n=106) and 1,055 younger (mean age 52 years; saxagliptin, n=531; placebo, n=524) patients were assessed. Regardless of age category, the adverse event incidence rates were generally similar between treatments, with confidence intervals for incidence rate ratios bridging 1. Treatment-related adverse events occurred in 36 older patients receiving saxagliptin versus 32 receiving placebo (incidence rate 34.1 versus 27.1 per 100 person-years) and in 150 younger patients in both treatment groups (incidence rate 24.0 versus 27.8 per 100 person-years). With saxagliptin versus placebo, serious adverse events occurred in eight versus 14 older (incidence rate 5.7 versus 9.9 per 100 person-years) and 49 versus 44 younger patients (incidence rate 6.5 versus 6.6 per 100 person-years). There were two deaths (one patient ≥ 65 years) with saxagliptin and six (none aged ≥ 65 years) with placebo. Older patients

[Measure of premature mortality: comparison of deaths before age 65 and expected years of life lost].

PubMed

Lapostolle, A; Lefranc, A; Gremy, I; Spira, A

2008-08-01

For many years in France, premature mortality (i.e., deaths before 65 years old) and avoidable deaths have generally been used to monitor health of the population and help to elaborate policies in this area. This paper aims to examine the utility of another indicator of premature mortality, which makes it possible to take into account the impact of deaths, the expected years of life lost (EYLL). Mortality data for France in the years 2000 to 2002 were obtained from the Centre for Epidemiology of the Medical Causes of Death. Premature mortality was defined as death before 65 years of age. For the calculation of EYLL, the mortality norm chosen was French-life expectancy for the years 2001 to 2003. In order to study the spatial distribution of the indicators above defined, standardized ratios were calculated for each administrative area, taking France as the reference population. Irrespective of the gender and indicator considered, ranking of the causes emphasized three major groups of pathological conditions, which are strongly distinguished from the others: cardiovascular diseases, malignant neoplasm and injuries. The ranking of causes varied considerably according to the indicator used. The spatial representation of standardized ratios of expected years of life lost and deaths before 65 showed a strong North-South trend. The concept of premature mortality is difficult to define and discussions persist on the age limit to use for its quantification. The choice of an indicator strongly depends on the use which one wishes to make. The simple analysis of deaths before 65 years currently used to describe premature mortality in France makes it possible to describe its frequency. The use of a summary measure as EYLL allows to quantify the impact of premature mortality by giving different weights to deaths depending on the age of occurrence. EYLL, thus, seems to be an indicator, which is particularly adapted to decision-making in public health, depending on choices and

Fifteen-year Outcomes Following Conservative Management Among Men Aged 65 Years or Older with Localized Prostate Cancer.

PubMed

Lu-Yao, Grace L; Albertsen, Peter C; Moore, Dirk F; Lin, Yong; DiPaola, Robert S; Yao, Siu-Long

2015-11-01

To understand the threat posed by localized prostate cancer and the potential impact of surgery or radiation, patients and healthcare providers require information on long-term outcomes following conservative management. To describe 15-yr survival outcomes and cancer therapy utilization among men 65 years and older managed conservatively for newly diagnosed localized prostate cancer. This is a population-based cohort study with participants living in predefined geographic areas covered by the Surveillance, Epidemiology, and End Results program. The study includes 31 137 Medicare patients aged ≥65 yr diagnosed with localized prostate cancer in 1992-2009 who initially received conservative management (no surgery, radiotherapy, cryotherapy, or androgen deprivation therapy [ADT]). All patients were followed until death or December 31, 2009 (for prostate cancer-specific mortality [PCSM]) and December 31, 2011 (for overall mortality). Competing-risk analyses were used to examine PCSM, overall mortality, and utilization of cancer therapies. The 15-yr risk of PCSM for men aged 65-74 yr diagnosed with screening-detected prostate cancer was 5.7% (95% confidence interval [CI] 3.7-8.0%) for T1c Gleason 5-7 and 22% (95% CI 16-35%) for Gleason 8-10 disease. After 15 yr of follow-up, 24% (95% CI 21-27%) of men aged 65-74 yr with screening-detected Gleason 5-7 cancer received ADT. The corresponding result for men with Gleason 8-10 cancer was 38% (95% CI 32-44%). The major study limitations are the lack of data for men aged <65 yr and detailed clinical information associated with secondary cancer therapy. The 15-yr outcomes following conservative management of newly diagnosed Gleason 5-7 prostate cancer among men aged ≥65 yr are excellent. Men with Gleason 8-10 disease managed conservatively face a significant risk of PCSM. We examined the long-term survival outcomes for a large group of patients diagnosed with localized prostate cancer who did not have surgery, radiotherapy

Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005: a register-based cohort study.

PubMed

Farrants, Kristin; Kjeldgård, Linnea; Marklund, Staffan; Head, Jenny; Alexanderson, Kristina

2018-02-01

Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work. Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years. Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort. Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.

Pneumococcal Vaccination Among Medicare Beneficiaries Occurring After the Advisory Committee on Immunization Practices Recommendation for Routine Use Of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults Aged ≥65 Years.

PubMed

Black, Carla L; Williams, Walter W; Warnock, Rob; Pilishvili, Tamara; Kim, David; Kelman, Jeffrey A

2017-07-14

On September 19, 2014, CDC published the Advisory Committee on Immunization Practices (ACIP) recommendation for the routine use of 13-valent pneumococcal conjugate vaccine (PCV13) among adults aged ≥65 years, to be used in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) (1). This replaced the previous recommendation that adults aged ≥65 years should be vaccinated with a single dose of PPSV23. As a proxy for estimating PCV13 and PPSV23 vaccination coverage among adults aged ≥65 years before and after implementation of these revised recommendations, CDC analyzed claims for vaccination submitted for reimbursement to the Centers for Medicare & Medicaid Services (CMS). Claims from any time during a beneficiary's enrollment in Medicare Parts A (hospital insurance) and B (medical insurance) since reaching age 65 years were assessed among beneficiaries continuously enrolled in Medicare Parts A and B during annual periods from September 19, 2009, through September 18, 2016. By September 18, 2016, 43.2% of Medicare beneficiaries aged ≥65 years had claims for at least 1 dose of PPSV23 (regardless of PCV13 status), 31.5% had claims for at least 1 dose of PCV13 (regardless of PPSV23 status), and 18.3% had claims for at least 1 dose each of PCV13 and PPSV23. Claims for either type of pneumococcal vaccine were highest among beneficiaries who were older, white, or with chronic and immunocompromising medical conditions than among healthy adults. Implementation of the National Vaccine Advisory Committee's standards for adult immunization practice to assess vaccination status at every patient encounter, recommend needed vaccines, and administer vaccination or refer to a vaccinating provider might help increase pneumococcal vaccination coverage and reduce the risk for pneumonia and invasive pneumococcal disease among older adults (2).

Bone and heart abnormalities of subclinical hyperthyroidism in women below the age of 65 years.

PubMed

Rosario, Pedro Weslley

2008-12-01

The objective of the present study was to evaluate bone and cardiac abnormalities and symptoms and signs of thyroid hormone excess in women with subclinical hyperthyroidism (SCH) aged < 65 years. Forty-eight women with SCH were evaluated. The control group consisted of 48 euthyroid volunteers. The mean symptom rating scale score was significantly higher in patients. Cardiac involvement, both morphological and affecting systolic and diastolic functions, was also observed in patients. Women with SCH showed a significant increase in serum markers of bone formation and resorption. In addition, bone mineral density (BMD) was lower in the femoral neck but not in the lumbar spine in patients before menopause, whereas a lower BMD was observed at both sites in postmenopausal patients. SCH is not completely asymptomatic in women aged < 65 years, and is associated with heart abnormalities and with increased bone turnover and reduced BMD even before menopause.

Elderly men over 65 years of age with late-onset hypogonadism benefit as much from testosterone treatment as do younger men.

PubMed

Saad, Farid; Yassin, Aksam; Haider, Ahmad; Doros, Gheorghe; Gooren, Louis

2015-04-01

To investigate the potential benefits of testosterone administration to elderly men (>65 years) with late-onset hypogonadism (LOH) in comparison with younger men and to assess the safety of testosterone administration to elderly men. A total of 561 hypogonadal men from two registry studies were divided into age groups of ≤65 years (group Y, n=450; range, 32-65 years) and >65 years (group O, n=111; range, 66-84 years). Following an initial 6-week interval, all men were treated with 3-month injections of parenteral testosterone undecanoate for up to 6 years. Over the 6 years, there was a progressive decrease of body weight and waist circumference. Beneficial effects on lipids and other metabolic factors and on psychological and sexual functioning progressed over the first 24 to 42 months and were sustained. Rather than a deterioration, there was an improvement of urinary parameters. Prostate volume and prostate-specific antigen increased moderately. Hematocrit levels increased but remained within safe margins. The benefits of restoring serum testosterone in men with LOH were not significantly different between men older than 65 years of age and younger men. There were no indications that side effects were more severe in elderly men. The effects on prostate and urinary function and hematocrit were within safe margins. Age itself need not be a contraindication to testosterone treatment of elderly men with LOH.

Corynebacterium species nasopharyngeal carriage in asymptomatic individuals aged ≥ 65 years in Germany.

PubMed

Teutsch, Barbara; Berger, Anja; Marosevic, Durdica; Schönberger, Katharina; Lâm, Thiên-Trí; Hubert, Kerstin; Beer, Steffi; Wienert, Peter; Ackermann, Nikolaus; Claus, Heike; Drayß, Maria; Thiel, Kathrin; van der Linden, Mark; Vogel, Ulrich; Sing, Andreas

2017-10-01

The prevalence of protective anti-diphtheria toxin antibodies decreases with age. Therefore, the elderly might serve as reservoir for potentially toxigenic Corynebacterium (C.) species (C. diphtheriae, C. ulcerans, and C. pseudotuberculosis). This study aimed to examine the colonization rate of the nasopharynx with corynebacteria of individuals aged 65 years and older. In the period from October 2012 to June 2013, nasal and throat swabs were taken from 714 asymptomatic subjects aged 65-106 years (average age 77.2) at three regions in Germany and investigated for Corynebacterium species. A total of 402 strains of Corynebacterium species were isolated from 388 out of 714 asymptomatic subjects (carriage rate 54.3%). The carriage rate was significantly higher in study participants living in retirement homes (68.4%) compared to those living autonomously at home (51.1%). Strains were isolated mostly from the nose (99%). Corynebacterium accolens was the most often isolated species (39.8%), followed by C. propinquum (24.1%), C. pseudodiphtheriticum (19.4%), and C. tuberculostearicum (10.2%). No C. diphtheriae, C. ulcerans, and C. pseudotuberculosis strains were isolated. A subsample of 74 subjects was tested serologically for anti-diphtheria antibodies. Protective anti-diphtheria toxin antibodies were found in 29.7% of the subjects; 70.3% showed no protective immunity. These results suggest that carriage of potentially toxigenic corynebacteria is very rare among people aged 65 and older in Germany. However, the low prevalence of protective anti-diphtheria toxin antibodies might pose a risk for acquiring diphtheria especially for the elderly.

Aging in the Americas: Disability-free Life Expectancy Among Adults Aged 65 and Older in the United States, Costa Rica, Mexico, and Puerto Rico.

PubMed

Payne, Collin F

2018-01-11

To estimate and compare disability-free life expectancy (DFLE) and current age patterns of disability onset and recovery from disability between the United States and countries in Latin America and the Caribbean. Disability is measured using the activities of daily living scale. Data come from longitudinal surveys of older adult populations in Costa Rica, Mexico, Puerto Rico, and the United States. Age patterns of transitions in and out of disability are modeled with a discrete-time logistic hazard model, and a microsimulation approach is used to estimate DFLE. Overall life expectancy for women aged 65 is 20.11 years in Costa Rica, 19.2 years in Mexico, 20.4 years in Puerto Rico, and 20.5 years in the United States. For men, these figures are 19.0 years in Costa Rica, 18.4 years in Mexico, 18.1 years in Puerto Rico, and 18.1 years in the United States. Proportion of remaining life spent free of disability for women at age 65 is comparable between Mexico, Puerto Rico, and the United States, with Costa Rica trailing slightly. Male estimates of DFLE are similar across the four populations. Though the older adult population of Latin America and the Caribbean lived many years exposed to poor epidemiological and public health conditions, their functional health in later life is comparable with the older adult population of the United States. © The Author(s) 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Opportunistic screening for atrial fibrillation versus detecting symptomatic patients aged 65 years and older: A cluster-controlled clinical trial.

PubMed

González Blanco, Virginia; Pérula de Torres, Luis Ángel; Martín Rioboó, Enrique; Martínez Adell, Miguel Ángel; Parras Rejano, Juan Manuel; González Lama, Jesús; Ruiz Moruno, Javier; Martín Alvarez, Remedios; Fernández García, José Ángel; Ruiz de Castroviejo, Joaquin; Roldán Villalobos, Ana; Ruiz Moral, Roger

2017-01-06

The goal of this study was to assess the effectiveness of opportunistic screening through pulse palpation in the early detection of atrial fibrillation in subjects aged≥65 years versus detection through an active search for patients with symptoms and/or complications and sequelae associated. This was a cluster randomized controlled trial performed in 48 primary care centers of the Spanish National Healthcare System. A total of 368 physicians and nurses were randomized. The researchers in the experimental group (EG) performed opportunistic screening for auricular fibrillation, whereas the researchers in the control group (CG) actively searched for symptomatic patients. An ECG was performed on patients found to have an irregular heartbeat to confirm the diagnosis of auricular fibrillation. A total of 5,465 patients with a mean age of 75.61 years were recruited for the EG, and 1,525 patients with a mean age of 74.07 years were recruited for the CG. Of these, 58.6% were female, without significant differences between groups. Pulse was irregular in 4.3 and 15.0% of the patients in the EG and the CG, respectively (P<.001). A total of 164 new cases of atrial fibrillation were detected (2.3%), 1.1% in the EG and 6.7% in the CG (adjusted OR: 0.29; 95% CI 0.18-0.45). Case finding for atrial fibrillation in patients aged≥65 years with symptoms or signs suggestive of atrial fibrillation is a more effective strategy than opportunistic screening through pulse palpation in asymptomatic patients. The trial is registered in ClinicalTrials.gov (NCT01291953; February 8, 2011). Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Smoking, sex, risk factors and abdominal aortic aneurysms: a prospective study of 18 782 persons aged above 65 years in the Southern Community Cohort Study.

PubMed

Jahangir, Eiman; Lipworth, Loren; Edwards, Todd L; Kabagambe, Edmond K; Mumma, Michael T; Mensah, George A; Fazio, Sergio; Blot, William J; Sampson, Uchechukwu K A

2015-05-01

Abdominal aortic aneurysm (AAA) is a leading cause of death in the USA. We evaluated the incidence and predictors of AAA in a prospectively followed cohort. We calculated age-adjusted AAA incidence rates (IR) among 18 782 participants aged ≥65 years in the Southern Community Cohort Study who received Medicare coverage from 1999-2012, and assessed predictors of AAA using multivariable Cox proportional hazards models, overall and stratified by sex, adjusting for demographic, lifestyle, socioeconomic, medical and other factors. HRs and 95% CIs were calculated for AAA in relation to factors ascertained at enrolment. Over a median follow-up of 4.94 years, 281 cases were identified. Annual IR was 153/100,000, 401, 354 and 174 among blacks, whites, men and women, respectively. AAA risk was lower among women (HR 0.48, 95% CI 0.36 to 0.65) and blacks (HR 0.51, 95% CI 0.37 to 0.69). Smoking was the strongest risk factor (former: HR 1.91, 95% CI 1.27 to 2.87; current: HR 5.55, 95% CI 3.67 to 8.40), and pronounced in women (former: HR 3.4, 95% CI 1.83 to 6.31; current: HR 9.17, 95% CI 4.95 to 17). A history of hypertension (HR 1.44, 95% CI 1.04 to 2.01) and myocardial infarction or coronary artery bypass surgery (HR 1.9, 95% CI 1.37 to 2.63) was negatively associated, whereas a body mass index ≥25 kg/m(2) (HR 0.72; 95% CI 0.53 to 0.98) was protective. College education (HR 0.6, 95% CI 0.37 to 0.97) and black race (HR 0.44, 95% CI 0.28 to 0.67) were protective among men. Smoking is a major risk factor for incident AAA, with a strong and similar association between men and women. Further studies are needed to evaluate benefits of ultrasound screening for AAA among women smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

QuickStats: Percentage* of Adults Aged ≥18 Years Who Cannot or Find It Very Difficult to Stand or Be on Their Feet for About 2 Hours Without Using Special Equipment,† by Age Group and Sex - National Health Interview Survey,§ United States, 2015.

PubMed

2016-12-02

A reported 10.2% of adults aged ≥18 years cannot, or find it very difficult to, stand or be on their feet for about 2 hours without using special equipment. The percentage of adults who reported this difficulty increased with age: 2.9% of those aged 18-44 years, 11.8% of those aged 45-64 years, 19.1% of those 65-74 years, and 33.2% of those aged ≥75 years. Overall, women were more likely (11.9%) than men (8.3%) to report this difficulty, and higher percentages were noted for women within each age group.

Polyfluoroalkyl Chemicals and Menopause among Women 20–65 Years of Age (NHANES)

PubMed Central

Hoffman, Kate; Thayer, Kristina A.; Daniels, Julie L.

2013-01-01

Background: Polyfluoroalkyl chemicals (PFCs) such as perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) have been associated with early menopause. However, previous cross-sectional studies have lacked adequate data to investigate possible reverse causality (i.e., higher serum concentrations due to decreased excretion after menopause). Objectives: We investigated the association between PFOS, PFOA, perfluorononanoate (PFNA), and perfluorohexane sulfonate (PFHxS) and age at natural menopause among women 20–65 years of age in NHANES (National Health and Nutrition Examination Survey). Methods: We used proportional hazard models to estimate hazard ratios (HRs) for the onset of natural menopause as a function of age and serum PFC levels, and to investigate reverse causation by estimating associations between PFC levels and the rate of hysterectomy. We also used multivariable linear regression to determine whether time since menopause predicted serum PFC levels. Results: After adjusting for age at survey, race/ethnicity, education, ever smoking, and parity, women with higher levels of PFCs had earlier menopause than did women with the lowest PFC levels. We observed a monotonic association with PFHxS: The HR was 1.42 (95% CI: 1.08, 1.87) for serum concentrations in tertile 2 versus tertile 1, and 1.70 (95% CI: 1.36, 2.12) for tertile 3 versus tertile 1. We also found evidence of reverse causation: PFCs were positively associated with rate of hysterectomy, and time since natural menopause was positively associated with serum PFCs. Conclusions: Our findings suggest a positive association between PFCs and menopause; however, at least part of the association may be due to reverse causation. Regardless of underlying cause, women appear to have higher PFC concentrations after menopause. Citation: Taylor KW, Hoffman K, Thayer KA, Daniels JL. 2014. Polyfluoroalkyl chemicals and menopause among women 20–65 years of age (NHANES). Environ Health Perspect 122:145�

Comparison of Delay Times Between Symptom Onset of an Acute ST-elevation Myocardial Infarction and Hospital Arrival in Men and Women <65 Years Versus ≥65 Years of Age.: Findings From the Multicenter Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) Study.

PubMed

Ladwig, Karl-Heinz; Fang, Xiaoyan; Wolf, Kathrin; Hoschar, Sophia; Albarqouni, Loai; Ronel, Joram; Meinertz, Thomas; Spieler, Derek; Laugwitz, Karl-Ludwig; Schunkert, Heribert

2017-12-15

Early administration of reperfusion therapy in acute ST-elevation myocardial infarctions (STEMI) is crucial to reduce mortality. Although female sex and old age are key factors contributing to an inadequate long prehospital delay time, little is known whether women ≥65 years are a particular risk population. Hence, we studied the interaction of sex and age (<65 years or ≥65 years) and the contribution of chest pain to delay time during STEMI. Bedside interview data were collected in 619 STEMI patients from the Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study. Sex and age group stratification disclosed an excess delay risk for women ≥65 years, accounting for a 2.39 (95% confidence interval (CI) 1.39 to 4.10)-fold higher odds to delay longer than 2 hours compared with all other patient groups including younger women (p ≤0.002). Median delay time was 266 minutes in women ≥65 years and 148 minutes in younger women (p <0.001). Chest pain during STEMI had the lowest frequency both in women (81%) and men ≥65 years (83%) and the highest frequency (95%) in younger women. Experiencing non-chest pain was 2.32-fold (95% CI, 1.20 to 4.46, p <0.05) higher in women ≥65 years than in all other patients. Mediation analysis disclosed that the effect accounted for only 9% of the variance. Age specific educational strategies targeting women ≥65 years at risk are urgently needed. To tailor adequate strategies, more research is required to understand age- and sex driven barriers to timely identification of ischemic symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

Pap Smear Test Prevalence within Three Years (Age 18+) - Small Area Estimates

Cancer.gov

For Pap smear test, a woman 18 years of age or older must have reported having at least one Pap smear test in her life. Furthermore, she should have had one within the last three years by the time of interview.

Development of horizontal tooth wear in maxillary anterior teeth from five to 18 years of age.

PubMed

Nyström, M; Könönen, M; Alaluusua, S; Evälahti, M; Vartiovaara, J

1990-11-01

Sizes of horizontal wear facets of maxillary anterior teeth were studied longitudinally from the primary dentition at age five to the young adult dentition at the age of 18 years. By a planimetric method, we calculated the wear areas on dental casts taken at the ages of five, ten, 14, and 18 years from the dentition of 39 healthy, orthodontically untreated subjects with good morphological occlusion. For young adults, we also studied the association between the amount of wear and reported parafunctions, maximal bite force, salivary buffer capacity, salivary flow rate, and some cephalometric variables. Size of wear facets on all anterior teeth increased with age. Significant correlations were found between the total wear areas of the six anterior primary teeth at five years of age and those of their permanent successors at age 14 (r = 0.44) and 18 (r = 0.39). For an individual, tooth wear at five years of age was, however, of low predictive value for tooth wear in young adulthood, whereas tooth wear at 14 years of age predicted it well (r = 0.89). Highest correlations between tooth wear and background factors at 18 years of age were found for maximal anterior bite force (r = 0.44) and for the size of the gonial angle (r = -0.31). Wear of anterior teeth was not associated with reported parafunctions in young adulthood.

Development of reference equations for spirometry in Japanese children aged 6-18 years.

PubMed

Takase, Masato; Sakata, Hiroshi; Shikada, Masahiro; Tatara, Katsuyoshi; Fukushima, Takayoshi; Miyakawa, Tomoo

2013-01-01

Spirometry is the most widely used pulmonary function test and the measured values of spirometric parameters need to be evaluated using reference values predicted for the corresponding race, sex, age, and height. However, none of the existing reference equations for Japanese children covers the entire age range of 6-18 years. The Japanese Society of Pediatric Pulmonology had organized a working group in 2006, in order to develop a new set of national standard reference equations for commonly used spirometric parameters that are applicable through the age range of 6-18 years. Quality assured spirometric data were collected through 2006-2008, from 14 institutions in Japan. We applied multiple regression analysis, using age in years (A), square of age (A(2)), height in meters (H), square of height (H(2)), and the product of age and height (AH) as explanatory variables to predict forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV(1)), peak expiratory flow (PEF), forced expiratory flow between 25% and 75% of the FVC (FEF(25-75%)), instantaneous forced expiratory flow when 50% (FEF(50%)) or 75% (FEF(75%)) of the FVC have been expired. Finally, 1,296 tests (674 boys, 622 girls) formed the reference data set. Distributions of the percent predicted values did not differ by ages, confirming excellent fit of the prediction equations throughout the entire age range from 6 to 18 years. Cut-off values (around 5 percentile points) for the parameters were also determined. We recommend the use of this new set of prediction equations together with suggested cut-off values, for assessment of spirometry in Japanese children and adolescents. Copyright © 2012 Wiley Periodicals, Inc.

[Establish Assessment Model of 18 Years of Age in Chinese Han Population by Mandibular Third Molar].

PubMed

Fan, Fei; Dai, Xin-hua; Wang, Liang; Li, Yuan; Zhang, Kui; Deng, Zhen-hua

2016-02-01

To explore the value of estimating chronologic age based on the grades of mandibular third molar development. To evaluate whether mandibular third molar could be used as an indicator for estimating the age under or over 18 years. The mineralization status of mandibular third molar of 1 845 individuals aged 10 - 30 was graded and marked based on Demirjian's classification of grades reformed by Orhan. Gender difference was examined by t-test. A cubic regression model was established to analyze the correlation between third molar and chronologic age. Each grade of age cumulative distribution diagram and ROC curve was respectively performed to evaluate the relationship between third molar and the age of 18. Using Bayes discriminant analysis, an equation was established for estimating the age of 18. The inner-rater reliability was 0.903. Statistical analysis showed a moderate correlation between age and grade. Significant differences of both genders were found only in grade D and H (P < 0.05). Males at the grades from 1 to D and females at the grades from 1 to C were under 18 years old, and both males and females at grade H were over 18 years old. The area under the ROC curve was 0.797 (P < 0.05). Third molar development shows a high correlation with age, and combined with other indicators, it can be used to estimate the age of 18.

Live Attenuated Influenza Vaccine, Trivalent, Is Safe in Healthy Children 18 Months to 4 Years, 5 to 9 Years, and 10 to 18 Years of Age in a Community-Based, Nonrandomized, Open-Label Trial

PubMed Central

Piedra, Pedro A.; Gaglani, Manjusha J.; Riggs, Mark; Herschler, Gayla; Fewlass, Charles; Watts, Matt; Kozinetz, Claudia; Hessel, Colin; Glezen, W. Paul

2006-01-01

Objective Influenza-associated deaths in healthy children that were reported during the 2003–2004 influenza season heightened the public awareness of the seriousness of influenza in children. In 1996–1998, a pivotal phase III trial was conducted in children who were 15 to 71 months of age. Live attenuated influenza vaccine, trivalent (LAIV-T), was shown to be safe and efficacious. In a subsequent randomized, double-blind, placebo-controlled LAIV-T trial in children who were 1 to 17 years of age, a statistically significant increase in asthma encounters was observed for children who were younger than 59 months. LAIV-T was not licensed to children who were younger than 5 years because of the concern for asthma. We report on the largest safety study to date of the recently licensed LAIV-T in children 18 months to 4 years, 5 to 9 years, and 10 to 18 years of age in a 4-year (1998–2002) community-based trial that was conducted at Scott & White Memorial Hospital and Clinic (Temple, TX). Methods An open-label, nonrandomized, community-based trial of LAIV-T was conducted before its licensure. Medical records of all children were surveyed for serious adverse events (SAEs) 6 weeks after vaccination. Health care utilization was evaluated by determining the relative risk (RR) of medically attended acute respiratory illness (MAARI) and asthma rates at 0 to 14 and 15 to 42 days after vaccination compared with the rates before vaccination. Medical charts of all visits coded as asthma were reviewed for appropriate classification of events: acute asthma or other. We evaluated the risk for MAARI (health care utilization for acute respiratory illness) 0 to 14 and 15 to 42 days after LAIV-T by a method similar to the postlicensure safety analysis conducted on measles, mumps, and rubella and on diphtheria, tetanus, and whole-cell pertussis vaccines. Results All children regardless of age were administered a single intranasal dose of LAIV-T in each vaccine year. In the 4 years of

Urinary incontinence, depression, and economic outcomes in a cohort of women between the ages of 54 and 65 years.

PubMed

Hung, Kristin J; Awtrey, Christopher S; Tsai, Alexander C

2014-04-01

To estimate the association between urinary incontinence (UI) and probable depression, work disability, and workforce exit. The analytic sample consisted of 4,511 women enrolled in the population-based Health and Retirement Study cohort. The analysis baseline was 1996, the year that questions about UI were added to the survey instrument, and at which time study participants were 54-65 years of age. Women were followed-up with biennial interviews until 2010-2011. Outcomes of interest were onset of probable depression, work disability, and workforce exit. Urinary incontinence was specified in different ways based on questions about experience and frequency of urine loss. We fit Cox proportional hazards regression models to the data, adjusting the estimates for baseline sociodemographic and health status variables previously found to confound the association between UI and the outcomes of interest. At baseline, 727 participants (survey-weighted prevalence, 16.6%; 95% confidence interval [CI] 15.4-18.0) reported any UI, of which 212 (survey-weighted prevalence, 29.2%; 95% CI 25.4-33.3) reported urine loss on more than 15 days in the past month; and 1,052 participants were categorized as having probable depression (survey-weighted prevalence, 21.6%; 95% CI 19.8-23.6). Urinary incontinence was associated with increased risks for probable depression (adjusted hazard ratio, 1.43; 95% CI 1.27-1.62) and work disability (adjusted hazard ratio, 1.21; 95% CI 1.01-1.45), but not workforce exit (adjusted hazard ratio, 1.06; 95% CI 0.93-1.21). In a population-based cohort of women between ages 54 and 65 years, UI was associated with increased risks for probable depression and work disability. Improved diagnosis and management of UI may yield significant economic and psychosocial benefits.

Hospital costs associated with atrial fibrillation for ischemic stroke patients aged 18-64 years in the United States

PubMed Central

Wang, Guijing; Joo, Heesoo; Tong, Xin; George, Mary G.

2015-01-01

Background and purpose Hospital costs associated with atrial fibrillation (AFib) among stroke patients have not been well-studied, especially among people younger than 65 years. We estimated the AFib-associated hospital costs in U.S. patients aged 18-64 years. Methods We identified hospital admissions with a primary diagnosis of ischemic stroke from the 2010-2012 MarketScan Commercial Claims and Encounters inpatient datasets, excluding those with capitated health insurance plans, aged <18 or >64, missing geographic region, hospital costs below the 1st or above 99th percentile, and having carotid intervention (N=40,082). We searched the data for AFib and analyzed the costs for non-repeat and repeat stroke admissions separately. We estimated the AFib-associated costs using multivariate regression models controlling for age, sex, geographic region, and Charlson comorbidity index. Results Of the 33,500 non-repeat stroke admissions, 2,407 (7.2%) had AFib. Admissions with AFib cost $4,991 more than those without AFib ($23,770 vs. $18,779). For the 6,582 repeat stroke admissions, 397 (6.0%) had AFib. The costs were $3,260 more for those with AFib than those without ($24,119 vs. $20,929). After controlling for potential confounders, AFib-associated costs for non-repeat stroke admissions were $4,905, representing 20.6% of the total costs for the admissions. Both the hospital costs and the AFib-associated costs were associated with age, but not sex. AFib-associated costs for repeat stroke admissions were not significantly higher than for non-AFib patients, except for those aged 55-64 ($3,537). Conclusions AFib increased the hospital cost of ischemic stroke substantially. Further investigation on AFib-associated costs for repeat stroke admissions is needed. PMID:25851767

Adherence and Persistence Among Statin Users Aged 65 Years and Over: A Systematic Review and Meta-analysis.

PubMed

Ofori-Asenso, Richard; Jakhu, Avtar; Zomer, Ella; Curtis, Andrea J; Korhonen, Maarit Jaana; Nelson, Mark; Gambhir, Manoj; Tonkin, Andrew; Liew, Danny; Zoungas, Sophia

2018-05-09

Older people (aged ≥ 65 years) have distinctive challenges with medication adherence. However, adherence and persistence patterns among older statin users have not been comprehensively reviewed. As part of a broader systematic review, we searched Medline, Embase, PsycINFO, CINAHL, Database of Abstracts of Reviews of Effects, CENTRAL, and the National Health Service Economic Evaluation Database through December 2016 for English articles reporting adherence and/or persistence among older statin users. Data were analyzed via descriptive methods and meta-analysis using random-effect modeling. Data from more than 3 million older statin users in 82 studies conducted in over 40 countries were analyzed. At 1-year follow-up, 59.7% (primary prevention 47.9%; secondary prevention 62.3%) of users were adherent (medication possession ratio [MPR] or proportion of days covered [PDC] ≥ 80%). For both primary and secondary prevention subjects, 1-year adherence was worse among individuals aged more than 75 years than those aged 65-75 years. At 3 and ≥10 years, 55.3% and 28.4% of users were adherent, respectively. The proportion of users persistent at 1-year was 76.7% (primary prevention 76.0%; secondary prevention 82.6%). Additionally, 68.1% and 61.2% of users were persistent at 2 and 4 years, respectively. Among new statin users, 48.2% were nonadherent and 23.9% discontinued within the first year. The proportion of statin users who were adherent based on self-report was 85.5%. There is poor short and long term adherence and persistence among older statin users. Strategies to improve adherence and reduce discontinuation are needed if the intended cardiovascular benefits of statin treatment are to be realized.

Hip arthroplasty with the thrust plate prosthesis in patients of 65 years of age or older: 67 patients followed 2-7 years.

PubMed

Karatosun, Vasfi; Unver, Bayram; Gunal, Izge

2008-04-01

Thrust plate prosthesis (TPP) is a relatively new concept in total hip arthroplasty and advocated to be used in young patients. We retrospectively evaluated the results of 67 patients (71 hips) who were older than 65 years of age and underwent hip arthroplasty using the TPP. There were 50 female and 17 male patients with a mean age 71 (range 65-89) years. All patients received accelerated rehabilitation program either with full weight bearing in the second postoperative day or at 6 weeks. All patients were followed-up for at least 2 years (range 28-87 months). The average Harris hip score improved from 43 (range 8-72) to 93 (range 64-100) at the latest follow-up (p < 0.001). The overall revision rate was 8.4%. However, when the patients with definitive history of trauma were excluded the rate for loosening and technical errors decreased to 4.2%. There was no significant difference between the Harris hip score of patients with full weight bearing in the second postoperative day or 6 weeks (p = 0.57). We conclude that the TPP could be indicated for older patients without age limit and that an accelerated rehabilitation program with early weight bearing can be applied to these patients.

26 CFR 1.37-2 - Credit for individuals age 65 or over.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 1 2013-04-01 2013-04-01 false Credit for individuals age 65 or over. 1.37-2... TAXES Credits Against Tax § 1.37-2 Credit for individuals age 65 or over. (a) In general. This section... age of 65 before the close of the taxable year. This section shall not apply to an individual for any...

26 CFR 1.37-2 - Credit for individuals age 65 or over.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Credit for individuals age 65 or over. 1.37-2... TAXES Credits Against Tax § 1.37-2 Credit for individuals age 65 or over. (a) In general. This section... age of 65 before the close of the taxable year. This section shall not apply to an individual for any...

26 CFR 1.37-2 - Credit for individuals age 65 or over.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Credit for individuals age 65 or over. 1.37-2... TAXES Credits Against Tax § 1.37-2 Credit for individuals age 65 or over. (a) In general. This section... age of 65 before the close of the taxable year. This section shall not apply to an individual for any...

26 CFR 1.37-2 - Credit for individuals age 65 or over.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Credit for individuals age 65 or over. 1.37-2... TAXES Credits Against Tax § 1.37-2 Credit for individuals age 65 or over. (a) In general. This section... age of 65 before the close of the taxable year. This section shall not apply to an individual for any...

[Relationship between dysphagia and malnutritition in patients over 65 years of age].

PubMed

Galán Sánchez-Heredero, María José; Santander Vaquero, Cecilio; Cortázar Sáez, Milagros; de la Morena López, Felipe; Susi García, Rosario; Martínez Rincón, María Del Carmen

2014-01-01

The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (>65y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity. A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index). A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyngeal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition. Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Stereotactic radiosurgery for brain metastases: a case-matched study comparing treatment results for patients 80 years of age or older versus patients 65-79 years of age.

PubMed

Watanabe, Shinya; Yamamoto, Masaaki; Sato, Yasunori; Kawabe, Takuya; Higuchi, Yoshinori; Kasuya, Hidetoshi; Yamamoto, Tetsuya; Matsumura, Akira; Barfod, Bierta E

2014-11-01

Recently, an increasing number of patients with brain metastases, even patients over 80 years of age, have been treated with stereotactic radiosurgery (SRS). However, there is little information on SRS treatment results for patients with brain metastases 80 years of age and older. The authors undertook this study to reappraise whether SRS treatment results for patients 80 years of age or older differ from those of patients who are 65-79 years old. This was an institutional review board-approved, retrospective cohort study. Among 2552 consecutive brain metastasis patients who underwent SRS during the 1998-2011 period, we studied 165 who were 80 years of age or older (Group A) and 1181 who were age 65-79 years old (Group B). Because of the remarkable disproportion in patient numbers between the 2 groups and considerable differences in pre-SRS clinical factors, the authors conducted a case-matched study using the propensity score matching method. Ultimately, 330 patients (165 from each group, A and B) were selected. For time-to-event outcomes, the Kaplan-Meier method was used to estimate overall survival and competing risk analysis was used to estimate other study end points, as appropriate. Although the case-matched study showed that post-SRS median survival time (MST, months) was shorter in Group A patients (5.3 months, 95% CI 3.9-7.0 months) than in Group B patients (6.9 months, 95% CI 5.0-8.1 months), this difference was not statistically significant (HR 1.147, 95% CI 0.921-1.429, p = 0.22). Incidences of neurological death and deterioration were slightly lower in Group A than in Group B patients (6.3% vs 11.8% and 8.5% vs 13.9%), but these differences did not reach statistical significance (p = 0.11 and p = 0.16). Furthermore, competing risk analyses showed that the 2 groups did not differ significantly in cumulative incidence of local recurrence (HR 0.830, 95% CI 0.268-2.573, p = 0.75), rates of repeat SRS (HR 0.738, 95% CI 0.438-1.242, p = 0.25), or incidence

Comparison of intensive, pediatric-inspired therapy with non-intensive therapy in older adults aged 55-65 years with Philadelphia chromosome-negative acute lymphoblastic leukemia.

PubMed

Ribera, Josep-Maria; García, Olga; Gil, Cristina; Mercadal, Santiago; García-Cadenas, Irene; Montesinos, Pau; Barba, Pere; Vives, Susana; González-Campos, José; Tormo, Mar; Esteve, Jordi; López, Aurelio; Moreno, María José; Ribera, Jordi; Alonso, Natalia; Bermúdez, Arancha; Amigo, María Luz; Genescà, Eulàlia; García, Daniel; Vall-Llovera, Ferran; Bergua, Juan Miguel; Guàrdia, Ramon; Monteserín, María Carmen; Bernal, Teresa; Calbacho, María; Martínez, María Pilar; Feliu, Evarist

2018-05-01

The standardization of treatment of older adults with Philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL) is challenging, especially in the age range of 55-65 years. This study aimed to compare intensive, pediatric-inspired therapy with non-intensive therapy in this population of patients. The outcomes of 67 patients prospectively included in two consecutive pediatric-inspired intensive protocols (ALL-HR03 and ALL-HR11) from the Spanish PETHEMA Group were compared with those from 44 patients included in a contemporary semi-intensive protocol (ALL-OLD07). Baseline patient and ALL characteristics were similar in both groups, except for a younger median age in the intensive group (medians: 58 vs. 62 years). Patients treated intensively had a higher complete remission rate (85% vs. 64%, p = 0.005), a lower cumulative incidence of relapse (39% [95%CI, 25% to 52%] vs. 60% [95%CI, 38% to 77%], p = .003), a similar cumulative incidence of treatment-related mortality (28% [95% CI, 18%, 40%] vs. 21% [95% CI, 10%, 34%]) and superior event-free survival at 2 years (37% [95%CI, 25%-49%) vs. 21% [8%-34%], p = 0.002). On multivariable analysis the type of protocol was the only variable with independent significance for event-free survival (HR [95% CI]: 2 [1.3, 3], p = .002). Compared with less intensive chemotherapy, pediatric-inspired intensive chemotherapy significantly improves the outcome of older adults with Ph-negative ALL in the age range of 55-65 years. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Weight and height local growth charts of Algerian children and adolescents (6-18 years of age)].

PubMed

Bahchachi, N; Dahel-Mekhancha, C C; Rolland-Cachera, M F; Badis, N; Roelants, M; Hauspie, R; Nezzal, L

2016-04-01

Measurements of height and weight provide important information on growth and development, puberty, and nutritional status in children and adolescents. The aim of this study was to develop contemporary reference growth centiles for Algerian children and adolescents (6-18 years of age). A cross-sectional growth survey was conducted in government schools on 7772 healthy schoolchildren (45.1% boys and 54.9% girls) aged 6-18 years in Constantine (eastern Algeria) in 2008. Height and weight were measured with portable stadiometers and calibrated scales, respectively. Smooth reference curves of height and weight were estimated with the LMS method. These height and weight curves are presented together with local data from Arab countries and with the growth references of France, Belgium (Flanders), and the World Health Organization (WHO) 2007. In girls, median height and weight increased until 16 and 17 years of age, respectively, whereas in boys, they increased through age 18 years. Between ages 11 and 13 years (puberty), girls were taller and heavier than boys. After puberty, boys became taller than girls, by up to 13 cm by the age of 18 years. Median height and weight of Algerian boys and girls were generally intermediate between those observed in other Arab countries. They were higher than the French reference values up to the age of 13 years and lower than Belgian and WHO reference values at all ages. The present study provides Algerian height- and weight-for-age growth charts, which should be recommended as a national reference for monitoring growth and development in children and adolescents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Implementing an influenza vaccination programme for adults aged ≥65 years in Poland: a cost-effectiveness analysis.

PubMed

Brydak, Lidia; Roiz, Julie; Faivre, Pascaline; Reygrobellet, Camille

2012-02-01

Influenza is a common respiratory disease occurring in seasonal patterns, and may lead to severe complications in frail populations such as the elderly. In Poland, influenza vaccination is recommended for people aged ≥65 years; however the vaccine coverage rate in the elderly is very low. The fact that influenza vaccine is neither reimbursed by the National Health Insurance (Narodowy Fundusz Zdrowia [NFZ]) nor financed via a National Immunization Program (NIP) could be a reason for the low coverage rate. This study assessed the cost effectiveness of the full reimbursement of an influenza vaccination programme in Poland for people aged ≥65 years. A decision-analytic model was developed to compare costs and outcomes associated with the current situation in which influenza vaccination is not reimbursed and a new situation in which it would be fully covered by the NFZ. The model was parameterized to Poland using data from the literature and from the Central Statistic Office of Poland. Within the elderly population, 50% were considered to be at high risk of influenza complications. An influenza attack rate of 3.5% was used for calculation purposes. Influenza-associated hospitalizations and death rates were estimated at 439.9 per 100 000 person-years and 79.1 per 100 000 person-years, respectively. Cost estimates were derived from a cost study conducted in Poland. Costs are presented in Polish Zloty (PLN) [2009 mean exchange rate: 1 PLN = €0.232]. Only direct medical costs were included to fit to the NFZ perspective. To reflect the seasonality of influenza, a time horizon of 1 year was chosen. Life-years and quality-adjusted life-years (QALYs) accumulated over future years were discounted at a rate of 5% as recommended by Polish guidelines. Deterministic and probabilistic sensitivity analyses were conducted. In Poland, the introduction of the public funding of influenza vaccination for people aged ≥65 years would cost PLN 79 million when an increase in

Fracture Incidence and Characteristics in Young Adults Aged 18 to 49 Years: A Population-Based Study.

PubMed

Farr, Joshua N; Melton, L Joseph; Achenbach, Sara J; Atkinson, Elizabeth J; Khosla, Sundeep; Amin, Shreyasee

2017-12-01

Although fractures in both the pediatric and, especially, the elderly populations have been extensively investigated, comparatively little attention has been given to the age group in between. Thus, we used the comprehensive (inpatient and outpatient) data resources of the Rochester Epidemiology Project to determine incidence rates for all fractures among young adult (age range, 18 to 49 years) residents of Olmsted County, Minnesota, in 2009 to 2011, and compared the distribution of fracture sites and causes in this young adult cohort with those for older residents aged 50 years or older. During the 3-year study period, 2482 Olmsted County residents aged 18 to 49 years experienced 1 or more fractures. There were 1730 fractures among 1447 men compared with 1164 among 1035 women, and the age-adjusted incidence of all fractures was 66% greater among the men (1882 [95% confidence interval 1793-1971] versus 1135 [95% CI 1069-1201] per 100,000 person-years; p < 0.001). Of all fractures, 80% resulted from severe trauma (eg, motor vehicle accidents) compared with 33% in Olmsted County residents age ≥50 years who sustained a fracture in 2009 to 2011. Younger residents (aged 18 to 49 years), when compared with older residents (aged ≥50 years), had a greater proportion of fractures of the hands and feet (40% versus 18%) with relatively few fractures observed at traditional osteoporotic fracture sites (14% versus 43%). Vertebral fractures were still more likely to be the result of moderate trauma than at other sites, especially in younger women. In conclusion, whereas pediatric and elderly populations often fracture from no more than moderate trauma, young adults, and more commonly men, suffer fractures primarily at non-osteoporotic sites due to more significant trauma. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

Use of levetiracetam in a population of patients aged 65 years and older: a subset analysis of the KEEPER trial.

PubMed

Ferrendelli, J A; French, J; Leppik, I; Morrell, M J; Herbeuval, A; Han, J; Magnus, L

2003-12-01

Levetiracetam (Keppra) was evaluated in a subset of patients aged >/=65 years (n=78) enrolled in a large (n=1030) open-label, phase IV trial (the KEEPER trial). A 4-week dose adjustment was followed by a 12-week evaluation period. An overall median reduction in partial seizures of 80.1% (n=65) was observed. Overall, 76.9% of patients were >/=50% responders, 56.9% were >/=75% responders, and 40.0% were 100% responders. Levetiracetam was well tolerated, with 42.3% of patients reporting one or more adverse events. A total of 15 patients (19.2%) experienced an adverse event that led to discontinuation. Somnolence (n=13,16.7%) and dizziness (n=7,9.0%) were the most commonly reported adverse events. Despite the limitations of the open-label study design, these data provide information regarding the use of levetiracetam as add-on therapy for the treatment of partial-onset seizures in patients >/=65 years of age, including those requiring concomitant medications.

The provision of mental health services in England for people over 65 years of age, 1970-78.

PubMed

Hilton, Claire

2008-09-01

The twentieth century saw an increasing number of people living into old age, and consequently a higher prevalence of age-related chronic degenerative brain disorders. By 1971 the mental hospitals were almost half full with people over 65 years of age. Thus plans to close the mental hospitals meant that the development of community mental health services for older people was a necessity. Although there was a multi-disciplinary focus on the care of older people, the lead in service development was largely taken by psychiatrists, both individually and through the Group for the Psychiatry of Old Age at the Royal College of Psychiatrists.

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Are you age 65? 408.214 Section 408.214... Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day before the anniversary of your birth corresponding to age 65. Thus, you must have been born on or before...

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Are you age 65? 408.214 Section 408.214... Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day before the anniversary of your birth corresponding to age 65. Thus, you must have been born on or before...

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Are you age 65? 408.214 Section 408.214... Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day before the anniversary of your birth corresponding to age 65. Thus, you must have been born on or before...

Isolated coronary artery bypass grafting in extracorporeal circulation in patients over 65 years old - does age still matter?

PubMed

Miśkowiec, Dawid; Walczak, Andrzej; Ostrowski, Stanisław; Wrona, Ewa; Bartczak, Karol; Jaszewski, Ryszard

2014-06-01

Coronary artery bypass grafting (CABG) is conducted more and more commonly in patients in advanced age. To analyze the influence of age and concurrent risk factors on the complications and early mortality after CABG. Medical records of 2194 patients were analyzed retrospectively. A group of 1303 patients who had undergone isolated CABG was selected. 106 (4.8%) patients were excluded due to missing data in their medical records. The remaining 1197 patients were divided into two subgroups by age: 1(st) group < 65 years (n = 662; 55.3%); 2(nd) group ≥ 65 years (n = 535; 44.7%). The total 30-day mortality was 3.93% and was six times higher in the older group (1.21 vs. 7.29%; p < 0.001). Complications were observed in 176 (14.70%) patients, more often in the older group (10.42% vs. 20.0%; p < 0.001). In this group all kinds of complications were noted more often and in particular: postoperative myocardial infarction (1.96% vs. 5.42%; p = 0.001), respiratory dysfunction (1.36% vs. 4.11%; p = 0.005), neurological complications (1.81% vs. 3.74%; p = 0.04) and multi-organ dysfunction syndrome (0.30% vs. 1.68%, p = 0.03). The older patients required longer time under mechanical ventilation (24.0 ± 27.9 vs. 37.0 ± 74.1 hours; p = 0.004) and stayed longer in the intensive care unit: 2.5 ± 3.0 vs. 4.1 ± 7.84 days; p < 0.001. Independent predictors of death were: female sex [OR (95% CI) = 2.4 (1.2-4.5)], age ≥ 65 years [OR = 4.9 (2.1-11.1)], eGFR < 60 mL/min/1.73 m(2) [OR = 2.2 (1.0-4.7)], time at extracorporeal circulation > 72 minutes [OR = 5.5 (2.7-10.9)] and left main stem stenosis (> 50%) [OR = 2.4 (1.3-4.6)]. Age still significantly influences postoperative complications and mortality after isolated CABG.

Muscle strength and soft tissue composition as measured by dual energy x-ray absorptiometry in women aged 18-87 years.

PubMed

Madsen, O R; Lauridsen, U B; Hartkopp, A; Sørensen, O H

1997-01-01

Dual energy x-ray absorptiometry (DEXA) offers the possibility of assessing regional soft tissue composition, i.e. lean mass (LM) and fat mass: LM may be considered a measure of muscle mass. We examined age-related differences in LM, percentage fat (%fat) and muscle strength in 100 healthy non-athletic women aged 18-87 years. Relationships between muscle strength and leg LM in 20 elite female weight lifters and in 18 inactive women with previous hip fractures were also studied. The LM and %fat of the whole body, trunk, arms and legs were derived from a whole body DEXA scan. Isokinetic knee extensor strength (KES) and flexor strength (KFS) at 30 degrees.s-1 were assessed using an isokinetic dynamometer. The women aged 71-87 years had 35% lower KES and KFS than the women aged 18-40 years (P < 0.0001). Differences in LM were less pronounced. The LM of the legs, for instance, was 15% lower in the old than in the young women (P < 0.0001). In a multiple regression analysis with age, body mass, height and leg LM or KES as independent variables and KES or leg LM as the dependent variable, age was the most important predictor of KES (r(partial) = -0.74, P < 0.0001). The same applied to KFS. Body mass, not age, was the most important predictor of leg LM (r(partial) = 0.65, P < 0.0001) and of LM at all other measurement sites. The LM measured at different regions decreased equally with increasing age. The KES:leg LM ratio was negatively correlated with age (r = -0.70, P < 0.0001). The weight lifters had significantly higher KES:leg LM ratios than age-matched controls (+ 12%, P < 0.0001) and vice versa for the women with previous hip fractures (-36%, P < 0.0001). In conclusion, from our study it would seem that in healthy nonathletic women, age is a more important determinant of muscle strength than is LM as measured by DEXA. Muscle strengthening exercises and inactivity seem to have a considerably stronger influence on muscle strength than on LM.

Falls, risk factors and fear of falling among persons older than 65 years of age.

PubMed

Gazibara, Tatjana; Kurtagic, Ilma; Kisic-Tepavcevic, Darija; Nurkovic, Selmina; Kovacevic, Nikolina; Gazibara, Teodora; Pekmezovic, Tatjana

2017-07-01

Falling represents a major public health problem among older persons because it leads to premature mortality, loss of independence, and placement in assisted-living facilities. The purpose of this study was to assess the main features and risks for falls among persons older than 65 years of age as well as to quantify their fear of falling. A total of 354 persons older than 65 years of age were recruited at a community health centre. Characteristics of the most recent fall were obtained through detailed interviews with study participants. The Falls Efficacy Scale was used to quantify fear of falling. Frequency of falling was 15.8%. Falls occurred most often while walking (49%). One-half of fallers (49.1%) sustained an injury. Head haematomas and soft tissues contusions were the most common consequences of falls. The average Falls Efficacy Scale score was significantly higher in fallers ( P = 0.001). Multiple logistic regression analysis showed that having a fear of falling (odds ratio = 4.14, 95% confidence interval: 1.22-14.08, P = 0.02) and being a woman (odds ratio = 2.10, 95% confidence interval: 0.97-4.53, P = 0.05) were independent risk factors for falling among older persons. The frequency of falls among older people was similar to those in other populations. These results could be used to help select older persons who should be enrolled in fall prevention programmes. © 2017 Japanese Psychogeriatric Society.

9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

Code of Federal Regulations, 2011 CFR

2011-01-01

... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate during...

9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

Code of Federal Regulations, 2012 CFR

2012-01-01

... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate during...

9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

Code of Federal Regulations, 2013 CFR

2013-01-01

... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate during...

Fifteen-Year Survival of Endoscopic Anterior Cruciate Ligament Reconstruction in Patients Aged 18 Years and Younger.

PubMed

Morgan, Matthew D; Salmon, Lucy J; Waller, Alison; Roe, Justin P; Pinczewski, Leo A

2016-02-01

The current body of literature surrounding anterior cruciate ligament (ACL) survival and the variables contributing to further ACL injuries after primary ACL reconstruction in children and adolescents is limited, with no long-term evidence examining the incidence and contributing factors of further ACL injuries in this younger patient population. To determine the long-term survival of the ACL graft and the contralateral ACL (CACL) after primary reconstruction in patients aged ≤18 years and to identify the factors that increase the odds of subsequent ACL injuries. Case series; Level of evidence, 4. Patients having undergone primary ACL reconstruction at age ≤18 years between 1993 and 1998 who were included in a prospective database by a single surgeon were considered for this study. Single-incision endoscopic ACL reconstruction was performed with either an autologous bone-patellar tendon-bone graft or a hamstring tendon graft. At a minimum of 15 years after ACL reconstruction, patients completed a subjective survey involving the International Knee Documentation Committee (IKDC) questionnaire in addition to questions regarding current symptoms, further ACL injuries, family history of ACL injury, and current level of activity. A total of 288 adolescents (age range, 13-18 years) met the inclusion criteria, of whom 242 (84%) were reviewed at a mean of 16 years and 6 months after ACL reconstruction. Of these patients, 75 (31%) sustained a further ACL injury: 27 (11.2%) suffered an ACL graft rupture, 33 suffered a CACL injury (13.6%), and 15 sustained both an ACL graft rupture and a CACL injury (6.2%) over 15 years. Survival of the ACL graft was 95%, 92%, 88%, 85%, and 83% at 1, 2, 5, 10, and 15 years, respectively, and survival of the CACL was 99%, 98%, 90%, 83%, and 81%, respectively. Survival of the ACL graft was less favorable in those with a family history of ACL injury than in those without a family history (69% vs 90%, respectively; hazard ratio [HR], 3.6; P

Health-Related Quality of Life Among People Aged ≥65 Years with Self-reported Visual Impairment: Findings from the 2006–2010 Behavioral Risk Factor Surveillance System

PubMed Central

Crews, John E.; Chou, Chiu-Fang; Zhang, Xinzhi; Zack, Matthew M.; Saaddine, Jinan B.

2016-01-01

Purpose To examine the association between health-related quality of life (HRQoL) and visual impairment among people aged ≥65 years. Methods We used cross-sectional data from the 2006–2010 Behavioral Risk Factor Surveillance System to examine six HRQoL measures: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, and moderate/severe. We examined the association between self-reported visual impairment and HRQoL using logistic regression accounting for the survey’s complex design. Results People with self-reported moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days compared to those reporting a little or no visual impairment. After controlling for all covariates (age, sex, marital status, race/ethnicity, education, income, diabetes, heart disease, stroke, heart attack, body mass index, leisure time activity, smoking, and medical care cost concerns) and comparing to those with no self-reported visual impairment, people reporting a little visual impairment were more likely to have fair/poor health (odds ratio, OR, 1.2, 95% confidence interval, CI, 1.1–1.3), life dissatisfaction (OR 1.6, 95% CI 1.3–2.0), and disability (OR 1.5, 95% CI 1.3–1.6), and those with self-reported moderate/severe visual impairment had more fair/poor health (OR 1.8, 95% CI 1.6–2.0), life dissatisfaction (OR 2.3, 95% CI 1.8–2.9), and disability (OR 2.0, 95% CI 1.8–2.2). They also had more frequent physically unhealthy days (OR 1.9, 95% CI 1.7–2.1), mentally unhealthy days (OR 1.8, 95% CI 1.5–2.1), and activity limitations days (OR 1.9, 95% CI 1.6–2.2). Conclusion Poor HRQoL is strongly associated with the severity of self-reported visual impairment among people aged ≥65 years. PMID:24955821

Very Low Prevalence of Vaccine Human Papillomavirus Types Among 18- to 35-Year Old Australian Women 9 Years Following Implementation of Vaccination.

PubMed

Machalek, Dorothy A; Garland, Suzanne M; Brotherton, Julia M L; Bateson, Deborah; McNamee, Kathleen; Stewart, Mary; Rachel Skinner, S; Liu, Bette; Cornall, Alyssa M; Kaldor, John M; Tabrizi, Sepehr N

2018-04-23

A quadrivalent human papillomavirus vaccination program targeting females aged 12-13 years commenced in Australia in 2007, with catch-up vaccination of 14-26 year olds through 2009. We evaluated the program's impact on HPV prevalence among women aged 18-35 in 2015. HPV prevalence among women aged 18-24 and 25-35 was compared with prevalence in these age groups in 2005-2007. For women aged 18-24, we also compared prevalence with that in a postvaccine study conducted in 2010-2012. For the 2015 sample, Vaccination Register-confirmed 3-dose coverage was 53.3% (65.0% and 40.3% aged 18-24 and 25-35, respectively). Prevalence of vaccine HPV types decreased from 22.7% (2005-2007) and 7.3% (2010-2012), to 1.5% (2015) (P trend < .001) among women aged 18-24, and from 11.8% (2005-2007) to 1.1% (2015) (P = .001) among those aged 25-35. This study, reporting the longest surveillance follow-up to date, shows prevalence of vaccine-targeted HPV types has continued to decline among young women. A substantial fall also occurred in women aged 25-35, despite lower coverage. Strong herd protection and effectiveness of less than 3 vaccine doses likely contributed to these reductions.

Rib fracture fixation in the 65 years and older population: A paradigm shift in management strategy at a Level I trauma center.

PubMed

Fitzgerald, Michael T; Ashley, Dennis W; Abukhdeir, Hesham; Christie, D Benjamin

2017-03-01

Rib fractures after chest wall trauma are a common injury; however, they carry a significant morbidity and mortality risk. The impact of rib fractures in the 65-year and older patient population has been well documented as have the mortality and pneumonia rates. We hypothesize that patients 65 years and older receiving rib plating (RP) have decreased mortality, complication rates, and an accelerated return to normal functional states when compared with controls. With institutional review board approval, a retrospective review analyzed patients 65 years and older with rib fractures admitted from 2009 to 2015 receiving RP (RP group) (n = 23) compared to nonoperative, injury-matched controls admitted from 2003 to 2008 (NO group) (n = 50). Patients were followed prospectively with regard to lifestyle and functional satisfaction. Independent variables analyzed included Injury Severity Score (ISS), number of rib fractures, mortalities, hospital days, intensive care unit days, pneumonia development, respiratory complications, readmission rates, need for and length of rehabilitation stay time. Comparisons were by χ tests/Fisher's exact tests, Student's t tests and Wilcoxon rank sum tests. From 2003 to 2008, 50 NO patients were admitted with ages ranging 65 to 97 years, average ISS of 18.47 (14.28-22.66) versus ages ranging from 63 to 89 years, average ISS of 20.71 (15.7-25.73) for the RP group (n = 23). Average hospital days were 16.76 (10.35-23.18) and 18.36 (13.61-23.11) in the NO and RP groups, respectively. Average intensive care unit days were 11.65 (6.45-16.85) and 8.29 (5.31-11.26) days in the NO and RP groups, respectively. Four respiratory readmissions, two deaths, seven pneumonias, seven pleural-effusions, and 19 recurrent pneumothoraces were encountered in the NO group versus 0 in the RP group (p < 0.001). An equal percentage of patients in both groups entered rehabilitation facilities with average stay time of 18.5 and 28.53 days for the RP and NO groups

Health screenings for women ages 18 to 39

MedlinePlus

Health maintenance visit - women - ages 18 to 39; Physical exam - women - ages 18 to 39; Yearly exam - ... 39; Checkup - women - ages 18 to 39; Women's health - ages 18 to 39; Preventive care - women - ages ...

A comparison of measured height and demi-span equivalent height in the assessment of body mass index among people aged 65 years and over in England.

PubMed

Hirani, Vasant; Mindell, Jennifer

2008-05-01

to examine differences between measured height and demi-span equivalent height (DEH) among people aged >or=65 and investigate the impact on body mass index (BMI) of using DEH. nationally representative cross-sectional sample of adults living in England. 3,346 non-institutionalised adults aged >or=65, taking part in the Health Survey for England (HSE) 2001. height, weight and demi-span measurements were taken according to standardised HSE protocols. DEH was calculated using Bassey's equation. the height measurement was lower than the DEH from age group 70-74 years onwards in men and in each age group in women. No significant differences in mean DEH and measured height were found for men (-0.46) or women (-2.64). BMI derived from measured height did not differ significantly from BMI derived from DEH. The prevalence of underweight was lower when using measured height than when using DEH in women aged >or=65, particularly in those aged 80 years and over. The prevalence of overweight and obesity was higher using measured height than DEH in women aged >or=65. we confirmed in a large nationally representative sample that demi-span measurement may be a useful estimate of stature in people (particularly women) aged >or=65 for BMI calculations.

Health information literacy in everyday life: a study of Finns aged 65-79 years.

PubMed

Eriksson-Backa, Kristina; Ek, Stefan; Niemelä, Raimo; Huotari, Maija-Leena

2012-06-01

This article examines the health information literacy of elderly Finns. The results are based on a survey conducted in January 2011. The questionnaire was distributed to 1000 persons that were randomly drawn from the Finnish Population Register. The respondents were aged 65-79 years (mean age 70 years) and lived in the Turku region in Finland. A total of 281 questionnaires (28%) were returned. χ(2) analyses were used to find possible relationships between demographic factors, as well as interest, seeking activity, current self-rated health and different dimensions of health information literacy, including needs, seeking and use of health-related information. Significant relationships were found between education level, interest in health information, seeking activity, self-rated current health and dimensions of health information literacy. Some categories of elderly people are more vulnerable regarding obtaining and use of health information: those with lower levels of education, those with poor health, and those who are not interested in and active at seeking information. For people who are found in any of these categories, it is important that available health-related information is understandable and can be accessed without too much effort-something that information providers should take into account.

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Are you age 65? 408.214 Section 408.214 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day...

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Are you age 65? 408.214 Section 408.214 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day...

Knowledge of influenza vaccination recommendation and early vaccination uptake during the 2015-16 season among adults aged ≥18years - United States.

PubMed

Lu, Peng-Jun; Srivastav, Anup; Santibanez, Tammy A; Christopher Stringer, M; Bostwick, Michael; Dever, Jill A; Stanley Kurtz, Marshica; Williams, Walter W

2017-08-03

Since 2010, the Advisory Committee on Immunization Practices (ACIP) has recommended that all persons aged ≥6months receive annual influenza vaccination. We analyzed data from the 2015 National Internet Flu Survey (NIFS), to assess knowledge and awareness of the influenza vaccination recommendation and early influenza vaccination coverage during the 2015-16 season among adults. Predictive marginals from a multivariable logistic regression model were used to identify factors independently associated with adults' knowledge and awareness of the vaccination recommendation and early vaccine uptake during the 2015-16 influenza season. Among the 3301 respondents aged ≥18years, 19.6% indicated knowing that influenza vaccination is recommended for all persons aged ≥6months. Of respondents, 62.3% indicated awareness that there was a recommendation for influenza vaccination, but did not indicate correct knowledge of the recommended age group. Overall, 39.9% of adults aged ≥18years reported having an influenza vaccination. Age 65years and older, being female, having a college or higher education, not being in work force, having annual household income ≥$75,000, reporting having received an influenza vaccination early in the 2015-16 season, having children aged ≤17years in the household, and having high-risk conditions were independently associated with a higher correct knowledge of the influenza vaccination recommendation. Approximately 1 in 5 had correct knowledge of the recommendation that all persons aged ≥6months should receive an influenza vaccination annually, with some socio-economic groups being even less aware. Clinic based education in combination with strategies known to increase uptake of recommended vaccines, such as patient reminder/recall systems and other healthcare system-based interventions are needed to improve vaccination, which could also improve awareness. Published by Elsevier Ltd.

Robotic versus laparoscopic Roux-en-Y gastric bypass (RYGB) in obese adults ages 18 to 65 years: a systematic review and economic analysis.

PubMed

Bailey, Jonathan G; Hayden, Jill A; Davis, Philip J B; Liu, Richard Y; Haardt, David; Ellsmere, James

2014-02-01

In the United States, 37.5 % of adults (78 million) are obese. The direct medical costs of treating obesity-related disease account for more than 6 % of the national health expenditure. Robotic bariatric surgery is becoming more common, but it is unclear whether robotic procedures result in lower complication rates. Additionally, some evidence is conflicting regarding the costs of robotic Roux-en-Y gastric bypass (RYGB) compared with those of laparoscopic RYGB. This study aimed to compare complication rates, operative characteristics, and expected costs between robotic and laparoscopic RYGB. A systematic review of the literature was performed with searches of five databases and grey literature, hand searches, and reference and forward citation searches. Studies comparing robotic versus laparoscopic RYGB involving patients ages 18-65 years who met the National Institutes of Health (NIH) criteria for bariatric surgery were included in the study if they reported overall or major complication rates. Outcomes were pooled using random-effects metaanalysis. A decision-tree economic analysis was performed to calculate expected costs associated with each technique. The systematic search strategy returned 1,374 potentially relevant studies. The inclusion criteria were met by 10 of these studies, which included results from 2,557 patients. The overall major and minor complications did not differ significantly between the robotic and laparoscopic groups. The rates for anastomotic leak, bleeding, stricture, and reoperation did not differ significantly. An economic analysis found that the expected costs for robotic RYGB ($15,447) were higher than for laparoscopic RYGB ($11,956). Sensitivity analyses produced similar results. The complication rates did not differ significantly between robotic and laparoscopic RYGB, but the expected costs were greater for robotic RYGB. Further cost effectiveness analyses are recommended before adoption of a robotic approach to RYGB.

Ten-year immune persistence and safety of the HPV-16/18 AS04-adjuvanted vaccine in females vaccinated at 15-55 years of age.

PubMed

Schwarz, Tino F; Galaj, Andrzej; Spaczynski, Marek; Wysocki, Jacek; Kaufmann, Andreas M; Poncelet, Sylviane; Suryakiran, Pemmaraju V; Folschweiller, Nicolas; Thomas, Florence; Lin, Lan; Struyf, Frank

2017-11-01

Women remain at risk of human papillomavirus (HPV) infection for most of their lives. The duration of protection against HPV-16/18 from prophylactic vaccination remains unknown. We investigated the 10-year immune response and long-term safety profile of the HPV-16/18 AS04-adjuvanted vaccine (AS04-HPV-16/18 vaccine) in females aged between 15 and 55 years at first vaccination. Females who received primary vaccination with three doses of AS04-HPV-16/18 vaccine in the primary phase-III study (NCT00196937) were invited to attend annual evaluations for long-term immunogenicity and safety. Anti-HPV-16/18 antibodies in serum and cervico-vaginal secretions (CVS) were measured using enzyme-linked immunosorbent assay (ELISA). Serious adverse events (SAEs) were recorded throughout the follow-up period. Seropositivity rates for anti-HPV-16 remained high (≥96.3%) in all age groups 10 years after first vaccination. It was found that 99.2% of 15-25-year olds remained seropositive for anti-HPV-18 compared to 93.7% and 83.8% of 26-45-year olds and 45-55-year olds, respectively. Geometric mean titers (GMT) remained above natural infection levels in all age groups. Anti-HPV-16 and anti-HPV-18 titers were at least 5.3-fold and 3.1-fold higher than titers observed after natural infection, respectively, and were predicted to persist above natural infection levels for ≥30 years in all age groups. At Year 10, anti-HPV-16/18 antibody titers in subjects aged 15-25 years remained above plateau levels observed in previous studies. Correlation coefficients for antibody titers in serum and CVS were 0.64 (anti-HPV-16) and 0.38 (anti-HPV-18). This study concluded that vaccinated females aged 15-55 years elicited sustained immunogenicity with an acceptable safety profile up to 10 years after primary vaccination, suggesting long-term protection against HPV. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Isolated coronary artery bypass grafting in extracorporeal circulation in patients over 65 years old – does age still matter?

PubMed Central

Walczak, Andrzej; Ostrowski, Stanisław; Wrona, Ewa; Bartczak, Karol; Jaszewski, Ryszard

2014-01-01

Introduction Coronary artery bypass grafting (CABG) is conducted more and more commonly in patients in advanced age. Aim of the study To analyze the influence of age and concurrent risk factors on the complications and early mortality after CABG. Material and methods Medical records of 2194 patients were analyzed retrospectively. A group of 1303 patients who had undergone isolated CABG was selected. 106 (4.8%) patients were excluded due to missing data in their medical records. The remaining 1197 patients were divided into two subgroups by age: 1st group < 65 years (n = 662; 55.3%); 2nd group ≥ 65 years (n = 535; 44.7%). Results The total 30-day mortality was 3.93% and was six times higher in the older group (1.21 vs. 7.29%; p < 0.001). Complications were observed in 176 (14.70%) patients, more often in the older group (10.42% vs. 20.0%; p < 0.001). In this group all kinds of complications were noted more often and in particular: postoperative myocardial infarction (1.96% vs. 5.42%; p = 0.001), respiratory dysfunction (1.36% vs. 4.11%; p = 0.005), neurological complications (1.81% vs. 3.74%; p = 0.04) and multi-organ dysfunction syndrome (0.30% vs. 1.68%, p = 0.03). The older patients required longer time under mechanical ventilation (24.0 ± 27.9 vs. 37.0 ± 74.1 hours; p = 0.004) and stayed longer in the intensive care unit: 2.5 ± 3.0 vs. 4.1 ± 7.84 days; p < 0.001. Independent predictors of death were: female sex [OR (95% CI) = 2.4 (1.2-4.5)], age ≥ 65 years [OR = 4.9 (2.1-11.1)], eGFR < 60 mL/min/1.73 m2 [OR = 2.2 (1.0-4.7)], time at extracorporeal circulation > 72 minutes [OR = 5.5 (2.7-10.9)] and left main stem stenosis (> 50%) [OR = 2.4 (1.3-4.6)]. Conclusions Age still significantly influences postoperative complications and mortality after isolated CABG. PMID:26336419

Health screenings for men ages 18 to 39

MedlinePlus

Health maintenance visit - men - ages 18 to 39; Physical exam - men - ages 18 to 39; Yearly exam - ... 39; Checkup - men - ages 18 to 39; Men's health - ages 18 to 39; Preventive care exam - men - ...

Prevalence of metabolic syndrome and associated factors in women aged 35 to 65 years who were enrolled in a family health program in Brazil.

PubMed

Schmitt, Ana Carolina Basso; Cardoso, Maria Regina Alves; Lopes, Heno; Pereira, Wendry Maria Paixão; Pereira, Elaine Cristina; de Rezende, Debora Aparecida Paccola; Guarizi, Rubia Guibo; Dellu, Mayra Cecilia; Oliveira, Jéssica de Moura; Flauzino, Erika; Blümel, Juan E; Aldrighi, José Mendes

2013-04-01

The aims of this study were to estimate the prevalence of metabolic syndrome among women aged 35 to 65 years and to identify associated factors. This was a cross-sectional study. We randomly selected 581 women (aged 35-65 y) from among those enrolled in a family health program in the city of Pindamonhangaba, Brazil. Metabolic syndrome was identified in accordance with the definition of the National Cholesterol Education Program Adult Treatment Panel III. Health conditions and lifestyle habits were evaluated by a survey, and anthropometric measurements were obtained. The prevalence of metabolic syndrome was estimated, and Poisson regression was used to evaluate the associations between metabolic syndrome `and the factors investigated. The prevalence of metabolic syndrome was 42.2% (95% CI, 38.1-46.2). The most common metabolic syndrome component was abdominal obesity (60.6%), followed by low levels of high-density lipoprotein cholesterol (51.3%), high levels of triglycerides (41.4%), high blood pressure (31.7%), and diabetes (13.9%). The following factors were associated with metabolic syndrome: the 45- to 54-year age group (prevalence ratio, 1.54; 95% CI, 1.08-2.01), the 55- to 65-year age group (prevalence ratio, 3.51; 95% CI, 1.49-3.10), hyperuricemia (prevalence ratio, 2.95; 95% CI, 1.15-1.86), and sleep apnea risk (prevalence ratio, 2.41; 95% CI, 1.16-1.82). We found an inverse association between metabolic syndrome and having had more than 5 years of schooling (prevalence ratio, 0.65; 95% CI, 0.65-1.04). The prevalence of metabolic syndrome is high, and the associated clinical factors are hyperuricemia and risk of sleep apnea.

Are two doses of human papillomavirus vaccine sufficient for girls aged 15-18 years? Results from a cohort study in India.

PubMed

Bhatla, Neerja; Nene, Bhagwan M; Joshi, Smita; Esmy, Pulikottil O; Poli, Usha Rani Reddy; Joshi, Geeta; Verma, Yogesh; Zomawia, Eric; Pimple, Sharmila; Prabhu, Priya R; Basu, Partha; Muwonge, Richard; Hingmire, Sanjay; Sauvaget, Catherine; Lucas, Eric; Pawlita, Michael; Gheit, Tarik; Jayant, Kasturi; Malvi, Sylla G; Siddiqi, Maqsood; Michel, Angelika; Butt, Julia; Sankaran, Subha; Kannan, Thiraviam Pillai Rameshwari Ammal; Varghese, Rintu; Divate, Uma; Willhauck-Fleckenstein, Martina; Waterboer, Tim; Müller, Martin; Sehr, Peter; Kriplani, Alka; Mishra, Gauravi; Jadhav, Radhika; Thorat, Ranjit; Tommasino, Massimo; Pillai, M Radhakrishna; Sankaranarayanan, Rengaswamy

2018-06-01

Extending two-dose recommendations of HPV vaccine to girls between 15 and 18 years will reduce program cost and improve compliance. Immunogenicity and vaccine targeted HPV infection outcomes were compared between 1795 girls aged 15-18 years receiving two (1-180 days) and 1515 girls of same age receiving three (1-60-180 days) doses. Immunogenicity outcomes in 15-18 year old two-dose recipients were also compared with the 10-14 year old three-dose (N = 2833) and two-dose (N = 3184) recipients. The 15-18 year old two-dose recipients had non-inferior L1-binding antibody titres at seven months against vaccine-targeted HPV types compared to three-dose recipients at 15-18 years and three-dose recipients at 10-14 years of age. Neutralizing antibody titres at 18 months in 15-18 year old two-dose recipients were non-inferior to same age three-dose recipients for all except HPV 18. The titres were inferior to those in the 10-14 year old three-dose recipients for all targeted types. Frequency of incident infections from vaccine-targeted HPV types in the 15-18 year old two-dose recipients was similar to the three dose recipients. None of the girls receiving two or three doses had persistent infection from vaccine-targeted types. These findings support that two doses of HPV vaccine can be extended to girls aged 15-18 years. Copyright © 2018. Published by Elsevier B.V.

Comparison of immunization rates of adults ages 65 years and older managed within two nurse practitioner-owned clinics with national immunization rates.

PubMed

Wright, Wendy L; Morrell, Elise; Lee, Jennie; Cuellar, Norma Graciela; White, Patricia

2017-07-01

Adults ages ≥65 years are at increased risk for infectious diseases. Ensuring these individuals are fully vaccinated is imperative. The purpose of this study was to assess the immunization rates of adults ages ≥65 years managed by nurse practitioners (NPs) and compare the results with national immunization rates and Healthy People 2020 goals. A convenience sample of adults ages ≥65 years was obtained from two NP-managed clinics. The vaccine records of each subject were reviewed for documentation of having received five vaccines (tetanus, diphtheria, and pertussis; influenza; pneumococcal polysaccharide vaccine 23; pneumococcal conjugate vaccine 13; and herpes zoster vaccine). One hundred and fifty females (70.8%) and 62 males (29.2%) met inclusion criteria. NP-managed patients had higher immunization rates than the national averages across all five major vaccines. The herpes zoster vaccination rates exceeded the recommendations from Healthy People 2020 whereas pneumococcal and influenza rates were below. The stocking of vaccines within the NP-managed clinics, direct billing to Medicare for Part D vaccines, and previsit care planning likely contributed to the high vaccination rates. These high immunization rates in patients managed by NPs provide support for the important role that NPs play in the care of older adults. ©2017 American Association of Nurse Practitioners.

Bioprosthetic mitral valve replacement in patients aged 65 years or younger: long-term outcomes with the Carpentier-Edwards PERIMOUNT pericardial valve.

PubMed

Bourguignon, Thierry; Espitalier, Fabien; Pantaleon, Clémence; Vermes, Emmanuelle; El-Arid, Jean Marc; Loardi, Claudia; Karam, Elias; Candolfi, Pascal; Ivanes, Fabrice; Aupart, Michel

2018-02-12

Mitral valve replacement using a bioprosthesis remains controversial in young patients because data on long-term outcomes are missing. This study evaluated the long-term results of the PERIMOUNT pericardial mitral bioprosthesis in patients aged 65 years or younger. From 1984 to 2010, 148 Carpentier-Edwards PERIMOUNT mitral bioprostheses were implanted in 148 patients aged 65 years or younger. Baseline clinical, perioperative and follow-up data were recorded prospectively. Structural valve deterioration (SVD) was defined by strict echocardiographic assessment. The mean follow-up period was 8.6 ± 5.5 years, for a total of 1269 valve-years. Operative mortality rate was 2.0%. Fifty-one late deaths occurred (linearized rate 4.0% per valve-year). Actuarial survival rates averaged 70 ± 4%, 53 ± 6% and 31 ± 7% after 10, 15 and 20 years of follow-up, respectively. Actuarial freedom from SVD at 10, 15 and 20 years was 78 ± 5%, 47 ± 7% and 19 ± 7%, respectively. Reoperation was associated with no operative mortality. Actuarial freedom from reoperation due to SVD at 10, 15 and 20 years was 82 ± 4%, 50 ± 6% and 25 ± 8%, respectively. Competing risk analysis demonstrated an actual risk of explantation secondary to SVD at 20 years of 44 ± 5%. Expected valve durability was 14.2 years for this age group. In the selected patients aged 65 years or younger undergoing mitral valve replacement with a pericardial bioprosthesis, the expected valve durability was 14.2 years. Reoperation for SVD was associated with a low risk of mortality. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Beverage consumption patterns of Canadian adults aged 19 to 65 years.

PubMed

Nikpartow, Nooshin; Danyliw, Adrienne D; Whiting, Susan J; Lim, Hyun J; Vatanparast, Hassanali

2012-12-01

To investigate the beverage intake patterns of Canadian adults and explore characteristics of participants in different beverage clusters. Analyses of nationally representative data with cross-sectional complex stratified design. Canadian Community Health Survey, Cycle 2.2 (2004). A total of 14 277 participants aged 19-65 years, in whom dietary intake was assessed using a single 24 h recall, were included in the study. After determining total intake and the contribution of beverages to total energy intake among age/sex groups, cluster analysis (K-means method) was used to classify males and females into distinct clusters based on the dominant pattern of beverage intakes. To test differences across clusters, χ2 tests and 95 % confidence intervals of the mean intakes were used. Six beverage clusters in women and seven beverage clusters in men were identified. 'Sugar-sweetened' beverage clusters - regular soft drinks and fruit drinks - as well as a 'beer' cluster, appeared for both men and women. No 'milk' cluster appeared among women. The mean consumption of the dominant beverage in each cluster was higher among men than women. The 'soft drink' cluster in men had the lowest proportion of the higher levels of education, and in women the highest proportion of inactivity, compared with other beverage clusters. Patterns of beverage intake in Canadian women indicate high consumption of sugar-sweetened beverages particularly fruit drinks, low intake of milk and high intake of beer. These patterns in women have implications for poor bone health, risk of obesity and other morbidities.

Reference centile curves for wrist circumference for Indian children aged 3-18 years.

PubMed

Khadilkar, Vaman; Chiplonkar, Shashi; Ekbote, Veena; Kajale, Neha; Mandlik, Rubina; Khadilkar, Anuradha

2018-01-26

Childhood obesity and its consequences have reached alarming proportions worldwide and in India. Wrist circumference is emerging as an easily measurable reproducible parameter for screening children at risk of obesity-related morbidities such as hypertension and insulin resistance. The objectives of this study were: (1) to compute age and gender-specific wrist circumference percentiles for 3-18-year-old apparently healthy Indian children and adolescents; (2) to assess the relationship of wrist circumference with measures of obesity and adiposity such as body mass index (BMI), fat percentage and blood pressure (BP) and (3) to suggest age and gender-specific cut-offs for wrist circumference percentile for the risk of hypertension in Indian children and adolescents. This was a cross-sectional study on samples of 10,199 3-18-year-old children (5703 boys) from randomly selected schools from five major cities in India. Height, weight, waist and wrist circumference and BP were recorded. Body composition was measured using bioelectrical impedance analysis (BIA). Wrist circumference percentiles were computed using the LMS method. The average wrist circumference of boys and girls was 10.4 cm and 10.0 cm at 3 years and increased to 15.1 cm and 13.9 cm, respectively, at 18 years. Compared to their Caucasian counterparts, Indian children's wrists were smaller. Receiver operating characteristic (ROC) curve analysis derived the 70th percentile of wrist circumference as the cut-off for identifying the risk of hypertension. Contemporary cross-sectional reference percentile curves for wrist circumference for 3-18-year-old Indian children are presented. The 70th percentile of the current study is proposed as the cut-off to screen children for cardiometabolic risk factors such as hypertension.

Patterns of linear growth and skeletal maturation from birth to 18 years of age in overweight young adults.

PubMed

Johnson, W; Stovitz, S D; Choh, A C; Czerwinski, S A; Towne, B; Demerath, E W

2012-04-01

To estimate differences in skeletal maturity and stature from birth to age 18 years between individuals who are overweight vs normal weight in young adulthood. Weight, length and height, and relative skeletal age (skeletal-chronological age) were assessed annually from birth to age 18 years in 521 subjects (255 women) in the Fels Longitudinal Study who were overweight or obese (body mass index (BMI) >25 kg m(-2), n=131) or normal weight (n=390) in young adulthood (18-30 years). Generalized estimating equations were used to test for skeletal maturity and stature differences by young adult BMI status. Differences in height increased during puberty, being significant for girls at ages 10 to 12 years, and for boys at ages 11 to 13 years (P-values<0.001), with overweight or obese adults being ∼3 cm taller at those ages than normal weight adults. These differences then diminished so that by age 18 years, overweight or obese adults were not significantly different in stature to their normal weight peers. Differences in skeletal maturity were similar, but more pervasive; overweight or obese adults were more skeletally advanced throughout childhood. Skeletal maturity differences peaked at chronological age 12 in boys and 14 in girls (P-values<0.001), with overweight or obese adults being ∼1 year more advanced than normal weight adults. This descriptive study is the first to track advanced skeletal maturity and linear growth acceleration throughout infancy, childhood and adolescence in individuals who become overweight, showing that differences occur primarily around the time of the pubertal growth spurt. Increased BMI in children on a path to becoming overweight adults precedes an advancement in skeletal development and subsequently tall stature during puberty. Further work is required to assess the predictive value of accelerated pubertal height growth for assessing obesity risk in a variety of populations.

Total energy expenditure in adults aged 65 years and over measured using doubly-labelled water: international data availability and opportunities for data sharing.

PubMed

Porter, Judi; Nguo, Kay; Gibson, Simone; Huggins, Catherine E; Collins, Jorja; Kellow, Nicole J; Truby, Helen

2018-03-26

Increasing population lifespan necessitates a greater understanding of nutritional needs in older adults (65 year and over). A synthesis of total energy expenditure in the older population has not been undertaken and is needed to inform nutritional requirements. We aimed to establish the extent of the international evidence for total energy expenditure (TEE) using doubly-labelled water (DLW) in older adults (65 years and over), report challenges in obtaining primary data, and make recommendations for future data sharing. Four databases were searched to identify eligible studies; original research of any study design where participant level TEE was measured using DLW in participants aged ≥65 years. Once studies were identified for inclusion, authors were contacted where data were not publicly available. Screening was undertaken of 1223 records; the review of 317 full text papers excluded 170 records. Corresponding or first authors of 147 eligible studies were contacted electronically. Participant level data were publicly available or provided by authors for 45 publications (890 participants aged ≥65 years, with 248 aged ≥80 years). Sixty-seven percent of the DLW data in this population were unavailable due to authors unable to be contacted or declining to participate, or data being irretrievable. The lack of data access limits the value of the original research and its contribution to nutrition science. Openly accessible DLW data available through publications or a new international data repository would facilitate greater integration of current research with previous findings and ensure evidence is available to support the needs of the ageing population. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016047549 .

The Associations of Lens Power With Age and Axial Length in Healthy Chinese Children and Adolescents Aged 6 to 18 Years.

PubMed

Xiong, Shuyu; Zhang, Bo; Hong, Yuan; He, Xiangui; Zhu, Jianfeng; Zou, Haidong; Xu, Xun

2017-11-01

To investigate the relationship between lens power and age as well as the relationship between lens power and axial length (AL) in Chinese children and adolescents. The participants underwent a comprehensive ophthalmic examination that included AL, cycloplegic refraction, and Pentacam measurements. The crystalline lens power was calculated using Bennett's formula and then compared among the children of different age groups, refractive statuses, and AL categories. The association of lens power and AL was analyzed using multiple regression. A total of 1992 children and adolescents aged 6- to 18-years old were included. The difference in lens power was greater before 10-years old, followed by a relatively smaller difference in children aged 10 to 14 years and the difference in lens power came to a near plateau in adolescents after 14-years old. The negative association between lens power and AL was found to be more evident in nonmyopes than in myopes irrespective of age (younger than 10 years: nonmyopes: β = -1.499, myopes: β = -0.872; older than 10 years: nonmyopes: β = -1.288, myopes: β = -0.390, all P < 0.001). The lens power in children and adolescents aged 6 to 18 years exhibited three stages. The association between lens power and AL differed between the nonmyopes and myopes. These findings suggested that less reduction in lens power might be associated with both growing age and increasing AL in myopes.

From Childhood Conduct Problems to Poor Functioning at Age 18 Years: Examining Explanations in a Longitudinal Cohort Study.

PubMed

Wertz, Jasmin; Agnew-Blais, Jessica; Caspi, Avshalom; Danese, Andrea; Fisher, Helen L; Goldman-Mellor, Sidra; Moffitt, Terrie E; Arseneault, Louise

2018-01-01

Childhood conduct problems are associated with poor functioning in early adulthood. We tested a series of hypotheses to understand the mechanisms underlying this association. We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 twins born in England and Wales in 1994 and 1995, followed up to age 18 years with 93% retention. Severe conduct problems in childhood were assessed at ages 5, 7, and 10 years using parent and teacher reports. Poor functioning at age 18 years, including cautions and convictions, daily cigarette smoking, heavy drinking, and psychosocial difficulties, was measured through interviews with participants and official crime record searches. Participants 18 years old with versus without a childhood history of severe conduct problems had greater rates of each poor functional outcome, and they were more likely to experience multiple poor outcomes. This association was partly accounted for by concurrent psychopathology in early adulthood, as well as by early familial risk factors, both genetic and environmental. Childhood conduct problems, however, continued to predict poor outcomes at age 18 years after accounting for these explanations. Children with severe conduct problems display poor functioning at age 18 years because of concurrent problems in early adulthood and familial risk factors originating in childhood. However, conduct problems also exert a lasting effect on young people's lives independent of these factors, pointing to early conduct problems as a target for early interventions aimed at preventing poor functional outcomes. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

[Nutritional status of the population over 65 years of age in the city of Badajoz].

PubMed

Suárez-Gómez, A; Sánchez-Vega, J; Suárez-González, F; Peral-Pacheco, D; Dorado-Martin, J J; Suárez-Gómez, M

2017-03-01

Nutritional status is strongly associated with the level of health and quality of life of the population, and is especially relevant in the case of the elderly. The aim was to study the nutritional status in a population of non-institutionalised over 65 year-olds in the city of Badajoz, describing the sociodemographic variables, biochemical parameters, and functional assessment. A descriptive study was performed using a design population, which was randomised and stratified in health centres of the city, with a sample size of 298 patients being obtained. The sociodemographic variables included gender, age, educational level, anthropometric analysis with estimated body mass index, and percentage fat weight. Statistical tests were performed using SPSS v.15 statistical package. The prevalence of overweight and obesity as measured by fat weight was 61.9% (56.1-67.8), with a body mass index of 65.8% (60.2-71.4). It was higher in women, with a fat weight of 67.3% (2.56 to 2.73) and a body mass index of 71.8% (2.64 to 2.78). The nutritional status of the population according to the questionnaire "Know your nutritional health" was rated "good". The most common nutritional problem in the non-institutionalised population over 65 years in the city of Badajoz is obesity, especially in women, and in people with low educational level. This high prevalence suggests that health education on a better lifestyle in this population should be a priority. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

30 CFR 18.65 - Flame test of hose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Inspections and Tests § 18.65 Flame... wire gauze. (2) A Pittsburgh-Universal Bunsen-type burner (inside diameter of burner tube 11 mm.), or...

30 CFR 18.65 - Flame test of hose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Inspections and Tests § 18.65 Flame... wire gauze. (2) A Pittsburgh-Universal Bunsen-type burner (inside diameter of burner tube 11 mm.), or...

30 CFR 18.65 - Flame test of hose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Inspections and Tests § 18.65 Flame... wire gauze. (2) A Pittsburgh-Universal Bunsen-type burner (inside diameter of burner tube 11 mm.), or...

30 CFR 18.65 - Flame test of hose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Inspections and Tests § 18.65 Flame... wire gauze. (2) A Pittsburgh-Universal Bunsen-type burner (inside diameter of burner tube 11 mm.), or...

Accuracy of Cameriere's cut-off value for third molar in assessing 18 years of age.

PubMed

De Luca, S; Biagi, R; Begnoni, G; Farronato, G; Cingolani, M; Merelli, V; Ferrante, L; Cameriere, R

2014-02-01

Due to increasingly numerous international migrations, estimating the age of unaccompanied minors is becoming of enormous significance for forensic professionals who are required to deliver expert opinions. The third molar tooth is one of the few anatomical sites available for estimating the age of individuals in late adolescence. This study verifies the accuracy of Cameriere's cut-off value of the third molar index (I3M) in assessing 18 years of age. For this purpose, a sample of orthopantomographs (OPTs) of 397 living subjects aged between 13 and 22 years (192 female and 205 male) was analyzed. Age distribution gradually decreases as I3M increases in both males and females. The results show that the sensitivity of the test was 86.6%, with a 95% confidence interval of (80.8%, 91.1%), and its specificity was 95.7%, with a 95% confidence interval of (92.1%, 98%). The proportion of correctly classified individuals was 91.4%. Estimated post-test probability, p was 95.6%, with a 95% confidence interval of (92%, 98%). Hence, the probability that a subject positive on the test (i.e., I3M<0.08) was 18 years of age or older was 95.6%. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Impact of intraventricular hemorrhage on cognitive and behavioral outcomes at 18 years of age in low birth weight preterm infants.

PubMed

Ann Wy, P; Rettiganti, M; Li, J; Yap, V; Barrett, K; Whiteside-Mansell, L; Casey, P

2015-07-01

Although high-grade intraventricular hemorrhage (IVH; grades III-IV) in preterm and low birth weight infants are clearly associated with increased risk of long-term adverse neurodevelopmental sequelae, the impact of low-grade IVH (grades I-II) has been less clear. Some studies have followed these infants through early school age and have shown some conflicting results regarding cognitive outcome. Such studies that assess children at younger ages may not accurately predict outcomes in later childhood, as it is known that fluid and crystallized intelligence peak at age 26 years. There is paucity of data in current medical literature, which correlates low-grade IVH with outcomes in early adulthood. To determine the link between the occurrence of low-grade IVH in low birth weight (birth weight ⩽2500 g) infants born prematurely (gestational age <37 weeks) and intellectual function, academic achievement, and behavioral problems to the age of 18 years. This study is an analysis of data derived from the Infant Health and Development Program (IHDP), a multisite national collaborative study and a randomized controlled trial of education intervention for low birth weight infants from birth until 3 years of age with follow-up through 18 years of age. A total of 985 infants were enrolled in the IHDP. Of the 462 infants tested for IVH, 99 demonstrated sonographic evidence of low-grade IVH, whereas 291 showed no sonographic evidence of IVH. Several outcomes were compared between these two groups. Intelligence was assessed using Stanford-Binet Intelligence scales at age 3 years, Wechsler Intelligence Scale for Children (WISC-III) at age 8 years, Wechsler Abbreviated Scale of Intelligence (WASI) at age 18 years and Woodcock Johnson Tests of Achievement at age 8 and 18 years. Behavior was measured using the Achenbach Behavior Checklist at age 3 years and Child Behavior Checklist (CBCL) at age 8 and 18 years. Outcomes were compared between the IVH-positive and IVH-negative groups

Health State Utility Impact of Breast Cancer in U.S. Women Aged 18-44 Years.

PubMed

Brown, Derek S; Trogdon, Justin G; Ekwueme, Donatus U; Chamiec-Case, Linda; Guy, Gery P; Tangka, Florence K; Li, Chunyu; Trivers, Katrina F; Rodriguez, Juan L

2016-02-01

Breast cancer affects women's health-related quality of life negatively, but little is known about how breast cancer affects this in younger women aged 18-44 years. This study measures preference-based health state utility (HSU) values, a scaled index of health-related quality of life for economic evaluation, for younger women with breast cancer and compares these values with same-age women with other cancers and older women (aged ≥45 years) with breast cancer. Data from the 2009 and 2010 Behavioral Risk Factor Surveillance System were analyzed in 2014. The sample included 218,852 women; 7,433 and 18,577 had histories of breast and other cancers. HSU values were estimated using Healthy Days survey questions and a published mapping algorithm. Linear regression models for HSU were estimated by age group (18-44 and ≥45 years). The adjusted breast cancer HSU impact was four times larger for younger women than for older women (-0.097 vs -0.024, p<0.001). For younger women, the effect of breast cancer on HSU was 70% larger than that of other cancers (-0.097 vs -0.057, p=0.024). Younger breast cancer survivors reported lower HSU values than older survivors, highlighting the impact of breast cancer on the physical and mental health of younger women. The estimates may be used to evaluate quality-adjusted life-years or expectancy for prevention or treatment of breast cancer. This study also indicates that separate quality of life adjustments for women by age group are important for economic analysis of public health breast cancer interventions. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

Reference charts of sitting height, leg length and body proportions for Chinese children aged 0-18 years.

PubMed

Zhang, Ya-qin; Li, Hui

2015-01-01

The reference charts of sitting height (SH), subischial leg length (LL) and the sitting height/leg length ratio (SH/LL) are useful tools in assessing body proportion for clinicians and researchers in related areas. However, reference charts of body proportions for Chinese children and adolescents are limited. To construct reference charts of SH, LL and SH/LL for Chinese children and adolescents. Stature and sitting height of 92 494 (46 240 boys and 46 254 girls) healthy Han nationality children, aged 0-18 years, were measured in two national large-scale cross-sectional surveys in 2005 in China. SH/LL was selected as the indicator of body proportion. References of SH, LL and SH/LL were constructed using the LMS method. The reference charts demonstrated that SH and LL increased with age. Growth in SH slowed by the age of 17 years in boys and 15 years in girls. Similarly, growth in LL slowed at 16 years in boys and 14 years in girls. The SH/LL ratio declined from birth (2.00 in boys and 2.03 in girls) to 13 years in boys (1.11) and to 11 years in girls (1.13), then increased slightly to the age of 18 (1.16 in boys and 1.18 in girls). The gender difference of SH/LL was not significantly different before the age of 11 years. After the age of 11, SH/LL appeared elevated in girls compared to boys. The reference charts of SH, LL and SH/LL are useful tools for assessing body proportions for Chinese children and adolescent individuals.

Detection of mild cognitive impairment in people older than 65 years of age and its relationship to cardiovascular risk factors (DECRIVAM)

PubMed Central

2011-01-01

Background Studies centered on the detection of cognitive impairment and its relationship to cardiovascular risk factors in elderly people have gained special relevance in recent years. Knowledge of the cardiovascular risk factors that may be associated to cognitive impairment could be very useful for introducing treatments in early stages - thereby possibly contributing to improve patient quality of life. The present study explores cognitive performance in people over 65 years of age in Salamanca (Spain), with special emphasis on the identification of early symptoms of cognitive impairment, with the purpose of detecting mild cognitive impairment and of studying the relationships between this clinical situation and cardiovascular risk factors. Methods/Design A longitudinal study is contemplated. The reference population will consist of 420 people over 65 years of age enrolled through randomized sampling stratified by healthcare area, and who previously participated in another study. Measurement: a) Sociodemographic variables; b) Cardiovascular risk factors; c) Comorbidity; d) Functional level for daily life activities; and e) Study of higher cognitive functions based on a neuropsychological battery especially adapted to the evaluation of elderly people. Discussion We hope that this study will afford objective information on the representative prevalence of cognitive impairment in the population over 65 years of age in Salamanca. We also hope to obtain data on the relationship between cognitive impairment and cardiovascular risk factors in this specific population group. Based on the results obtained, we also will be able to establish the usefulness of some of the screening tests applied during the study, such as the Mini-Mental State Examination and the 7 Minute Screen test. Trial registration ClinicalTrials.gov: NCT01327196 PMID:21708036

General practice and the provision of information and services for physically disabled people aged 16 to 65 years.

PubMed Central

Chesson, R A; Sutherland, A M

1992-01-01

The study reported here was part of a larger survey investigating the nature and extent of disability in the Grampian region. Interviews with 212 people aged between 16 and 65 years who had a wide range of physical disabilities elicited perceptions of current and past service provision. Respondents expressed a strong need for information on disability services and reported difficulty in knowing whom to approach for this. General practitioners were the most commonly reported source of such information and low usage of the Department of Social Security, social work departments and voluntary organizations was identified. No significant relationship was found between degree of disability and frequency of consultation with a general practitioner. However, the more severe the disability the more likely it was that the general practitioner initiated contact rather than the patient. Although in general those interviewed were satisfied with medical information given regarding their diagnosis, they were more critical of information provided in relation to coping with the disorder, including that concerning benefits and services. The study confirmed the pivotal role of the general practitioner in the care of physically disabled people in the community aged between 16 and 65 years. The need to re-evaluate the role of the general practitioner in the provision of information and services is discussed. PMID:1472395

Predictive value of low BMD for 1-year fracture outcomes is similar for postmenopausal women ages 50-64 and 65 and Older: results from the National Osteoporosis Risk Assessment (NORA).

PubMed

Siris, Ethel S; Brenneman, Susan K; Miller, Paul D; Barrett-Connor, Elizabeth; Chen, Ya-Ting; Sherwood, Louis M; Abbott, Thomas A

2004-08-01

The relationship of low bone mass and fracture in younger postmenopausal women has not been extensively studied. In a large cohort of postmenopausal women > or =50 years of age, we found the relationship of BMD measured at peripheral sites and subsequent 1-year fracture risk to be similar between women <65 and those > or =65 years of age. Low bone mass and fractures are prevalent in older postmenopausal women. However, the frequency of low bone mass and fracture in younger postmenopausal women has not been studied extensively. There are very limited data regarding the association between BMD measurements and fractures in postmenopausal women who are between the ages of 50 and 64. In the National Osteoporosis Risk Assessment (NORA) we studied the frequency of low bone mass and its association with fracture in women 50-64 years of age in comparison with women > or =65 of age. NORA enrolled 200,160 postmenopausal women > or =50 years of age who had no prior diagnosis of osteoporosis. Baseline BMD was measured at the heel, forearm, or finger. A 1-year follow-up survey requesting incident fractures since baseline was completed by 163,935 women, 87,594 (53%) of whom were 50-64 years of age. The association between BMD and fracture was assessed using logistic regression, adjusted for important covariates. Thirty-one percent of women 50-64 years of age had low bone mass (T scores < or = -1.0) compared to 62% of women > or =65 years of age. During the first year of follow-up, 2440 women reported fractures of wrist/forearm, rib, spine, or hip, including 440 hip fractures. Nine hundred four women 50-64 years of age reported fractures, including 86 hip fractures, accounting for 37% of fractures and 20% of hip fractures reported in the entire NORA cohort. Relative risk for osteoporotic fracture was 1.5 for each SD decrease in BMD for both the younger and older groups of women. Low BMD in younger postmenopausal women 50-64 years of age showed a 1-year relative risk of fracture

Coeval Ar-40/Ar-39 ages of 65.0 million years ago from Chicxulub crater melt rock and Cretaceous-Tertiary boundary tektites

NASA Technical Reports Server (NTRS)

Swisher, Carl C., III; Grajales-Nishimura, Jose M.; Montanari, Alessandro; Margolis, Stanley V.; Claeys, Philippe; Alvarez, Walter; Renne, Paul; Cedillo-Pardo, Esteban; Maurrasse, Florentin J.-M. R.; Curtis, Garniss H.

1992-01-01

Ar-40/Ar-39 dating of drill-core samples of a glassy melt rock recovered from beneath a massive impact breccia contained with the 180-kilometer subsurface Chicxulub crater yields well-behaved incremental heating spectra with a mean plateau age of 64.98 +/- 0.05 million years ago (Ma). The glassy melt rock of andesitic composition was obtained from core 9 (1390 to 1393 meters) in the Chicxulub 1 well. The age of the melt rock is virtually indistinguishable from Ar-40/Ar-39 ages obtained on tektite glass from Beloc, Haiti, and Arroyo el Mimbral, northeastern Mexico, of 65.01 +/- 0.08 Ma (mean plateau age for Beloc) and 65.07 +/- 0.10 Ma (mean total fusion age for both sites). The Ar-40/Ar-39 ages, in conjunction with geochemical and petrological similarities, strengthen the suggestion that the Chicxulub structure is the source for the Haitian and Mexican tektites and is a viable candidate for the Cretaceous-Tertiary boundary impact site.

Nonmedical Prescription Stimulant Use Among Girls 10–18 Years of Age: Associations With Other Risky Behavior

PubMed Central

Striley, Catherine Woodstock; Kelso-Chichetto, Natalie E.; Cottler, Linda B.

2017-01-01

Purpose Little is known about the risk factors for nonmedical use (NMU) of prescription stimulants among adolescent girls. We aimed to measure the association of nonmedical prescription stimulant use with empirically linked risk factors, including weight control behavior (WCB), gambling, and depressed mood, in pre-teen and teenaged girls. Methods We assessed the relationship between age and race, gambling, WCB, depressive mood, and nonmedical prescription stimulant use using multivariable logistic regression. The study sample included 5,585 females, aged 10–18 years, recruited via an entertainment venue intercept method in 10 U.S. metropolitan areas as part of the National Monitoring of Adolescent Prescription Stimulants Study (2008–2011). Results NMU of prescription stimulants was reported by 6.6% (n = 370) of the sample. In multivariable logistic regression, 1-year increase in age was associated with a 21% (95% confidence interval [CI]: .15, .28) increase in risk for NMU. Whites and other race/ethnicity girls had 2.67 (CI: 1.85, 3.87) and 1.71 (1.11, 2.65) times higher odds for NMU, compared to African-Americans. Depressive mood (adjusted odds ratio: 2.69, CI: 2.04, 5.57) and gambling (adjusted odds ratio: 1.90, 1.23, 2.92) were associated with increased odds for NMU. A dose-response was identified between WCB and NMU, where girls with unhealthy and extreme WCB were over five times more likely to endorse NMU. Conclusions We contribute to the literature linking WCB, depression, gambling, and the NMU of prescription stimulants in any population and uniquely do so among girls. PMID:27998704

Health-related quality of life among people aged ≥65 years with self-reported visual impairment: findings from the 2006-2010 behavioral risk factor surveillance system.

PubMed

Crews, John E; Chou, Chiu-Fang; Zhang, Xinzhi; Zack, Matthew M; Saaddine, Jinan B

2014-10-01

To examine the association between health-related quality of life (HRQoL) and visual impairment among people aged ≥65 years. We used cross-sectional data from the 2006-2010 Behavioral Risk Factor Surveillance System to examine six HRQoL measures: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, and moderate/severe. We examined the association between self-reported visual impairment and HRQoL using logistic regression accounting for the survey's complex design. People with self-reported moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days compared to those reporting a little or no visual impairment. After controlling for all covariates (age, sex, marital status, race/ethnicity, education, income, diabetes, heart disease, stroke, heart attack, body mass index, leisure time activity, smoking, and medical care cost concerns) and comparing to those with no self-reported visual impairment, people reporting a little visual impairment were more likely to have fair/poor health (odds ratio, OR, 1.2, 95% confidence interval, CI, 1.1-1.3), life dissatisfaction (OR 1.6, 95% CI 1.3-2.0), and disability (OR 1.5, 95% CI 1.3-1.6), and those with self-reported moderate/severe visual impairment had more fair/poor health (OR 1.8, 95% CI 1.6-2.0), life dissatisfaction (OR 2.3, 95% CI 1.8-2.9), and disability (OR 2.0, 95% CI 1.8-2.2). They also had more frequent physically unhealthy days (OR 1.9, 95% CI 1.7-2.1), mentally unhealthy days (OR 1.8, 95% CI 1.5-2.1), and activity limitations days (OR 1.9, 95% CI 1.6-2.2). Poor HRQoL is strongly associated with the severity of self-reported visual impairment among people aged ≥65 years.

Developmental antecedents of political ideology: a longitudinal investigation from birth to age 18 years.

PubMed

Fraley, R Chris; Griffin, Brian N; Belsky, Jay; Roisman, Glenn I

2012-01-01

The study reported here examined the developmental antecedents of conservative versus liberal ideologies using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development and a follow-up study conducted when the sample was 18 years old. Specifically, we examined variation in conservative versus liberal ideologies at age 18 years as a function of parenting attitudes and child temperament during the first 5 years of life. Consistent with long-standing theories on the development of political attitudes, our results showed that parents' authoritarian attitudes assessed when children were 1 month old predicted conservative attitudes in those children more than 17 years later. Consistent with the findings of Block and Block (2006), our results also showed that early childhood temperament predicted variation in conservative versus liberal ideologies.

Fingolimod Prescribed for the Treatment of Multiple Sclerosis in Patients Younger Than Age 18 Years.

PubMed

Fragoso, Yara Dadalti; Alves-Leon, Soniza Vieira; Barreira, Amilton Antunes; Callegaro, Dagoberto; Brito Ferreira, Maria Lucia; Finkelsztejn, Alessandro; Gomes, Sidney; Magno Goncalves, Marcus Vinicius; Moraes Machado, Maria Iris; Marques, Vanessa Daccach; Cunha Matta, Andre Palma; Papais-Alvarenga, Regina Maria; Apostolos Pereira, Samira Luisa; Tauil, Carlos Bernardo

2015-08-01

There have been no clinical trials for approval of medications for treating multiple sclerosis in patients younger than age 18 years. All treatments are based on personal experience and data from open observational studies. Fingolimod is an oral drug for multiple sclerosis that has been shown to be efficient and safe in adults. The aim of our study is to describe patients with multiple sclerosis who started treatment with fingolimod before the age of 18 years. Seventeen patients treated with fingolimod were identified in the Brazilian database of children and adolescents with multiple sclerosis. The average time of use of the drug was 8.6 months. Fingolimod showed a good safety and efficacy profile in these patients, all of whom had very active multiple sclerosis. After starting treatment with fingolimod, only one patient had a relapse and a new lesion on magnetic resonance imaging. The patients' degree of disability did not progress. No major adverse events were reported in relation to the first dose of the drug, nor in the short- and medium-term treatment. No patient has been followed for longer than 18 months, thus limiting long-term conclusions. Off-label use of fingolimod in patients younger than age 18 years may be a good therapeutic option for multiple sclerosis control. Copyright © 2015 Elsevier Inc. All rights reserved.

A comparison of folic acid awareness and intake among young women aged 18-24 years.

PubMed

Hilton, Judith Johnson

2007-10-01

To investigate public understanding of the importance of folic acid intake in young women aged 18-24 years. A written questionnaire designed by the researcher was administered to 138 young women aged 18-24 years attending college or those seeking care in the county health facility. A total of 88 complete questionnaires were used for the data analysis. Young women were not aware of the importance of folic acid, were not taking multivitamins containing folic acid, and were not consuming enough folic acid in their diets. No relationship existed between pregnancy intention and folic acid intake, suggesting that those who were planning a pregnancy in the near future were not consuming adequate amounts of folic acid. A lack of knowledge regarding the importance of folic acid may lead to poor pregnancy outcomes. Many educational opportunities exist and should be developed in clinics, physician's offices, and classes which involve young women in this age group.

Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18-64 years old.

PubMed

Raghu, Ganesh; Chen, Shih-Yin; Hou, Qiang; Yeh, Wei-Shi; Collard, Harold R

2016-07-01

We sought to present the epidemiology of idiopathic pulmonary fibrosis (IPF) in adults 18-64 years old in the USA.From adults aged 18-64 years in a large administrative claims data in 2004-2010, patients with IPF were identified using diagnosis codes. We estimated annual incidence and cumulative prevalence of IPF over time, and examined potential risk factors for the IPF diagnosis.The annual cumulative prevalence increased steadily in the first few years (from 13.4 cases per 100 000 persons in 2005 to 18.2 cases in 2010 per 100 000 persons), which is likely due to a methodological reason, while the annual incidence of IPF decreased over time (from 7.9 cases per 100 000 person-years in 2005 to 5.8 cases in 2010 per 100 000 person-years). The overall decrease was mainly driven by a decreasing trend in the younger patients (aged 18-44 years), while the incidence in older patients remained stable. Consistent trends were observed in subgroups defined by previously published more restrictive algorithms for diagnosis. Older age and male sex were associated with a higher incidence of disease (p<0.05).In US adults younger than 65 years, we observed a decreasing incidence of IPF over time which may partially explain the plateau of cumulative prevalence in the last few years of our data. Copyright ©ERS 2016.

High prevalence of frequent attendance in the over 65s.

PubMed

McMahon, C Geraldine; Power Foley, Megan; Robinson, David; O'Donnell, Kate; Poulton, Miriam; Kenny, Rose A; Bennett, Kathleen

2018-02-01

Characteristics of older frequent users of Emergency Departments (EDs) are poorly understood. Our aim was to examine the characteristics of the ED frequent attenders (FAs) by age (under 65 and over 65 years). We examined the prevalence of FA attending the ED of an Urban Teaching Hospital in a cross-sectional study between 2009 and 2011. FA was defined as an individual who presented to the ED four or more times over a 12-month period. Randomly selected groups of FA and non-FA from two age groups (under 65 and over 65 years) were then examined to compare the characteristics between older FAs and non-FAs and older FAs and younger FAs. Logistic regression was used to calculate the odds ratio and 95% confidence intervals for 12-month mortality in FA compared with non-FA aged at least 65 years. Overall, 137 150 ED attendances were recorded between 2009 and 2011. A total of 21.6% were aged at least 65 years, 4.4% of whom were FAs, accounting for 18.4% of attendances by patients older than 65 years. There was a bimodal age distribution of FA (mean±SD; under 65 years 40±12.7; and over 65 years 76.9±7.4). Older FAs were five times more likely to present outside normal working hours and 5.5 times more likely to require admission. Cardiovascular emergencies were the most common complaint, in contrast with the younger FA group, where injury and psychosocial conditions dominated. The odds ratio for death at 12 months was 2.07 (95% confidence interval 0.93-4.63; P=0.07), adjusting for age and sex. One-in-five ED patients older than 65 years of age are FAs. Older FAs largely present with complex medical conditions. Enhanced access to expert gerontology assessment should be considered as part of effective intervention strategies for older ED users.

Usefulness of Cytokeratin-18M65 in Diagnosing Non-Alcoholic Steatohepatitis in Japanese Population.

PubMed

Hasegawa, Yutaka; Kim, Soo Ryang; Hatae, Takashi; Ohta, Mitsuhiro; Fujinami, Aya; Sugimoto, Kayo; Kim, Ke Ih; Imoto, Susumu; Tohyama, Madoka; Kim, Soo Ki; Ikura, Yoshihiro; Kudo, Masatoshi

2015-10-01

The aim of this study was to evaluate cytokeratin-18M65 (CK-18M65) for distinguishing between simple steatosis (SS) and non-alcoholic steatohepatitis (NASH) against healthy individuals (HIs) in Japanese population. The serum from 24 HIs, 21 patients with SS and 20 patients with NASH were examined. Serum CK-18M65 was measured by enzyme-linked immunosorbent assay. Aspartate aminotransferase was significantly different between NASH patients and HIs with p < 0.0001 (SS patients and HIs: p < 0.0001), as was alanine aminotransferase between NASH patients and HIs with p < 0.0001 (SS patients and HIs: p < 0.0001). Serum CK-18M65 increased in a stepwise fashion in HIs and also in SS and NASH patients. Multivariate logistic regression analysis revealed that NASH could be diagnosed with the use of CK-18M65 alone (p = 0.0285, OR 1.0038, 95% CI 1.0004-1.0073). At the optimal cut-off level of 548 U/l, CK-18M65 had an AUC value of 0.7369, 60.00% sensitivity and 85.70% specificity. In patients with NASH, no significant difference was observed between low fibrosis (Stage 0-1, 794.30 ± 454.41, n = 10) and high fibrosis (Stage 2-3, 809.70 ± 641.43, n = 10; p = 0.5967) and between slight steatosis (<33%, 512.89 ± 229.65, n = 9) and moderate steatosis (≥33%, 655.13 ± 480.78, n = 32) in patients with non-alcoholic fatty liver disease (NAFLD; p = 0.7647) with the use of CK-18M65. Serum CK-18M65 distinguished NASH from SS, but could not assess the severity of steatosis in NAFLD patients or the grade of fibrosis in NASH patients in Japanese population. © 2015 S. Karger AG, Basel.

Lifelong occupational exposures and hearing loss among elderly Latino Americans aged 65–75 years

PubMed Central

Hong, OiSaeng; Chin, Dal Lae; Kerr, Madeleine J.

2015-01-01

Objective The purpose of this study is to determine the relationship between occupational exposures and hearing among elderly Latino Americans. Design A descriptive, correlational design used for this secondary analysis with the data from the Sacramento Area Latino Study of Aging (SALSA). Study sample A total of 547 older adults were included. Results A majority of participants (58%) reported occupational exposures to loud noise and/or ototoxic chemicals. About 65% and over 90% showed hearing loss at low and high frequencies, respectively. Participants with occupational exposure to loud noise and/or ototoxic chemicals were, significantly, two times more likely to have hearing loss at high frequencies compared to those without exposure (OR = 2.29; 95% CI: 1.17 – 4.51, p = .016), after controlling for other risk factors of hearing loss such as age, gender, household income, current smoking, and diabetes. However, lifelong occupational exposure was not significantly associated with hearing loss at low frequencies (OR = 1.43; 95% CI: 0.94 – 2.18, p = .094). Conclusion Lifelong occupational exposure to loud noise and/or ototoxic chemicals was significantly associated with hearing loss among elderly Latino Americans. Healthy work life through protection from harmful auditory effects of occupational exposures to noise and chemicals will have a positive impact on better hearing in later life. PMID:25549170

Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

PubMed

Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

2014-01-01

In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

Periodontal status and selected parameters of oral condition of Poles aged 65 to 74 years.

PubMed

Konopka, Tomasz; Dembowska, Elżbieta; Pietruska, Małgorzata; Dymalski, Paweł; Górska, Renata

2015-01-01

The goal of this study was the evaluation of the periodontal health by means of CPI score in inhabitants of big and small cities in the age range from 65 to 74 and making comparison with previous Polish and European studies from XXI century. Also an average number of natural teeth, the edentulous persons percentage, the percentage of people with oral function maintenance and prevalence of oral mucosal diseases were evaluated. There were also attempts to evaluate essential behaviours related to the oral health and the percentage of people that are treated with use of non-reimbursed or reimbursed services. Studies were conducted in 5 big cities: Warszawa, Szczecin, Wrocław, Białystok and Toruń, as well as in 4 towns, such as Oława, Police, Łobez and Ełk. From sampling 7400 people aged from 65 to 74 years for the study reported only 807 people. In the mouth evaluated CPI score, number of natural teeth and prevalence of pathological lesions on cavity mucosa. Answers for questions on selected attitudes and health-seeking behaviours related to the oral health and the range of dental treatment were also analysed. Distribution of values of CPI codes in the whole group was as follows: CPI0-1.2%, CPI1-9.4%, CPI2-16.6%, CPI3-21.8%, CPI4-19.7% and the number of people excluded from examinations (1 tooth in the sextant or edentulous 31.3%). The state of the periodontium was worse in big cities and in men. An average number of teeth was 13.7 and was higher in big cities and in men. The percentage of edentulous persons was 28.9% and was higher in towns and in woman. The percentage of people with oral function maintenance was 25.15% and was higher in big cities and in men. The most three common pathologies of the oral cavity were leukoplakia and leukokeratosis that were found in 10.5% of examined people, candidiasis 5.82% and lichen planus 2.2%. The state of the periodontium of Poles at the age from 65 to 74 has not been improved in XXI century, but also does not

Incidence of Cushing's syndrome and Cushing's disease in commercially-insured patients <65 years old in the United States.

PubMed

Broder, Michael S; Neary, Maureen P; Chang, Eunice; Cherepanov, Dasha; Ludlam, William H

2015-06-01

To estimate the incidence of Cushing's syndrome (CS) and Cushing's disease (CD) in the US. MarketScan Commercial database 2007-2010 (age <65 years) was used. CS patients were defined with ≥2 claims of CS diagnosis, while CD patients were defined with CS plus a benign pituitary adenoma diagnosis or hypophysectomy in the same calendar year. Annual incidence was calculated by dividing the number of CS or CD cases by the total number of members with the same enrollment requirement during the calendar years. CS incidence rates per million person-years were 48.6 in 2009 and 39.5 in 2010. The lowest rates of CS were in ≤17-year-olds and highest rates were in 35 to 44-year-olds. CD incidence rates were 7.6 in 2009 and 6.2 in 2010. The lowest rates of CD were in ≤17-year-olds and highest rates were in 18 to 24-year-olds. The rates varied by sex (2.3-2.7 in males, 9.8-12.1 in females). In females, lowest rates ranged 2.5-4.0 in ≤17-year-olds and highest 16.7-27.2 in 18-24 year olds. In males, there were too few cases to report estimates by age. In the first large US-based study, the annual incidence of CS in individuals <65 years old was nearly 49 cases per million, substantially higher than previous estimates, which were based primarily on European data. Using similar methods, we estimated the incidence of CD at nearly 8 cases per million US population. These estimates, if confirmed in other epidemiologic databases, represent a new data reference in these rare conditions.

Prevalence of cognitive impairment in individuals aged over 65 in an urban area: DERIVA study.

PubMed

Rodríguez-Sánchez, Emiliano; Mora-Simón, Sara; Patino-Alonso, María C; García-García, Ricardo; Escribano-Hernández, Alfonso; García-Ortiz, Luis; Perea-Bartolomé, Ma Victoria; Gómez-Marcos, Manuel A

2011-11-17

Few data are available on the prevalence of cognitive impairment (CI) in Spain, and the existing information shows important variations depending on the geographical setting and the methodology employed. The aim of this study was to determine the prevalence of CI in individuals aged over 65 in an urban area, and to analyze its associated risk factors. A descriptive, cross-sectional, home questionnaire-based study; Populational, urban setting. The reference population comprised over-65s living in the city of Salamanca (Spain) in 2009. Randomized sampling stratified according to health district was carried out, and a total of 480 people were selected. In all, 327 patients were interviewed (68.10%), with a mean age of 76.35 years (SD: 7.33). Women accounted for 64.5% of the total. A home health questionnaire was used to obtain the following data: age, sex, educational level, family structure, morbidity and functionality. All participants completed a neuropsychological test battery. The prevalence data were compared with those of the European population, with direct adjustment for age and sex. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment - no dementia (CIND), and dementia. The prevalence of CI among these over-65s was 19% (14.7% CIND and 4.3% dementia). The age-and sex-adjusted global prevalence of CI was 14.9%. CI increased with age (p < 0.001) and decreased with increasing educational level (p < 0.001). Significant risk factors were found with the multivariate analyses: age (OR = 1.08, 95%CI: 1.03-1.12), anxiety-depression (OR = 3.47, 95%CI: 1.61-7.51) and diabetes (OR = 2.07, 95%CI: 1.02-4.18). In turn, years of education was found to be a protective factor (OR = 0.79, 95%CI: 0.70-0.90). Although CI was more frequent among women and in people living without a partner, these characteristics were not significantly associated with CI risk. The observed raw prevalence of CI was 19% (14.9% after adjusting for age

Effects of Age on Maximal Work Capacity in Women Aged 18-48 Years.

ERIC Educational Resources Information Center

Hartung, G. Harley; And Others

Fifty-six healthy nontrained women aged 18 to 48 were tested for maximal work capacity on a bicycle ergometer. The women were divided into three age groups. A continuous step-increment bicycle ergometer work test was administered with the workload starting at 150 kpm (kilometers per minute) and 50 pedal rpm (revolutions per minute). The workload…

Age-Related 12-Year Changes in Dietary Diversity and Food Intakes among Community-Dwelling Japanese Aged 40 to 79 Years.

PubMed

Otsuka, R; Nishita, Y; Tange, C; Tomida, M; Kato, Y; Imai, T; Ando, F; Shimokata, H

2018-01-01

This study describes trends in dietary diversity and food intake over 12 years according to age at first participation in the study. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study. Participants included 922 men and 879 women who participated in the first study-wave (age, 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Study-waves were conducted biennially. Dietary intake was calculated from 3-day dietary records with photographs. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on food intake. A mixed-effects model was used to estimate linear changes in dietary diversity and food intake over 12 years according to age at first study-wave. Mean (standard deviation (SD)) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8), respectively. Mean (SD, range) dietary diversity score was 0.86 (0.06, 0.52-0.96) in men and 0.88 (0.04, 0.66-0.96) in women, respectively. Fixed effects for interactions of age and time with dietary diversity score were statistically significant (p<0.05). The slope of dietary diversity among men aged 40 to 55 years increased (40-year-old slope = 0.00093/year, p<0.01; 55-year-old slope = 0.00035/year, p=0.04), with a decreasing trend started at 65 years old, although this trend was not significant (65-year-old slope = -0.00003/year, p=0.88; 79-year-old slope = -0.00057/year, p=0.21). The slope of dietary diversity among women aged 40 to 44 years increased (40-year-old slope = 0.00053/year, p=0.02; 44-year-old slope = 0.00038/year, p=0.04), whereas the slope of dietary diversity among women aged 63 to 79 years decreased (63-year-old slope = -0.00033/year, p=0.03; 79-year-old slope = -0.00092/year, p<0.001). Fruit, milk and dairy intake decreased in men around their 60s; milk and dairy intake decreased in women around their 50s; and beans and fruit

Association of Physical Performance and Pain With Fear of Falling Among Community-Dwelling Japanese Women Aged 65 Years and Older.

PubMed

Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

2015-09-01

Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women.The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured.The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts.Maintaining physical functioning and managing pain may be important for elderly women with fear of falling.

Randomized Open Trial Comparing 2-Dose Regimens of the Human Papillomavirus 16/18 AS04-Adjuvanted Vaccine in Girls Aged 9-14 Years Versus a 3-Dose Regimen in Women Aged 15-25 Years.

PubMed

Puthanakit, Thanyawee; Huang, Li-Min; Chiu, Cheng-Hsun; Tang, Ren-Bin; Schwarz, Tino F; Esposito, Susanna; Frenette, Louise; Giaquinto, Carlo; McNeil, Shelly; Rheault, Paul; Durando, Paolo; Horn, Michael; Klar, Maximilian; Poncelet, Sylviane; De Simoni, Stéphanie; Friel, Damien; De Muynck, Benoit; Suryakiran, Pemmaraju V; Hezareh, Marjan; Descamps, Dominique; Thomas, Florence; Struyf, Frank

2016-08-15

This randomized, open trial compared regimens including 2 doses (2D) of human papillomavirus (HPV) 16/18 AS04-adjuvanted vaccine in girls aged 9-14 years with one including 3 doses (3D) in women aged 15-25 years. Girls aged 9-14 years were randomized to receive 2D at months 0 and 6 (M0,6; (n = 550) or months 0 and 12 (M0,12; n = 415), and women aged 15-25 years received 3D at months 0, 1, and 6 (n = 482). End points included noninferiority of HPV-16/18 antibodies by enzyme-linked immunosorbent assay for 2D (M0,6) versus 3D (primary), 2D (M0,12) versus 3D, and 2D (M0,6) versus 2D (M0,12); neutralizing antibodies; cell-mediated immunity; reactogenicity; and safety. Limits of noninferiority were predefined as <5% difference in seroconversion rate and <2-fold difference in geometric mean antibody titer ratio. One month after the last dose, both 2D regimens in girls aged 9-14 years were noninferior to 3D in women aged 15-25 years and 2D (M0,12) was noninferior to 2D (M0,6). Geometric mean antibody titer ratios (3D/2D) for HPV-16 and HPV-18 were 1.09 (95% confidence interval, .97-1.22) and 0.85 (.76-.95) for 2D (M0,6) versus 3D and 0.89 (.79-1.01) and 0.75 (.67-.85) for 2D (M0,12) versus 3D. The safety profile was clinically acceptable in all groups. The 2D regimens for the HPV-16/18 AS04-adjuvanted vaccine in girls aged 9-14 years (M0,6 or M0,12) elicited HPV-16/18 immune responses that were noninferior to 3D in women aged 15-25 years. NCT01381575. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

Uraemic symptom burden and clinical condition in women and men of ≥65 years of age with advanced chronic kidney disease: results from the EQUAL study.

PubMed

van de Luijtgaarden, Moniek W M; Caskey, Fergus J; Wanner, Christoph; Chesnaye, Nicholas C; Postorino, Maurizio; Janmaat, Cynthia J; Rao, Anirudh; Torino, Claudia; Klinger, Marian; Drechsler, Christiane; Heimburger, Olof; Szymczak, Maciej; Evans, Marie; Dekker, Friedo W; Jager, Kitty J

2018-06-13

The epidemiology and prognosis of chronic kidney disease (CKD) differ by sex. We aimed to compare symptom prevalence and the clinical state in women and men of ≥65 years of age with advanced CKD receiving routine nephrology care. The European QUALity study on treatment in advanced chronic kidney disease (EQUAL) study follows patients from six European countries of ≥65 years of age  years whose estimated glomerular filtration rate (eGFR) dropped to ≤20 mL/min/1.73 m2 for the first time during the last 6 months. The Dialysis Symptom Index was used to assess the prevalence and severity of 33 uraemic symptoms. Data on the clinical state at baseline were collected from medical records. Prevalence was standardized using the age distribution of women as the reference. The results in women (n = 512) and men (n = 967) did not differ with age (77.0 versus 75.7 years) or eGFR (19.0 versus 18.5). The median number of symptoms was 14 [interquartile range (IQR) 9-19] in women, and 11 (IQR 7-16) in men. Women most frequently reported fatigue {39% [95% confidence interval (CI) 34-45]} and bone/joint pain [37% (95% CI 32-42)] as severe symptoms, whereas more men reported difficulty in becoming sexually aroused [32% (95% CI 28-35)] and a decreased interest in sex [31% (95% CI 28-35)]. Anaemia [73% (95% CI 69-77) versus 85% (95% CI 82-87)] was less common in women than in men, as were smoking history and cardiovascular comorbidity. However, a diagnosis of liver disease other than cirrhosis, psychiatric disease and mild malnutrition were more common among women. Women in secondary care with an incident eGFR ≤20 mL/min/1.73 m2 reported a higher symptom burden, while their clinical state was considered similar or even more favourable as compared with men.

Immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine in healthy Chinese girls and women aged 9 to 45 years.

PubMed

Zhu, Fengcai; Li, Juan; Hu, Yuemei; Zhang, Xiang; Yang, Xiaoping; Zhao, Hui; Wang, Junzhi; Yang, Jianguo; Xia, Guodong; Dai, Qinyong; Tang, Haiwen; Suryakiran, Pemmaraju; Datta, Sanjoy K; Descamps, Dominique; Bi, Dan; Struyf, Frank

2014-01-01

Immunogenicity and safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine were evaluated in healthy Chinese females aged 9-45 years in 2 phase IIIB, randomized, controlled trials. Girls aged 9-17 years (ClinicalTrials.gov, NCT00996125) received vaccine (n = 374) or control (n = 376) and women aged 26-45 years (NCT01277042) received vaccine (n = 606) or control (n = 606) at months 0, 1, and 6. The primary objective was to show non-inferiority of anti-HPV-16 and -18 immune responses in initially seronegative subjects at month 7, compared with Chinese women aged 18-25 years enrolled in a separate phase II/III trial (NCT00779766). Secondary objectives were to describe the anti-HPV-16 and -18 immune response, reactogenicity and safety. At month 7, immune responses were non-inferior for girls (9-17 years) vs. young women (18-25 years): the upper limit of the 95% confidence interval (CI) for the geometric mean titer (GMT) ratio (women/girls) was below the limit of 2 for both anti-HPV-16 (0.37 [95% CI: 0.32, 0.43]) and anti-HPV-18 (0.42 [0.36, 0.49]). Immune responses at month 7 were also non-inferior for 26-45 year-old women vs. 18-25 year-old women: the upper limit of the 95% CI for the difference in seroconversion (18-25 minus 26-45) was below the limit of 5% for both anti-HPV-16 (0.00% [-1.53, 1.10]) and anti-HPV-18 (0.21% [-1.36, 1.68]). GMTs were 2- to 3-fold higher in girls (9-17 years) as compared with young women (18-25 years). The HPV-16/18 AS04-adjuvanted vaccine had an acceptable safety profile when administered to healthy Chinese females aged 9-45 years.

Impact of Gait Speed and Instrumental Activities of Daily Living on All-Cause Mortality in Adults ≥65 Years of Age with Heart Failure

PubMed Central

Lo, Alexander X.; Donnelly, John P.; McGwin, Gerald; Bittner, Vera; Ahmed, Ali; Brown, Cynthia J.

2015-01-01

Mobility and function are important predictors of survival. However, their combined impact on mortality in adults ≥65 years of age with heart failure (HF) is not well understood. This study examined the role of gait speed and instrumental activities of daily living (IADL) in all-cause mortality in a cohort of 1,119 community-dwelling Cardiovascular Health Study participants ≥65 years of age with incident HF. Data on HF and mortality were collected through annual examinations or contact during the 10-year follow-up period. Slower gait speed (<0.8m/s vs. ≥0.8m/s) and IADL impairment (≥1 vs. 0 areas of dependence) were determined from baseline and follow-up assessments. A total of 740 (66%) of the 1119 participants died during the follow-up period. Multivariate Cox proportional hazards models showed that impairments in either gait speed (hazard ratio 1.37, 95% CI 1.10-1.70; p=0.004) or IADL (HR 1.56, 95% CI 1.29-1.89; p<0.001), measured within 1 year before the diagnosis of incident HF, were independently associated with mortality, adjusting for socio-demographic and clinical characteristics. The combined presence of slower gait speed and IADL impairment was associated with a greater risk of mortality and suggested an additive relationship between gait speed and IADL. In conclusion, gait speed and IADL are important risk factors for mortality in adults ≥65 years of age with HF, but the combined impairments of both gait speed and IADL can have an especially important impact on mortality. PMID:25655868

30 CFR 18.65 - Flame test of hose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Inspections and Tests § 18.65 Flame... variable-speed electric fan and an ASME flow nozzle (16-81/2 inches reduction) to attain constant air velocities at any speed between 50-500 feet a minute. (4) An electric timer or stopwatch to measure the...

Burden of disease associated with lower levels of income among US adults aged 65 and older.

PubMed

Lubetkin, Erica I; Jia, Haomiao

2017-01-16

Persons aged 65 years and older represent a heterogeneous group whose prevalence in the USA is expected to markedly increase. Few investigations have examined the total burden of disease attributable to lower levels of income in a single number that accounts for morbidity and mortality. We ascertained respondents' health-related quality of life (HRQOL) scores and mortality status from the 2003 to 2004, 2005 to 2006, 2007 to 2008 and 2009 to 2010 cohorts of the National Health and Nutrition Examination Survey (NHANES) with mortality follow-up through 31 December 2011. A mapping algorithm based on respondents' age and answers to the 4 core Healthy Days questions was used to obtain values of a preference-based measure of HRQOL, the EuroQol five dimensions questionnaire (EQ-5D) index, which enables quality-adjusted life years (QALYs) to be calculated. We included only respondents aged 65 years and older at the baseline, yielding a total sample size of 4952. We estimated mean QALYs according to different categories of income based on the percentage of Federal Poverty Level (FPL). After adjusting for age, gender and education, the remaining QALYs decreased with each successive decrement of category of income, ranging from 18.4 QALY (≥500% FPL) to 8.6 QALY (<100% FPL). Compared with participants with a mean income of ≥250% FPL, participants with an income <250% FPL had significant losses in QALY for most of the sociodemographic groups examined. In contrast, persons with a lower educational attainment did not show a corresponding loss in QALY according to income category. This study confirmed the association between lower income category and greater burden of disease, as measured by QALYs lost, among the US population aged 65 years and older. Our findings provide additional evidence of the role played by other key determinants of health and how factors not traditionally addressed by the healthcare system impact the life cycle of individuals and communities

[Fruit and vegetables intake among the Chinese migrant population aged 18 to 59 years old in 2012].

PubMed

Zhang, Mei; Wang, Linhong; Deng, Qian; Zhao, Yinjun; Huang, Zhengjing; Li, Yichong; Jiang, Yong; Wang, Limin

2014-11-01

To describe the intake of fruit and vegetables among employed migrant population aged 18 to 59 year-olds in China. Data from the Migrant Population Survey related to China Chronic Disease and Risk Factor Surveillance that conducted in 170 counties/districts in 31 provinces, 2012, was used. Information on non-communicable diseases and related risk factors among migrant population were collected through face-to-face questionnaire interview, physical measurement and lab tests. A total of 48 704 subjects aged 18 to 59 years old were included in our study. Sample was standardized by age and sex. Information on average daily fruit and vegetables intake, prevalence of low fruit and vegetables intake, grouped by sex, age, industries, and education level were analyzed. The average daily intakes of vegetables and fruits were 353.7 (95%CI:351.3-356.2) g and 125.1 (95%CI:123.4-126.9) g respectively, among the employed migrant population aged 18-59 years old in China. Prevalence of low fruit and vegetables intake was 44.1% (95% CI:43.5%-44.6% ) among employed migrant population, 46.2% (95% CI: 45.5%-47.0%)for males and 41.2% (95% CI:40.3%-42.0%)for females (χ(2) = 82.19, P < 0.05). Among different professions, the prevalence of low fruit and vegetables intake was the highest among people working in accommodation and restaurants (46.2%, 95%CI:45.0%-47.3%) while the lowest seen among those working in social services (42.5%, 95%CI:41.4%-43.7%,χ(2) = 15.81, P < 0.05). The prevalence of low fruit and vegetables intake showed a decrease along with the increase of education levels (χ(2) = 22.29, P < 0.05). In 2012, more than 40% of the employed migrant population aged 18 to 59 years old in China had low fruit and vegetables intake. Being male and with low education level were risk factors linked with the higher prevalence of low fruit and vegetables intake.

Prevalence of metabolic syndrome with International Diabetes Federation Criteria and ATP III Program in patients 65 years of age or older.

PubMed

De Luis, D A; Lopez Mongil, R; Gonzalez Sagrado, M; Lopez Trigo, J A; Mora, P F; Castrodeza Sanz, J

2010-05-01

The relationship between cardiovascular factors and death can vary with age, very few studies have examined metabolic syndrome in the elderly. The aim of this study is to assess the prevalence of the MS in a sample of elderly institutionalized patients (> 65 years) using ATPIII and IDF definitions. This was a cross-sectional survey covering a sample of representative of the institutionalized Spanish population aged above 65 years. The final sample study consisted of 862 patients, 556 females and 306 males. ATPIII and IDF definitions were used to classify the patients. Prevalence of MS was different according to the two definitions used. When the IDF definition was applied, total prevalence was 48.91% (CI 95%:43.47-50.25), while prevalence according to ATPIII criteria was 46.80% (CI = 43.47-50.25). a higher prevalence of MS was found in females as compared to males. Using IDF criteria, odds ratio was 1.9 (CI 95%:1.4-2.6) and 1.7 (CI 95%:1.2-2.2) according to ATPIII criteria. a steady decrease is seen in MS prevalence as the age of patients increases (the last two groups (85-94 ys and > 95 ys), both for the ATP III and the IDF definitions. A higher prevalence of MS in this elderly population as compared to general population was observed. A decrease of this prevalence above 95 years was detected.

Age-related decrements in bone mineral density in women over 65

NASA Technical Reports Server (NTRS)

Steiger, P.; Cummings, S. R.; Black, D. M.; Spencer, N. E.; Genant, H. K.

1992-01-01

Age-related changes in bone density contribute to the risk of fractures. To describe the relationship between age and bone mass in elderly women, we studied a large cohort of women over age 65 years who were recruited from population-based lists in four cities in the United States. Bone density in g/cm2 was measured by single-photon absorptiometry (SPA) and dual x-ray absorptiometry (DXA) at the distal and proximal radius, the calcaneus, the lumbar spine, and the proximal femur. Centralized data collection was used to control data quality and consistency. We found a strong inverse relationship between bone density and age for most sites. Decrements in bone density between women aged 65-69 years and women 85 years and older exceeded 16% in all regions except the spine, where the difference between the two age groups was 6%. Ward's triangle and the calcaneus exhibited the largest decrements, with 26 and 21%, respectively. The estimates of annual changes in bone mineral density by linear regression at sites other than the spine ranged from -0.82% at the femoral neck and trochanter to -1.30% at Ward's triangle. Correlations between the different regions ranged from r = 0.51 between the proximal radius and Ward's triangle to r = 0.66 between the distal radius and calcaneus. We conclude that the inverse relationship between age and bone mass measured by absorptiometry techniques in white women continues into the ninth decade of life. The relationship is strongest for bone density of Ward's triangle and the calcaneus and weakest for the spine.

Immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine in healthy Chinese girls and women aged 9 to 45 years

PubMed Central

Zhu, Fengcai; Li, Juan; Hu, Yuemei; Zhang, Xiang; Yang, Xiaoping; Zhao, Hui; Wang, Junzhi; Yang, Jianguo; Xia, Guodong; Dai, Qinyong; Tang, Haiwen; V Suryakiran, Pemmaraju; Datta, Sanjoy K; Descamps, Dominique; Bi, Dan; Struyf, Frank

2014-01-01

Immunogenicity and safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine were evaluated in healthy Chinese females aged 9–45 years in 2 phase IIIB, randomized, controlled trials. Girls aged 9–17 years (ClinicalTrials.gov, NCT00996125) received vaccine (n = 374) or control (n = 376) and women aged 26–45 years (NCT01277042) received vaccine (n = 606) or control (n = 606) at months 0, 1, and 6. The primary objective was to show non-inferiority of anti-HPV-16 and -18 immune responses in initially seronegative subjects at month 7, compared with Chinese women aged 18–25 years enrolled in a separate phase II/III trial (NCT00779766). Secondary objectives were to describe the anti-HPV-16 and -18 immune response, reactogenicity and safety. At month 7, immune responses were non-inferior for girls (9–17 years) vs. young women (18–25 years): the upper limit of the 95% confidence interval (CI) for the geometric mean titer (GMT) ratio (women/girls) was below the limit of 2 for both anti-HPV-16 (0.37 [95% CI: 0.32, 0.43]) and anti-HPV-18 (0.42 [0.36, 0.49]). Immune responses at month 7 were also non-inferior for 26–45 year-old women vs. 18–25 year-old women: the upper limit of the 95% CI for the difference in seroconversion (18–25 minus 26–45) was below the limit of 5% for both anti-HPV-16 (0.00% [–1.53, 1.10]) and anti-HPV-18 (0.21% [–1.36, 1.68]). GMTs were 2- to 3-fold higher in girls (9–17 years) as compared with young women (18–25 years). The HPV-16/18 AS04-adjuvanted vaccine had an acceptable safety profile when administered to healthy Chinese females aged 9–45 years. PMID:25424785

Greater Short-Term Weight Loss in Women 20-45 versus 55-65 Years of Age Following Bariatric Surgery

PubMed Central

Ochner, Christopher N.; Teixeira, Julio; Geary, Nori; Asarian, Lori

2013-01-01

Background Whether and how sex and age affect bariatric-surgery outcome is poorly understood. Estrogens regulate body composition in women and animals and increased weight loss in a rodent model of gastric bypass, suggesting that premenopausal women may lose more weight following bariatric surgery. Methods 1,356 female gastric-bypass or gastric-banding patients were retrospectively grouped as 20-45 y old (presumptively premenopausal; n = 1199) and 55-65 y old (presumptively postmenopausal; n = 157). Mixed-model ANCOVA followed by Bonferroni-corrected t-tests were used to categorically test the effect of age on percent excess body weight loss (%EBWL) at 1 and 2 y post-surgery, controlling for preoperative EBW and surgery type. Age effects were also tested dimensionally in all women and in 289 male patients. Results 20-45 y-old women showed greater %EBWL 1 and 2 y post-surgery than 55-65 y-old women (p’s < 0.0005). No age effect was detected in 20-25 vs. 30-35, 30-35 vs. 40-45, or 20-25 vs. 40-45 y-old women (p’s > 0.2) This age effect was detected only after gastric banding, with 20-45 y-old women losing ~7 kg more than 55-65 y-old women after 2 y. Dimensional analysis confirmed a significant inverse effect of age on bariatric surgery outcome in women, but did not detect any effect in men. Conclusions Results indicate that 55-65 y-old women lose less weight than 20-45 y-old women in the initial 2 y after bariatric surgery, especially gastric banding; this may be mediated by age- or menopause-associated changes in physical activity, energy expenditure, or energy intake. PMID:23700235

Diffuse Lung Disease in Biopsied Children 2 to 18 Years of Age. Application of the chILD Classification Scheme.

PubMed

Fan, Leland L; Dishop, Megan K; Galambos, Csaba; Askin, Frederic B; White, Frances V; Langston, Claire; Liptzin, Deborah R; Kroehl, Miranda E; Deutsch, Gail H; Young, Lisa R; Kurland, Geoffrey; Hagood, James; Dell, Sharon; Trapnell, Bruce C; Deterding, Robin R

2015-10-01

Children's Interstitial and Diffuse Lung Disease (chILD) is a heterogeneous group of disorders that is challenging to categorize. In previous study, a classification scheme was successfully applied to children 0 to 2 years of age who underwent lung biopsies for chILD. This classification scheme has not been evaluated in children 2 to 18 years of age. This multicenter interdisciplinary study sought to describe the spectrum of biopsy-proven chILD in North America and to apply a previously reported classification scheme in children 2 to 18 years of age. Mortality and risk factors for mortality were also assessed. Patients 2 to 18 years of age who underwent lung biopsies for diffuse lung disease from 12 North American institutions were included. Demographic and clinical data were collected and described. The lung biopsies were reviewed by pediatric lung pathologists with expertise in diffuse lung disease and were classified by the chILD classification scheme. Logistic regression was used to determine risk factors for mortality. A total of 191 cases were included in the final analysis. Number of biopsies varied by center (5-49 biopsies; mean, 15.8) and by age (2-18 yr; mean, 10.6 yr). The most common classification category in this cohort was Disorders of the Immunocompromised Host (40.8%), and the least common was Disorders of Infancy (4.7%). Immunocompromised patients suffered the highest mortality (52.8%). Additional associations with mortality included mechanical ventilation, worse clinical status at time of biopsy, tachypnea, hemoptysis, and crackles. Pulmonary hypertension was found to be a risk factor for mortality but only in the immunocompetent patients. In patients 2 to 18 years of age who underwent lung biopsies for diffuse lung disease, there were far fewer diagnoses prevalent in infancy and more overlap with adult diagnoses. Immunocompromised patients with diffuse lung disease who underwent lung biopsies had less than 50% survival at time of last follow-up.

[The causes of symptomatic epilepsy in children aged 3-18 years hospitalized in the year 2006-2007].

PubMed

Gergont, Aleksandra; Kroczka, Sławomir; Kaciński, Marek

2008-01-01

Epilepsy can be one of symptoms of the damage to CNS in children with neurodevelopmental deficits, it is more difficult however to diagnose seizures if they are the first symptom of severe brain damage. This retrospective research was conducted to study causes of symptomatic epilepsy in children aged 3-18 year hospitalized between 2006 and 2007 year in the Department of Pediatric Neurology. 156 children with symptomatic epilepsy occurred after 2 years of life were included. The diagnosis of symptomatic epilepsy was established including clinical picture, neuro-radiological tests and EEG. The information from parents was helpful to analyze the type of seizures. The clinical state of children was analyzed, especially psychomotor development, focal deficits, as well as results of CT and/or MRI, in some children psychological testing was performed, molecular or serological. 156 children with epilepsy were hospitalized, within encephalopathy was diagnosed in 61 children. In 42 children static encephalopathy was associated with birth trauma, in 7 progressive encephalopathy was diagnosed, in 1 child CO intoxication caused encephalopathy, and in 11 cases the cause was not identified. Malformations of nervous system were associated with epilepsy in 37 children, geneticaly determined syndromes in 6, and the head trauma in other 6 children. Disorders of vascular origin caused epilepsy in 16 children, and neuroinfections in 9 children. In 2 children epilepsy was associated with ADEM, and in 11 children nonspecific de/dysmyelination was detected. The brain tumor was detected in 6 children with symptomatic epilepsy. The most common disorder leading to epilepsy in children aged 3-18 years was encephalopathy, within hypoxic-ischemic encephalopathy. The other in sequence were malformations of nervous system and vascular diseases.

Association of Physical Performance and Pain With Fear of Falling Among Community—Dwelling Japanese Women Aged 65 Years and Older

PubMed Central

Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

2015-01-01

Abstract Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women. The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured. The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts. Maintaining physical functioning and managing pain may be important for elderly women with fear of falling. PMID:26334906

Impact of post-remission therapy in patients aged 65-70 years with de novo acute myeloid leukemia: a comparison of two concomitant randomized ALFA trials with overlapping age inclusion criteria.

PubMed

Itzykson, Raphael; Gardin, Claude; Pautas, Cécile; Thomas, Xavier; Turlure, Pascal; Raffoux, Emmanuel; Terré, Christine; Fenaux, Pierre; Castaigne, Sylvie; Dombret, Hervé; Boissel, Nicolas

2011-06-01

There is no standard post-remission therapy in older patients with acute myeloid leukemia. From 1999 to 2006, the Acute Leukemia French Association group ran two concurrent randomized trials with overlapping inclusion criteria for patients aged 65 to 70 with acute myeloid leukemia, with different post-remission strategies: two intensive courses in the 9801 trial, one intensive course or six outpatient courses in the 9803 trial. We analyzed the outcome of these patients per protocol and per post-remission therapy. Two hundred and eleven patients aged 65 to 70 years with de novo acute myeloid leukemia were enrolled in trial 9801 (n=76) or 9803 (n=135). The patients in the two trials had comparable white blood cell counts (P=0.3), cytogenetics (P=0.49), and complete remission rates (70% and 57%, respectively; P=0.17). Overall survival was identical in both trials (32% and 34% at 2 years, respectively; P=0.71). Overall survival after complete remission was identical in the 103 of 130 patients who received the planned post-remission courses (n=44 with two intensive courses, n=28 with one intensive course, n=31 with six outpatient courses; 41%, 55%, and 58% at 2 years, respectively; P=0.34). Even in patients with favorable or normal karyotype (n=97), overall survival from complete remission was not improved by more intensive post-remission therapy. In patients aged 65 to 70 years with de novo acute myeloid leukemia in complete remission after standard intensive induction chemotherapy, there is no apparent benefit from intensive post-remission therapy. (ClinicalTrials.gov Identifiers: NCT00931138 and NCT00363025).

Blood pressure at age 60-65 versus age 70-75 and vascular dementia: a population based observational study.

PubMed

Peng, Mingkai; Chen, Guanmin; Tang, Karen L; Quan, Hude; Smith, Eric E; Faris, Peter; Hachinski, Vladimir; Campbell, Norm R C

2017-10-27

Vascular dementia (VaD) is the second most common form of dementia. However, there were mixed evidences about the association between blood pressure (BP) and risk of VaD in midlife and late life and limited evidence on the association between pulse pressure and VaD. This is a population-based observational study. 265,897 individuals with at least one BP measurement between the ages of 60 to 65 years and 211,116 individuals with at least one BP measurement between the ages of 70 to 75 years were extracted from The Health Improvement Network in United Kingdom. Blood pressures were categorized into four groups: normal, prehypertension, stage 1 hypertension, and stage 2 hypertension. Cases of VaD were identified from the recorded clinical diagnoses. Multivariable survival analysis was used to adjust other confounders and competing risk of death. All the analysis were stratified based on antihypertensive drug use status. Multiple imputation was used to fill in missing values. After accounting for the competing risk of death and adjustment for potential confounders, there was an association between higher BP levels in the age 60-65 cohort with the risk of developing VaD (hazard ratio [HR] 1.53 (95% confidence interval: 1.04, 2.25) for prehypertension, 1.90 (1.30, 2.78) for stage 1 hypertension, and 2.19 (1.48, 3.26) for stage 2 hypertension) in the untreated group. There was no statistically significant association between BP levels and VaD in the treated group in the age 60-65 cohort and age 70-75 cohort. Analysis on Pulse Pressure (PP) stratified by blood pressure level showed that PP was not independently associated with VaD. High BP between the ages of 60 to 65 years is a significant risk for VaD in late midlife. Greater efforts should be placed on early diagnosis of hypertension and tight control of BP for hypertensive patients for the prevention of VaD.

The Age-Varying Association of Student Status with Excessive Alcohol Use: Ages 18 to 30 Years.

PubMed

Evans-Polce, Rebecca J; Maggs, Jennifer L; Staff, Jeremy; Lanza, Stephanie T

2017-02-01

There is a well-known link between attending college and engaging in excessive alcohol use. This study examines in a national sample how the association between student status and excessive alcohol use changes from late adolescence through young adulthood and whether the association of student status with excessive alcohol use is different for students residing with versus away from parents during the school year. This study used cross-sectional data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of noninstitutionalized civilian adults residing in the United States. Our analyses included nonhigh school young adults who were ages 18 to 30 years (n = 8,645). Excessive alcohol use included past-year (i) high-intensity drinking (men: ≥10 standard drinks; women: ≥8) and (ii) exceeding weekly drinking guidelines (men: >14 drinks per week; women: >7). Students who resided away from their parents and students who lived with their parents during the school year were compared to nonstudents. Analyses using time-varying effect modeling showed that the relationship of student status with excessive alcohol use varied as a function of age. Overall student status lost its association with excessive alcohol use in the early 20s, after controlling for demographics and other adult social roles. The association between student status and excessive alcohol use also varied considerably across age and depending on whether the student was residing with or away from parents. The association of student status with excessive alcohol use is heterogeneous in terms of both age and living arrangements, suggesting opportunities for interventions targeting problematic alcohol use. Future research should examine additional sources of heterogeneity of students in their risk for excessive alcohol use. Copyright © 2016 by the Research Society on Alcoholism.

18 CFR 366.4 - FERC-65, notification of holding company status, FERC-65A, exemption notification, and FERC-65B...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false FERC-65, notification... Section 366.4 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... NATURAL GAS ACT BOOKS AND RECORDS Definitions and Provisions Under PUHCA 2005, the Federal Power Act and...

18 CFR 366.4 - FERC-65, notification of holding company status, FERC-65A, exemption notification, and FERC-65B...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false FERC-65, notification... Section 366.4 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... NATURAL GAS ACT BOOKS AND RECORDS Definitions and Provisions Under PUHCA 2005, the Federal Power Act and...

A cross-sectional study of cryptorchidism in children: testicular volume and hormonal function at 18 years of age

PubMed Central

Varela-Cives, R.; Méndez-Gallart, R.; Estevez-Martínez, E.; Rodríguez-Barca, P.; Bautista-Casasnovas, A.; Pombo-Arias, M.; Tojo-Sierra, R.

2015-01-01

Purpose To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood. Materials and Methods Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism. Results Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 mL. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment. Bilateral cryptorchidism Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH. Conclusions Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or age of initial treatment exerts

Enterobius vermicularis infection among children aged 1-8 years in a rural area in Malaysia.

PubMed

Norhayati, M; Hayati, M I; Oothuman, P; Azizi, O; Fatmah, M S; Ismail, G; Minudin, Y M

1994-09-01

The infection rate and relationship of enterobiasis with socio-economic status were determined in children aged 1-8 years, living in a rural area in Malaysia. Of the 178 subjects 40.4% were infected with Enterobius vermicularis. The distribution of enterobiasis among these children were analyzed in relation to age groups and sex. The rate of infection was significantly higher in older children (5-7 years). The association of enterobiasis with other factors studied such as number of persons per house, household income per months and mother's employment status were not significant. The sensitivity of three successive days anal swabs compared to a single swab was found to be statistically significant.

Gender differences in association between psychological distress and detailed living arrangements among Japanese older adults, aged 65-74 years.

PubMed

Kikuchi, Hiroyuki; Takamiya, Tomoko; Odagiri, Yuko; Ohya, Yumiko; Nakaya, Tomoki; Shimomitsu, Teruichi; Inoue, Shigeru

2014-05-01

Past studies have shown that living alone is detrimental to older adults' mental health. However, there has been little focus on how older adults' psychological distress differed by more detailed living arrangement, as well as by gender. The present study investigates various living arrangements in association with psychological distress among older men and women. Data from community-dwelling Japanese older adults were collected through a mail survey (n = 1,807, aged 65-74 years, 51.5 % men). Psychological distress level was measured using Kessler's six-item psychological distress scale. Living arrangements were categorized into four groups; "living with spouse only", "living with spouse and other family", "living with other family without spouse" or "living alone". Multiple logistic regression analyses were used to examine the associations of living arrangements with psychological distress level. Older adults living alone were observed to have higher psychological distress. In addition, gender-stratified analyses showed that higher distress levels were observed among older men living with family, but without a spouse (OR: 2.85, 95 % CI: 1.51-5.39). In contrast, higher distress was observed among older women living with spouse and other family (OR: 1.53, 95 % CI: 1.03-2.28). Psychological distress in older Japanese adults was associated with living arrangements, but such associations differed by gender. The association of living with a spouse on older men's mental health was striking, while living with any family was found to be rather important for older women, aged 65-74 years.

Adverse events after tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine administered to adults 65 years of age and older reported to the Vaccine Adverse Event Reporting System (VAERS), 2005-2010.

PubMed

Moro, Pedro L; Yue, Xin; Lewis, Paige; Haber, Penina; Broder, Karen

2011-11-21

Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine was not licensed for use in adults aged ≥65 years due to lack of sufficient efficacy and safety data. To characterize reports to the Vaccine Adverse Event Reporting System (VAERS) among adults aged ≥65 years who received Tdap vaccine 'off-label' to assess for potential vaccine safety concerns. We searched VAERS for US reports of adverse events (AEs) in subjects aged ≥65 years who received Tdap vaccine from 9/1/2005 to 9/08/2010. Medical records were requested for all reports coded as serious (death, hospitalization, prolonged hospitalization, permanent disability, life-threatening-illness). Proportional reporting ratio (PRR) was used to assess for higher proportionate reporting for AEs after Tdap compared with Td reports in subjects aged ≥65 years. VAERS received 243 reports following Tdap administered to persons aged ≥65 years. Eleven (4.5%) reports were serious, including two deaths. Most common AEs were local reactions in 100 (41.2%) reports. Seventy-eight (32.1%) reports contained coding terms that denoted inappropriate administration of vaccine. 'Cough' was the only term associated with disproportionately higher reporting after Tdap compared with Td. Six of seven Tdap reports containing the term 'Cough' were non-serious. Clinical review of serious reports identified no unusual patterns of AEs. Our VAERS review of the 'off-label' use of Tdap vaccine in adults ≥65 years did not find any safety concerns that warrant further study. These data will provide useful baseline information to assist CDC and FDA with monitoring efforts as permissive recommendations for Tdap in older persons are adopted. Published by Elsevier Ltd.

Influenza vaccination health impact and cost effectiveness among adults aged 50 to 64 and 65 and older.

PubMed

Maciosek, Michael V; Solberg, Leif I; Coffield, Ashley B; Edwards, Nichol M; Goodman, Michael J

2006-07-01

Influenza causes approximately 36,000 deaths per year in the United States despite the presence of an effective vaccine. This assessment of the value of influenza vaccination to the U.S. population is part of an update to the 2001 ranking of clinical preventive services recommended by the U.S. Preventive Services Task Force. The forthcoming ranking will include the new recommendation of the Advisory Committee on Immunization Practices to extend influenza vaccination to adults aged 50 to 64 years. This service is evaluated on the two most important dimensions: burden of disease prevented and cost effectiveness. Study methods, described in a companion article, are designed to ensure consistency across many services. Over the lifetime of a birth cohort of 4 million, it is estimated that about 275,000 quality-adjusted life years (QALYs) would be saved if influenza vaccination were offered annually to all people after age 50. Eighty percent of the QALYs saved (220,000) would be achieved by offering the vaccine only to persons aged 65 and older. In year 2000 dollars, the cost effectiveness of influenza vaccination is $980 per QALY saved in persons aged 65 and older, and $28,000 per QALY saved in persons aged 50 to 64. When the costs of patient time and travel are excluded, the cost effectiveness ratio of vaccinating 50- to 64-year-olds decreases to $7200 per QALY saved, and vaccinating those aged 65 and older saves $17 per person vaccinated. Influenza vaccination is a high-impact, cost-effective service for persons aged 65 and older. Vaccinations are also cost effective for persons aged 50 to 64.

Body build classes as a method for systematization of age-related anthropometric changes in girls aged 7-8 and 17-18 years.

PubMed

Kasmel, Jaan; Kaarma, Helje; Koskel, Säde; Tiit, Ene-Margit

2004-03-01

A total of 462 schoolgirls aged 7-8 and 17-18 years were examined anthropometrically (45 body measurements and 10 skinfolds) in a cross-sectional study. The data were processed in two age groups: 7-8-year-olds (n = 205) and 17-18-year-olds (n = 257). Relying on average height and weight in the groups, both groups were divided into five body build classes: small, medium, large, pyknomorphous and leptomorphous. In these classes, the differences in all other body measurements were compared, and in both age groups, analogous systematic differences were found in length, width and depth measurements and circumferences. This enabled us to compare proportional changes in body measurements during ten years, using for this ratios of averages of basic measurements and measurement groups in the same body build classes. Statistical analysis by the sign test revealed statistically significant differences between various body build classes in the growth of averages. Girls belonging to the small class differed from the girls of the large class by an essentially greater increase in their measurements. Our results suggest that the growth rate of body measurements of girls with different body build can be studied by the help of body build classification.

Impact of post-remission therapy in patients aged 65–70 years with de novo acute myeloid leukemia: a comparison of two concomitant randomized ALFA trials with overlapping age inclusion criteria

PubMed Central

Itzykson, Raphael; Gardin, Claude; Pautas, Cécile; Thomas, Xavier; Turlure, Pascal; Raffoux, Emmanuel; Terré, Christine; Fenaux, Pierre; Castaigne, Sylvie; Dombret, Hervé; Boissel, Nicolas

2011-01-01

Background There is no standard post-remission therapy in older patients with acute myeloid leukemia. Design and Methods From 1999 to 2006, the Acute Leukemia French Association group ran two concurrent randomized trials with overlapping inclusion criteria for patients aged 65 to 70 with acute myeloid leukemia, with different post-remission strategies: two intensive courses in the 9801 trial, one intensive course or six outpatient courses in the 9803 trial. We analyzed the outcome of these patients per protocol and per post-remission therapy. Results Two hundred and eleven patients aged 65 to 70 years with de novo acute myeloid leukemia were enrolled in trial 9801 (n=76) or 9803 (n=135). The patients in the two trials had comparable white blood cell counts (P=0.3), cytogenetics (P=0.49), and complete remission rates (70% and 57%, respectively; P=0.17). Overall survival was identical in both trials (32% and 34% at 2 years, respectively; P=0.71). Overall survival after complete remission was identical in the 103 of 130 patients who received the planned post-remission courses (n=44 with two intensive courses, n=28 with one intensive course, n=31 with six outpatient courses; 41%, 55%, and 58% at 2 years, respectively; P=0.34). Even in patients with favorable or normal karyotype (n=97), overall survival from complete remission was not improved by more intensive post-remission therapy. Conclusions In patients aged 65 to 70 years with de novo acute myeloid leukemia in complete remission after standard intensive induction chemotherapy, there is no apparent benefit from intensive post-remission therapy. (ClinicalTrials.gov Identifiers: NCT00931138 and NCT00363025) PMID:21459791

[Old and offline? : Findings on the use of the Internet by people aged 65 years and older in Switzerland].

PubMed

Seifert, Alexander; Schelling, Hans Rudolf

2016-10-01

The supply of information and communication is becoming continuously more focused on the Internet. While the age groups up to 64 years have shown a vast increase in the use of the Internet since 1997, intensive use of the Internet by age groups above 64 years lags behind and this is not only the case in Switzerland. Against this background and an interest in finding out more about Internet (non)use of older people, two representative surveys were conducted in Switzerland, one in 2009 and another one in 2014. The data used were acquired throughout Switzerland via a standardized telephone survey. The random sample (2014) consisted of 1037 people aged between 65 and 100 years old. Although the digital divide between the age groups has lessened over the past years, only 55.7 % of the elderly people interviewed were using the Internet in the autumn of 2014. Internet usage differs greatly between age groups. Resources such as education, income and health positively impact actual use of the Internet. Additionally, recommendations from a person's social environment, as well as an affinity for technology and a personal benefit assessment have a positive impact on Internet usage. In particular, security concerns and difficulties of use were mentioned as predominant reasons for the non-use of the Internet. Some of the people questioned felt excluded from society because they did not use the Internet. Internet usage among elderly people depends on individual and social resources, as well as on general attitude towards technology and personal benefit expectations. The exclusion of today's elderly "offliners" should be avoided, even if the digital divide will decrease in the future.

Opioids, antiepileptic and anticholinergic drugs and the risk of fractures in patients 65 years of age and older: a prospective population-based study.

PubMed

Nurminen, Janne; Puustinen, Juha; Piirtola, Maarit; Vahlberg, Tero; Lyles, Alan; Kivelä, Sirkka-Liisa

2013-05-01

in men, the concomitant use of two or more benzodiazepines or two or more antipsychotics is associated with an increased risk of fracture(s). Potential associations between the concomitant use of drugs with central nervous system effects and fracture risk have not been studied. the purpose was to describe the gender-specific risk of fractures in a population aged 65 years or over associated with the use of an opioid, antiepileptic or anticholinergic drug individually; or, their concomitant use with each other; or the concomitant use of one of these with a psychotropic drug. this study was part of a prospective, population-based study performed in Lieto, Finland. Information about fractures in 1,177 subjects (482 men and 695 women) was confirmed with radiology reports. at 3 years of follow-up, the concomitant use of an opioid with an antipsychotic was associated with an increased risk of fractures in men. During the 6-year follow-up, the concomitant use of an opioid with a benzodiazepine was also related to the risk of fractures for males. No significant associations were found for females. the concomitant use of an opioid with an antipsychotic, or with a benzodiazepine may increase the risk of fractures in men aged 65 years and older.

Factors affecting the variability in the observed levels of cadmium in blood and urine among former and current smokers aged 20-64 and ≥ 65years.

PubMed

Jain, Ram B

2017-03-01

Data from National Health and Nutrition Examination Survey for 1999-2012 were used to evaluate factors that affect observed levels of blood cadmium (BCd) and urine cadmium (UCd) among former and current smokers aged 20-64 and ≥65 years. Adjusted levels (AGM) for BCd and UCd were higher among females as compared to males. The order of AGM for BCd by race/ethnicity for 20-64 years old was non-Hispanic white (NHW) < non-Hispanic black (NHB) and NHW > NHB for ≥65 years old. The order of AGMs for UCd for 20-64-year-old current smokers was NHW > NHB and NHW > NHB for former smokers. For 20-64-year-old current smokers, exposure to environmental tobacco smoke at home was associated with higher levels of BCd. Levels of both UCd and BCd increased with age, but the rate of increase was as much as seven times higher among ≥65 years old than 20-64 years old. For current smokers, the number of cigarettes smoked inside home was positively associated with the levels of BCd. For current smokers aged 20-64 years, the number of cigarettes smoked inside home was positively associated with the levels of UCd (p < 0.01), and the number of cigarettes smoked every day on the days they were smoked was also positively associated with the levels of UCd (p < 0.01). Among former smokers, levels of both UCd and BCd were positively associated (p < 0.1) with the number of cigarettes smoked per day at the time of quitting smoking and negatively associated with the time since smoking was quitted (p < 0.01).

Effects of a Regular Motor Activity on Somatic and Fitness Variables in Boys Aged 17-18 Years

ERIC Educational Resources Information Center

Piotrowska, Joanna

2011-01-01

Study aim: To assess the somatic and fitness changes in semisedentary boys persuaded to undertake Nordic Walking activities throughout a school year. Material and methods: Two groups of schoolboys aged 17-18 years were studied: regularly attending physical education (PE) classes (Group A; n = 46) and those who avoided PE classes by submitting sick…

Age differences in health care spending, fiscal year 1976.

PubMed

Gibson, R M; Mueller, M S; Fisher, C R

1977-08-01

Of the $120.4 billion spent by the Nation for personal health care in fiscal year 1976, 29% was spent for those aged 65 or older, 15% for those under age 19, and the remaining 56% for those aged 19-64. The average health bill reached $1,521 for the aged, $547 for the intermediate age group, and $249 for the young. Public funds financed 68% of the health expenses of the aged with Medicare and Medicaid together accounting for 59%. Private sources paid 74% of the health expenses of the young and 70% of the expenses of those aged 19-64. Third-party payments met 65% of the health expenditures of all those under age 65.

25 CFR 115.429 - What do you need to do when you reach 18 years of age to access your trust funds?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false What do you need to do when you reach 18 years of age to access your trust funds? 115.429 Section 115.429 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... What do you need to do when you reach 18 years of age to access your trust funds? You must contact OTFM...

Mild cognitive impairment due to alzheimer disease is less likely under the age of 65.

PubMed

Shin, Soojeong; Kim, Jong Hun; Cho, Jeong Hee; Kim, Gyu Sik; Choi, Sun-Ah; Lee, Jun Hong

2015-01-01

Patients with amnestic mild cognitive impairment (aMCI) are considered to have a high risk for Alzheimer dementia (AD). Even high positive predictive values, however, cannot be guaranteed even by tests with high sensitivity and specificity when disease prevalence is low. If we regard the clinical criteria for aMCI as a test for predicting aMCI due to AD, the positive predictive value of the criteria will be low by definition in young patients with aMCI (age below 65 years) because of the low prevalence of AD in this age group. To test this hypothesis, we compared CSF biomarkers for AD between young (age below 65 years) and old (age 65 years or older) age groups of normal cognition, aMCI, and AD of the Alzheimer's Disease Neuroimaging Initiative database. Using these biomarkers, we observed that the prevalence of aMCI due to AD differed significantly between the young and the old. For example, only 28.2% young aMCI, but 63.2% old aMCI, had abnormal CSF amyloid measures consistent with AD pathology. As posited, the presence of aMCI due to AD was lower in young aMCI than in old aMCI. Given that the likelihood of aMCI due to AD is reduced in younger subjects, more attention to and evaluation of alternative diagnoses need to be considered in this group.

Erectile dysfunction and correlated factors in Brazilian men aged 18-40 years.

PubMed

Martins, Fernando Gonini; Abdo, Carmita Helena Najjar

2010-06-01

Few population-based studies in erectile dysfunction (ED) included subjects less than 40 years old and analyzed the several factors and consequences potentially associated with this condition. Evaluation of the prevalence of erectile dysfunction (ED) and associated factors in a sample of Brazilian men aged 18 to 40 years old. Cross-sectional study in which subjects were contacted in public places of 18 major Brazilian cities and interviewed using an anonymous questionnaire. Survey data were submitted to chi-squared, student's t-test and logistic regression analyses. The data were collected by means of a self-administered questionnaire with 87 questions about sociodemographic variables, general health, habits and lifestyle-related factors, sexual behavior and sexual difficulties, including ED which was assessed by a single question. Prevalence of ED in 1,947 men was 35.0% (73.7% mild, 26.3% moderate/complete). Greater frequency of ED was seen in subjects that never had information about sex, experienced difficulties in the beginning of sexual life and have never masturbated. ED was associated to lower level of education, but not to race, sexual orientation, employment or marital status. Also, no association was found between ED and smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, hyperlipidemia, depression or anxiety. ED caused negative impact in men's self-esteem, interpersonal relationships, work and leisure activities, and in sexual life satisfaction. Less than 10% of men with ED had received medical treatment for this problem. Prevalence of ED in this young population was high, mostly of mild severity. Low education and psychosocial problems were associated to ED and, due probably to the sample subjects' young age, no association was found with organic problems. Measures in the fields of education and psychosocial difficulties prevention would have a positive impact in the control of erectile dysfunction in the young

Prevalence and type distribution of human papillomavirus among women older than 18 years in Egypt: a multicenter, observational study.

PubMed

Shaltout, Mohamed Fadel; Sallam, Hassan N; AbouSeeda, Maged; Moiety, Fady; Hemeda, Hossam; Ibrahim, Ahmed; Sherbini, Moutaz E L; Rady, Helmy; Gopala, Kusuma; DeAntonio, Rodrigo

2014-12-01

Persistent infection with high-risk (HR) human papillomavirus (HPV) is associated with premalignant lesions and cervical cancer, the third most common cancer amongst women globally and the second most frequent in Egypt. We studied the prevalence and type distribution of HPV and documented HPV infection awareness and health-related behaviours for HPV infection. This was a multicenter, hospital-based observational study of women ≥18 years of age who attended for a gynaecological examination during October 2010-August 2011. Cervical samples were tested using Linear Array HPV genotyping. Two questionnaires on awareness and health-related behaviour were completed. Four hundred and forty-three women with a mean age of 39.3±14.0 years were included in the analysis. HPV DNA was detected in 10.4% of women; a single HPV-type infection was found in 6.5% and multiple infections in 3.8%. The most prevalent HR types among HPV-positive women were HPV-16 (19.6%) and HPV-31 and HPV-51 (15.2% each); low-risk types included HPV-62 (17.4%) and HPV-84 (10.9%). The prevalence of HPV-18 was low (6.5%). The prevalence of any HR HPV-type was highest in women aged 45-54 years (9.2%). The overall prevalence of HPV in Egypt was 10.4% and was highest (9.2%) amongst women aged 45-54 years. These data provide important reference information for public health authorities considering HPV prevention in Egypt. Copyright © 2014. Published by Elsevier Ltd.

Vaccination coverage among children and adolescents below 18 years of age in French Guiana: inventory and determinant factors.

PubMed

Koïvogui, A; Carbunar, A; Imounga, L-M; Laruade, C; Laube, S

2018-05-01

The purpose of this study was to estimate the vaccination coverage (VC) rate in persons aged from 9 months to 18 years and to describe it according to the predictive factors of good vaccination status. Descriptive and etiological study. The study involved 1332 persons aged below 18 years and members of 521 representative households in French Guiana. VC was estimated by the proportion of people with complete immunization for 13 vaccines (four mandatory, seven recommended, and two specific). This vaccination status was described in terms of sociodemographic characteristics. The relationship between vaccination status and predictive factors was analyzed in a hierarchical mixed, polytomic, and ordered regression model. For compulsory vaccination, VC was 81.2% for yellow fever, 63.4% for diphtheria, 61.7% for tetanus, and 61.6% for poliomyelitis. The proportion of people with complete immunization for recommended vaccines remains well below 50% (11.7% for pneumococcus and 6.2% for meningitis). Regardless of the vaccine, respondents aged 3-7 years were 2.5 times more likely to have an up-to-date vaccination compared to respondents younger than 3 years of age (P < 0.001). The VC observed in this study is still below the departmental objectives. The link between age and vaccination status could be explained by the efforts of the national education authorities to systematically check health cards for preschool and school enrollment. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

United States national prevalence of electrocardiographic abnormalities in black and white middle-age (45- to 64-Year) and older (≥65-Year) adults (from the Reasons for Geographic and Racial Differences in Stroke Study).

PubMed

Prineas, Ronald J; Le, Anh; Soliman, Elsayed Z; Zhang, Zhu-Ming; Howard, Virginia J; Ostchega, Yechiam; Howard, George

2012-04-15

A United States national sample of 20,962 participants (57% women, 44% blacks) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study provided general population estimates for electrocardiographic (ECG) abnormalities among black and white men and women. The participants were recruited from 2003 to 2007 by random selection from a commercially available nationwide list, with oversampling of blacks and those from the stroke belt, with a cooperation rate of 49%. The measurement of risk factors and 12-lead electrocardiograms (centrally coded using Minnesota code criteria) showed 28% had ≥1 major ECG abnormality. The prevalence of abnormalities was greater (≥35%) for those ≥65 years old, with no differences between blacks and whites. However, among men <65 years, blacks had more major abnormalities than whites, most notably for atrial fibrillation, major Q waves, and left ventricular hypertrophy. Men generally had more ECG abnormalities than women. The most common ECG abnormalities were T-wave abnormalities. The average heart rate-corrected QT interval was longer in women than in men, similar in whites and blacks, and increased with age. However, the average heart rate was greater in women than in men and in blacks than in whites and decreased with age. The prevalence of ECG abnormalities was related to the presence of hypertension, diabetes, blood pressure, and age. In conclusion, black men and women in the United States have a significantly greater prevalence of ECG abnormalities than white men and women at age 45 to 64 years; however, these proportions, although larger, tended to equalize or reverse after age 65. Copyright © 2012 Elsevier Inc. All rights reserved.

Effect of early and current Helicobacter pylori infection on the risk of anaemia in 6.5-year-old Ethiopian children.

PubMed

Taye, Bineyam; Enquselassie, Fikre; Tsegaye, Aster; Amberbir, Alemayehu; Medhin, Girmay; Fogarty, Andrew; Robinson, Karen; Davey, Gail

2015-07-14

Epidemiological and clinical studies in high income countries have suggested that Helicobacter pylori (H. pylori) may cause anaemia, but evidence is lacking from low income countries.We examined associations between H. pylori infection in early childhood and anaemia at the age of 6.5 years in an Ethiopian birth cohort. In 2011/12, 856 children (85.1 % of the 1006 original singletons in a population-based birth cohort) were followed up at age six and half. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. Haemoglobin level and red cell indices were examined using an automated haematological analyzer (Cell Dyn 1800, Abbott, USA), and stool samples analyzed for H. pylori antigen. The independent effects of H. pylori infection (measured at age 3.5 and 6.5 years) on anaemia, haemoglobin level, and red cell indices (measured at age 6.5 years) were determined using multiple logistic and linear regression. The prevalence of anemia was 34.8 % (257/739), and the mean (SD) haemoglobin concentration was 11.8 (1.1) gm/dl. Current H. pylori infection at age 6.5 years was positively, though not significantly related to prevalence of anaemia (adjusted OR, 95 % CI, 1.15; 0.69, 1.93, p = 0.59). Any H. pylori infection up to age 6.5 years was significantly associated with an increased risk of anaemia at age 6.5 (adjusted OR, 95 % CI, 1.68; 1.22, 2.32, p = 0.01). A significant reduction in haemoglobin concentration and red cell indices was also observed among children who had any H. pylori infection up to age 6.5 (Hb adjusted β = -0.19, 95 % CI, -0.35 to -0.03, p = 0.01; MCV adjusted β = -2.22, 95 % CI, -3.43 to -1.01, p = 0.01; MCH adjusted β = -0.63, 95 % CI, -1.15 to - 0.12, p = 0.01; and MCHC adjusted β = -0.67, 95 % CI, -1.21 to -0.14, p = 0.01), respectively. This study provides further evidence from a low income country that any H. pylori infection up to age 6.5 is associated with higher prevalence

The national trend of blood lead levels among Chinese children aged 0-18 years old, 1990-2012.

PubMed

Li, Min-ming; Cao, Jia; Xu, Jian; Cai, Shi-zhong; Shen, Xiao-ming; Yan, Chong-huai

2014-10-01

We analyzed the epidemiological data during 1990-2012 that investigated the blood lead level (BLL) in the population aged 0-18 years old in China mainland and provided evidence of the benefits of implementing policies to prevent lead pollution based on the dynamic changes of BLL. Data were collected through databases including China Knowledge Resource Integrated Database (CNKI), CBM disc, Wanfang Data, Pubmed and Medline. The inclusion criteria were: 1. Epidemiological study in healthy population not included studies limited to specific patient; 2. Study subject was not the specific lead exposure population; 3. Sample size should be no less than 100 (for neonatal, no less than 50); 4. BLL detection was under strict quality control; and 5. Results should be presented as BLL (arithmetic mean level or geometric mean level). 62 articles were included in this study. All the surveys in these articles contained 189,352 subjects in 19 provinces, autonomous regions and municipalities. Linear regression analysis showed a significant decrease between 1990 and 2012 with an estimated regression coefficient of 3.05/year (SE=0.01, p<0.001). BLL gradually declined since early 21st century. Median levels of BLL among the three economic zones were 51.4 μg/L in the eastern zone, 52.72 μg/L in the central zone and 46.2 μg/L in the western zone respectively. Median BLLs in male and female population aged 0-18 years old of China were 48.8 μg/L and 46.1μg/L. Median levels of BLL among the different age ranges were 74.9 μg/L in newborn, 46.4 μg/L in 0 to 3 years old, 57.6 μg/L in 3 to 7 years old and 55.6 μg/L in above 7 years old respectively. In conclusion, the BLL in the Chinese population of 0-18 years old has gradually dropped in the past 10 years. The decline in temporal trend still remains under potential impacts of several factors such as economical level, gender and age difference. Although, China has made significant achievements in the control prevention of lead

Physical performance and daily walking duration: associations in 1271 women and men aged 65-90 years.

PubMed

Rapp, Kilian; Klenk, Jochen; Benzinger, Petra; Franke, Sebastian; Denkinger, Michael D; Peter, Richard

2012-10-01

Several tests of physical performance like gait speed or standing balance are part of the geriatric assessment. Measures of physical activity like daily walking duration are more difficult to assess but may be of higher relevance for daily requirements. It is therefore of interest to what extent physical performance measures are associated with physical activity. In a cohort study, baseline screening was performed in 1271 community-living people aged 65-90 years from Ulm, Germany. Average daily walking duration was assessed in all participants by accelerometers over a one-week period. Habitual gait speed, 5-Chair-Rise test, standing balance and handgrip strength served as measures of physical performance. The association between measures of physical performance and physical activity was calculated by linear regression analysis. The mean daily walking duration was 104.8 minutes in men and 103.0 minutes in women. A positive relationship between gait speed and walking duration was observed in men and women with low gait speed (≤0.8 m/s) but not in participants above this threshold. Standing balance and hand grip strength were positively and 5-Chair-Rise test inversely related with average daily walking duration. A relationship between hand grip strength and walking duration was only observed in women aged 75 years and more. Physical performance measures and objectively measured walking duration are related with each other but only a small percentage of the variance of daily walking duration was explained by physical performance measures. Therefore, factors other than physical performance seem to influence daily walking duration to a great extent.

18. Southeast end room; view to northeast, 65mm lens plus ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. Southeast end room; view to northeast, 65mm lens plus electronic flash illumination. Failed south wall at right. - Benicia Arsenal, Powder Magazine No. 5, Junction of Interstate Highways 680 & 780, Benicia, Solano County, CA

Vaccination of adults 65 years of age and older with tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Boostrix(®)): results of two randomized trials.

PubMed

Weston, Wayde M; Friedland, Leonard R; Wu, Xiangfeng; Howe, Barbara

2012-02-21

Pertussis can cause significant morbidity in elderly patients, who can also transmit this disease to infants and young children. There is little data available on the use of acellular pertussis vaccines in recipients ≥65 years of age. Two studies examined the safety and immunogenicity of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine (Boostrix(®)) in healthy ≥65 year olds. In Study A subjects received single doses of Tdap and seasonal influenza vaccine either co-administered or given one month apart. In Study B subjects received either Tdap or tetanus-diphtheria (Td) vaccine. Antibodies were measured before and one month after vaccination. Reactogenicity and safety were actively assessed using diary cards. A total of 1104 subjects 65 years of age and older received a Tdap vaccination in the two studies. In study A, no differences in immune responses to Tdap or influenza vaccine were observed between co-administered or sequentially administered vaccines. In study B, Tdap was non-inferior to Td with respect to diphtheria and tetanus seroprotection, and anti-pertussis GMCs were non-inferior to those observed in infants following a 3-dose diphtheria, tetanus and acellular pertussis (DTaP) primary vaccination series, in whom efficacy against pertussis was demonstrated. Reports of adverse events were similar between Tdap and Td groups. Tdap was found to be immunogenic in subjects ≥65 years, with a safety profile comparable to US-licensed Td vaccine. Tdap and influenza vaccine may be co-administered without compromise of either the reactogenicity or immunogenicity profiles of the two vaccines. Copyright © 2012 Elsevier Ltd. All rights reserved.

Frequency and outcomes of painful physical symptoms in a naturalistic population with major depressive disorder: an analysis of pooled observational studies focusing on subjects aged 65 years and over.

PubMed

Brnabic, A; Raskin, J; Alev, L; Serap Monkul, E; Lowry, A

2012-12-01

To estimate the frequency of painful physical symptoms (PPS) in elderly subjects (≥ 65 years) with major depressive disorder (MDD) in real-world clinical conditions and to establish whether PPS are associated with poor depression outcomes, including more severe depression and worse health-related quality of life (HRQoL). Observational studies of MDD that included assessment of PPS and elderly subjects were screened. Measures of PPS were based on the Somatic Symptom Inventory (SSI) or Visual Analogue Scale (VAS). Data from a variety of depressive symptom severity and HRQoL scales were used. Analysis cohorts were based on age [aged ≥ 65 years (elderly) or < 65 years (younger)] and/or PPS status (presence or absence); five subsets were used to examine specific outcomes in matched elderly subjects. Data from seven studies (representing 26 countries) were collated. Of the 11,477 subjects, 14% were aged ≥ 65 years and 71% were classified as having PPS (PPS+). PPS were more frequent in elderly subjects (74% vs. 70% of younger subjects) and were positively associated with being female and Hispanic, and negatively associated with being East Asian in the elderly. The presence of PPS was associated with more severe clinical symptomatology and comparatively poorer HRQoL in elderly subjects. PPS, although frequent in younger MDD patients, were slightly more frequent in elderly MDD patients and associated with comparatively poorer clinical and functional outcomes. As elderly patients report somatic symptoms more readily than emotional symptoms, physicians should consider depression in addition to physical causes when PPS are present. © 2012 Blackwell Publishing Ltd.

Economic burden of informal care attributable to stroke among those aged 65 years or older in China.

PubMed

Joo, Heesoo; Liang, Di

2017-02-01

Stroke is a leading cause of disability in China, frequently resulting in the need for informal care. No information, however, is available on costs of informal care associated with stroke, required to understand the true cost of stroke in China. Using the 2011 China Health and Retirement Longitudinal Study, we identified 4447 respondents aged ≥65 years suitable for analyses, including 184 stroke survivors. We estimated the economic burden of informal care associated with stroke using a two-part model. The monthly number of hours of informal caregiving associated with stroke was 29.2 h/stroke survivor, and the average annual cost of informal care associated with stroke was 10,612 RMB per stroke survivor. The findings stress the necessity of proper interventions to prevent stroke and will be useful for estimating the economic burden of stroke.

Work after age 65: A prospective study of Australian men and women.

PubMed

Majeed, Tazeen; Forder, Peta M; Tavener, Meredith; Vo, Kha; Byles, Julie

2017-06-01

This study describes hours in paid work for Australian men and women aged over 65, focusing on associations between work and education. Data were analysed separately for men and women, from baseline and first follow-up surveys of the 45 and Up Study. Generalised estimating equation models were used to identify associations between work, education and other factors over time. The odds of doing paid work increased with higher education level and decreased with time, age, poorer physical function and having health conditions (high blood pressure, diabetes, stroke and breast cancer). Un-partnered women were more likely to work in later life than partnered women. This study quantifies the importance of education and health factors in determining continued participation of Australian men and women in paid work in later life. These factors need to be considered for policies aiming to increase workforce participation beyond 65 years of age. © 2017 AJA Inc.

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus

PubMed Central

Karyekar, Chetan S; Ravichandran, Shoba; Allen, Elsie; Fleming, Douglas; Frederich, Robert

2013-01-01

Purpose To assess safety and efficacy of saxagliptin in older patients with type 2 diabetes mellitus (T2DM). Patients and methods This was a post hoc analysis of pooled data from older patients (≥65 years of age) from five 24-week phase III trials: three studies of saxagliptin versus placebo as an add-on therapy to metformin, glyburide, or a thiazolidinedione; and two studies of saxagliptin versus placebo as monotherapy in drug-naïve patients. Separate analyses were conducted on one study of initial combination therapy with saxagliptin plus metformin versus metformin monotherapy in drug-naïve patients. The safety analysis population for the five-study pool included 428 patients ≥ 65 years of age with baseline glycated hemoglobin (HbA1c) 7.0% to 10.5% who received saxagliptin 2.5 or 5 mg or placebo, and for the study of initial combination therapy included 69 patients ≥ 65 years of age with baseline HbA1c 8.0% to 12.0% who received saxagliptin 5 mg in combination with metformin or metformin monotherapy. The primary efficacy endpoint was change from baseline HbA1c. Results In the five-study pool, the differences in the adjusted mean change from baseline HbA1c among older patients receiving saxagliptin versus placebo were −0.60% (95% confidence interval [CI], −0.99% to −0.21%) for saxagliptin 2.5 mg and −0.55% (−0.97% to −0.14%) for saxagliptin 5 mg; in the initial combination study, the difference was −1.22% (−2.27% to −0.17%) among older patients receiving saxagliptin 5 mg plus metformin versus metformin monotherapy. The results were generally similar in older and younger patients. Saxagliptin was well tolerated; the incidence and types of adverse events were similar for saxagliptin and comparators. Hypoglycemia was reported in 3.0% to 9.4% of patients receiving saxagliptin (0%–8.0% for comparators) and was confirmed (finger stick glucose ≤ 50 mg/dL, with associated symptoms) in 0% to 0.7% (0%–0.7% for comparators); hypoglycemic

Age differences in health care spending, fiscal year 1977.

PubMed

Gibson, R M; Fisher, C R

1979-01-01

This report of health care spending in fiscal year 1977 reveals that of the $142.6 billion spent by the Nation for personal health care in fiscal year 1977, 29 percent was spent for those aged 65 or older, 59 percent for those aged 19-64, and 13 percent for those below age 19. The average health bill reached $1,745 for the aged, $661 for the intermediate age group, and $253 for the young. Public funds financed 67 percent of the health expenses of the aged, with Medicare and Medicaid together accounting for 61 percent. More than two-thirds of the health expenses of the young and 71 percent of the expenses of those aged 19-64 were paid by private sources. Third-party payments met 68 percent of the health expenditures of all those under age 65.

Dental age estimation: periodontal ligament visibility (PLV)-pattern recognition of a conclusive mandibular maturity marker related to the lower left third molar at the 18-year threshold.

PubMed

Lucas, Victoria S; McDonald, Fraser; Andiappan, Manoharan; Roberts, Graham

2017-05-01

The purpose of this study was to explore the applicability of periodontal ligament visibility (PLV) at the 18-year threshold. This mandibular maturity marker is graded into four separate age related stages, PLV-A, PLV-B, PLV-C, and PLV-D. These are discernible on a dental panoramic tomograph (DPT). The sample comprised a total of 2000 DPTs evenly divided into half yearly age bands from 16.00 to 25.99 years with 50 females and 50 males in each age band. It was found that PLV-A and PLV-B had minimum values below the 18-year threshold. PLV-C and PLV-D in females had minimum values of 18.08 and 18.58 years, respectively. In males, the minimum values for PLV-C was 18.10 years and PLV-D was 18.67 years. It was concluded that the presence of PLV-C or PLV-D indicates that a subject is over 18 years with a very high level of probability.

[Epidemic status and secular trends of malnutrition among children and adolescents aged 7-18 years from 2005 to 2014 in China].

PubMed

Dong, Y H; Wang, Z H; Yang, Z G; Wang, X J; Chen, Y J; Zou, Z Y; Ma, J

2017-06-18

To understand and analyze the current situation and secular trends for prevalence of malnutrition among Chinese children and adolescents aged 7-18 years from 2005 to 2014, and to provide important scientific basis for students' nutrition improvement. All the subjects aged 7-18 years in both sexes were sampled from 2005, 2010 and 2014 Chinese National Surveys on Students Constitution and Health. According to the new students' health standard of "Screening Standard for Malnutrition of school-age children and adolescents"(WS/T456-2014) in 2014 of China, the nutritional status of children in 31 provinces (autonomous regions and municipalities, excluding Hong Kong, Macao and Taiwan province) were analyzed and compared in different ages, genders, regions and provinces from 2005 to 2014. The Tibetan students was used with the data of Tibetan minority and all the other students from 30 provinces (autonomous regions, municipalities) were Han minority. The prevalence of malnutrition of children and adolescents of Han minority aged 7-18 years in 2014 was 10.0%. The prevalence of malnutrition components, including stunting, mild wasting and moderate severe wasting, were 0.8%, 3.7%, and 5.5%. Compared with 2005 and 2010, the prevalence of malnutrition of Han children and adolescents in 2014 had declined with 5.0 and 2.6 percentage points, respectively, and its components had declined with 1.0, 1.8, 2.2 and 0.4, 1.1, 1.2 percentage points, respectively. The prevalence of malnutrition of 2014 in boys was higher than in girls (11.1% vs.8.9%), the rural was higher than the urban (11.0% vs.9.1%) and the west (11.7%) was higher than the east (9.0%) and the middle (9.2%). Mild wasting of Chinese children and adolescents aged 7-18 years was the main component in malnutrition and the stunting in the Han and Tibetan children and adolescents only accounted for 8.0% and 7.5%, respectively. Compared with 2005 and 2010, the prevalence of malnutrition for Chinese children and adolescents aged

Prevalence of metabolic syndrome and associated socioeconomic and demographic factors among Palestinian adults (20-65 years) at the Gaza Strip.

PubMed

Sirdah, Mahmoud M; Al Laham, Nahed A; Abu Ghali, Asmaa S

2011-01-01

Metabolic syndrome (MetS) is a multifaceted syndrome and has been described as a clustering of several risk factors for cardiovascular disease. This study was conducted to estimate the prevalence of MetS and its individual components among Palestinian adults, 20-65 years old in Gaza Strip. In addition to find any possible associations with socioeconomic and demographic factors. The study sample included 230 adults aged 20-65 years. Data were collected by questionnaire interviews, anthropometrics, and biochemical analysis that included: serum glucose, total cholesterol, triglyceride, HDL, and LDL. MetS was defined according to the NCEP/ATP III diagnostic criteria. Overall prevalence of MetS was 23.0% among the study subjects, with no significant differences between males (18.1%) and females (28.1%). The prevalence of MetS increased significantly with age and was associated significantly with physical activity and martial status, while no significant associations were found with household income; geographical locality; smoking; watching TV; or family history. Age, sex, physical activity and marital status are risk factors independently associated with MetS in the Palestinian population at the Gaza Strip. National health awareness and preventive programs should be established aiming at decreasing of MetS trends in the Palestinian population at Gaza Strip. Copyright © 2012 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Risk factors and outcome of increased red blood cell transfusion in cardiac surgical patients aged 65 years and older.

PubMed

Isil, Canan Tulay; Yazici, Pinar; Bakir, Ihsan

2015-02-01

The use of blood products is not uncommon during cardiac surgery in elderly patients. We conducted this study to investigate the risk factors and adverse outcomes of increased red blood cell (RBC) transfusion in the patients aged ≥ 65 years undergoing cardiac surgery. During 1 year period, 288 patients (197 male/91 female) aged ≥ 65 years who underwent coronary and/or valvular surgery were retrospectively reviewed. Patients were stratified into groups on the basis of the number of transfusions received (< 4 and ≥ 4 U) which was classified as increased transfusion. Univariate analysis and multivariate logistic regression were used to identify risk factors for increased transfusion. The mean unit of RBC transfusion was 4.5 ± 3.1 and 55.9% (n = 161) of patients received ≥ 4 U RBC. The overall postoperative complication rate was 36% and significantly higher in those with ≥ 4 U) RBC transfusion (p < 0.01). Risk factors including age, EuroSCORE, and low body surface were significantly higher in patient with ≥ 4 U RBC transfusion. Besides, preoperative anemia, postoperative drainage volume, and fresh frozen plasma (FFP) transfusion during hospital stay were found to be significantly associated with increased transfusion requirements. No difference was observed in mortality (p = 0.13). These results suggest that improvement in blood transfusion policy in elderly patients undergoing cardiac surgery requires elimination of preoperative anemia, careful attention to surgical hemostasis, and FFP use. Georg Thieme Verlag KG Stuttgart · New York.

Lung transplantation for patients older than 65 years: is it a feasible option?

PubMed

Machuca, T N; Camargo, S M; Schio, S M; Lobato, V; Sanchez, L B; Perin, F; Felicetti, J C; Camargo, J J

2011-01-01

Advanced age has been a relative contraindication to lung transplantation. However, the exact age limit for this procedure has not yet been established. The aim of this work is to present our experience with this particular group. This retrospective review included medical charts of patients who underwent lung transplantation at our institution from January 2004 to February 2009: namely, 112 cadaveric lung transplants with 12 patients (10.7%) >65 years old. There were 9 male patients and the overall mean age was 68 years (range 66-72). The indications were pulmonary fibrosis in 8 and emphysema in 4 cases. Four patients had mild coronary artery disease and 4 systemic hypertension. All of the procedures were unilateral and only 2 required extracorporeal circulation. Only 5 patients received blood product transfusions intraoperatively; the mean ischemic time was 222 minutes. Four patients developed primary graft dysfunction, the mean requirement for mechanical ventilation was 30 hours, and the mean intensive care unit stay, 11 days. Postoperative complications were respiratory infections (n = 8), catheter-related infection (n = 1), atrial fibrillation (n = 2). The mean hospital stay was 28 days and the 1-year survival was 75%. Lung transplantation is a feasible option for well-selected patients with end-stage pulmonary disease who are >65 years old. Our study reinforces the modern trend for unilateral procedures in this situation. Copyright © 2011 Elsevier Inc. All rights reserved.

Sports engagement and age at first myocardial infarction in men under 55 years of age.

PubMed

Janggen, Christoph; Gräni, Christoph; Brunner, Jonas; Trachsel, Lukas D; Windecker, Stephan; Eser, Prisca; Räber, Lorenz; Wilhelm, Matthias

2017-01-01

Low levels of physical activity in childhood are associated with clustering of cardiovascular risk factors (CVRF) as predisposition for atherosclerosis. We assessed the association between sports engagement and age at first myocardial infarction (MI) in a cohort of men under 55 years of age. The Bern percutaneous coronary intervention Registry (NCT 02241291) was analyzed from March 2009 until January 2012. Male patients with first MI, age 18 to 54 years and body mass index ≤25kg/m2 were included. Patients were stratified into two groups based on their starting age with organized sports ≥1 h/week outside school (EARLY: <18, CONTROL: ≥18 years or never). We assessed age at time of first MI, CVRF, and volume of sports training. Of 4,394 consecutive patients, 123 fulfilled the inclusion criteria (EARLY n = 81, CONTROL n = 42). Age at the time of first MI was 3 years younger in the EARLY compared to the CONTROL group (46.8±6.0 vs. 49.8±4.6 years, p = 0.006). Total lifetime training hours, and average yearly training hours, both, before and after age 18, were significantly greater in the EARLY group. Years of training <18 years were weakly inversely correlated with age at first MI (r2 = 0.075, p = 0.002). The proportion of sports-related MI was not different between EARLY and CONTROL (13.6% vs. 11.9%). Patients in the EARLY group had fewer CVRF (2 vs. 3; p = 0.001). Prevalence of smoking was equally high in both groups (63.0% and 64.3%). In our patients aged 54 and younger, the first MI occurred 3 years earlier in those who started regular sports activity before age 18, despite a more active lifestyle and favorable CVRF profile.

Recommended Immunization Schedules for Persons Aged 0 through 18 Years--United States, 2010. Morbidity and Mortality Weekly Report QuickGuide. Volume 58, Number 51 & 52

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2010

2010-01-01

The Advisory Committee on Immunization Practices (ACIP) annually publishes an immunization schedule for persons aged 0 through 18 years that summarizes recommendations for currently licensed vaccines for children aged 18 years and younger and includes recommendations in effect as of December 15, 2009. The changes to the previous schedule are…

Trends and variability in blood lead concentrations among US adults aged 20-64 years and senior citizens aged ≥65 years.

PubMed

Jain, Ram B

2016-07-01

Using data from National Health and Nutrition Examination Survey for the period 2003-2012, the objective of this study was to evaluate trends in blood lead levels (BLL) among adults aged 20-64 years (adults) and seniors aged ≥65 years (seniors). In addition, the contribution of other factors like gender, race/ethnicity, smoking, and exposure to secondhand smoke at home in explaining variability in BLL was also evaluated by fitting regression models with log10 transformed values of BLL as dependent variables. BLL decreased over 2003-2012 (p < 0.01). Irrespective of gender, race/ethnicity, and smoking status, seniors were found to have higher BLL than adults. Based on the magnitude of differences between the 5th and 95th percentiles, variability in the levels of blood lead was found to be substantially higher among seniors than among adults. Males had statistically significantly higher adjusted BLL than females (2.32 vs. 1.76 μg/dL for seniors, p < 0.01 and 1.66 vs. 1.13 μg/dL for adults, p < 0.01). Non-Hispanic whites had statistically significantly lower adjusted BLL than non-Hispanic blacks (1.99 vs. 2.42 μg/dL for seniors, p < 0.01 and 1.22 vs. 1.42 μg/dL for adults, p < 0.01). When compared with non-smokers, smokers had statistically significantly higher BLL (2.19 vs. 1.86 μg/dL for seniors, p < 0.01 and 1.54 vs. 1.22 μg/dL for adults, p < 0.01). Non-obese had statistically significantly higher BLL than obese individuals (2.11 vs. 1.93 μg/dL for seniors, p < 0.01 and 1.48 vs. 1.27 μg/dL for adults, p < 0.01). Exposure to secondhand smoke at home (SHS) was associated with statistically significantly higher BLL than when there was no exposure to SHS (β = 0.0683, p = 0.03 for seniors; β = 0.034, p = 0.034, p < 0.01 for adults).

The relationship between zinc intake and growth in children aged 1-8 years: a systematic review and meta-analysis.

PubMed

Stammers, A L; Lowe, N M; Medina, M W; Patel, S; Dykes, F; Pérez-Rodrigo, C; Serra-Majam, L; Nissensohn, M; Moran, V H

2015-02-01

It is estimated that zinc deficiency affects 17% of the world's population, and because of periods of rapid growth children are at an increased risk of deficiency, which may lead to stunting. This paper presents a systematic review and meta-analysis of the randomised controlled trials (RCTs) that assess zinc intake and growth in children aged 1-8 years. This review is part of a larger systematic review by the European Micronutrient Recommendations Aligned Network of Excellence that aims to harmonise the approach to setting micronutrient requirements for optimal health in European populations (www.eurreca.org). Searches were performed of literature published up to and including December 2013 using MEDLINE, Embase and the Cochrane Library databases. Included studies were RCTs in apparently healthy child populations aged from 1 to 8 years that supplied zinc supplements either as capsules or as part of a fortified meal. Pooled meta-analyses were performed when appropriate. Nine studies met the inclusion criteria. We found no significant effect of zinc supplementation of between 2 weeks and 12 months duration on weight gain, height for age, weight for age, length for age, weight for height (WHZ) or WHZ scores in children aged 1-8 years. Many of the children in the included studies were already stunted and may have been suffering from multiple micronutrient deficiencies, and therefore zinc supplementation alone may have only a limited effect on growth.

Validation (in Spanish) of the Mini Nutritional Assessment survey to assess the nutritional status of patients over 65 years of age.

PubMed

Muñoz Díaz, Belén; Molina-Recio, Guillermo; Romero-Saldaña, Manuel; Redondo Sánchez, Juana; Aguado Taberné, Cristina; Arias Blanco, Carmen; Molina-Luque, Rafael; Martínez De La Iglesia, Jorge

2018-06-05

To validate the Mini Nutritional Assessment (MNA) in a Spanish population over 65 years of age with varying degrees of independence. This cross-sectional validation study used the Chang nutritional assessment method as a reference test. 248 subjects (75.4% female), with a mean age of 83, completed the study. They were classified into three groups: (i) autonomous patients who were able to take part in activities outside their home; (ii) patients who require help with daily self-care; (iii) patients living in a residential health care facility. . Three health centres and three residential care homes situated in Cordoba (Spain). The kappa values for intra-observer and inter-observer agreement were 0.870 and 0.784, respectively. The intra-class correlation coefficient intra-observer was 0.874 and the inter-observer was 0.789. The sensitivity and specificity readings for the diagnostic accuracy of MNA were 63.2% and 72.9% in the total sample, respectively. The area under the curve was 0.726. For patients in the Group A, B and C, the sensitivity was 89.3%, 60.7% and 18.8%, and the specificity was 23.3%, 56.8% and 94.1%, respectively. The results for the reliability of the survey were excellent, and its internal consistency was acceptable. The diagnostic accuracy, as measured by the sensitivity and specificity readings, was lower than that obtained with the original survey. It can therefore be considered more suitable for a population with limited autonomy, and less appropriate for independent patients. The results may not be relevant to patients outside of the Cordova region in Spain.

[Pharmaco-economic aspects of vaccination against invasive pneumococcal infections in persons over 65 years of age; review of the literature on cost effectiveness analysis].

PubMed

Postma, M J; Heijnen, M L A; Beutels, Ph; Jager, J C

2002-05-04

To assess the cost-effectiveness of vaccination to prevent invasive pneumococcal disease in the elderly. Review of the literature. Articles in Dutch or English reporting studies into the cost-effectiveness of vaccination for the prevention of invasive pneumococcal infection in persons over 65 years of age were retrieved from Medline (1980-2000; search terms: 'pneumococcal' and 'vaccine' in combination with 'costs' or 'economics') and on the basis of the reference lists in the articles found. The following aspects of the selected studies were assessed: the net costs per year of life gained, the incidence of invasive pneumococcal disease in the elderly, the mortality due to invasive pneumococcal infections, the effectiveness of the vaccine in the prevention of invasive pneumococcal infections, and the costs of the vaccine and its administration. Attention was also given to specific age categories and to the effects of varying certain crucial assumptions. We retrieved a total of five studies: one each for the USA, Canada, the Netherlands and Spain and a multinational study for five European countries. The cost-effectiveness of vaccination of the elderly against invasive pneumococcal infections varied from cost savings to [symbol: see text] 33,000,-per life-year gained. The Dutch study estimated the cost-effectiveness at [symbol: see text] 10,100,-per life-year gained (price level 1995). Almost all the studies selected based their estimate of the effectiveness of vaccination on the same case-control study from the USA. The potential effects on cost-effectiveness of more extensive influenza vaccination and of the inclusion of re-vaccination against pneumococci were not included in the analyses. The cost-effectiveness of vaccination against invasive pneumococcal infections in persons over 65 years of age (in the Netherlands as well as in several other countries) was below the previously accepted threshold of [symbol: see text] 20,000,-.

Medical Care Costs of Breast Cancer in Privately Insured Women Aged 18-44 Years.

PubMed

Allaire, Benjamin T; Ekwueme, Donatus U; Guy, Gery P; Li, Chunyu; Tangka, Florence K; Trivers, Katrina F; Sabatino, Susan A; Rodriguez, Juan L; Trogdon, Justin G

2016-02-01

Breast cancer in women aged 18-44 years accounts for approximately 27,000 newly diagnosed cases and 3,000 deaths annually. When tumors are diagnosed, they are usually aggressive, resulting in expensive treatment costs. The purpose of this study is to estimate the prevalent medical costs attributable to breast cancer treatment among privately insured younger women. Data from the 2006 MarketScan database representing claims for privately insured younger women were used. Costs for younger breast cancer patients were compared with a matched sample of younger women without breast cancer, overall and for an active treatment subsample. Analyses were conducted in 2013 with medical care costs expressed in 2012 U.S. dollars. Younger women with breast cancer incurred an estimated $19,435 (SE=$415) in additional direct medical care costs per person per year compared with younger women without breast cancer. Outpatient expenditures comprised 94% of the total estimated costs ($18,344 [SE=$396]). Inpatient costs were $43 (SE=$10) higher and prescription drug costs were $1,048 (SE=$64) higher for younger women with breast cancer than in younger women without breast cancer. For women in active treatment, the burden was more than twice as high ($52,542 [SE=$977]). These estimates suggest that breast cancer is a costly illness to treat among younger, privately insured women. This underscores the potential financial vulnerability of women in this age group and the importance of health insurance during this time in life. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

18 CFR 1301.65 - Derivative classification.

Code of Federal Regulations, 2014 CFR

2014-04-01

... classification. 1301.65 Section 1301.65 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Protection of National Security Classified Information § 1301.65 Derivative classification. (a) In... classified, and the marking of newly developed material consistent with the classification markings that...

18 CFR 1301.65 - Derivative classification.

Code of Federal Regulations, 2013 CFR

2013-04-01

... classification. 1301.65 Section 1301.65 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Protection of National Security Classified Information § 1301.65 Derivative classification. (a) In... classified, and the marking of newly developed material consistent with the classification markings that...

18 CFR 1301.65 - Derivative classification.

Code of Federal Regulations, 2012 CFR

2012-04-01

... classification. 1301.65 Section 1301.65 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Protection of National Security Classified Information § 1301.65 Derivative classification. (a) In... classified, and the marking of newly developed material consistent with the classification markings that...

Cognitive impairment 18 years before clinical diagnosis of Alzheimer disease dementia

PubMed Central

Wilson, Robert S.; Weuve, Jennifer; Barnes, Lisa L.; Evans, Denis A.

2015-01-01

Objective: To examine the relation of performance on brief cognitive tests to development of clinically diagnosed Alzheimer disease (AD) dementia over the following 18 years in a sample of African Americans and European Americans. Methods: A composite cognitive test score based on tests of episodic memory, executive function, and global cognition was constructed in a prospective population-based sample of 2,125 participants (55% African American and 61% female) aged 65 years and older residing in 4 Chicago neighborhoods. Time before AD dementia diagnosis was categorized into 6 groups corresponding to data collection periods: 0.1–0.9, 1.0–3.9, 4.0–6.9, 7.0–9.9, 10.0–12.9, and 13.0–17.9 years. Results: Of 2,125 participants without clinical AD dementia, 442 (21%) developed clinical AD dementia over 18 years of follow-up. Lower composite cognitive test scores were associated with the development of AD dementia over the duration of the study. The magnitude of association between composite cognitive test score and development of AD dementia increased from an odds ratio of 3.39 (95% confidence interval 1.72, 6.67; p < 0.001) at 13.0–17.9 years to 9.84 (95% confidence interval 7.41, 13.06; p < 0.001) at 0.1–0.9 years, per SD increment. These associations were consistently larger among European Americans than among African Americans. Performance on individual cognitive tests of episodic memory, executive function, and global cognition also significantly predicted the development of AD dementia, with associations exhibiting a similar trend over 18 years. Conclusions: Our findings suggest that cognitive impairment may manifest in the preclinical phase of AD dementia substantially earlier than previously established. PMID:26109713

Cognitive impairment 18 years before clinical diagnosis of Alzheimer disease dementia.

PubMed

Rajan, Kumar B; Wilson, Robert S; Weuve, Jennifer; Barnes, Lisa L; Evans, Denis A

2015-09-08

To examine the relation of performance on brief cognitive tests to development of clinically diagnosed Alzheimer disease (AD) dementia over the following 18 years in a sample of African Americans and European Americans. A composite cognitive test score based on tests of episodic memory, executive function, and global cognition was constructed in a prospective population-based sample of 2,125 participants (55% African American and 61% female) aged 65 years and older residing in 4 Chicago neighborhoods. Time before AD dementia diagnosis was categorized into 6 groups corresponding to data collection periods: 0.1-0.9, 1.0-3.9, 4.0-6.9, 7.0-9.9, 10.0-12.9, and 13.0-17.9 years. Of 2,125 participants without clinical AD dementia, 442 (21%) developed clinical AD dementia over 18 years of follow-up. Lower composite cognitive test scores were associated with the development of AD dementia over the duration of the study. The magnitude of association between composite cognitive test score and development of AD dementia increased from an odds ratio of 3.39 (95% confidence interval 1.72, 6.67; p < 0.001) at 13.0-17.9 years to 9.84 (95% confidence interval 7.41, 13.06; p < 0.001) at 0.1-0.9 years, per SD increment. These associations were consistently larger among European Americans than among African Americans. Performance on individual cognitive tests of episodic memory, executive function, and global cognition also significantly predicted the development of AD dementia, with associations exhibiting a similar trend over 18 years. Our findings suggest that cognitive impairment may manifest in the preclinical phase of AD dementia substantially earlier than previously established. © 2015 American Academy of Neurology.

Suicidal ideation, suicide attempt, and occupations among employed adults aged 18-64years in the United States.

PubMed

Han, Beth; Crosby, Alex E; Ortega, LaVonne A G; Parks, Sharyn E; Compton, Wilson M; Gfroerer, Joseph

2016-04-01

Approximately 70% of all US suicides are among working-age adults. This study was to determine whether and how 12-month suicidal ideation and suicide attempt were associated with specific occupations among currently employed adults aged 18-64 in the U.S. Data were from 184,300 currently employed adults who participated in the 2008-2013 National Surveys on Drug Use and Health (NSDUH). NSDUH provides nationally representative data on suicidal ideation and suicide attempt. Descriptive analyses and multivariable logistic regressions were conducted. Among currently employed adults aged 18-64 in the U.S., 3.5% had suicidal ideation in the past 12months (3.1% had suicidal ideation only, and 0.4% had suicidal ideation and attempted suicide). Compared with adults in farming, fishing, and forestry occupations (model adjusted prevalence (MAP)=1.6%), adults in the following occupations were 3.0-3.6 times more likely to have suicidal ideation in the past year (model adjusted relative risks (MARRs)=3.0-3.6): lawyers, judges, and legal support workers (MAP=4.8%), social scientists and related workers (MAP=5.4%), and media and communication workers (MAP=5.8%). Among employed adults aged 18-64 in the U.S., the 12-month prevalence of suicidal ideation varies by occupations. Adults in occupations that are at elevated risk for suicidal ideation may warrant focused suicide prevention. Published by Elsevier Inc.

Health hazards and medical treatment of volunteers aged 18-30 years working in international social projects of non-governmental organizations (NGO).

PubMed

Küpper, T; Rieke, B; Neppach, K; Morrison, A; Martin, J

2014-01-01

The specific health risk profile and diversity of treatments sought by young volunteers participating in international social projects should differ from those of their older colleagues. In the absence of any data to identify whether this was correct, a retrospective analysis was performed using a standardized questionnaire. Questions included what diseases occurred, and details of the frequency and types of treatment sought during their stay - (e.g. self-treatment, medical/dental intervention, or local healer). The 153 participants were aged 18-30 years and worked in a non-governmental organization for >6 months. The participants were: 53% female, mean age 20 years, and mean duration of stay was 11.2 months. Their NGO placement abroad was in Latin America 65.4%, 14.4% in Africa, and 9.8% in Asia. 83% of the young volunteers had received some advice regarding travel medicine before their departure. However, they suffered from more injuries compared to private travellers, and febrile infections were more common when compared to older studies. 21.2% suffered from dental problems and 50% of them sought medical treatment. This study highlights a previously unreported higher risk profile of specific health problems occurring in young NGO volunteers, including some potentially life-threatening diagnoses that differed from their older colleagues and normal travellers. It is recommended that young volunteers should receive age specific, comprehensive pre-departure training in health and safety, first aid, and management of common health problems. A medical check-up upon returning home should be mandatory. The provision of a basic first aid kit to each volunteer before departure is also recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

Thyrotropin levels within the lower normal range are associated with an increased risk of hip fractures in euthyroid women, but not men, over the age of 65 years.

PubMed

Leader, Avi; Ayzenfeld, Racheli Heffez; Lishner, Michael; Cohen, Efrat; Segev, David; Hermoni, Doron

2014-08-01

The contemporary literature on the relationship between serum TSH levels and osteoporotic fractures in euthyroid individuals is limited by conflicting results and analyses conducted on a small number of fractures. Our objective was to examine the association between the normal range of variation of TSH and the incidence of hip fractures in male and female euthyroid patients aged 65 years or older. We performed a population-based historical prospective cohort study within the Clalit Health Services population. Clalit Health Services members aged ≥65 years with at least 1 TSH measurement during the year 2004. We excluded patients with preexisting hip fracture, thyroid disease, malignancy, or chronic kidney disease. The primary outcome was hip fracture, and the secondary outcome was any other osteoporotic fracture. Adjusted odds ratios comparing episodes of each outcome across 3 TSH groups (low, 0.35-1.6 mIU/L; intermediate, 1.7-2.9 mIU/L; high, 3-4.2 mIU/L) were generated using logistic regression models. The 14 325 included participants suffered from 514 hip fractures (mean follow-up, 102 ± 3 months). Women, but not men, in the lowest TSH group had a higher incidence of hip fractures (odds ratio = 1.28, 95% confidence interval = 1.03-1.59, P = .029) when compared with the intermediate group, after multivariate adjustment for age, comorbidities, and use of drugs affecting bone metabolism. There was no difference in hip fracture incidence between intermediate- and high-TSH groups. No association was found between TSH levels and other osteoporotic fractures. TSH levels within the lower normal range are associated with an increased risk of hip fractures in euthyroid women, but not men, aged 65 years and more.

Immunogenicity and safety of a single dose of a CRM-conjugated meningococcal ACWY vaccine in children and adolescents aged 2-18 years in Taiwan: results of an open label study.

PubMed

Huang, Li-Min; Chiu, Nan-Chang; Yeh, Shu-Jen; Bhusal, Chiranjiwi; Arora, Ashwani Kumar

2014-09-08

MenACWY-CRM (Menveo®, Novartis Vaccines, Siena, Italy) is a quadrivalent meningococcal conjugate vaccine developed to help prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, W, and Y. It is approved within the European Union in persons >2 years of age and in persons from 2 months to 55 years of age in the United States, among other countries. Little is known about the immunogenicity and safety of this vaccine in Taiwanese children >2 years and adolescents. This study assessed the immunogenicity and safety of a single injection of MenACWY-CRM vaccine in Taiwanese subjects aged 2-18 years old. In this phase III, multicentre, open-label study 341 subjects received one dose of MenACWY-CRM. Immunogenicity measures were rates of seroresponse (defined as the proportion of subjects with a postvaccination hSBA ≥1:8 if the prevaccination (baseline) titre was <1:4, or at least a fourfold higher hSBA titre than baseline if the prevaccination titre was ≥1:4), percentages of subjects with serum bactericidal activity (hSBA) ≥1:8 for serogroups A, C, W and Y and hSBA geometric mean titres (GMTs). Local and systemic reactions and all adverse events (AEs) were recorded for 7 days, and medically attended AEs for 1 month post-vaccination. Seroresponse rates after MenACWY-CRM vaccination at Day 29 for the serogroups A, C, W, and Y were 83%, 93%, 50%, and 65%, respectively. At Day 29 the percentages of subjects with hSBA ≥1:8 against all four serogroups A, C, W and Y were: 83%, 96%, 96% and 82%, respectively. GMTs against all serogroups rose by ≥7-fold from baseline to Day 29. The vaccine was well tolerated. A single dose of MenACWY-CRM demonstrated a robust immune response, and an acceptable safety profile in Taiwanese children and adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.

The gender- and age-specific 10-year and lifetime absolute fracture risk in Tromsø, Norway.

PubMed

Ahmed, Luai A; Schirmer, Henrik; Bjørnerem, Ashild; Emaus, Nina; Jørgensen, Lone; Størmer, Jan; Joakimsen, Ragnar M

2009-01-01

Aim of this study is to estimate the gender- and age-specific 10-year and lifetime absolute risks of non-vertebral and osteoporotic (included hip, distal forearm and proximal humerus) fractures in a large cohort of men and women. This is a population-based 10 years follow-up study of 26,891 subjects aged 25 years and older in Tromsø, Norway. All non-vertebral fractures were registered from 1995 throughout 2004 by computerized search in radiographic archives. Absolute risks were estimated by life-table method taking into account the competing risk of death. The absolute fracture risk at each year of age was estimated for the next 10 years (10-year risk) or up to the age of 90 years (lifetime risk). The estimated 10-year absolute risk of all non-vertebral fracture was higher in men than women before but not after the age of 45 years. The 10-year absolute risk for non-vertebral and osteoporotic fractures was over 10%, respectively, in men over 65 and 70 years and in women over 45 and 50 years of age. The 10-year absolute risks of hip fractures at the age of 65 and 80 years were 4.2 and 18.6% in men, and 9.0 and 24.0% in women, respectively. The risk estimates for distal forearm and proximal humerus fractures were under 5% in men and 13% in women. The estimated lifetime risks for all fracture locations were higher in women than men at all ages. At the age of 50 years, the risks were 38.1 and 24.8% in men and 67.4 and 55.0% in women for all non-vertebral and osteoporotic fractures, respectively. The estimated gender- and age-specific 10-year and lifetime absolute fracture risk were higher in Tromsø than in other populations. The high lifetime fracture risk reflects the increased burden of fractures in this cohort.

Effect of e-cigarette advertisements and antismoking messages on explicit and implicit attitudes towards tobacco and e-cigarette smoking in 18–65-year-olds: a randomised controlled study protocol

PubMed Central

Albery, Ian P; Frings, Daniel

2017-01-01

Introduction Since the advent of e-cigarettes, e-cigarette advertising has escalated and companies are able to use marketing strategies that are not permissible for tobacco products. Research into the effect of e-cigarette advertising on attitudes towards tobacco and e-cigarettes is in its infancy. To date, no research has compared indirect (implicit) measures of attitude towards e-cigarettes with direct (explicit) measures. Furthermore, little consideration has been given to how viewing online advertisements may have an effect on attitudes towards e-cigarettes or how positive attitudes to e-cigarettes may undermine antismoking public health messages. The objectives of this study are to investigate (1) the relationship between explicit and implicit attitudes towards tobacco and e-cigarettes, (2) the effect of e-cigarette advertising on these attitudes and (3) the effect of these attitudes on the efficacy of antismoking health messages. Methods and analysis In experiment 1 an analysis of covariance will be conducted to determine whether viewing an e-cigarette advertisement, compared with a neutral image, has an effect on implicit or explicit attitudes towards tobacco and e-cigarettes, and if these attitudes differ between smokers, vapers and non-smokers aged 18 - 25 years. In experiment 2, moderation analysis will be conducted to assess whether attitudes towards e-cigarettes moderate the psychological efficacy of antismoking health messages in participants aged 18–65 years. In each experiment, attitudes will be measured preintervention and postintervention and 1 week later (n=150) in participants who are smokers (n=50), vapers (n=50) or non-smokers (n=50). Ethics and dissemination Approval for this study has been given by the London South Bank University’s (LSBU) Research Ethics Committee. The findings of these studies will be submitted for publication and disseminated via conferences. The results will be integrated into course provision for practitioners

[Prevalence of myopia and increase trend in children and adolescents aged 7-18 years in Han ethnic group in China, 2005-2014].

PubMed

Dong, Y H; Liu, H B; Wang, Z H; Yang, Z P; Xu, R B; Yang, Z G; Ma, J

2017-05-10

Objective: To understand and evaluate the prevalence of myopia and its trend in children and adolescents aged 7-18 years in Han ethnic group in China from 2005 to 2014, and provide evidence for the prevention of myopia. Methods: The data of 2005, 2010 and 2014 Chinese National Students Constitution and Health Surveys were collected. The children and adolescents with complete detection data of binoculus were selected as study subjects. The sample size of three studies were 233 108, 215 319 and 212 743, respectively. The method of curve fitting was used to simulate the myopia detection increase model and analyze the gender and area specific myopia detection increase trends and characteristics from 2005 to 2014. Results: The overall myopia detection rate increased gradually in the children and adolescents aged 7 to 18, which was 47.5 % in 2005, 55.5 % in 2010 and 57.1 % in 2014, respectively. The increase slowed in 2014. A"parabola" shape of myopia detection increase rate was observed. Myopia detection rate increased with age before puberty and decreased with age after puberty gradually. A"cross phenomenon" of myopia detection increase was observed in boys and girls between urban and rural areas. The increase of myopia detection was mainly in urban students before puberty and in rural students after puberty. The age of myopia prevalence peak has become earlier constantly in children and adolescents aged 7-18 years from 2005 to 2014, which was 13 years old in 2005, 12 years old in 2010 and 11 years old in 2014. The increase rate was about 7 % . During 2005-2014, the increase rate of myopia detection gradually increased in younger students and tended to zero in older students. Conclusion: The detection rate of myopia was still high in children and adolescents in China. The age of myopia prevalence peak has become earlier gradually.

What Are Friends for? Friendships and Loneliness Over the Lifespan-From 18 to 79 Years.

PubMed

Nicolaisen, Magnhild; Thorsen, Kirsten

2017-01-01

Preventing and reducing loneliness is crucial to well-being and good health. Social relationships protect people against loneliness. Friendship qualities like intimacy and frequency of contact may vary throughout a person's lifespan. This study explores aspects of friendship and loneliness among people in different age groups: 18 to 29, 30 to 49, 50 to 64, and 65 to 79 years old. Data are from the Norwegian Life Course, Gender and Generations study (N = 14,725). Young people see their friends most often. The proportion of people without confidant friends is higher among older age groups. However, older age groups report higher levels of satisfaction with their contact with friends. Multivariate regression analyses show that the aspiration for contact with friends is more significant to loneliness than actual contact in all age groups. Dissatisfaction with contact with friends is strongly related to loneliness in all age groups. © The Author(s) 2016.

Incident Detection of High-Risk Human Papillomavirus Infections in a Cohort of High-Risk Women Aged 25–65 Years

PubMed Central

Winer, Rachel L.; Hughes, James P.; Feng, Qinghua; Stern, Joshua E.; Xi, Long Fu; Koutsky, Laura A.

2016-01-01

Background. The risk of incident high-risk human papillomavirus (HR-HPV) infection associated with recent sexual behaviors is undefined in mid-adult women (defined as women aged 25–65 years). Methods. Triannually, 420 female online daters aged 25–65 years submitted vaginal specimens for HPV testing and completed health and sexual behavior questionnaires. The cumulative incidence of and risk factors for incident HR-HPV detection were estimated by Kaplan–Meier and Cox proportional hazards methods. Results. The 12-month cumulative incidence of HR-HPV detection was 25.4% (95% confidence interval [CI], 21.3%–30.1%). Current hormonal contraceptive use was positively associated with incident HR-HPV detection. Lifetime number of male sex partners was also positively associated but only among women not recently sexually active with male partners. In analysis that adjusted for hormonal contraceptive use and marital status, women reporting multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership had a hazard of incident HR-HPV detection that was 2.81 times (95% CI, 1.38–5.69 times) that for women who reported no male sex partners in the past 6 months. Thus, among women with multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership, approximately 64% of incident HR-HPV infections were attributable to one of those partners. Conclusions. Among high-risk mid-adult women with recent new male partners, multiple male partners, or male partners who were casual or had ≥1 concurrent partnership, about two thirds of incident HR-HPV detections are likely new acquisitions, whereas about one third of cases are likely redetections of prior infections. PMID:27009602

[Study of polymedicated patients over 65 years-old in an urban primary care centre].

PubMed

Garrido-Garrido, E M; García-Garrido, I; García-López-Durán, J C; García-Jiménez, F; Ortega-López, I; Bueno-Cavanillas, A

2011-01-01

To identify and characterise the polymedicated population over 65 years-old; and to determine the prevalence of drugs and the diseases in this population subgroup. Cross-sectional study. A primary care centre Zaidín-Centro in Granada. Andalusian Public Health Service. A total of 305 patients over 65 years-old taking polypharmacy (defined as use of five or more drugs, during a period equal to or greater than six months by any route) selected by stratified sampling by sex, age and number of drugs consumed. The analysed variables were sex, age, number of diseases, number of drugs and medical doctor. The prevalence of polypharmacy in patients over 65 years-old was 33.77%. These patients were using an average number of drugs of 8.7±2.5 and had an average number of diseases of 5.56±1.89. The prevalence of polypharmacy was greater among women, but differences decreased in people more than 85 years old. The antihypertensive pharmacological group was the most commonly used, in accordance with the most frequent disease, arterial hypertension. We found a strong relationship between the number of drugs and the number of diseases (p=0.05). Chronic use of drugs in the elderly is of considerable magnitude, affecting one out of every three. Polypharmacy in the elderly is a common and serious problem that needs to be reviewed and evaluated continuously. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

The efficacy and safety of febuxostat for urate lowering in gout patients ≥65 years of age

PubMed Central

2012-01-01

Background The incidence of gout rises with increasing age. Management of elderly (≥65 years) gout patients can be challenging due to high rates of comorbidities, such as renal impairment and cardiovascular disease, and concomitant medication use. However, there is little data specifically addressing the efficacy and safety of available urate-lowering therapies (ULT) in the elderly. The objective of this post hoc analysis was to examine the efficacy and safety of ULT with febuxostat or allopurinol in a subset of elderly subjects enrolled in the CONFIRMS trial. Methods Hyperuricemic (serum urate [sUA] levels ≥ 8.0 mg/dL) gout subjects were enrolled in the 6-month, double-blind, randomized, comparative CONFIRMS trial and randomized, 1:1:1, to receive febuxostat, 40 mg or 80 mg, or allopurinol (200 mg or 300 mg based on renal function) once daily. Flare prophylaxis was provided throughout the study duration. Study endpoints were the percent of elderly subjects with sUA <6.0 mg/dL at the final visit, overall and by renal function status, percent change in sUA from baseline to final visit, flare rates, and rates of adverse events (AEs). Results Of 2,269 subjects enrolled, 374 were elderly. Febuxostat 80 mg was significantly more efficacious (82.0%) than febuxostat 40 mg (61.7%; p < 0.001) or allopurinol (47.3%; p < 0.001) for achieving the primary efficacy endpoint. Febuxostat 40 mg was also superior to allopurinol in this population (p = 0.029). In subjects with mild-to-moderate renal impairment, significantly greater ULT efficacy was observed with febuxostat 40 mg (61.6%; p = 0.028) and febuxostat 80 mg (82.5%; p < 0.001) compared to allopurinol 200/300 mg (46.9%). Compared to allopurinol 200/300 mg, the mean percent change in sUA from baseline was significantly greater for both febuxostat 80 mg (p < 0.001) and febuxostat 40 mg (p = 0.011) groups. Flare rates declined steadily in all treatment groups. Rates of AEs were low and comparable across treatments

Diet Quality Associated with Total Sodium Intake among US Adults Aged ≥18 Years-National Health and Nutrition Examination Survey, 2009-2012.

PubMed

Mercado, Carla I; Cogswell, Mary E; Perrine, Cria G; Gillespie, Cathleen

2017-10-25

Diet quality or macronutrient composition of total daily sodium intake (dNa) <2300 mg/day in the United States (US) is unknown. Using data from 2011-2014 NHANES (National Health and Nutrition Examination Survey), we examined 24-h dietary recalls ( n = 10,142) from adults aged ≥18 years and investigated how diet composition and quality are associated with dNa. Diet quality was assessed using components of macronutrients and Healthy Eating Index 2010 (HEI-2010). Associations were tested using linear regression analysis adjusted for total energy (kcal), age, gender, and race/ethnicity. One-day dNa in the lower quartiles were more likely reported among women, older adults (≥65 years old), and lower quartiles of total energy (kcal) ( p -values ≤ 0.001). With increasing dNa, there was an increase in the mean protein, fiber, and total fat densities, while total carbohydrates densities decreased. As dNa increased, meat protein, refined grains, dairy, and total vegetables, greens and beans densities increased; while total fruit and whole fruit densities decreased. Modified HEI-2010 total score (total score without sodium component) increased as dNa increased (adjusted coefficient: 0.11, 95% confidence interval = 0.07, 0.15). Although diet quality, based on modified HEI-2010 total score, increased on days with greater dNa, there is much room for improvement with mean diet quality of about half of the optimal level.

Productivity Costs Associated With Breast Cancer Among Survivors Aged 18-44 Years.

PubMed

Ekwueme, Donatus U; Trogdon, Justin G; Khavjou, Olga A; Guy, Gery P

2016-02-01

No study has quantified productivity losses associated with breast cancer in younger women aged 18-44 years. This study estimated productivity costs, including work and home productivity losses, among younger women who reported ever receiving a breast cancer diagnosis. A two-part regression model and 2000-2010 National Health Interview Survey data were used to estimate the number of work and home productivity days missed because of breast cancer, adjusted for socioeconomic characteristics and comorbidities. Estimates for younger women were compared with those for women aged 45-64 years. Data were analyzed in 2013-2014. Per capita, younger women with breast cancer had annual losses of $2,293 (95% CI=$1,069, $3,518) from missed work and $442 (95% CI=$161, $723) from missed home productivity. Total annual breast cancer-associated productivity costs for younger women were $344 million (95% CI=$154 million, $535 million). Older women with breast cancer had lower per capita work loss productivity costs of $1,407 (95% CI=$899, $1,915) but higher total work loss productivity costs estimated at $1,072 million (95% CI=$685 million, $1,460 million) than younger women. Younger women with a history of breast cancer face a disproportionate share of work and home productivity losses. Although older women have lower per capita costs, total productivity costs were higher for older women because the number of older women with breast cancer is higher. The results underscore the importance of continued efforts by the public health community to promote and support the unique needs of younger breast cancer survivors. Published by Elsevier Inc.

Prevalence of smoking and BMI differences between smokers and non-smokers among children and adolescents aged 7-18 years in south-east Poland.

PubMed

Wandycz, Artur; Jankowiak, Łukasz; Jerzak, Izabela

2018-05-01

Objectives : The aim of the study was to determine the prevalence of smoking among children and adolescents aged 7-18 years, and also to determine the relationship between this addiction and the Body Mass Index (BMI). Methods : Basic anthropometric measurements were performed, and information concerning cigarette smoking and basic SES was gathered using the questionnaire method. Results : More than 5% of boys admit to smoking at the age of 10-11 years, and as many as 22% 18-year-olds admit to doing so. With regard to girls, the situation is slightly better because it is only among 14-year-olds that the percentage of smokers exceeds 5%. Smoking may affect average BMIs. Smoking had a negative impact on the magnitude of physical development indices among children between 8 and 12 years old. Conclusions : The percentage of smokers increases with age. Boys smoke more often than girls. Tobacco smoking in middle childhood (8-12 years) is associated with lower BMIs.

Evaluation of anthrax vaccine safety in 18 to 20 year olds: A first step towards age de-escalation studies in adolescents.

PubMed

King, James C; Gao, Yonghong; Quinn, Conrad P; Dreier, Thomas M; Vianney, Cabrini; Espeland, Eric M

2015-05-15

Anthrax vaccine adsorbed (AVA, BioThrax(®)) is recommended for post-exposure prophylaxis administration for the US population in response to large-scale Bacillus anthracis spore exposure. However, no information exists on AVA use in children and ethical barriers exist to performing pre-event pediatric AVA studies. A Presidential Ethics Commission proposed a potential pathway for such studies utilizing an age de-escalation process comparing safety and immunogenicity data from 18 to 20 year-olds to older adults and if acceptable proceeding to evaluations in younger adolescents. We conducted exploratory summary re-analyses of existing databases from 18 to 20 year-olds (n=74) compared to adults aged 21 to 29 years (n=243) who participated in four previous US government funded AVA studies. Data extracted from studies included elicited local injection-site and systemic adverse events (AEs) following AVA doses given subcutaneously at 0, 2, and 4 weeks. Additionally, proportions of subjects with ≥4-fold antibody rises from baseline to post-second and post-third AVA doses (seroresponse) were obtained. Rates of any elicited local AEs were not significantly different between younger and older age groups for local events (79.2% vs. 83.8%, P=0.120) or systemic events (45.4% vs. 50.5%, P=0.188). Robust and similar proportions of seroresponses to vaccination were observed in both age groups. AVA was safe and immunogenic in 18 to 20 year-olds compared to 21 to 29 year-olds. These results provide initial information to anthrax and pediatric specialists if AVA studies in adolescents are required. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stature-for-Age and Weight-for-Age Percentiles: Boys, 2 to 20 Years

MedlinePlus

2 to 20 years: Boys NAME Stature-for-age and Weight-for-age percentiles RECORD # Mother’s Stature Date Age in cm 160 62 S 155 60 T 150 ... 14 15 16 17 18 19 20 BMI* AGE (YEARS) cm 95 190 90 185 75 180 ...

Intra- and interrater reliability of the 'lumbar-locked thoracic rotation test' in competitive swimmers ages 10 through 18 years.

PubMed

Feijen, Stef; Kuppens, Kevin; Tate, Angela; Baert, Isabel; Struyf, Thomas; Struyf, Filip

2018-04-17

Measuring thoracic spine mobility can be of interest to competitive swimmers as it has been associated with shoulder girdle function and scapular position in subjects with and without shoulder pain. At present, no reliability data of thoracic spine mobility measurements are available in the swimming population. This study aims to evaluate the within-session intra- and interrater reliability of the "lumbar-locked rotation test" for thoracic spine rotation in competitive swimmers aged 10 to 18 years. This reliability study is part of a larger prospective cohort study investigating potential risk factors for the development of shoulder pain in competitive swimmers. Within-session, intra- and inter-rater reliability. Competitive swimming clubs in Belgium. 21 competitive swimmers. Intra- and inter-rater reliability of the lumbar-locked thoracic rotation test. Intraclass correlation coefficients (ICCs) ranged from 0.91 (95% CI 0.78 to 0.96) to 0.96 (0.89-0.98) for intra-rater reliability. Results for inter-rater reliability ranged from 0.89 (0.72-0.95) to 0.86 (0.65-0.94) respectively for right and left thoracic rotation. Results suggest good to excellent reliability of the lumbar-locked thoracic rotation test, indicating this test can be used reliably in clinical practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

Deterioration of Speech Recognition Ability Over a Period of 5 Years in Adults Ages 18 to 70 Years: Results of the Dutch Online Speech-in-Noise Test.

PubMed

Stam, Mariska; Smits, Cas; Twisk, Jos W R; Lemke, Ulrike; Festen, Joost M; Kramer, Sophia E

2015-01-01

The first aim of the present study was to determine the change in speech recognition in noise over a period of 5 years in participants ages 18 to 70 years at baseline. The second aim was to investigate whether age, gender, educational level, the level of initial speech recognition in noise, and reported chronic conditions were associated with a change in speech recognition in noise. The baseline and 5-year follow-up data of 427 participants with and without hearing impairment participating in the National Longitudinal Study on Hearing (NL-SH) were analyzed. The ability to recognize speech in noise was measured twice with the online National Hearing Test, a digit-triplet speech-in-noise test. Speech-reception-threshold in noise (SRTn) scores were calculated, corresponding to 50% speech intelligibility. Unaided SRTn scores obtained with the same transducer (headphones or loudspeakers) at both test moments were included. Changes in SRTn were calculated as a raw shift (T1 - T0) and an adjusted shift for regression towards the mean. Paired t tests and multivariable linear regression analyses were applied. The mean increase (i.e., deterioration) in SRTn was 0.38-dB signal-to-noise ratio (SNR) over 5 years (p < 0.001). Results of the multivariable regression analyses showed that the age group of 50 to 59 years had a significantly larger deterioration in SRTn compared with the age group of 18 to 39 years (raw shift: beta: 0.64-dB SNR; 95% confidence interval: 0.07-1.22; p = 0.028, adjusted for initial speech recognition level - adjusted shift: beta: 0.82-dB SNR; 95% confidence interval: 0.27-1.34; p = 0.004). Gender, educational level, and the number of chronic conditions were not associated with a change in SRTn over time. No significant differences in increase of SRTn were found between the initial levels of speech recognition (i.e., good, insufficient, or poor) when taking into account the phenomenon regression towards the mean. The study results indicate that hearing

Progression of Myopic Maculopathy during 18-Year Follow-up.

PubMed

Fang, Yuxin; Yokoi, Tae; Nagaoka, Natsuko; Shinohara, Kosei; Onishi, Yuka; Ishida, Tomoka; Yoshida, Takeshi; Xu, Xian; Jonas, Jost B; Ohno-Matsui, Kyoko

2018-06-01

To examine the progression pattern of myopic maculopathy. Retrospective, observational case series. Highly myopic patients who had been followed up for 10 years or more. Using fundus photographs, myopic features were differentiated according to Meta-analysis of Pathologic Myopia (META-PM) Study Group recommendations. Progression pattern of maculopathy. The study included 810 eyes of 432 patients (mean age, 42.3±16.8 years; mean axial length, 28.8±1.9 mm; mean follow-up, 18.7±7.1 years). The progression rate of myopic maculopathy was 47.0 per 1000 eye-years. Within the pathologic myopia (PM) group (n = 521 eyes), progression of myopic maculopathy was associated with female gender (odds ratio [OR], 2.21; P = 0.001), older age (OR, 1.03; P = 0.002), longer axial length (OR, 1.20; P = 0.007), greater axial elongation (OR, 1.45; P = 0.005), and development of parapapillary atrophy (PPA; OR, 3.14; P < 0.001). Diffuse atrophy, found in 217 eyes without choroidal neovascularization (CNV) or lacquer cracks (LCs) at baseline, progressed in 111 (51%) eyes, leading to macular diffuse atrophy (n = 64; 64/111 or 58%), patchy atrophy (n = 59; 53%), myopic CNV (n = 18; 16%), LCs (n = 9; 5%), and patchy-related macular atrophy (n = 3; 3%). Patchy atrophy, detected in 63 eyes without CNV or LCs at baseline, showed progression in 60 eyes (95%), leading to enlargement of original patchy atrophy (n = 59; 59/60 or 98%), new patchy atrophy (n = 29; 48%), CNV-related macular atrophy (n = 13; 22%), and patchy-related macular atrophy (n = 5; 8%). Of 66 eyes with LCs, 43 eyes (65%) showed progression with development of new patchy atrophy (n = 38; 38/43 or 88%) and new LCs (n = 7; 16%). Reduction in best-corrected visual acuity (BCVA) was associated mainly (all P < 0.001) with the development of CNV or CNV-related macular atrophy and enlargement of macular atrophy. The most frequent progression patterns were an extension of peripapillary diffuse atrophy to macular diffuse

Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age.

PubMed

Lowe, Adrian J; Angelica, Bianca; Su, John; Lodge, Caroline J; Hill, David J; Erbas, Bircan; Bennett, Catherine M; Gurrin, Lyle C; Axelrad, Christine; Abramson, Michael J; Allen, Katrina J; Dharmage, Shyamali C

2017-06-01

Few studies have simultaneously addressed the importance of age of onset and persistence of eczema for the subsequent development of asthma and hay fever, particularly into early adulthood. A high-risk birth cohort was recruited comprising 620 infants, who were then followed up frequently until 2 years of age, annually from age 3 to 7, then at 12 and 18 years, to document any episodes of eczema, current asthma, and hay fever. The generalized estimation equation technique was used to examine asthma and hay fever outcomes at 6 (n = 325), 12 (n = 248) and 18 (n = 240) years, when there was consistency of associations across the follow-ups. Very early-onset persistent (onset <6 months, still present from 2 to 5 years) eczema was related to current asthma (adjusted OR = 3.2 [95% CI = 1.7-6.1]), as was very early-onset remitting eczema (onset <6 months but not present from 2-5 years, OR = 2.7, 95% CI = 1.0-7.2) and early-onset persistent eczema (onset from 6-24 months, OR = 2.3, 95% CI = 1.2-4.7). Late-onset eczema (commenced from 2-5 years) was associated with increased risk of asthma at 12 years (OR = 3.0, 95% CI=1.1-8.2) but not at age 6 years. Only very early-onset persistent eczema was associated with increased risk of hay fever (aOR = 2.4, 95% CI = 1.4-4.1). Eczema which commences in early infancy and persists into toddler years is strongly associated with asthma, and to a lesser extent hay fever, in high-risk children. If these associations are causal, prevention of early-life eczema might reduce the risk of respiratory allergy. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

The 12-Month Prevalence of DSM-IV Anxiety Disorders among Nigerian Secondary School Adolescents Aged 13-18 Years

ERIC Educational Resources Information Center

Adewuya, Abiodun O.; Ola, Bola A.; Adewumi, Tomi A.

2007-01-01

Aims: To estimate the 12-month prevalence of DSM-IV-specific anxiety disorders among Nigerian secondary school adolescents aged 13-18 years. Method: A representative sample of adolescents (n=1090) from senior secondary schools in a semi-urban town in Nigeria was assessed for the 12-month prevalence of DSM-IV-specific anxiety. Results: The 12-month…

[Recurrences of bipolar disorders - comparative study of bipolar disorders, recurring depressions and single depressions in a cohort of patients aged over 65 years].

PubMed

Galland, F; Vaille-Perret, E; Gerbaud, L; Jalenques, I

2007-09-01

Bipolar mood disorders, after starting at adulthood, may remain active throughout life, but bipolar disorders may only be revealed in later life. Indeed, Yet few data on bipolar disorders in the elderly have been reported in the litterature. The influence of normal aging on the outcome of the disease as well as the specific prognosis of bipolar disorders in the elderly has occasionally been studied. Eventually Finally, and contrasting with adults, few studies comparing the various subtypes of mood disorders were have been performed in the elderly. We therefore developed a study in patients aged 65 or above, in order to evaluate the course (recurrences) of bipolar disorders, compared to recurring depressions and single depressions, and to determine the influence of recurrences on the outcome of bipolar disorders. Patients aged over 65 years were inpatients admitted to the department of psychiatry in 2000 for one of the three previously mentioned diagnoses according to DSM IV. Retrospective data were collected from medical reports. Prospectively, data were collected from the general practitioner of each patient (relying on telephone calls), before statistical analysis was performed. Our study demonstrates a more severe outcome for bipolar disorders compared to recurring depressions and single depressions. Patients with bipolar disorders have a higher prevalence of psychiatric recurrences. Furthermore, the greater the number of previous relapses (or the longer the duration and intensity of the disease), the higher the risk of future new future recurrences both in bipolar disorders and recurring depressions. An age of onset of bipolar disorders before 60 years and more than 5 in-hospital admissions increase the risk of recurrences. We originally compare the outcome of bipolar disorders in the elderly, to recurring depressions and single depressions. We confirm the fatal outcome of recurrences in bipolar disorders in old age. Bipolar disorders in the elderly should be

Trends in overweight or obesity and other anthropometric indices in adults aged 18-60 years in western Saudi Arabia.

PubMed

Azzeh, Firas Sultan; Bukhari, Hassan Mazzhar; Header, Eslam Ahmed; Ghabashi, Mai Adil; Al-Mashi, Salma Saad; Noorwali, Nafeesah Mohammed

2017-01-01

The prevalence of overweight and obesity has increased considerably in Saudi Arabia in the past two decades. We conducted this study because to examine trends in weight gain with age and related anthropometric measurements in Saudi Arabia such data are limited. To determine trends in overweight and obesity and examine anthropometric indices by age group. Analytical cross-sectional study. Universities, malls, and hospitals in the cities of Mecca, Jeddah, and Al-Taif. Participants were selected by convenience sampling. Body weight, body fat percentage, visceral fat percentage, and skeletal muscle percentage were measured with the Omron body composition monitor device. Waist circumference, height, and body mass index (BMI) were also measured. Changes in BMI, body fat percentage, visceral fat percentage, and skel-etal muscle with age for both genders. We selected 2548 Saudis, 1423 males and 1125 females, aged 18 to 60 years. A significant trend (ptrend < .001) for BMI and all anthropometric indices was observed with age for both genders. About 55.1% of the participants were overweight and obese (BMI > 25 kg/m2). Obesity and overweight were more prevalent in men than in women and was observed early in both genders, at the ages of 18-19 in men and 30-39 years for women. In the age range of 40-60 years, muscle mass dropped significantly (P < .05) for both genders. Mean waist circumference and visceral fat were significantly (P < .001) higher in men than in women, but the mean total body fat percentage was higher in females than in males (P < .001). Significant trends were observed for BMI, WC, body fat, visceral fat, and muscle mass for both genders with age. National programs should be maintained to encourage physical activity and weight reduction as well as focusing on obesity-related lifestyle and behaviors at early ages to prevent weight gain and possibly muscle wasting with age. There was an unequal distribution in numbers of subjects between study groups

Continuing screening mammography in women aged 70 to 79 years: impact on life expectancy and cost-effectiveness.

PubMed

Kerlikowske, K; Salzmann, P; Phillips, K A; Cauley, J A; Cummings, S R

1999-12-08

Mammography is recommended and is cost-effective for women aged 50 to 69 years, but the value of continuing screening mammography after age 69 years is not known. In particular, older women with low bone mineral density (BMD) have a lower risk of breast cancer and may benefit less from continued screening. To compare life expectancy and cost-effectiveness of screening mammography in elderly women based on 3 screening strategies. Decision analysis and cost-effectiveness analysis using a Markov model. General population of women aged 65 years or older. The analysis compared 3 strategies: (1) Undergoing biennial mammography from age 65 to 69 years; (2) undergoing biennial mammography from age 65 to 69 years, measurement of distal radial BMD at age 65 years, discontinuing screening at age 69 years in women in the lowest BMD quartile for age, and continuing biennial mammography to age 79 years in those in the top 3 quartiles of distal radius BMD; and (3) undergoing biennial mammography from age 65 to 79 years. Deaths due to breast cancer averted, life expectancy, and incremental cost-effectiveness ratios. Compared with discontinuing mammography screening at age 69 years, measuring BMD at age 65 years in 10000 women and continuing mammography to age 79 years only in women with BMD in the top 3 quartiles would prevent 9.4 deaths and add, on average, 2.1 days to life expectancy at an incremental cost of $66773 per year of life saved. Continuing mammography to age 79 years in all 10000 elderly women would prevent 1.4 additional breast cancer deaths and add only 7.2 hours to life expectancy at an incremental cost of $117689 per year of life saved compared with only continuing mammography to age 79 years in women with BMD in the top 3 quartiles. This analysis suggests that continuing mammography screening after age 69 years results in a small gain in life expectancy and is moderately cost-effective in those with high BMD and more costly in those with low BMD. Women

A Simple Algorithm to Predict Falls in Primary Care Patients Aged 65 to 74 Years: The International Mobility in Aging Study.

PubMed

Gomez, Fernando; Wu, Yan Yan; Auais, Mohammad; Vafaei, Afshin; Zunzunegui, Maria-Victoria

2017-09-01

Primary care practitioners need simple algorithms to identify older adults at higher risks of falling. Classification and regression tree (CaRT) analyses are useful tools for identification of clinical predictors of falls. Prospective cohort. Community-dwelling older adults at 5 diverse sites: Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). In 2012, 2002 participants aged 65-74 years from 5 international sites were assessed in the International Mobility in Aging Study. In 2014 follow-up, 86% of the participants (n = 1718) were reassessed. These risk factors for the occurrence of falls in 2014 were selected based on relevant literature and were entered into the CaRT as measured at baseline in 2012: age, sex, body mass index, multimorbidity, cognitive deficit, depression, number of falls in the past 12 months, fear of falling (FoF) categories, and timed chair-rises, balance, and gait. The 1-year prevalence of falls in 2014 was 26.9%. CaRT procedure identified 3 subgroups based on reported number of falls in 2012 (none, 1, ≥2). The 2014 prevalence of falls in these 3 subgroups was 20%, 30%, and 50%, respectively. The "no fall" subgroup was split using FoF: 30% of the high FoF category (score >27) vs 20% of low and moderate FoF categories (scores: 16-27) experienced a fall in 2014. Those with multiple falls were split by their speed in the chair-rise test: 56% of the slow category (>16.7 seconds) and the fast category (<11.2 seconds) had falls vs 28% in the intermediate group (between 11.2 and 16.7 seconds). No additional variables entered into the decision tree. Three simple indicators: FoF, number of previous falls, and time of chair rise could identify those with more than 50% probability of falling. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

[Prevalence of cardiovascular diseases and cardiovascular risk factors in older than 65 years persons in an urban area: DERIVA study].

PubMed

Rodríguez-Sánchez, Emiliano; García-Ortiz, Luis; Gómez-Marcos, Manuel A; Recio-Rodríguez, José I; Mora-Simón, Sara; Pérez-Arechaederra, Diana; Agudo-Conde, Cristina; Escribano-Hernández, Alfonso; Patino-Alonso, María C

2013-01-01

To estimate the prevalence of cardiovascular diseases, cardiovascular risk factors, and the psychosocial characteristics associated with them in an urban population aged 65 years and older. Descriptive cross-sectional study of the population. City of Salamanca (Spain). A total of 480 participants aged 65 and older were selected using a stratified randomized sampling method. A health questionnaire was completed in the participants' homes. Weight, height, waist circumference, arterial pressure, blood glucose and cholesterol, were measured, and the standardized prevalence for a European population was estimated. A total of 327 participants were interviewed (68.10% of those selected), mean age of participants was 76 (SD: 7.33). Of the total, 64.5% were women and 20.2% (15.8-24.5) had some cardiovascular disease. In males, the most prevalent cardiovascular disease was ischemic heart disease (12.1% [6.1-18]), while in females it was heart failure (10.4% [6.3-14.6]). Hypertension was the most frequent cardiovascular risk factor for males (63.8% [53.2-70.9]) and females (69.7%.[63.5-75.9]), followed by diabetes in males (36.2% [27.5-45]), and sedentary lifestyle in females (36.0% [29.5-42.5]). Those with cardiovascular diseases were more dependent and had a worse prognosis (Charlson's Comorbility Index). Ischemic heart disease is the most prevalent heart disease in males, while heart failure is the most prevalent disease for females. Almost 80% of the population aged 65 and older did not suffer any of the three cardiovascular diseases that are the main causes of mortality in this group of age. Participants who had a CVD were more dependent for activities of daily living. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Recurrent and chronic headaches in children below 6 years of age.

PubMed

Raieli, Vincenzo; Eliseo, Mario; Pandolfi, Eleonora; La Vecchia, Michela; La Franca, Girolama; Puma, Domenico; Ragusa, Donatella

2005-06-01

The objective was to determine the frequency of headache subtypes, according to International Headache Society (IHS) criteria, in a population of children below 6 years visiting a Center for Diagnosis and Treatment of Headache in Youth. Medical records of the children below 6 years at their first visit, admitted for headache between 1997 and 2003, were studied. Headache was classified according to the IHS criteria 2004. Children with less than three headache attacks or less than 15 days of daily headache were excluded. We found 1598 medical records of children who visited our Headache Center in the study period. One hundred and five (6.5%) were children younger than 6 years. The mean age at the first medical control was 4.8+/-1.3 years (range 17-71 months). There were 59 males (56.1%) and 46 females (43.9%). The mean age at onset of headaches was 4.3 years (range 14-69 months). According to the IHS criteria we found 37 cases (35.2%) with migraine, 19 cases (18%) with episodic tension headache, 5 cases (4.8%) with chronic daily headache, 13 cases (12.4%) with primary stabbing headache, 18 cases (17.1%) with post-traumatic headache, 7 cases (6.6%) with other non-dangerous secondary headaches (otorhinolaryngological diseases, post-infectious headaches), 3 cases (2.85%) with dangerous headaches (Arnold-Chiari type 1 malformation, brain tumour) and 9 cases (8.6%) with unclassifiable headaches. Six children (5.7%) reported more than one headache subtype. The prevalence of dangerous headaches was higher than those in school age (chi(2)=4.70, p<0.05). Our study shows some differences in headaches in this population vs. school children. In fact at this age migraine is the most common headache, but we also found an increase of secondary causes among the chronic/recurrent and daily headaches, especially posttraumatic disorders and potentially dangerous headaches. Finally our study shows the highest prevalence of the idiopathic stabbing headache in pre-school children in

Reference equations for the six-minute walk distance in the healthy Chinese population aged 18–59 years

PubMed Central

Zou, He; Zhu, Xiuruo; Zhang, Jia; Wang, Yi; Wu, Xiaozhen; Liu, Fang; Xie, Xiaofeng

2017-01-01

Background The six-minute walk test (6MWT) is a safe, simple, inexpensive tool for evaluating the functional exercise capacity of patients with chronic respiratory disease. However, there is a lack of standard reference equations for the six-minute walk distance (6MWD) in the healthy Chinese population aged 18–59 years. Aims The purposes of the present study were as follows: 1) to measure the anthropometric data and walking distance of a sample of healthy Chinese Han people aged 18–59 years; 2) to construct reference equations for the 6MWD; 3) to compare the measured 6MWD with previously published equations. Method The anthropometric data, demographic information, lung function, and walking distance of Chinese adults aged 18–59 years were prospectively measured using a standardized protocol. We obtained verbal consent from all the subjects before the test, and the study design was approved by the ethics committee of Wenzhou People's Hospital. The 6MWT was performed twice, and the longer distance was used for further analysis. Results A total of 643 subjects (319 females and 324 males) completed the 6MWT, and average walking distance was 601.6±55.51 m. The walking distance was compared between females and males (578±49.85 m vs. 623±52.53 m; p < 0.0001) and between physically active subjects and sedentary subjects (609.3±56.17 m vs. 592±53.23 m; p < 0.0001). Pearson’s correlation indicated that the 6MWD was significantly correlated with various demographic and the 6MWT variables, such as age, height, weight, body mass index (BMI), heart rate after the test and the difference in the heart rate before and after the test. Stepwise multiple regression analysis showed that age and height were independent predictors associated with the 6MWD. The reference equations from white, Canadian and Chilean populations tended to overestimate the walking distance in our subjects, while Brazilian and Arabian equations tended to underestimate the walking distance. There

Effect of e-cigarette advertisements and antismoking messages on explicit and implicit attitudes towards tobacco and e-cigarette smoking in 18-65-year-olds: a randomised controlled study protocol.

PubMed

Booth, Paula; Albery, Ian P; Frings, Daniel

2017-06-23

Since the advent of e-cigarettes, e-cigarette advertising has escalated and companies are able to use marketing strategies that are not permissible for tobacco products. Research into the effect of e-cigarette advertising on attitudes towards tobacco and e-cigarettes is in its infancy. To date, no research has compared indirect (implicit) measures of attitude towards e-cigarettes with direct (explicit) measures. Furthermore, little consideration has been given to how viewing online advertisements may have an effect on attitudes towards e-cigarettes or how positive attitudes to e-cigarettes may undermine antismoking public health messages. The objectives of this study are to investigate (1) the relationship between explicit and implicit attitudes towards tobacco and e-cigarettes, (2) the effect of e-cigarette advertising on these attitudes and (3) the effect of these attitudes on the efficacy of antismoking health messages. In experiment 1 an analysis of covariance will be conducted to determine whether viewing an e-cigarette advertisement, compared with a neutral image, has an effect on implicit or explicit attitudes towards tobacco and e-cigarettes, and if these attitudes differ between smokers, vapers and non-smokers aged 18 - 25 years. In experiment 2, moderation analysis will be conducted to assess whether attitudes towards e-cigarettes moderate the psychological efficacy of antismoking health messages in participants aged 18-65 years. In each experiment, attitudes will be measured preintervention and postintervention and 1 week later (n=150) in participants who are smokers (n=50), vapers (n=50) or non-smokers (n=50). Approval for this study has been given by the London South Bank University's (LSBU) Research Ethics Committee. The findings of these studies will be submitted for publication and disseminated via conferences. The results will be integrated into course provision for practitioners training at LSBU. © Article author(s) (or their employer(s) unless

[Management of patients under 18years of age by adult intensive care unit professionals: Level of training, workload, and specific challenges].

PubMed

Brossier, D; Villedieu, F; Letouzé, N; Pinto Da Costa, N; Jokic, M

2017-03-01

In routine practice, intensive care physicians rarely have to manage children under 18years of age, particularly those under 15. This study's objectives were to assess the quality of training in pediatrics of adult intensive care teams, to document the workload generated by care of pediatric patients, and to identify the difficulties encountered in managing minors as patients. A survey was administered in Lower Normandy from 4 April 2012 to 1 September 2012. Physicians, residents, nurses, and nurses' aides practicing in one of the nine intensive care units of Lower Normandy were asked to complete an electronic or paper format questionnaire. This questionnaire assessed their level of pediatric training, the workload management of pediatric patients entailed, and the challenges posed by these patients. One hundred and nine questionnaires were returned (by 26 attending physicians, 18 residents, 38 nurses, and 27 nurses' aides). Eighty-three of the respondents (76%) had no experience in a pediatric unit of any kind. Forty-two percent thought that the pediatric age range lies between 3months and 15years of age. However, more than 50% of respondents would like the upper limit to be 16years or even older. Ninety-three respondents (85%) estimated having some exposure to pediatric patients in their routine practice, but this activity remained quite low. Seventy-three (67%) reported difficulties with the management of these young patients. This survey provides current information regarding the level of training of adult intensive care unit professionals and their concerns about managing patients under 18years of age, both in terms of workload and specific challenges. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Long-term immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine in 10- to 14-year-old girls: open 6-year follow-up of an initial observer-blinded, randomized trial.

PubMed

Schwarz, Tino F; Huang, Li-Min; Lin, Tzou-Yien; Wittermann, Christoph; Panzer, Falko; Valencia, Alejandra; Suryakiran, Pemmaraju V; Lin, Lan; Descamps, Dominique

2014-12-01

Immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine were evaluated up to 6 years postvaccination (month 72) in preteen/adolescent girls. Participants, who had received 3 HPV-16/18 AS04-adjuvanted vaccine doses at 10-14 years of age in an initial controlled, observer-blinded, randomized study (NCT00196924) and participated in the open 3-year follow-up (NCT00316706), were invited to continue the follow-up for up to 10 years postvaccination (NCT00877877). Anti-HPV-16 and -18 antibody titers were measured by enzyme-linked immunosorbent assays at yearly visits and were used to fit the modified power-law and piecewise models, predicting long-term immunogenicity. Serious adverse events (SAEs) and pregnancy information were recorded. In the according-to-protocol immunogenicity cohort, all participants (N = 505) with data available remained seropositive for anti-HPV-16 and -18 antibodies at month 72. In initially seronegative participants, anti-HPV-16 and -18 antibody geometric mean titers were 65.8- and 33.0-fold higher than those associated with natural infection (NCT00122681) and 5.0- and 2.5-fold higher than those measured at month 69-74 in a study demonstrating vaccine efficacy in women aged 15-25 years (NCT00120848). Exploratory antibody modeling, based on the 6-year data, predicted that vaccine-induced population anti-HPV-16 and -18 antibody geometric mean titers would remain above those associated with natural infection for at least 20 years postvaccination. The HPV-16/18 AS04-adjuvanted vaccine safety profile was clinically acceptable. In preteen/adolescent girls, the HPV-16/18 AS04-adjuvanted vaccine induced high anti-HPV-16 and -18 antibody levels up to 6 years postvaccination, which were predicted to remain above those induced by natural infection for at least 20 years.

Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow

PubMed Central

Tkacheva, Olga N; Runikhina, Nadezda K; Ostapenko, Valentina S; Sharashkina, Natalia V; Mkhitaryan, Elen A; Onuchina, Julia S; Lysenkov, Sergei N; Yakhno, Nikolai N

2018-01-01

Background Geriatric syndromes (GSs) are common in older adults and have a significant effect on their quality of life, disability, and use of health care resources. Few studies have assessed the prevalence of GSs in Russia. The aim of this study is to assess the prevalence of GSs among older adults living in the community in Moscow. Methods A cross-sectional study was conducted in four community clinics in Moscow. A total of 1,220 patients completed a screening questionnaire, and 356 of them also underwent a comprehensive geriatric assessment (CGA). Results The mean age of the 1,220 participants was 74.9±6.1 years; 75.5% were women. Based on the questionnaire, 58.3% reported visual or hearing impairment, 58.2% cognitive impairment, 46% mood disorder, 42% difficulty walking, 28.3% urinary incontinence, 21.3% traumatic falls (over the previous year), and 12.2% weight loss. The mean number of GSs per patient was 2.9±1.5. Based on CGA, a decline in Instrumental Activity of Daily Living score was identified in 34.8% of the patients, a risk of malnutrition (Mini-Nutritional Assessment score, 17–23.5) in 25.8%, probable cognitive impairment (Mini-Mental State Examination score <25) in 8.6%, and symptoms of depression (15-item Geriatric Depression Scale score >5) in 36.2%. On the whole, patients demonstrated good mobility (average walking speed, 1±0.2 m/s) and hand grip strength (23.9±6.4 kg in women and 39.1±8.3 kg in men), but poor balance (only 39.4% were able to maintain their balance on one leg for 10 s or more). Conclusion The results of this study demonstrate a high prevalence of GSs among community-dwelling people aged 65 years and older in Moscow. The results provide a better understanding of the needs of older adults in Russia and can facilitate planning for medical and social assistance for this population. PMID:29467572

Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow.

PubMed

Tkacheva, Olga N; Runikhina, Nadezda K; Ostapenko, Valentina S; Sharashkina, Natalia V; Mkhitaryan, Elen A; Onuchina, Julia S; Lysenkov, Sergei N; Yakhno, Nikolai N; Press, Yan

2018-01-01

Geriatric syndromes (GSs) are common in older adults and have a significant effect on their quality of life, disability, and use of health care resources. Few studies have assessed the prevalence of GSs in Russia. The aim of this study is to assess the prevalence of GSs among older adults living in the community in Moscow. A cross-sectional study was conducted in four community clinics in Moscow. A total of 1,220 patients completed a screening questionnaire, and 356 of them also underwent a comprehensive geriatric assessment (CGA). The mean age of the 1,220 participants was 74.9±6.1 years; 75.5% were women. Based on the questionnaire, 58.3% reported visual or hearing impairment, 58.2% cognitive impairment, 46% mood disorder, 42% difficulty walking, 28.3% urinary incontinence, 21.3% traumatic falls (over the previous year), and 12.2% weight loss. The mean number of GSs per patient was 2.9±1.5. Based on CGA, a decline in Instrumental Activity of Daily Living score was identified in 34.8% of the patients, a risk of malnutrition (Mini-Nutritional Assessment score, 17-23.5) in 25.8%, probable cognitive impairment (Mini-Mental State Examination score <25) in 8.6%, and symptoms of depression (15-item Geriatric Depression Scale score >5) in 36.2%. On the whole, patients demonstrated good mobility (average walking speed, 1±0.2 m/s) and hand grip strength (23.9±6.4 kg in women and 39.1±8.3 kg in men), but poor balance (only 39.4% were able to maintain their balance on one leg for 10 s or more). The results of this study demonstrate a high prevalence of GSs among community-dwelling people aged 65 years and older in Moscow. The results provide a better understanding of the needs of older adults in Russia and can facilitate planning for medical and social assistance for this population.

Endurance Exercise and Health-Related Quality of Life in 50-65 Year-Old Adults.

ERIC Educational Resources Information Center

Stewart, Anita L.; And Others

1993-01-01

Evaluated health-related quality of life in relation to endurance exercise over prior year for 194 previously sedentary, healthy men and women aged 50 to 65. In three exercise regimens studied, subjects who participated more had better physical health; no differences were observed in general psychological well-being. Extent of participation was…

National observatory on the therapeutic management in ambulatory care patients aged 65 and over, with type 2 diabetes, chronic pain or atrial fibrillation.

PubMed

Becquemont, Laurent; Benattar-Zibi, Linda; Bertin, Philippe; Berrut, Gilles; Corruble, Emmanuelle; Danchin, Nicolas; Delespierre, Tiba; Derumeaux, Geneviève; Falissard, Bruno; Forette, Francoise; Hanon, Olivier; Pasquier, Florence; Pinget, Michel; Ourabah, Rissane; Piedvache, Céline

2013-01-01

The primary objective of the S.AGES cohort is to describe the real-life therapeutic care of elderly patients. Patients and methods. This is a prospective observational cohort study of 3 700 non-institutionalized patients over the age of 65 years with either type 2 diabetes mellitus (T2DM), chronic pain or atrial fibrillation (AF) recruited by French general practitioners (GPs). Follow-up is planned for 3 years. Baseline characteristics. In the chronic pain sub-cohort, 33% of patients are treated with only grade 1 analgesics, 29% with grade 2 analgesics and 3% with grade 3 analgesics, and 22% have no pain treatment. In the T2DM sub-cohort, 61% of patients have well-controlled diabetes (Hb1c<7%) and 18% are treated with insulin. In the AF sub-cohort, 65% of patients have a CHADS2 score greater than 2, 77% are treated with oral anticoagulants, 17% with platelet inhibitors, 40% with antiarrhythmic drugs and 56% with rate slowing medications. Conclusion. The S.AGES cohort presents a unique opportunity to clarify the real-life therapeutic management of ambulatory elderly subjects and will help to identify the factors associated with the occurrence of major clinical events. © 2013 Société Française de Pharmacologie et de Thérapeutique.

Curiosity killed the cat: no evidence of an association between cat ownership and psychotic symptoms at ages 13 and 18 years in a UK general population cohort.

PubMed

Solmi, F; Hayes, J F; Lewis, G; Kirkbride, J B

2017-07-01

Congenital or early life infection with Toxoplasma gondii has been implicated in schizophrenia aetiology. Childhood cat ownership has been hypothesized as an intermediary marker of T. gondii infection and, by proxy, as a risk factor for later psychosis. Evidence supporting this hypothesis is, however, limited. We used birth cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate whether cat ownership in pregnancy and childhood (ages 4 and 10 years) was associated with psychotic experiences (PEs) in early (age 13, N = 6705) and late (age 18, N = 4676) adolescence, rated from semi-structured interviews. We used logistic regression to examine associations between cat ownership and PEs, adjusting for several sociodemographic and socioeconomic factors, household characteristics and dog ownership. Missing data were handled via multiple imputation. Cat ownership during pregnancy was not associated with PEs at age 13 years [adjusted odds ratio (OR) 1.15, 95% confidence interval (CI) 0.97-1.35] or 18 years (OR 1.08, 95% CI 0.86-1.35). Initial univariable evidence that cat ownership at ages 4 and 10 years was associated with PEs at age 13 years did not persist after multivariable adjustment (4 years: OR 1.18, 95% CI 0.94-1.48; 10 years: OR 1.12, 95% CI 0.92-1.36). There was no evidence that childhood cat ownership was associated with PEs at age 18 years. While pregnant women should continue to avoid handling soiled cat litter, given possible T. gondii exposure, our study strongly indicates that cat ownership in pregnancy or early childhood does not confer an increased risk of later adolescent PEs.

Income of People Aged 65 and Older: Overview From 1968 Survey of the Aged.

ERIC Educational Resources Information Center

Bixby, Lenore E.

1970-01-01

In a 1968 survey of the income of the aged, 8,248 persons were interviewed out of a population of 19.3 million persons aged 65 or over, excluding approximately 95,000 federal annuitants, 30,000 aliens, and a small number of persons not enrolled. The Current Medicare Survey was utilized to obtain certain selected characteristics of aged persons.…

Use of smokeless tobacco by Indian women aged 18-40 years during pregnancy and reproductive years.

PubMed

Nair, Saritha; Schensul, Jean J; Begum, Shahina; Pednekar, Mangesh S; Oncken, Cheryl; Bilgi, Sameena M; Pasi, Achhelal R; Donta, Balaiah

2015-01-01

This paper discusses patterns of daily smokeless tobacco (SLT) use and correlates of poly SLT use among married women aged 18-40 years in a Mumbai slum community with implications for tobacco control. Using a mixed methods approach, the study included a structured survey with 409 daily SLT users and in-depth interviews with 42 women. Participants for the survey were selected using a systematic sampling procedure (one woman in every fourth eligible household). Univariate and bivariate analysis, and multiple logistic regressions were conducted to identify demographic and social factors associated with women's use of poly SLT products. To illustrate survey results, in-depth interviews were analyzed using Atlas ti software. Sixty-four percent of the women surveyed used only one type of SLT; of these, 30% used mishri, 32% used pan with tobacco and the rest used chewed tobacco (11%), gul (17%) or gutkha (10%). Thirty-six percent used more than one type of SLT. Poly SLT users chewed or rubbed 50% more tobacco as compared to single users (mean consumption of tobacco per day: 9.54 vs. 6.49 grams; p<0.001). Women were more likely to be poly SLT users if they were illiterate as compared to literate (adjusted odds ratio [AOR]=1.67; 95% confidence interval [CI]=1.07-2.71), if they had lived in Mumbai for 10 years or more, versus less than ten years (AOR=1.67, 95% CI=1.03-2.71); and if their husband was a poly SLT user as compared to a non SLT user (AOR=2.78, 95% CI=1.63-4.76). No differences were noted between pregnant and non-pregnant women in SLT consumption patterns. Tobacco control policies and programs must focus specifically on both social context and use patterns to address SLT use among women of reproductive age with special attention to poly SLT users, an understudied and vulnerable population.

Suicidal ideation, suicide attempt, and occupations among employed adults aged 18–64 years in the United States

PubMed Central

Han, Beth; Crosby, Alex E.; Ortega, LaVonne A.G.; Parks, Sharyn E.; Compton, Wilson M.; Gfroerer, Joseph

2016-01-01

Objective Approximately 70% of all US suicides are among working-age adults. This study was to determine whether and how 12-month suicidal ideation and suicide attempt were associated with specific occupations among currently employed adults aged 18–64 in the U.S. Methods Data were from 184,300 currently employed adults who participated in the 2008–2013 National Surveys on Drug Use and Health (NSDUH). NSDUH provides nationally representative data on suicidal ideation and suicide attempt. Descriptive analyses and multivariable logistic regressions were conducted. Results Among currently employed adults aged 18–64 in the U.S., 3.5% had suicidal ideation in the past 12 months (3.1% had suicidal ideation only, and 0.4% had suicidal ideation and attempted suicide). Compared with adults in farming, fishing, and forestry occupations (model adjusted prevalence (MAP) = 1.6%), adults in the following occupations were 3.0–3.6 times more likely to have suicidal ideation in the past year (model adjusted relative risks (MARRs) = 3.0–3.6): lawyers, judges, and legal support workers (MAP = 4.8%), social scientists and related workers (MAP = 5.4%), and media and communication workers (MAP = 5.8%). Conclusions Among employed adults aged 18–64 in the U.S., the 12-month prevalence of suicidal ideation varies by occupations. Adults in occupations that are at elevated risk for suicidal ideation may warrant focused suicide prevention. PMID:26995251

Projections of the number of Australians with disability aged 65 and over eligible for the National Disability Insurance Scheme: 2017-2026.

PubMed

Biddle, Nicholas; Crawford, Heather

2017-12-01

To develop projections of the size of the Australian population aged 65 years and over eligible for disability support through the National Disability Insurance Scheme (NDIS) for the decade following its introduction, to support planning and costing of the scheme. We estimate disability and mortality transition probabilities and develop projections of the NDIS-eligible, ageing population from 2017 to 2026. An estimated 8000 men and 10 200 women aged 65 years and over will be eligible for support through the NDIS in 2017 (the scheme's first full year), increasing to 48 800 men and 56 900 women in 2026. Growth in the NDIS-eligible, ageing population has implications for relative budget allocations between the NDIS and the aged-care system, and projections of the size of this population are useful for calculating the overall cost of the NDIS. © 2017 AJA Inc.

Association between the prevalence of depression and age in a large representative German sample of people aged 53 to 80 years.

PubMed

Wild, Beate; Herzog, Wolfgang; Schellberg, Dieter; Lechner, Sabine; Niehoff, Doro; Brenner, Hermann; Rothenbacher, Dietrich; Stegmaier, Christa; Raum, Elke

2012-04-01

The aim of the study was to determine the association between the prevalence of clinically significant depression and age in a large representative sample of elderly German people. In the second follow-up (2005-2007) of the ESTHER cohort study, the 15-item geriatric depression scale (GDS-15) as well as a sociodemographic and clinical questionnaire were administered to a representative sample of 8270 people of ages 53 to 80 years. The prevalence of clinically significant depression was estimated using a GDS cut-off score of 5/6. Prevalence rates were estimated for the different age categories. Association between depression and age was analyzed using logistic regression, adjusted for gender, co-morbid medical disorders, education, marital status, physical activity, smoking, self-perceived cognitive impairment, and anti-depressive medication. Of the participants, 7878 (95.3%) completed more than twelve GDS items and were included in the study. The prevalence of clinically significant depression was 16.0% (95%CI = [15.2; 16.6]). The function of depression prevalence dependent on age group showed a U-shaped pattern (53-59: 21.0%, CI = [18.9; 23.3]; 60-64: 17.7%, CI = [15.7; 19.7]; 65-69: 12.6%, CI = [11.2; 14.0]; 70-74: 14.4%, CI = [12.6; 16.0]; 75-80: 17.1%, CI = [14.9; 19.4]). Adjusted odds ratios showed that the chances of being depressive decrease with the age category but remain relatively stable for people aged 65 and over. The prevalence of depression in the elderly seems to be associated with the age category. Adjusted odds ratios showed that people aged 60 and older had lower chances of being depressive than people aged 53 to 59 years. Copyright © 2011 John Wiley & Sons, Ltd.

Description of OPRA: A Danish database designed for the analyses of risk factors associated with 30-day hospital readmission of people aged 65+ years.

PubMed

Pedersen, Mona K; Nielsen, Gunnar L; Uhrenfeldt, Lisbeth; Rasmussen, Ole S; Lundbye-Christensen, Søren

2017-08-01

To describe the construction of the Older Person at Risk Assessment (OPRA) database, the ability to link this database with existing data sources obtained from Danish nationwide population-based registries and to discuss its research potential for the analyses of risk factors associated with 30-day hospital readmission. We reviewed Danish nationwide registries to obtain information on demographic and social determinants as well as information on health and health care use in a population of hospitalised older people. The sample included all people aged 65+ years discharged from Danish public hospitals in the period from 1 January 2007 to 30 September 2010. We used personal identifiers to link and integrate the data from all events of interest with the outcome measures in the OPRA database. The database contained records of the patients, admissions and variables of interest. The cohort included 1,267,752 admissions for 479,854 unique people. The rate of 30-day all-cause acute readmission was 18.9% ( n=239,077) and the overall 30-day mortality was 5.0% ( n=63,116). The OPRA database provides the possibility of linking data on health and life events in a population of people moving into retirement and ageing. Construction of the database makes it possible to outline individual life and health trajectories over time, transcending organisational boundaries within health care systems. The OPRA database is multi-component and multi-disciplinary in orientation and has been prepared to be used in a wide range of subgroup analyses, including different outcome measures and statistical methods.

Measuring Years of Inactivity, Years in Retirement, Time to Retirement, and Age at Retirement Within the Markov Model

PubMed Central

SKOOG, GARY R.; CIECKA, JAMES E.

2010-01-01

Retirement-related concepts are treated as random variables within Markov process models that capture multiple labor force entries and exits. The expected number of years spent outside of the labor force, expected years in retirement, and expected age at retirement are computed—all of which are of immense policy interest but have been heretofore reported with less precisely measured proxies. Expected age at retirement varies directly with a person’s age; but even younger people can expect to retire at ages substantially older than those commonly associated with retirement, such as age 60, 62, or 65. Between 1970 and 2003, men allocated most of their increase in life expectancy to increased time in retirement, but women allocated most of their increased life expectancy to labor force activity. Although people can exit and reenter the labor force at older ages, most 65-year-old men who are active in the labor force will not reenter after they eventually exit. At age 65, the probability that those who are inactive will reenter the labor force at some future time is .38 for men and .27 for women. Life expectancy at exact ages is decomposed into the sum of the expected time spent active and inactive in the labor force, and also as the sum of the expected time to labor force separation and time in retirement. PMID:20879680

Effectiveness of inactivated influenza vaccines in preventing influenza-associated deaths and hospitalizations among Ontario residents aged ≥ 65 years: estimates with generalized linear models accounting for healthy vaccinee effects.

PubMed

Ridenhour, Benjamin J; Campitelli, Michael A; Kwong, Jeffrey C; Rosella, Laura C; Armstrong, Ben G; Mangtani, Punam; Calzavara, Andrew J; Shay, David K

2013-01-01

Estimates of the effectiveness of influenza vaccines in older adults may be biased because of difficulties identifying and adjusting for confounders of the vaccine-outcome association. We estimated vaccine effectiveness for prevention of serious influenza complications among older persons by using methods to account for underlying differences in risk for these complications. We conducted a retrospective cohort study among Ontario residents aged ≥ 65 years from September 1993 through September 2008. We linked weekly vaccination, hospitalization, and death records for 1.4 million community-dwelling persons aged ≥ 65 years. Vaccine effectiveness was estimated by comparing ratios of outcome rates during weeks of high versus low influenza activity (defined by viral surveillance data) among vaccinated and unvaccinated subjects by using log-linear regression models that accounted for temperature and time trends with natural spline functions. Effectiveness was estimated for three influenza-associated outcomes: all-cause deaths, deaths occurring within 30 days of pneumonia/influenza hospitalizations, and pneumonia/influenza hospitalizations. During weeks when 5% of respiratory specimens tested positive for influenza A, vaccine effectiveness among persons aged ≥ 65 years was 22% (95% confidence interval [CI], -6%-42%) for all influenza-associated deaths, 25% (95% CI, 13%-37%) for deaths occurring within 30 days after an influenza-associated pneumonia/influenza hospitalization, and 19% (95% CI, 4%-31%) for influenza-associated pneumonia/influenza hospitalizations. Because small proportions of deaths, deaths after pneumonia/influenza hospitalizations, and pneumonia/influenza hospitalizations were associated with influenza virus circulation, we estimated that vaccination prevented 1.6%, 4.8%, and 4.1% of these outcomes, respectively. By using confounding-reducing techniques with 15 years of provincial-level data including vaccination and health outcomes, we estimated that

Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18-63 years.

PubMed

Ekamper, P; van Poppel, F; Stein, A D; Lumey, L H

2014-10-01

To quantify the relation between prenatal famine exposure and adult mortality, taking into account mediating effects of intermediary life conditions. Historical follow-up study. The Dutch famine (Hunger Winter) of 1944-1945 which occurred towards the end of WWII in occupied Netherlands. From 408,015 Dutch male births born 1944-1947, examined for military service at age 18, we selected for follow-up all men born at the time of the famine in six affected cities in the Western Netherlands (n=25,283), and a sample of unexposed time (n=10,667) and place (n=9087) controls. These men were traced and followed for mortality through the national population and death record systems. All-cause mortality between ages 18 and 63 years using Cox proportional hazards models adjusted for intermediary life conditions. An increase in mortality was seen after famine exposure in early gestation (HR 1.12; 95% confidence interval (CI): 1.01-1.24) but not late gestation (HR 1.04; 95% CI: 0.96-1.13). Among intermediary life conditions at age 18 years, educational level was inversely associated with mortality and mortality was elevated in men with fathers with manual versus non-manual occupations (HR 1.08; CI: 1.02-1.16) and in men who were declared unfit for military service (HR 1.44; CI: 1.31-1.58). Associations of intermediate factors with mortality were independent of famine exposure in early life and associations between prenatal famine exposure and adult mortality were independent of social class and education at age 18. Timing of exposure in relation to the stage of pregnancy may be of critical importance for later health outcomes independent of intermediary life conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

42 CFR 440.181 - Home and community-based services for individuals age 65 or older.

Code of Federal Regulations, 2010 CFR

2010-10-01

... age 65 or older. 440.181 Section 440.181 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Definitions § 440.181 Home and community-based services for individuals age 65 or older. (a) Description of services— Home and community-based services for individuals age 65 or older means services, not otherwise...

Community "San Gregorio." A Christian Educative Response to the Problem of Drug Abuse in Youth Aged 12-18 Years.

ERIC Educational Resources Information Center

Lamus, Jose Antonio Lopez; Sarmiento, Albeiro Saldana

This pamphlet describes the "San Gregorio" pilot program in Latin America, the first of its type on the continent as a program specifically for adolescent drug addicts. The Christian educative program is designed for males 12-18 years of age, who are addicted to psycho-active substances and evidence serious behavioral problems. It is…

[Experiences and results in hypertension screening in women between 20 and 65 years of age in Karl-Marx-City].

PubMed

Voigt, G; Börker, G; Edelmann, S; Hartung, A; Hartung, G; Heyne, S; Töpfer, V

1980-11-15

From 1975 to 1979 in the district of the City of Karl-Marx-Stadt 91,130 females at the age between 20 and 65 years were summoned to a gynaecologico-cardiological mass examination which was supported by computer. 56,460 females underwent the examination. According to the WHO-criteria two measurements of blood pressure were carried out, when increased blood pressure was present a third one and a fourth one by an examination group. A diagnostic standard programme was used. In the second measurement of blood pressure we established 19.8% of patients with hypertension and 28.6% patients with borderline values. 52.8% of the hypertensions were known. Of 10,685 females with known or established hypertension 10.1% underwent an optimum therapy. On the basis of these results a programme for the fight against hypertension was developed for the county Karl-Marx-Stadt.

Assessing prescription stimulant use, misuse and diversion among youth 10 to 18 years of age

PubMed Central

Cottler, Linda B.; Striley, Catherine Woodstock; Lasopa, Sonam O.

2018-01-01

Purpose Assessing medical and non-medical use of stimulants and diversion is a challenge, especially among youth, with different methods for recruitment, and definitions of non-medical use and use. The field needs inexpensive, yet effective and reliable, methods of data collection to understand the prescription drug use problem. Most studies of youth are school or web-based, and conducted with teens. Recent Findings The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) recruited 11,048 youth 10 to 18 years of age from urban, rural and suburban areas in ten US cities using an entertainment venue intercept study. This review discusses the effectiveness of the method and results from four cross sections as well as the representativeness of the sample. Lifetime prevalence of any stimulant use was 14.8%, with rates highest among rural 16 to 18 year olds. The rate of past 30 day use was 7.3%, with over half (3.9%) non-medical use. Nearly 12% of all youth (whether a user or not) reported lifetime incoming/outgoing diversion of prescription stimulants. Summary Because no study has focused on stimulant use among youth as young as 10 and 11, this study is a landmark for future comparisons and offers a unique strategy for sampling and data collection. PMID:23896947

Components of metabolic syndrome in relation to plasma levels of retinol binding protein 4 (RBP4) in a cohort of people aged 65 years and older.

PubMed

Majerczyk, M; Kocełak, P; Choręza, P; Arabzada, H; Owczarek, A J; Bożentowicz-Wikarek, M; Brzozowska, A; Szybalska, A; Puzianowska-Kuźnicka, M; Grodzicki, T; Więcek, A; Olszanecka-Glinianowicz, M; Chudek, J

2018-03-09

Elevated plasma concentration of retinol binding protein 4 (RBP4) has recently emerged as a potential risk factor as a component of developing metabolic syndrome (MS). Therefore, this study aimed to analyse the relationship between components of MS and concentrations of plasma RBP4 in a population of subjects 65 years and older. The study sample consisted of 3038 (1591 male) participants of the PolSenior study, aged 65 years and older. Serum lipid profile, concentrations of RBP4, glucose, insulin, C-reactive protein, IL-6, and activity of aminotransferases were measured. Nutritional status (BMI/waist circumference) and treatment with statins and fibrates were evaluated. Glomerular filtration rate (eGFR), de Ritis ratio, and fatty liver index (FLI), as well as HOMA-IR were calculated. Our study revealed a strong relationship between components of MS and RBP4 in both sexes: plasma RBP4 levels were increased in men by at least 3×, and in women by at least 4×. Hypertriglyceridemia was most strongly associated with elevated plasma RBP4 levels. Multivariate, sex-adjusted regression analysis demonstrated that chronic kidney disease [OR 1.86 (95% CI 1.78-1.94)], hypertriglyceridemia [OR 1.52 (1.24-1.87)], hypertension [OR 1.15 (1.12-1.19)], low serum HDL cholesterol [OR 0.94 (0.92-0.97)], and age > 80 years [OR 0.86 (0.81-0.90)] were each independently associated with RBP4 concentration (all p < 0.001). In Caucasians 65 years and older, RBP4 serum levels are associated with a number of components of MS, independent of sex and kidney function. Hypertriglyceridemia as a component of MS is most significantly related to RBP4 concentration.

Pigmentation in African American skin decreases with skin aging.

PubMed

Chien, Anna L; Suh, Jean; Cesar, Sabrina Sisto Alessi; Fischer, Alexander H; Cheng, Nancy; Poon, Flora; Rainer, Barbara; Leung, Sherry; Martin, Jo; Okoye, Ginette A; Kang, Sewon

2016-10-01

Tristimulus colorimetry, which uses the Commission Internationale de l'Eclairage L*a*b* model to quantify color, has previously been used to analyze pigmentation and erythema in human skin; however, colorimetry of African American skin is not well characterized. We sought to analyze skin color patterns in African Americans and compare them with those of Caucasians. Colorimetry readings of the sun-protected buttock and sun-exposed back of forearm were taken from 40 Caucasian and 43 African American participants from March 2011 through August 2015. African American participants also completed a lifestyle questionnaire. Correlation coefficients, paired t tests, and multivariable linear regression analyses were used for statistical comparisons. Forearm skin was lighter in African Americans ages 65 years and older versus 18 to 30 years (P = .02) but darker in Caucasians ages 65 years or older versus 18 to 30 years (P = .03). In African Americans ages 18 to 30 years, the buttock was darker than the forearm (P < .001), whereas in Caucasians the buttock was lighter than the forearm (P < .001). A lighter forearm than buttock was correlated with supplement use, smoking (ages 18-30 years), and less recreational sun exposure (ages ≥65 years) in African Americans. Our study was limited by the sample size and focal geographic source. Pigmentation patterns regarding sun-protected and sun-exposed areas in African Americans may differ from that of Caucasians, suggesting that other factors may contribute to skin pigmentation in African Americans. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

[Trends of vegetables and fruits consumption among Chinese adults aged 18 to 44 years old from 1991 to 2011].

PubMed

Xiao, Yingting; Su, Chang; Ouyang, Yifei; Zhang, Bing

2015-03-01

To identify the trends of vegetables and fruits consumption among Chinese adults aged 18 to 44 years old from 1991 to 2011. Twenty four hour dietary recall data from China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011) were used to identify the trends of vegetables and fruits consumption among Chinese between 18 and 44 years old. From 1991 to 2011, the proportion of daily consumption of vegetables rarely varied, while the vegetables intake declined significantly; and the proportion of daily consumption and intake of fruits kept increasing as follows. By 2011, the proportion of daily consumption and intake of vegetables and fruits among the respondents were 99.7%, 48.0%, 321.6 g/d, and 90.1 g/d respectively. A significant drop was found in the vegetables intake among the respondents against the vegetables intake as recommended by the Chinese dietary guidelines, up to 50.2% in 2011; a significant rise was found in the fruits intake of the respondents against the fruits intake as recommended by the said guidelines, up to 17.4% in 2011. The average daily intake of vegetables and fruits of young and middle-aged residents (18-44 age group) in nine provinces in China was found lower than that recommended in the Chinese dietary guidelines; in view of the high proportion of people having less vegetables and fruits intake that those recommended by the Chinese dietary guidelines, further measures are expected to encourage their vegetables and fruits intake.

Effectiveness and Duration of Protection Provided by the Live-attenuated Herpes Zoster Vaccine in the Medicare Population Ages 65 Years and Older.

PubMed

Izurieta, Hector S; Wernecke, Michael; Kelman, Jeffrey; Wong, Sarah; Forshee, Richard; Pratt, Douglas; Lu, Yun; Sun, Qin; Jankosky, Christopher; Krause, Philip; Worrall, Chris; MaCurdy, Tom; Harpaz, Rafael

2017-03-15

Tens of millions of seniors are at risk of herpes zoster (HZ) and its complications. Live attenuated herpes zoster vaccine (HZV) reduces that risk, although questions regarding effectiveness and durability of protection in routine clinical practice remain. We used Medicare data to investigate HZV effectiveness (VE) and its durability. This retrospective cohort study included beneficiaries ages ≥65 years during January 2007 through July 2014. Multiple adjustments to account for potential bias were made. HZV-vaccinated beneficiaries were matched to unvaccinated beneficiaries (primary analysis) and to HZV-unvaccinated beneficiaries who had received pneumococcal vaccination (secondary analysis). HZ outcomes in community and hospital settings were analyzed, including ophthalmic zoster (OZ) and postherpetic neuralgia (PHN). Among eligible beneficiaries (average age 77 years), the primary analysis found VE for community HZ of 33% (95% CI: 32%-35%) and 19% (95% CI: 17%-22%), for the first 3, and subsequent 4+ years postvaccination, respectively. In the secondary analysis, VE was, respectively, 37% (95% CI: 36%-39%) and 22% (95% CI: 20%-25%). In the primary analysis, VE for PHN was 57% (95% CI: 52%-61%) and 45% (95% CI: 36%-53%) in the first 3 and subsequent 4+ years, respectively; VE for hospitalized HZ was, respectively, 74% (95% CI: 67%-79%) and 55% (95% CI: 39%-67%). Differences in VE by age group were not significant. In both the primary and secondary analyses, HZV provided protection against HZ across all ages, but effectiveness declined over time. VE was higher and better preserved over time for PHN and HZ-associated hospitalizations than for community HZ. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

HIV Diagnoses Among Persons Aged 13-29 Years - United States, 2010-2014.

PubMed

Ocfemia, M Cheryl Bañez; Dunville, Richard; Zhang, Tianchi; Barrios, Lisa C; Oster, Alexandra M

2018-02-23

In 2014, persons aged 13-29 years represented 23% of the U.S. population, yet accounted for 40% of diagnoses of human immunodeficiency virus (HIV) infection during the same year (1). During 2010-2014, the rates of diagnosis of HIV infection decreased among persons aged 15-19 years, were stable among persons aged 20-24 years, and increased among persons aged 25-29 years (1). However, these 5-year age groups encompass multiple developmental stages and potentially mask trends associated with the rapid psychosocial changes during adolescence through young adulthood. To better understand HIV infection among adolescents aged 13-17 years and young adults aged 18-29 years in the United States and identify ideal ages to target primary HIV prevention efforts, CDC analyzed data from the National HIV Surveillance System (NHSS)* using narrow age groups. During 2010-2014, rates of diagnosis of HIV infection per 100,000 population varied substantially among persons aged 13-15 years (0.7), 16-17 years (4.5), 18-19 years (16.5), and 20-21 years (28.6), and were higher, but less variable, among persons aged 22-23 years (34.0), 24-25 years (33.8), 26-27 years (31.3), and 28-29 years (28.7). In light of the remarkable increase in rates between ages 16-17, 18-19, and 20-21 years, and a recent study revealing that infection precedes diagnosis for young persons by an average of 2.7 years (2), these findings demonstrate the importance of targeting primary prevention efforts to persons aged <18 years and continuing through the period of elevated risk in their mid-twenties.

Gender and age-specific seroprevalence of human papillomavirus 16 and 18 in general population in Tehran, Iran.

PubMed

Aghakhani, Arezoo; Mamishi, Setareh; Sabeti, Shahram; Bidari-Zerehpoosh, Farahnaz; Banifazl, Mohammad; Bavand, Anahita; Ramezani, Amitis

2017-04-01

The assessment of the gender and age-specific seroprevalence of human papillomavirus (HPV) is essential for planning of HPV vaccine implementation into the preventive programs. In this study, we aimed to determine the age-specific seroprevalence of HPV-16 and 18 in both males and females in Tehran, Iran. Three hundred and seventy-eight women (10-35 years) and 162 men (10-25 years) from Tehran, Iran, were enrolled. Anti-HPV IgG antibodies against HPV-16 and HPV-18 were detected by ELISA using papillomavirus type 16 and 18 L1-capsids as antigen. HPV-16 antibody was detected in 15.6 and 13.6% of women and men, respectively. Antibody against HPV-18 was found positive in 12.7 and 8% of women and men, respectively. The highest seroprevalence of HPV-16 and 18 were seen in women aged 26-30 years (22.2 and 19.4%, respectively), and the lowest HPV-16 and 18 seropositivity rates were seen in males and females aged 10-15 years (9.3 and 1.9%, respectively). In our cohort of study, in males, both anti-HPV-16 and 18 increased after age 15 years, peaking in men aged 21-25 years. In women, both HPV-16 and 18 seropositivity increased after 15 years, declined at 21-25 years, peaked in women aged 26-30 years and again decreased after 30 years. Our data showed increasing exposure rate to high-risk HPV vaccine types in our studied population over 15 years of age. In order to prevent the HPV-related cancers, implementation of HPV vaccine into the national immunization program in Iran and vaccination of females and males less than 15 years of age are suggested.

Prevalence of osteoporosis in men aged 65-75 in a primary care setting. A practice audit after application of the Canadian 2010 guidelines for osteoporosis screening.

PubMed

Ferrari, Robert

2015-03-01

Current Canadian osteoporosis guidelines recommend routine bone density screening of men at age 65. The purpose of this study is to determine the prevalence of osteoporosis in men aged 65-75 in after application of screening guidelines. All males aged 65-75 years who attended a large primary care clinic were advised of the 2010 Canadian osteoporosis guidelines and advised to obtain a bone density scan at or after their 65th birthday. Those who did not have a bone density scan since their 65th birthday were advised to obtain a scan, unless there was obvious reason not to do so (i.e. known osteoporosis). A record of the results for each patient were kept and tallied to determine the prevalence of osteoporosis. Osteoporosis was defined as a T-score of ≤ -2.5 in either the hip or lumbar spine. Of 574 male subjects in this clinic, between the ages of 65-75, 557 had a bone density scan, either already having done so at the time of being informed of the guidelines or obtaining a scan in the subsequent year after being informed of the guidelines. The prevalence of osteoporosis was 1.6% (9/557, 95% confidence interval 0.8-3.1%) in this sample. The average age of subjects with osteoporosis was 70.5 ± 1.4 years (range 68-75). None of the subjects under 68 years of age were found to have osteoporosis. The prevalence of osteoporosis in unselected male cohorts aged 65 may be too low to justify the routine bone density screening recommended in the 2010 Canadian osteoporosis guidelines.

Quality of Life in Rural and Urban Adults 65 Years and Older: Findings from the National Health and Nutrition Examination Survey

ERIC Educational Resources Information Center

Baernholdt, Marianne; Yan, Guofen; Hinton, Ivora; Rose, Karen; Mattos, Meghan

2012-01-01

Purpose: The proportion of people over 65 years of age is higher in rural areas than in urban areas, and their numbers are expected to increase in the next decade. This study used Andersen's behavioral model to examine quality of life (QOL) in a nationally representative sample of community-dwelling adults 65 years and older according to…

Association between socioeconomic and health factors and edentulism in people aged 65 and older - a population-based survey.

PubMed

Olofsson, Hanna; Ulander, Eva Lena; Gustafson, Yngve; Hörnsten, Carl

2017-08-01

To study edentulism and use of dental services in a population-based sample of people aged 65 years and older from northern Sweden and western Finland. In 2010, people aged 65, 70, 75 and 80 years who were living in one of 32 municipalities in northern Sweden and western Finland were invited to answer a questionnaire as part of the Gerontological Regional Database (GERDA) study ( n = 6099). The questionnaire contained items related to socioeconomic status, general health and edentulism. The prevalence of edentulism was 34.9% in Finland, compared with 20.6% in Sweden ( p < 0.001), 31.9% in rural areas, compared with 20.9% in urban areas ( p < 0.001), and 25% overall. The prevalence of edentulism rose from 17.8% in 65-year-olds, 23.8% in 70-year-olds, 33.5% in 75-year-olds and 37.3% in 80-year-olds ( p < 0.001), and was 23.8% in women, compared with 27% in men ( p < 0.001). In multivariate models, edentulism was associated with lower educational level (odds ratio (OR) 2.87, 95% confidence interval (CI) 2.31-3.58), low income level (OR 1.7, CI 1.09-1.47), residence in a rural area (OR 1.43, CI 1.23-1.66), male sex (OR 1.30, CI 1.12-1.52), dependence in instrumental activities of daily living (OR 1.48, CI 1.25-1.74), social isolation (OR 1.52, CI 1.17-1.98) and poor self-experienced health (OR 1.38, CI 1.17-1.62). One-quarter of the total sample was edentulous, with a higher prevalence of edentulism in Finland than in Sweden and in rural than in urban areas. Edentulism was associated with socioeconomic, psychological and health-related factors. These findings could be used to inform preventive measures and identify people aged 65 years and older who are in need of oral care.

Risk Factors for Osteoporosis and Fractures in Postmenopausal Women Between 50 and 65 Years of Age in a Primary Care Setting in Spain: A Questionnaire

PubMed Central

Luz Rentero, Maria; Carbonell, Cristina; Casillas, Marta; González Béjar, Milagros; Berenguer, Rafael

2008-01-01

Introduction Osteoporosis (OP) is a major, highly prevalent health problem and osteoporosis-related fractures account for high morbidity and mortality. Therefore, prevention and early detection of osteoporosis should strive to substantially reduce this risk of fracture. Objective The present observational, descriptive, cross-sectional study sought to assess the prevalence of risk factors for osteoporosis and fractures in a large sample of postmenopausal women aged 50 to 65 years attending Primary Care facilities in Spain. Methods We recruited 4,960 women, at 96 Primary Care centers. Demographic and anthropometrical data, as well as information regarding risk factors for OP were collected using a questionnaire. Results The prevalence rates for the major osteoporosis risk factors in our population were: low calcium intake, 43%; benzodiazepine use, 35.1%, and height loss, 30.1%. Other relatively prevalent factors include: having suffered at least one fall during the preceding year; positive family history of falls (particularly on the mother’s side), smoking, kyphosis, presence of any disease affecting bone metabolism, personal history of falls, and inability to rise from a chair without using one’s arms. The least frequent factors were weight loss of greater than 10% over the preceding 10 years and problems in sensory perception that affect patient’s ability to walk. Conclusions The main risk factors for osteoporosis in women 50-65 years of age are low calcium intake, use of benzodiazepines, and observed loss of height. Our results may help physicians to identify groups at risk for OP and fractures at early stages and consequently, optimize prevention and early diagnosis of osteoporosis in postmenopausal women. PMID:19088873

Childhood maltreatment preceding depressive disorder at age 18 years: A prospective Brazilian birth cohort study.

PubMed

Gallo, Erika Alejandra Giraldo; De Mola, Christian Loret; Wehrmeister, Fernando; Gonçalves, Helen; Kieling, Christian; Murray, Joseph

2017-08-01

Childhood maltreatment is linked with increased risk for mental illness in adolescence and adulthood. However, little evidence is available on whether different forms of maltreatment have specific effects, and no prospective studies in low- or middle-income countries have addressed this issue. Participants in a population-based, birth cohort study in Pelotas, Brazil (N=3715) self-reported exposure to maltreatment (emotional abuse, physical neglect, physical abuse, sexual abuse, domestic violence) in confidential questionnaires at age 15 years, and were assessed for major depression in interviews at age 18 years, using the MINI. Confounding variables concerning family characteristics were measured in interviews with mothers in the perinatal period and at age 11 years. Females exposed to emotional abuse (OR=2.7; 95%CI=1.9, 3.8) and domestic violence (OR=1.9; 95%CI=1.2, 2.9) were at increased risk for depression after adjustment for confounders and other types of maltreatment. Females exposed to two or more forms of maltreatment were at particularly high risk for depression (OR=4.1; 95%Cl=2.8, 6.1) compared with females not exposed to maltreatment. In adjusted analyses, maltreatment was not associated with depression for males. Detailed information about maltreatment such as timing and frequency was not available, and 1534 individuals were not included in the analyses, who had poorer and less educated mothers. Emotional abuse and domestic violence are strong risk factors for major depression for females. Early intervention to prevent maltreatment and its consequences is critical, especially for girls exposed to poly-maltreatment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Comprehensive care program for elderly patients over 65 years with hip fracture.

PubMed

Fernández-Moyano, A; Fernández-Ojeda, R; Ruiz-Romero, V; García-Benítez, B; Palmero-Palmero, C; Aparicio-Santos, R

2014-01-01

To report the health outcomes of a multidisciplinary care program for patients over 65 years with hip fracture. We have developed a care coordination model for the comprehensive care of hip fracture patients. It establishes what, who, when, how and where orthopedists, internists, family physicians, emergency, intensive care, physiotherapists, anesthetists, nurses and workers social intervene. All elderly patients over 65 years admitted with the diagnosis of hip fracture (years 2006 to 2010) were retrospectively evaluated. One thousand episodes of hip fracture, corresponding to 956 patients, were included. Mean age was 82 years and mean stay 6.7 days. This was reduced by 1.14 days during the 5 years of the program. A total of 85.1% were operated on before 72 yours, and 91.2% during the program. Incidence of surgical site infection was 1.5%. In-hospital mortality was 4.5%, (24.2% at 12 months). Readmissions at one years was 14.9%. Independence for basic activity of daily living was achieved by 40% of the patients. This multidisciplinary care program for hip fracture patients is associated with positive health outcomes, with a high percentage of patients treated early (more than 90%), reduced mean stay (less than 7 days), incidence of surgical site infections, readmissions and inpatient mortality and at one year, as well as adequate functional recovery. Copyright © 2012 Elsevier España, S.L. All rights reserved.

11 CFR 110.18 - Voting age population.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 11 Federal Elections 1 2011-01-01 2011-01-01 false Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting age...

11 CFR 110.18 - Voting age population.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 11 Federal Elections 1 2013-01-01 2012-01-01 true Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting age...

11 CFR 110.18 - Voting age population.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 11 Federal Elections 1 2014-01-01 2014-01-01 false Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting age...

11 CFR 110.18 - Voting age population.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 11 Federal Elections 1 2012-01-01 2012-01-01 false Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting age...

Oral contraceptives modify the effect of GATA3 polymorphisms on the risk of asthma at the age of 18 years via DNA methylation.

PubMed

Guthikonda, Kranthi; Zhang, Hongmei; Nolan, Vikki G; Soto-Ramírez, Nelís; Ziyab, Ali H; Ewart, Susan; Arshad, Hasan S; Patil, Veeresh; Holloway, John W; Lockett, Gabrielle A; Karmaus, Wilfried

2014-01-01

The prevalence of asthma in girls increases after puberty. Previous studies have detected associations between sex hormones and asthma, as well as between sex hormones and T helper 2 (Th2) asthma-typical immune responses. Therefore, we hypothesized that exogenous or endogenous sex hormone exposure (represented by oral contraceptive pill (OCP) use and early menarche, respectively) are associated with DNA methylation (DNA-M) of the Th2 transcription factor gene, GATA3, in turn affecting the risk of asthma in girls, possibly in interaction with genetic variants. Blood samples were collected from 245 female participants aged 18 years randomly selected for methylation analysis from the Isle of Wight birth cohort, UK. Information on use of OCPs, age at menarche, and concurrent asthma were assessed by questionnaire. Genome-wide DNA-M was determined using the Illumina Infinium HumanMethylation450 beadchip. In a first stage, we tested the interaction between sex hormone exposure and genetic variants on DNA-M of specific cytosine-phosphate-guanine (CpG) sites. In a second stage, we determined whether these CpG sites interact with genetic variants in GATA3 to explain the risk of asthma. Interactions between OCP use and seven single nucleotide polymorphisms (SNPs) of GATA3 were analyzed for 14 CpG sites (stage 1). The interaction between OCP use and SNP rs1269486 was found to be associated with the methylation level of cg17124583 (P = 0.002, false discovery rate (FDR) adjusted P = 0.04). DNA-M of this same CpG site was also influenced by the interaction between age at menarche and rs1269486 (P = 0.0017). In stage 2, we found that cg17124583 modified the association of SNP rs422628 with asthma risk at the age of 18 years (P = 0.006, FDR adjusted P = 0.04). Subjects with genotype AG showed an increase in average risk ratio (RR) from 0.31 (95% CI: 0.10 to 0.8) to 11.65 (95% CI: 1.71 to 79.5) when methylation level increased from 0.02 to 0.12, relative to

Prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in southwest China

PubMed Central

Liu, Ya; Hu, Rong; Ouyang, Ling-yun; Liu, Jian-xiong; Li, Xiu-jun; Yi, Yan-jing; Wang, Tzung-Dau; Zhao, Shui-ping

2017-01-01

This study aimed to assess the prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in Southwest China. From September 2013 to March 2014, a cross-sectional survey was conducted in 4021 hypertensive patients aged 40 to 79 years living in Chengdu and Chongqing, China. Fasting plasma glucose (FPG) and 2h plasma glucose (2-hPG) in an oral glucose-tolerance test (OGTT) were used for assessments. Whether the patients previously had diabetes (DM) was determined by their own reports. The survey was carried out by the same questionnaire for all respondents. DM prevalence was 32.0% in hypertensive patients aged 40 to 79 years in Southwest China, with the rates of 29.6% and 33.5% in men and women, respectively (P<0.001). DM prevalence increased with age age and body-mass index. DM prevalence rates were 16.9%, 24.7%, 38.2% and 41.9% in hypertensive patients aged 40–49, 50–59, 60–69 and over 70, respectively. DM prevalence were 30.6%, 27.9%, 37.1%, and 37.4%, for BMI<18.5, 18.5–24.9, 25.0–29.9, and ≥30, respectively. Prevalence of unrecognized DM were 20.8% in hypertensive patients aged 40 to 79 years in Southwest China. Using only fasting blood glucose testing without OGTT would have resulted in 65.0% of missed DM diagnosis in these newly diagnosed patients. The prevalence of DM and unrecognized DM were high in hypertensive patients aged 40 to 79 years in Southwest China.These findings indicate that hypertensive patients aged 40 to 79 years should regularly submit to community-based OGTT screening for timely DM diagnosis. PMID:28192474

Usefulness of peak exercise oxygen consumption and the heart failure survival score to predict survival in patients >65 years of age with heart failure.

PubMed

Parikh, Mona N; Lund, Lars H; Goda, Ayumi; Mancini, Donna

2009-04-01

Peak exercise oxygen consumption (Vo(2)) and the Heart Failure (HF) Survival Score (HFSS) were developed in middle-aged patient cohorts referred for heart transplantation with HF. The prognostic value of Vo(2) in patients >65 years has not been well studied. Accordingly, the prognostic value of peak Vo(2) was evaluated in these patients with HF. A retrospective analysis of 396 patients with HF >65 years with cardiopulmonary exercise testing was performed. Peak Vo(2) and components of the HFSS (presence of coronary artery disease, left ventricular ejection fraction, heart rate, mean arterial blood pressure, presence of intraventricular conduction defects, and serum sodium) were collected. Follow-up averaged 1,038 +/- 983 days. Outcome events were defined as death, implantation of a left ventricular assist device, or urgent transplantation. Patients were divided into risk strata for peak Vo(2) and HFSS based on previous cut-off points. Survival curves were derived using Kaplan-Meier analysis and compared using log-rank analysis. Survival differed markedly by Vo(2) stratum (p <0.0001), with significantly better survival rates for the low- (>14 ml/kg/min) versus medium- (10 to 14 ml/kg/min), low- versus high- (<10 ml/kg/min), and medium- versus high-risk strata (all p <0.05). Survival also differed markedly by HFSS stratum (p <0.0001), with significantly better survival rates for the low- (> or =8.10) versus medium- (7.20 to 8.09), low- versus high- (< or =7.19), and medium- versus high-risk strata (all p <0.0001). In conclusion, peak Vo(2) and the HFSS were both excellent parameters to predict survival in patients >65 years with HF.

Intergenerational changes in chest size and proportions in children and adolescents aged 3-18 from Kraków (Poland), within the last 70 years.

PubMed

Kryst, Łukasz; Woronkowicz, Agnieszka; Kowal, Małgorzata; Sobiecki, Jan

2017-03-01

The size and proportions of the human body change continuously in response to social change and economic development. As reported by papers on intergenerational changes in chest size, this part of the human body is also influenced by environmental factors. The aim of this study was to assess changes in the dimensions and proportions of the chest of children and adolescents over a span of 70 years. In 2010 an anthropological study was conducted on 3878 children and adolescents aged 3-18 years living in Kraków (Poland). Data on chest dimensions (breadth, depth, circumference, chest index) were compared to data from 1938 (3719 children) and 1983 (6464 children). In boys, chests became increasingly deep; in boys 18 years of age, the chest index increased by 4.8 units, unlike girls, whose chests markedly flattened. The chest index in girls 18 years of age decreased by 4.2 units. In almost all age categories these differences were statistically significant. Also, in all age categories, children studied in 2010 had a significantly bigger chest circumference than boys and girls surveyed in 1983, respectively, by averages of 3.6 cm and 3 cm. The main reason for these changes may be the socio-economic transformation, which has been especially strong in recent decades. These results may have practical importance in many areas of knowledge, including medicine, nutritional science, and sports. They can also be important for informing preventive measures that should be taken in order to increase the physical activity of children and youth, especially boys. © 2016 Wiley Periodicals, Inc.

Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

PubMed

Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K; Miglioretti, Diana L; Schechter, Clyde B; Ergun, Mehmet Ali; van den Broek, Jeroen J; Alagoz, Oguzhan; Sprague, Brian L; van Ravesteyn, Nicolien T; Near, Aimee M; Gangnon, Ronald E; Hampton, John M; Chandler, Young; de Koning, Harry J; Mandelblatt, Jeanne S; Tosteson, Anna N A

2016-11-15

Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Collaborative simulation modeling using national incidence, breast density, and screening performance data. United States. Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Average-risk women

QuickStats: Age-Adjusted Death Rates* for Females Aged 15-44 Years, by the Five Leading Causes of Death(†) - United States, 1999 and 2014.

PubMed

2016-07-01

The age-adjusted death rate for females aged 15-44 years was 5% lower in 2014 (82.1 per 100,000 population) than in 1999 (86.5). Among the five leading causes of death, the age-adjusted rates of three were lower in 2014 than in 1999: cancer (from 19.6 to 15.3, a 22% decline), heart disease (8.9 to 8.2, an 8% decline), and homicide (4.2 to 2.8, a 33% decline). The age-adjusted death rates for two of the five causes were higher in 2014 than in 1999: unintentional injuries (from 17.0 to 20.1, an 18% increase) and suicide (4.8 to 6.5, a 35% increase). Unintentional injuries replaced cancer as the leading cause of death in this demographic group.

Snacking is associated with improved healthy eating index (HEI-2005 scores in adolescents aged 12-18 years: NHANES, 1999-2004

USDA-ARS?s Scientific Manuscript database

The aim of this study was to examine the association of snacking with diet quality in adolescents aged 12-18 years (n = 5,811). Snacks/drinks were combined when eating occasions were named in the 24-h recall, but analysis separated snacks from snacks/drinks that were only drinks. Adolescents were cl...

Immunogenicity and safety of an AS03-adjuvanted H7N1 vaccine in adults 65years of age and older: A phase II, observer-blind, randomized, controlled trial.

PubMed

Madan, Anuradha; Ferguson, Murdo; Rheault, Paul; Seiden, David; Toma, Azhar; Friel, Damien; Soni, Jyoti; Li, Ping; Innis, Bruce L; Schuind, Anne

2017-04-04

H7 influenza strains can cause severe and often fatal human infections, especially in the elderly. This phase II, observer-blind, randomized trial (www.ClinicalTrials.gov: NCT01949090) assessed the immunogenicity and safety of a novel AS03-adjuvanted H7N1 vaccine that may serve as a model H7-subtype vaccine. 360 adults ≥65years of age in stable health received either 1 of 4 adjuvanted A/mallard/Netherlands/12/2000 split virion vaccine formulations (3.75μg or 7.5μg hemagglutinin adjuvanted with either AS03 A or AS03 B ) or saline placebo, given as a 2-dose series. Immunogenicity was assessed using hemagglutination-inhibition (HI) and microneutralization (MN) assays for the per-protocol cohort, comprising 332 participants at 21days post-each dose, 332 at month 6, and 309 at month 12 (HI assay only). Safety was assessed up to month 12 for all participants who had received ≥1 dose (360 participants). For H7N1 HI antibody assessment at day 42 (21days post-dose 2), seroprotection rates (SPR) in the vaccinated groups were 69.6%-88.7%, seroconversion rates (SCR) 69.6%-88.5%, mean geometric increase (MGI) 11.0-18.9, and HI geometric mean titers (GMTs) 55.0-104.8. These parameters declined by month 6 and month 12. Microneutralization GMTs were 46.2-74.7 in the vaccinated groups at day 42, while vaccine response rate (VRR; proportion with ≥4-fold increase in MN titer) was 46.4%-81.5%. For the cross-reactive H7N9 strain, at day 42, HI GMT were 64.3-201.3, SPR 78.6%-96.3%, SCR 79.3%-96.3%, and MGI 14.1-37.7; MN GMTs were 44.0-85.6, and VRR 46.4-85.2%. The most frequent solicited symptom was injection site pain (41.7%-65.0% of vaccine recipients). In total, 40 participants reported 67 serious adverse events; none were considered causally related to vaccination. In adults aged ≥65years, the adjuvanted H7N1 vaccine was immunogenic after 2 doses, and had an acceptable safety profile. www.ClinicalTrials.gov: NCT01949090. Copyright © 2017 GlaxoSmithKline. Published by

Use of Smokeless Tobacco by Indian Women Aged 18–40 Years during Pregnancy and Reproductive Years

PubMed Central

Nair, Saritha; Schensul, Jean J.; Begum, Shahina; Pednekar, Mangesh S.; Oncken, Cheryl; Bilgi, Sameena M.; Pasi, Achhelal R.; Donta, Balaiah

2015-01-01

Objectives This paper discusses patterns of daily smokeless tobacco (SLT) use and correlates of poly SLT use among married women aged 18–40 years in a Mumbai slum community with implications for tobacco control. Methods Using a mixed methods approach, the study included a structured survey with 409 daily SLT users and in-depth interviews with 42 women. Participants for the survey were selected using a systematic sampling procedure (one woman in every fourth eligible household). Univariate and bivariate analysis, and multiple logistic regressions were conducted to identify demographic and social factors associated with women’s use of poly SLT products. To illustrate survey results, in-depth interviews were analyzed using Atlas ti software. Results Sixty-four percent of the women surveyed used only one type of SLT; of these, 30% used mishri, 32% used pan with tobacco and the rest used chewed tobacco (11%), gul (17%) or gutkha (10%). Thirty-six percent used more than one type of SLT. Poly SLT users chewed or rubbed 50% more tobacco as compared to single users (mean consumption of tobacco per day: 9.54 vs. 6.49 grams; p<0.001). Women were more likely to be poly SLT users if they were illiterate as compared to literate (adjusted odds ratio [AOR]=1.67; 95% confidence interval [CI]=1.07-2.71), if they had lived in Mumbai for 10 years or more, versus less than ten years (AOR=1.67, 95% CI=1.03-2.71); and if their husband was a poly SLT user as compared to a non SLT user (AOR=2.78, 95% CI=1.63-4.76). No differences were noted between pregnant and non-pregnant women in SLT consumption patterns. Conclusions Tobacco control policies and programs must focus specifically on both social context and use patterns to address SLT use among women of reproductive age with special attention to poly SLT users, an understudied and vulnerable population. PMID:25786247

[Early implementation of home care and 30 day readmissions in >65 years Veneto region patients discharged for heart failure and with disability].

PubMed

Gennaro, Nicola; Maggi, Stefania; Pellizzari, Michele; Carlucci, Francesco; Pilotto, Alberto; Saugo, Mario

2014-01-01

Early implementation of home care and 30 day readmissions in >65 years Veneto region patients discharged for heart failure and with disability. The effectiveness of Home care (HC) on preventing rehospitalizations in patients discharged for heart failure (HF) are uncertain. The aim of the study was to measure the impact of HC on early rehospitalizations of patients discharged for HF and with disabilities. Cohort retrospective study on >65 years patients, discharged at home and with a Barthel index <50. Variables considered were: previous hospitalizations for ischaemic cardiopathy ad/or chronic obstructive pulmonary disease, number of hospital admissions in the previous year, length of index hospitalization; outcomes considered were: hospital readmissions and days of hospitalizations 30 days from hospital discharge in patients with or without a home care visit within two days from hospital discharge. Of the 5.094 patients (60%>85 years), 14.8% received a HC visit within 2 days from discharge (43.7% from a nurse); 18.3% of patients (933) were readmitted within one month. In multivariate analyses an HC access within 2 days did not reduce the risk for readmission (although with better results in younger males but not in older women). An early HC visit reduced the days of hospital stay in males of all ages (65-74 years IRR 0.53 CI 95% 0.37-0.75; 75-84 years IRR 0.71 CI95% 0.60-0.83; 85+ years IRR 0.79 CI 95% 0.67-0.93) while in >75 years females there was a significant increase. An early HC visit (within two days from discharge) may have positive effects on males, but not in older women, possibly for the coexistence of socio-economic factors.

Age- and sex-related differences in body composition in healthy subjects aged 18 to 82 years.

PubMed

He, Xue; Li, Zishuai; Tang, Xunhui; Zhang, Lijun; Wang, Li; He, Yongjun; Jin, Tianbo; Yuan, Dongya

2018-06-01

Significant changes in body composition are known to occur with aging. The aim of the present study was to provide a normative reference of body composition and to investigate age and sex-related differences in healthy subjects by multifrequency bioelectrical impedance analyzer (BIA).A cross-sectional study was conducted on a sample of 3451 healthy Chinese adults, 1611 males and 1840 females. The volunteers were enrolled in 5 different age bands (18-30, 31-40, 41-50, 51-60, 60+). All subjects were measured for weight and height and submitted to BIA, to determine body composition. Body composition measures accounted for differences between men and women.A decrease in fat-free mass and increase in percent body fat was observed with aging, although the phenomenon was proved to be attenuated in women. The central and visceral redistribution of fat mass was also shown along lifetime.This study is a report on body composition of healthy subjects, to be used as an important data for future investigations and differences between nationalities and countries.

Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years.

PubMed

Pearson, Rebecca M; Evans, Jonathan; Kounali, Daphne; Lewis, Glyn; Heron, Jon; Ramchandani, Paul G; O'Connor, Tom G; Stein, Alan

2013-12-01

Some small studies suggest that maternal postnatal depression is a risk factor for offspring adolescent depression. However, to our knowledge, no large cohort studies have addressed this issue. Furthermore, only 1 small study has examined the association between antenatal depression and later offspring depression. Understanding these associations is important to inform prevention. To investigate the hypothesis that there are independent associations between antenatal and postnatal depression with offspring depression and that the risk pathways are different, such that the risk is moderated by disadvantage (low maternal education) with postnatal depression but not with antenatal depression. Prospective investigation of associations between symptoms of antenatal and postnatal parental depression with offspring depression at age 18 years in a UK community-based birth cohort (Avon Longitudinal Study of Parents and Children) with data from more than 4500 parents and their adolescent offspring. Diagnosis of offspring aged 18 years with major depression using the International Classification of Diseases, 10th Revision. Antenatal depression was an independent risk factor. Offspring were 1.28 times (95% CI, 1.08-1.51; P = .003) more likely to have depression at age 18 years for each standard deviation increase in maternal depression score antenatally, independent of later maternal depression. Postnatal depression was also a risk factor for mothers with low education, with offspring 1.26 times (95% CI, 1.06-1.50; P = .01) more likely to have depression for each standard deviation increase in postnatal depression score. However, for more educated mothers, there was little association (odds ratio, 1.09; 95% CI, 0.88-1.36; P = .42). Analyses found that maternal education moderated the effects of postnatal but not antenatal depression. Paternal depression antenatally was not associated with offspring depression, while postnatally, paternal depression showed a similar pattern to

Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care

PubMed Central

2013-01-01

Background Frailty in the elderly increases their vulnerability and leads to a greater risk of adverse events. According to various studies, the prevalence of the frailty syndrome in persons age 65 and over ranges between 3% and 37%, depending on age and sex. Walking speed in itself is considered a simple indicator of health status and of survival in older persons. Detecting frailty in primary care consultations can help improve care of the elderly, and walking speed may be an indicator that could facilitate the early diagnosis of frailty in primary care. The objective of this work was to estimate frailty-syndrome prevalence and walking speed in an urban population aged 65 years and over, and to analyze the relationship between the two indicators from the perspective of early diagnosis of frailty in the primary care setting. Methods Population cohort of persons age 65 and over from two urban neighborhoods in northern Madrid (Spain). Cross-sectional analysis. Bivariate and multivariate analysis with binary logistic regression to study the variables associated with frailty. Different cut-off points between 0.4 and 1.4 m/s were used to study walking speed in this population. The relationship between frailty and walking speed was analyzed using likelihood ratios. Results The study sample comprised 1,327 individuals age 65 and older with mean age 75.41 ± 7.41 years; 53.4% were women. Estimated frailty in the study population was 10.5% [95% CI: 8.9-12.3]. Frailty increased with age (OR = 1.14; 95% CI: 1.10-1.19) and was associated with poor self-rated health (OR = 2.52; 95% CI: 1.43-4.44), number of drugs prescribed (OR = 1.17; 95% CI: 1.08-1.26) and disability (OR = 6.58; 95% CI: 3.92-11.05). Walking speed less than 0.8 m/s was found in 42.6% of cases and in 56.4% of persons age 75 and over. Walking speed greater than 0.9 m/s ruled out frailty in the study sample. Persons age 75 and older with walking speed <0.8 m/s are at particularly high

Stages in third molar development and eruption to estimate the 18-year threshold Malay juvenile.

PubMed

Mohd Yusof, Mohd Yusmiaidil Putera; Cauwels, Rita; Martens, Luc

2015-10-01

Age 18 years is considered as the age of majority by most countries. To ascertain the age of interest, both third molar development (TMD) and eruption (TME) staging scores are beneficial without needing multiple imaging modalities. This study aimed to assess the chronological course of TMD and TME in a Malay sub-adult population and evaluate predictions when specific stage(s) of TMD and TME have been attained that are pertinent to the age group of interest (<18 years or ≥18 years). A sample of 714 digital panoramic images for subjects stratified by age between 14.1 and 23.9 years was retrospectively collected. The techniques described by Gleiser and Hunt (modified by Kohler) and Olze were employed to stage TMD and TME, respectively. A binary logistic regression was performed to predict the 18-year threshold with staging score as predictors. Stages 4-6 (TMD) and A-B (TME) for males and stages 4 (TMD) and A (TME) for females were found to discriminate the <18-year group. For both genders, stages 9-10 (TMD) and D (TME) can be used as reference stages to estimate whether a subject is likely to be ≥18 years, with 94.74-100% and 85.88-96.38% correct predictions, respectively. Stages 4 (TMD) and A (TME) can also be used to identify juveniles (<18 years) with a high degree of correct predictions, 100%. The juvenility of an individual is easily anticipated by using the specific staging scores of both third molar variables (TMD and TME) without complex calculations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Social Support from Parents, Friends, Classmates, and Teachers in Children and Adolescents Aged 9 to 18 Years: Who Is Perceived as Most Supportive?

ERIC Educational Resources Information Center

Bokhorst, Caroline L.; Sumter, Sindy R.; Westenberg, P. Michiel

2010-01-01

Age and gender differences in perceived social support from parents, friends, classmates, and teachers were investigated in 304 boys and 351 girls aged 9-18 years. The social support scale for children and adolescents was used for this purpose. Analyses showed that the level of perceived social support from parents and friends was similar across…

Development of a list of high-risk operations for patients 65 years and older.

PubMed

Schwarze, Margaret L; Barnato, Amber E; Rathouz, Paul J; Zhao, Qianqian; Neuman, Heather B; Winslow, Emily R; Kennedy, Gregory D; Hu, Yue-Yung; Dodgion, Christopher M; Kwok, Alvin C; Greenberg, Caprice C

2015-04-01

No consensus exists regarding the definition of high-risk surgery in older adults. An inclusive and precise definition of high-risk surgery may be useful for surgeons, patients, researchers, and hospitals. To develop a list of high-risk operations. Retrospective cohort study and modified Delphi procedure. The setting included all Pennsylvania acute care hospitals (Pennsylvania Health Care Cost Containment Council [PHC4] April 1, 2001, to December 31, 2007) and a nationally representative sample of US acute care hospitals (Nationwide Inpatient Sample [NIS], Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality January 1, 2001, to December 31, 2006). Patients included were those 65 years and older admitted to PHC4 hospitals and those 18 years and older admitted to NIS hospitals. We identified International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes associated with at least 1% inpatient mortality in the PHC4. We used a modified Delphi procedure with 5 board-certified surgeons to further refine this list by excluding nonoperative procedures and operations that were unlikely to be the proximate cause of mortality and were instead a marker of critical illness (eg, tracheostomy). We then cross-validated this list of ICD-9-CM codes in the NIS. Modified Delphi procedure consensus of at least 4 of 5 panelists and proportion agreement in the NIS. Among 4,739,522 admissions of patients 65 years and older in the PHC4, a total of 2,569,589 involved a procedure, encompassing 2853 unique procedures. Of 1130 procedures associated with a crude inpatient mortality of at least 1%, 264 achieved consensus as high-risk operations by the modified Delphi procedure. The observed inpatient mortality in the NIS was at least 1% for 227 of 264 procedures (86%) in patients 65 years and older. The pooled inpatient mortality for these identified high-risk procedures performed on patients 65 years and older was double

Near Retirement Age (≥55 Years) Self-Reported Physical Symptoms and Use of Computers/Mobile Phones at Work and at Leisure

PubMed Central

Gobba, Fabriziomaria

2017-01-01

The aim of this research is to study the symptoms and use of computers/mobile phones of individuals nearing retirement age (≥55 years). A questionnaire was sent to 15,000 Finns (aged 18–65). People who were ≥55 years of age were compared to the rest of the population. Six thousand one hundred and twenty-one persons responded to the questionnaire; 1226 of them were ≥55 years of age. Twenty-four percent of the ≥55-year-old respondents used desktop computers daily for leisure; 47.8% of them frequently experienced symptoms in the neck, and 38.5% in the shoulders. Workers aged ≥55 years had many more physical symptoms than younger people, except with respect to symptoms of the neck. Female daily occupational users of desktop computers had more physical symptoms in the neck. It is essential to take into account that, for people aged ≥55 years, the use of technology can be a sign of wellness. However, physical symptoms in the neck can be associated with the use of computers. PMID:28991182

Is there an association between food patterns and life satisfaction among Norway's inhabitants ages 65 years and older?

PubMed

André, Beate; Canhão, Helena; Espnes, Geir A; Ferreira Rodrigues, Ana Maria; Gregorio, Maria João; Nguyen, Camilla; Sousa, Rute; Grønning, Kjersti

2017-03-01

The lack of information regarding older adults' health and lifestyles makes it difficult to design suitable interventions for people at risk of developing unhealth lifestyles. Therefore, there is a need to increase knowledge about older adults' food patterns and quality of life. Our aim was to determine associations among food patterns, anxiety, depression, and life satisfaction in Norwegian inhabitants ages 65+. The Nord-Trøndelag Health Study (The HUNT Study) is a large, population-based cohort study that includes data for 125 000 Norwegian participants. The cohort used for this study is wave three of the study, consisting of 11 619 participants age 65 and over. Cluster analysis was used to categorize the participants based on similarities in food consumption; two clusters were identified based on similarities regarding food consumption among participants. Significant differences between the clusters were found, as participants in the healthy food-patterns cluster had higher life satisfaction and lower anxiety and depression than those in the unhealthy food-patterns cluster. The associations among food patterns, anxiety, depression, and life satisfaction among older adults show the need for increased focus on interactions among food patterns, food consumption, and life satisfaction among the elderly in order to explore how society can influence these patterns. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Renal Tumors in Children Younger Than 12 Months of Age: A 65-Year Single Institution Review.

PubMed

Lamb, Margaret G; Aldrink, Jennifer H; O'Brien, Sarah H; Yin, Han; Arnold, Michael A; Ranalli, Mark A

2017-03-01

Wilms tumor (WT) is the most prevalent pediatric renal tumor and most commonly occurs between ages 1 and 5 years. Data are lacking on children younger than 12 months with renal tumors. The cancer registry at the authors' institution was queried to identify patients 12 months and younger with renal masses. Demographics, clinical presentation, histopathology, stage, and survival outcomes were reviewed. The most common presenting symptoms included an asymptomatic abdominal mass (73%) and hematuria (9%). Histopathology revealed WT in 73% of patients, mesoblastic nephroma in 20%. Of those infants younger than 1 month of age, mesoblastic nephroma was the most common histopathology (68%). The 5-year overall survival (OS) was 93%, and 5-year event-free survival (EFS) was 93% for the entire group. For patients with WT, 5-year OS was 88% and 5-year EFS was 83%. Outcomes for congenital mesoblastic nephroma were excellent with 5-year OS and EFS of 100%. Reasons for good prognosis may be multifactorial and may include frequent well child checks in the first year of life and favorable histology. Patients in this age group are more likely to be classified as very low risk and may be treated with surgical resection alone.

Comparison of the immunogenicity and safety of Cervarix and Gardasil human papillomavirus (HPV) cervical cancer vaccines in healthy women aged 18-45 years.

PubMed

Einstein, Mark H; Baron, Mira; Levin, Myron J; Chatterjee, Archana; Edwards, Robert P; Zepp, Fred; Carletti, Isabelle; Dessy, Francis J; Trofa, Andrew F; Schuind, Anne; Dubin, Gary

2009-10-01

This observer-blind study compared the prophylactic human papillomavirus (HPV) vaccines, Cervarix (GlaxoSmithKline) and Gardasil (Merck), by assessing immunogenicity and safety through one month after completion of the three-dose vaccination course. Women (n = 1106) were stratified by age (18-26, 27-35, 36-45 years) and randomized (1:1) to receive Cervarix (Months 0, 1, 6) or Gardasil (Months 0, 2, 6). At Month 7 after first vaccination, all women in the according-to-protocol cohort who were seronegative/DNA negative before vaccination for the HPV type analyzed had seroconverted for HPV-16 and HPV-18 serum neutralizing antibodies, as measured by pseudovirion-based neutralization assay (PBNA), except for two women aged 27-35 years in the Gardasil group who did not seroconvert for HPV-18 (98%). Geometric mean titers of serum neutralizing antibodies ranged from 2.3-4.8-fold higher for HPV-16 and 6.8-9.1-fold higher for HPV-18 after vaccination with Cervarix compared with Gardasil, across all age strata. In the total vaccinated cohort (all women who received at least one vaccine dose, regardless of their serological and DNA status prior to vaccination), Cervarix induced significantly higher serum neutralizing antibody titers in all age strata (p < 0.0001). Positivity rates for anti-HPV-16 and -18 neutralizing antibodies in cervicovaginal secretions and circulating HPV-16 and -18 specific memory B-cell frequencies were also higher after vaccination with Cervarix compared with Gardasil. Both vaccines were generally well tolerated. The incidence of unsolicited adverse events was comparable between vaccinated groups. The incidence of solicited symptoms was generally higher after Cervarix, injection site reactions being most common. However, compliance rates with the three-dose schedules were similarly high (>or= 84%) for both vaccines. Although the importance of differences in magnitude of immune response between these vaccines is unknown, they may represent determinants

The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older.

PubMed

Morillas, Pedro; Pallarés, Vicente; Fácila, Lorenzo; Llisterri, Jose Luis; Sebastián, María Eugenia; Gómez, Manuel; Castilla, Elena; Camarasa, Raquel; Sandin, Miriam; García-Honrubia, Antonio

2015-06-01

The CHADS2 score is a proven, essential tool for estimating cardioembolic risk (mainly stroke) in patients with nonvalvular atrial fibrillation, with the purpose of determining the indication for anticoagulant therapy. In this study we analyzed the use of CHADS2 in hypertensive patients without known atrial fibrillation in a Mediterranean population. The study included 887 hypertensive patients aged 65 years or older without atrial fibrillation or anticoagulant therapy, who attended a medical consultation. Data on the patients' main risk factors, cardiovascular history, and medication were collected, basic laboratory analyses and electrocardiography were performed, and the CHADS2 score (heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and previous stroke or transient ischemic attack) was calculated. A clinical follow-up was carried out, recording hospital admissions for a stroke or transient ischemic attack. The median duration of follow-up was 804 days. Mean age was 72.5 (SD,5.7) years, 46.6% were men, 27.8% had diabetes, and 8.6% were smokers. During follow-up, 40 patients were hospitalized for a stroke or transient ischemic attack (4.5%). The event-free survival analysis showed significant differences according to the CHADS2 score (log rank test, P < .001). On multivariate analysis, smoking and CHADS2 ≥3 were independent predictors of stroke or transient ischemic attack. The CHADS2 may be useful for estimating the risk of stroke or transient ischemic attack in hypertensive patients without known atrial fibrillation. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

[The epidemic status and secular trends of myopia prevalence for Chinese children and adolescents aged 7-18 years from 2005 to 2014].

PubMed

Dong, Y H; Liu, H B; Wang, Z H; Xu, R B; Yang, Z P; Ma, J

2017-04-06

Objective: To investigate the characteristics of geographic distribution and change trend of myopia prevalence for children and adolescents aged 7-18 years old from 2005 to 2014, which provides the basis for the prevention of myopia. Methods: Research material was selected from the data of 2005, 2010, and 2014 Chinese National Survey on Students Constitution and Health, including 31 provinces (with the exception of Hong Kong, Macao, and Taiwan). The complete detection data of binoculus in children and adolescents aged 7-18 years old were selected as our research objects. The research objects of three studies were 233 505, 216 474, and 215 160, respectively. We analyzed the characteristics of geographic distribution and change trend of myopia prevalence for children and adolescents aged 7-18 years old in 31 provinces from 2005 to 2014. Results: The overall myopia detection rates in Chinese children and adolescents aged 7 to 18 years old in 31 provinces were 47.4% (111 707/235 505), 55.6% (120 456/216 474), and 57.2% (122 965/215 160) in 2005, 2010 and 2014, respectively. The growth range in this two phases were 8.0 percentage points, and 1.6 percentage points, respectively, and the difference was statistically significant ( P< 0.05). The detection rate of Myopia was growing quickly from 2005 to 2010 and only three provinces were in the situation of decline state including Tianjin, Hainan, and Ningxia. 90.3 percent (28/31) of provinces were in the situation of growth state and the growth range was 1.3%-22.3%. The growth of myopia was in the situation of slowdown from 2010 to 2014, and 38.7 percent (12/31) of the provinces were in negative growth districts including Hebei, Shanxi, Inner Mongolia, Zhejiang, Fujian, Shandong, Hubei, Guangxi, Guizhou, Tibet, Qianghai, and Xinjiang. The growth range in other provinces was 0.4%-24.7%. Conclusion: The myopia detection rate was at a higher level and growing constantly in China. There was large difference for myopia of

Preteen insulin levels interact with caloric intake to predict increases in obesity at ages 18 to 19 years: a 10-year prospective study of black and white girls.

PubMed

Morrison, John A; Glueck, Charles J; Wang, Ping

2010-05-01

We evaluated the associations of teenage insulin and adolescent diet with 10-year weight gain in an analysis sample of black and white girls matched for pubertal stage, body mass index (BMI) (or fat mass), and insulin at ages 9 to 10 years. We hypothesized that preteen insulin and insulin resistance would interact with dietary factors to positively predict increases in BMI. Furthermore, we hypothesized that increased insulin and insulin resistance, interacting with higher caloric intake during adolescence, would lead to greater increments in BMI in black girls than in white girls. Prospective 10-year follow-up was performed on 215 pairs of black and white schoolgirls matched at baseline by BMI (or fat mass), insulin, and pubertal stage, with repeated measures of body habitus, insulin, and dietary intake. When matched for BMI, black girls had higher fat-free mass and white girls had higher fat mass at ages 9 to 10 years. Black-white differences in caloric intake were not significant at ages 9 to 10 years, but black girls consumed more calories at age 19 years. Black girls consumed a greater percentage of calories from fat throughout. At age 19 years, black girls had higher BMI, fat mass index, and insulin. When matched at ages 9 to 10 years for fat mass, black girls were heavier, had higher BMI, and had greater fat-free mass. By ages 18 to 19 years, black girls continued to have higher BMI, but had accrued higher fat mass and a higher percentage of body fat. By stepwise multiple regression, 10-year increases in BMI were predicted by ages 9 to 10 years BMI, 10-year change in insulin, and a 3-way interaction between ages 9 to 10 years insulin, adolescent caloric intake, and race (higher in black girls) (all Ps < .0001). Insulin at ages 9 to 10 years interacts with caloric intake to increase BMI by age 19 years. There appear to be intrinsic black-white metabolic differences that lead to greater gains in fat during adolescence in black girls. Evaluating BMI and insulin

Curiosity killed the cat: No evidence of an association between cat ownership and psychotic symptoms at age 13 and 18 years in a UK general population cohort

PubMed Central

Solmi, F.; Hayes, J.F; Lewis, G.; Kirkbride, J.B

2018-01-01

Background Congenital or early life infection with Toxoplasma Gondii has been implicated in schizophrenia aetiology. Childhood cat ownership has been hypothesised as an intermediary marker of T. Gondii infection and, by proxy, as a risk factor for later psychosis. Evidence supporting this hypothesis is, however, limited. Method We used birth cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate whether cat ownership in pregnancy and childhood (4, 10 years old) was associated with psychotic experiences (PEs) in early (age 13; N=6,705) and late (age 18; N=4,676) adolescence, rated from semi-structured interviews. We used logistic regression to examine associations between cat ownership and PEs, adjusting for several sociodemographic and socioeconomic factors, household characteristics and dog ownership. Missing data were handled via multiple imputation. Results Cat ownership during pregnancy was not associated with PEs at age 13 (adjusted odds ratio [OR]: 1.15, 95% confidence interval [CI]: 0.97-1.35) or 18 years (OR: 1.08, 95%CI: 0.86-1.35). Initial univariable evidence that cat ownership at 4 and 10 years was associated with PEs at age 13 years did not persist after multivariable adjustment (4 years OR: 1.18, 95%CI: 0.94-1.48; 10 years OR 1.12, 95%CI: 0.92; 1.36). There was no evidence that childhood cat ownership was associated with PEs at 18 years old. Conclusions While pregnant women should continue to avoid handling soiled cat litter, given possible T Gondii exposure, our study strongly indicates that cat ownership in pregnancy or early childhood does not confer an increased risk of later adolescent PEs. PMID:28222824

[Aging negative stereotypes and their relationship with sociodemographic variables over 65 elderly].

PubMed

Sánchez Palacios, Concepción; Trianes Torres, M Victoria; Blanca Mena, M José

2009-01-01

The aim of the present study was to determine whether there are any associations between the degree of belief in negative stereotypes of aging in 65- to 96-year-old and the following sociodemographic variables: gender, age, marital status and educational level. The sample consisted of 757 non-institutionalized people divided into four age groups. Gender was homogeneously distributed in all groups. During an interview, the participants responded to a questionnaire that was organized in two parts. The first part collected data on age, educational level, gender and marital status. The second part consisted of a scale of negative stereotype of aging (Cuestionario de Estereotipos Negativos hacia la Vejez [CENVE]), with three factors: health, social-motivational and character-personality. Significant differences were found in relation to age but not in relation to gender. In relation to the health factor, participants aged more than 80 showed weaker stereotypes than the remaining age groups. In relation to the social-motivational factor, the older the participants, the stronger the negative stereotypes in relation to a decrease in interests in life. Persons with lower educational level scored higher on the health and character-personality factors of the CENVE. The results are discussed in relation to their potential applications in psychosocial interventions.

An Evaluation of Functional Sit-to-Stand Power in Cohorts of Healthy Adults Aged 18-97 Years.

PubMed

Glenn, Jordan M; Gray, Michelle; Vincenzo, Jennifer; Paulson, Sally; Powers, Melissa

2017-04-01

This investigation examined differences in functional sit-to-stand power/velocity between cohorts of adults aged 18-97 years. This study included 264 healthy adults classified into four cohorts (18-40, C1; 60-69, C2; 70-79, C2; ≥ 80, C4). Participants completed the sit-to-stand task five times. Power and velocity were measured via the TENDO power analyzer. Absolute average power was maintained from C1-C3, but decreased (p < .01) in C4. Absolute peak power decreased between C1-C2 (p < .01), was similar between C2-C3, and decreased in C4 (p < .01). Relative (to body weight) average and peak power decreased between C1-C2 (p < .01), was similar between C2-C3, and decreased in C4 (p < .01). Average velocity was similar between C1 and C2, but decreased in C3 (p < .01) and C4 (p < .01), respectively. Peak velocity was significantly different between all cohorts (p < .01). Declines in functional power may plateau during the seventh and eighth decades, accelerating after 80 years.

Adult or not? Accuracy of Cameriere's cut-off value for third molar in assessing 18 years of age for legal purposes.

PubMed

Cameriere, R; Pacifici, A; Viva, S; Carbone, D; Pacifici, L; Polimeni, A

2014-09-01

The discovery of reliable means to determine the age of an individual is a fundamental objective in forensic medicine, in consideration of the constant increase of illegal immigration into the European community. In 2008 Cameriere et al. developed a method based on the relationship between age and the third molar index (I3m), which assesses the degree of maturation of the third molar through measurements made on orthopantomography. The purpose of this work was to test the accuracy of Cameriere's cut-off for I3m as a tool to assess full age (18) on a new sample of living subjects. Orthopantomographs of 287 Italian living subjects aged between 13 and 22 years have been randomly selected and included in the study. Identification number, gender, date of birth and date of execution of the radiograph were recorded for each patient on a Microsoft Excel® spreadsheet. Radiographs were digitalized and analyzed using a computerized image-processing program (Adobe® Photoshop® CS4). The results show that the sensitivity of the test was 84.1% and the specificity was 92.5%. The estimated post-test probability was 90.1%, with a confidence interval of 95% (83.6%, 95.2%). Thus, the probability that a person being positive to the test has 18 or more years of age was 90.1%. The results highlight the contribution of Cameriere's cut-off value for the I3m in the assessment of full age, always remembering that the simultaneous employment of previously introduced complementary methods is essential for the purpose.

Development of the Assisting Hand Assessment for adolescents (Ad-AHA) and validation of the AHA from 18 months to 18 years.

PubMed

Louwers, Annoek; Beelen, Anita; Holmefur, Marie; Krumlinde-Sundholm, Lena

2016-12-01

To develop and evaluate a test activity from which bimanual performance in adolescents with unilateral cerebral palsy (CP) can be observed and scored with the Assisting Hand Assessment (AHA), and to evaluate the construct validity of the AHA test items for the extended age range 18 months to 18 years. A new test activity was developed and evaluated for its ability to elicit bimanual actions in adolescents with (n=20) and without (n=10) unilateral CP. The AHA scores of 126 adolescents (mean age 14y 3mo, SD 2y 6mo; 71 males, 55 females) and 157 children with unilateral CP (mean age 6y 1mo, SD 2y 10mo; 102 males, 55 females) were analysed using the Rasch measurement model. The test activity elicited bimanual actions in 100% of typically developing adolescents and in 96.8% and 57.9% of adolescents with unilateral CP (moderately and severely limited hand function respectively). The scale demonstrated good construct validity; thus the same scoring criteria can be used for the age range studied. The new Assisting Hand Assessment for adolescents (Ad-AHA) activity is valid for use with 13- to 18-year-olds to elicit bimanual performance in adolescents with unilateral CP. The same AHA scoring criteria can be used both for children and for adolescents within the age range 18 months to 18 years. © 2016 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Chronic health conditions in Medicare beneficiaries 65 years old, and older with HIV infection.

PubMed

Friedman, Eleanor E; Duffus, Wayne A

2016-10-23

To examine sociodemographic factors and chronic health conditions of people living with HIV (PLWHIV/HIV+) at least 65 years old and compare their chronic disease prevalence with beneficiaries without HIV. National fee-for-service Medicare claims data (parts A and B) from 2006 to 2009 were used to create a retrospective cohort of beneficiaries at least 65 years old. Beneficiaries with an inpatient or skilled nursing facility claim, or outpatient claims with HIV diagnosis codes were considered HIV+. HIV+ beneficiaries were compared with uninfected beneficiaries on demographic factors and on the prevalence of hypertension, hyperlipidemia, ischemic heart disease, rheumatoid arthritis/osteoarthritis, and diabetes. Odds ratios (OR), 95% confidence intervals (CIs), and P values were calculated. Adjustment variables included age, sex, race/ethnicity, end stage renal disease (ESRD), and dual Medicare-Medicaid enrollment. Chronic conditions were examined individually and as an index from zero to all five conditions. Of 29 060 418 eligible beneficiaries, 24 735 (0.09%) were HIV+. HIV+ beneficiaries were more likely to be Hispanic, African-American, male, and younger (P > 0.0001) and were 1.5-2.1 times as likely to have a chronic disease [diabetes (adjusted OR) 1.51, 95% CI (1.47, 1.55): rheumatoid arthritis/osteoarthritis 2.14, 95% CI (2.08, 2.19)], and 2.4-7 times as likely to have 1-5 comorbid chronic conditions [1 condition (adjusted OR) 2.38, 95% CI (2.21, 2.57): 5 conditions 7.07, 95% CI (6.61, 7.56)]. Our results show that PLWHIV at least 65 years old are at higher risk of comorbidities than other fee-for-service Medicare beneficiaries. This finding has implications for the cost and health management of PLWHIV 65 years and older.

Incidence of eye cancer in Taiwan: an 18-year review.

PubMed

Cheng, C-Y; Hsu, W-M

2004-02-01

To describe the incidence and histologic patterns of eye cancers in Chinese in Taiwan. Beginning in 1979, cases of cancer in Taiwan were reported to the Taiwan National Cancer Registry. Information on all Chinese patients diagnosed with eye malignancies under the International Classification of Disease, Ninth Revision, site 190, was retrieved for analysis from the data bank of the Taiwan National Cancer Registry. In all, 733 cases with primary eye cancers were identified from 1979 to 1996, an 18-year period. The average annual age-standardized incidence of eye cancers was 2.46 per million population (2.57 for male and 2.33 for female). For cases less than 15 years of age, the most common eye malignancy was retinoblastoma (86.0%), followed by rhabdomyosarcoma (3.9%) and lymphoma (2.8%). For cases 15 years of age or older, the most common eye malignancy was melanoma (28.6%), followed by squamous cell sarcoma (21.0%) and lymphoma (20.8%). The time trends of the incidence of eye cancers were relatively stable over the 18-year period in Taiwan. Retinobalstoma, melanoma, and lymphoma were the three most common eye cancers in this Chinese population.

Prevalence and correlates of depersonalization in students aged 12-18 years in Germany.

PubMed

Michal, Matthias; Duven, Eva; Giralt, Sebastian; Dreier, Michael; Müller, Kai W; Adler, Julia; Beutel, Manfred E; Wölfling, Klaus

2015-06-01

Depersonalization (DP) involves unpleasant experiences of detachment from one's sense of self or unreality in the environment. DP may occur in a broad range of conditions, among healthy persons due to sleep loss, drug induced, secondary to anxiety disorders or primary in depersonalization disorder. Although DP has an early age of onset, little is known about the prevalence and correlates of DP among adolescents. Between January and June 2011, we conducted a questionnaire-based representative survey of pupils aged 12-18 years in the federal state Rhineland-Palatinate of Germany. The final sample comprised 3,809 pupils. We analyzed the prevalence of depersonalization and its correlates regarding sociodemographic characteristics, substance abuse, global mental distress and resilience factors. One-third of the sample showed severe global mental distress, and 11.9 % were in the range of clinically significant depersonalization. Depersonalized students were less often living with both parents (67.3 vs. 75.7 %), came more often from an disadvantaged socioeconomic background, had a very severe level of global mental distress (comparable to psychiatric inpatients), were more often smoking and abusing cannabis and they suffered from specific impairments regarding social insecurity, global self-efficacy and active coping abilities. Experiences of depersonalization were very common among adolescents and may indicate an increased risk for poor academic achievement and mental health in the long term. Prospective studies are needed to investigate the course and clinical relevance of depersonalization for the development of the adolescents.

Study of family factors in association with behavior problems amongst children of 6-18 years age group.

PubMed

Jogdand, Sandip S; Naik, Jd

2014-07-01

The 'behaviour problems' are having major impact on child's bodily and social development. The family provides emotional support to an individual as well as plays a major role in the formation of one's personality. The quality and nature of the parental nurturance that the child receives will profoundly influence his future development. The knowledge of these family factors associated with behaviour problems may be helpful to identify at risk children. To study the family factors associated with behaviour problems amongst children of 6-18 Yrs age group. an adopted urban slum area of Govt. Medical College, Miraj Dist-Sangli. Cross sectional study. the sample size was calculated based upon 40% prevalence obtained in pilot study. Total 600 Children in the age group of 6-18 years residing in the urban slum area and their parents were interviewed with the help of predesigned, pretested proforma. chi-square test and risk estimate with Odd's ratio. Our study result reveals significant association between prevalence of behaviour problems with absence of either or both real parents and alcoholism in the parent or care taker. The behaviour problems have good prognosis if they are recognized earlier. Family has great role in prevention of behaviour problems in children, so parental counseling may be helpful.

Chronic periodontitis among diabetics and nondiabetics aged 35-65 years, in a rural block in Vellore, Tamil Nadu: A cross-sectional study.

PubMed

Nand, Khushboo Yamima; Oommen, Anu Mary; Chacko, Rabin Kurudamannil; Abraham, Vinod Joseph

2017-01-01

Chronic periodontitis is a common cause of poor oral health globally. Those at higher risk of this preventable and easily treatable condition need to be identified so that efforts can be taken to decrease disease burden and subsequent consequences. The aims of the study were (1) To compare the prevalence of chronic periodontitis among individuals with and without type 2 diabetes, aged 35-65 years from a rural block in Vellore, Tamil Nadu and (2) to assess risk factors for chronic periodontitis among individuals with diabetes. A cross-sectional study was done in nine villages of Kaniyambadi block, Vellore, between October 2015 and July 2016 among participants aged 35-65 years of a previous cross-sectional survey which had identified individuals with and without type 2 diabetes. Chronic periodontitis was assessed using the Community Periodontal Index and Treatment Needs index. Oral hygiene was assessed clinically using the Simplified Oral Hygiene Index. Diabetes was defined as on medication for type 2 diabetes or detected to have fasting blood glucose ≥126 mg/dl (in a previous survey). Chi-square test and odds ratios (adjusted using logistic regression) were used to study risk factors for periodontitis among those with diabetes. Prevalence of chronic periodontitis was 45.9% (95% confidence interval [CI]: 40.88%-50.9%) among 98 individuals with diabetes and 35.6% (95% CI: 30.91-40.29%) among 104 individuals without diabetes. Poor oral hygiene (odds ratio: 8.33, 95% CI: 3.33-25.00), low socioeconomic status (odds ratio: 3.19, 95% CI: 1.00-10.12), and smoking (odds ratio: 3.51, 95% CI: 1.17-10.51) were associated with periodontitis among diabetics. Individuals with type 2 diabetes have a higher prevalence of periodontitis. As poor oral hygiene is a strong risk factor for periodontitis, there is a need for targeted education regarding dental hygiene to reduce this preventable condition.

Mandibular fractures in a group of Brazilian subjects under 18 years of age: A epidemiological analysis.

PubMed

Muñante-Cárdenas, J L; Asprino, L; De Moraes, M; Albergaria-Barbosa, J R; Moreira, R W F

2010-11-01

This study showed a retrospective analysis of the etiology, incidence and treatment of maxillofacial injuries in a pediatric and adolescent population of the State of Sao Paulo. We analyzed 2986 medical records of victims of facial trauma under 18 years, treated between 1999 and 2008 by the Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas, Sao Paulo - Brazil. During this period, 757 patients under 18 were victims of maxillofacial trauma, of which, 112 patients had 139 lines of fracture in the mandible. The most affected age group were male adolescents. The bicycle accidents constituted the main etiology (34.82%). The conservative treatment was used in 51% of cases, and 49% received surgical treatment. Only 5 cases of postoperative complications were identified. The incidence of trauma and mandible fractures in pediatric and adolescent patients was high in the area of study. Bicycle accidents and falls being the main etiological factors. The group of adolescents was most affected. The conservative and surgical treatment was used almost in the same proportion. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Prospective Study of Optimal Obesity Index Cut-Off Values for Predicting Incidence of Hypertension in 18–65-Year-Old Chinese Adults

PubMed Central

Ren, Qian; Su, Chang; Wang, Huijun; Wang, Zhihong; Du, Wenwen; Zhang, Bing

2016-01-01

Background Overweight and obesity increase the risk of elevated blood pressure; most of the studies that serve as a background for the debates on the optimal obesity index cut-off values used cross-sectional samples. The aim of this study was to determine the cut-off values of anthropometric markers for detecting hypertension in Chinese adults with data from prospective cohort. Methods This study determines the best cut-off values for the obesity indices that represent elevated incidence of hypertension in 18–65-year-old Chinese adults using data from the China Health and Nutrition Survey (CHNS) 2006–2011 prospective cohort. Individual body mass index (BMI), waist circumference (WC), waist:hip ratio (WHR) and waist:stature ratio (WSR) were assessed. ROC curves for these obesity indices were plotted to estimate and compare the usefulness of these obesity indices and the corresponding values for the maximum of the Youden indices were considered the optimal cut-off values. Results Five-year cumulative incidences of hypertension were 21.5% (95% CI: 19.4–23.6) in men and 16.5% (95% CI: 14.7–18.2) in women, and there was a significant trend of increased incidence of hypertension with an increase in BMI, WC, WHR or WSR (P for trend < 0.001) in both men and women. The Youden index indicated that the optimal BMI, WC, WHR, WSR cut-off values were 23.53 kg/m2, 83.7 cm, 0.90, and 0.51 among men. The optimal BMI, WC, WHR, WSR cut-off values were 24.25 kg/m2, 79.9 cm, 0.85 and 0.52 among women. Conclusions Our study supported the hypothesis that the cut-off values for BMI and WC that were recently developed by the Working Group on Obesity in China (WGOC), the cut-off values for WHR that were developed by the World Health Organization (WHO), and a global WSR cut-off value of 0.50 may be the appropriate upper limits for Chinese adults. PMID:26934390

Perceived stress and change in cognitive function among adults 65 years and older.

PubMed

Aggarwal, Neelum T; Wilson, Robert S; Beck, Todd L; Rajan, Kumar B; Mendes de Leon, Carlos F; Evans, Denis A; Everson-Rose, Susan A

2014-01-01

Exposure to acute and chronic stress can affect learning and memory, but most evidence comes from animal studies or clinical observations. Almost no population-based studies have investigated the relation of stress to cognition or changes in cognition over time. We examined whether higher levels of perceived stress were associated with accelerated decline in cognitive function in older blacks and whites from a community-based population sample. Participants included 6207 black and white adults (65.7% black, 63.3% women) from the Chicago Health and Aging Project. Two to five in-home assessments were completed over an average of 6.8 years of follow-up and included sociodemographics, health behaviors, psychosocial measures, cognitive function tests, and health history. Perceived stress was measured by a six-item scale, and a composite measure of four tests of cognition was used to determine cognitive function at each assessment. Mixed-effects regression models showed that increasing levels of perceived stress were related to lower initial cognitive scores (B = -0.0379, standard error = 0.0025, p < .001) and a faster rate of cognitive decline (stress × time interaction: B = -0.0015, standard error = 0.0004, p < .001). Results were similar after adjusting for demographic variables, smoking, systolic blood pressure, body mass index, chronic medical conditions, and psychosocial factors and did not vary by race, sex, age, or education. Increasing levels of stress are independently associated with accelerated declines in cognitive function in black and white adults 65 years and older.

The Associations between Falls, Fall Injuries and Labor Market Outcomes among U.S. Workers 65 Years and Older.

PubMed

Scott, Kenneth; Fisher, Gwenith G; Barón, Anna E; Tompa, Emile; Stallones, Lorann; DiGuiseppi, Carolyn

2018-06-13

To examine whether falls are associated with the subsequent ability to work among workers 65 years and older. This longitudinal cohort study followed older workers enrolled in the Health and Retirement Study. Outcomes included time to health-related work limitation and to labor force exit. After adjustment multiple falls with or without a medically-treated injury were associated with time to limitation (HR = 1.77, 95% CI: 1.30-2.40; HR = 1.48, 95% CI: 1.26-1.73, respectively). Adjustment mitigated a crude relationship between falls and time to exit. Significant interactions suggest the relationship between falls and labor force exit depends on age, race and job demands. Falls, both non-injurious and injurious, are associated with subsequent health-related work limitation among workers 65 and older. Fall prevention activities would benefit workers who want or need to keep working past age 65.

Experience of place for young adults under 65 years with complex disabilities moving into purpose-built residential care.

PubMed

Muenchberger, Heidi; Ehrlich, Carolyn; Kendall, Elizabeth; Vit, Marina

2012-12-01

The aim of this research was to examine first-person accounts of the significance of place for young adults (aged between 18 and 65 years of age) with complex disabilities moving into purpose-built residential care accommodation. Interviews with residents, family members and staff working at the accommodation site considered the impact of the physical, care and social environment on the experience of place. Five elements of experience were identified, including (a) freedom and self-expression, (b) designed for disability (c) flexible and responsive care environment, (d) establishing relationships and (e) defining spaces. Findings confirmed the need for a 'value added approach' to housing and support for young adults with complex disability. A value added approach extends the importance of place beyond the physical context for people with complex conditions and incorporates essential symbolic and relational concepts of value--being of value (for family members), having value (for residents) and giving value (for staff). The framework of the therapeutic landscape is applied within the context of supported residential care and the factors that promote a healing environment are examined. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Influenza immunisation rate for 2005 and factors associated with receiving this vaccine in patients aged 65 years and over admitted to a general medical ward at Auckland City Hospital.

PubMed

Curry, Elizabeth; Kerr, Nathan; Yang, Joseph; Briggs, Simon

2006-10-13

To assess the influenza immunisation rate for 2005 in patients aged 65 years and over admitted to a general medical ward at Auckland City Hospital, New Zealand; to identify factors associated with receiving this vaccine; and to assess whether particular patient groups have a low influenza immunisation rate. Consecutive patients aged 65 years and over admitted to two medical wards were surveyed. Demographic data, how recently patients had last seen their general practitioner (GP), whether patients had received an influenza vaccine reminder from their GP, and whether patients had received the influenza vaccine in 2005 were recorded. Logistic regression analysis was performed to investigate which variables were associated with receiving the influenza vaccine. 148 of 200 (74%) patients who answered the questionnaire received the influenza vaccine. The variables found to be associated with receiving the influenza vaccine were whether patients had seen their GP in the last 6 months and whether patients had received an influenza vaccine reminder from their GP. Three-quarters of patients in this study received the influenza vaccine. We have not been able to identify patient groups that have a low influenza immunisation rate. Reminding patients of the benefits of the influenza vaccine or offering this at the time of discharge from hospital as autumn approaches each year may increase the influenza immunisation rate of those recently hospitalised.

Psychopathic personality development from ages 9 to 18: Genes and environment.

PubMed

Tuvblad, Catherine; Wang, Pan; Bezdjian, Serena; Raine, Adrian; Baker, Laura A

2016-02-01

The genetic and environmental etiology of individual differences was examined in initial level and change in psychopathic personality from ages 9 to 18 years. A piecewise growth curve model, in which the first change score (G1) influenced all ages (9-10, 11-13, 14-15, and 16-18 years) and the second change score (G2) only influenced ages 14-15 and 16-18 years, fit the data better did than the standard single slope model, suggesting a turning point from childhood to adolescence. The results indicated that variations in levels and both change scores were mainly due to genetic (A) and nonshared environmental (E) influences (i.e., AE structure for G0, G1, and G2). No sex differences were found except on the mean values of level and change scores. Based on caregiver ratings, about 81% of variance in G0, 89% of variance in G1, and 94% of variance in G2 were explained by genetic factors, whereas for youth self-reports, these three proportions were 94%, 71%, and 66%, respectively. The larger contribution of genetic variance and covariance in caregiver ratings than in youth self-reports may suggest that caregivers considered the changes in their children to be more similar as compared to how the children viewed themselves.

Awareness of Cardiovascular Risk Factors in U.S. Young Adults Aged 18–39 Years

PubMed Central

Bucholz, Emily M.; Gooding, Holly C.; de Ferranti, Sarah D.

2018-01-01

Introduction Young adults with hyperlipidemia, hypertension, and diabetes are at increased risk of developing heart disease later in life. Despite emphasis on early screening, little is known about awareness of these risk factors in young adulthood. Methods Data from the nationally representative cross-sectional survey National Health and Nutrition Examination Survey 2011–2014 were analyzed in 2017 to estimate the prevalence of self-reported awareness of hypercholesterolemia, hypertension, and diabetes in U.S. young adults aged 18–39 years (n=11,083). Prevalence estimates were weighted to population estimates using survey procedures, and predictors of awareness were identified using weighted logistic regression. Results Among U.S. young adults, the prevalence of hypercholesterolemia, hypertension, and diabetes was 8.8% (SE=0.4%), 7.3% (SE=0.3%), and 2.6% (SE=0.2%), respectively. The prevalence of borderline high cholesterol, blood pressure, and blood glucose were substantially higher (21.6% [SE= 0.6%], 26.9% [SE=0.7%], and 18.9% [SE=0.6%], respectively). Awareness was low for hypercholesterolemia (56.9% [SE=2.4%]) and moderate for hypertension and diabetes (62.7% [SE=2.4%] and 70.0% [SE=2.7%]); <25% of young adults with borderline levels of these risk factors were aware of their risk. Correlates of risk factor awareness included older age, insurance status, family income above the poverty line, U.S. origin, having a usual source of health care, and the presence of comorbid conditions. Conclusions Despite the high prevalence of cardiovascular risk factors in U.S. young adults, awareness remains less than ideal. Interventions that target access may increase awareness and facilitate achieving treatment goals in young adults. PMID:29433955

[Body mass index charts of Algerian children and adolescents (6-18 years)].

PubMed

Bahchachi, N; Dahel-Mekhancha, C-C; Rolland-Cachera, M-F; Roelants, M; Hauspie, R; Nezzal, L

2017-12-01

The body mass index (BMI) is widely accepted as a measure of overweight and obesity in children. There are no BMI reference charts for Algerian children and adolescents. The purpose of this study was to construct BMI percentile curves appropriate for children aged 6-18 years in Algeria. The weight and height of 7772 (54.9% girls) healthy schoolchildren from Constantine (eastern Algeria) were measured in 2008/2009. Weight and height for age curves based on the same sample were published previously. The BMI for age percentile curves were estimated in girls and boys separately using the LMS smoothing method. In both sexes, the median BMI increased with age. Girls had lower BMI values than boys before the age of 10 years but they were higher after this age until 18 years of age. Within the study population, the prevalence of overweight (including obesity) and obesity in girls and boys together was 13.7% and 3.0%, respectively, according to the International Obesity Task Force (IOTF) and 16.9% and 4.9% according to the World Health Organization (WHO) (2007). The median BMI curves of Algerian girls and boys were generally lower than those observed in other Arab countries. Compared with other references, the median BMI values of girls were lower than those of a Belgian Flemish population and WHO 2007 until 14 years of age and higher than the French reference between 7 and 18 years of age. The BMI values of Algerian boys were close to the Belgian (Flemish population), French and WHO 2007 references between 6 and 9 years of age and generally lower thereafter. These BMI curves are complementary to the height and weight charts published previously for the assessment of growth in children and adolescents. They were developed according to international guidelines and could serve as a national reference. They could be used as a complement to the 0- to 5-year-old WHO 2006 standards. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Safety of probiotics and synbiotics in children under 18 years of age.

PubMed

van den Nieuwboer, M; Brummer, R J; Guarner, F; Morelli, L; Cabana, M; Claassen, E

2015-01-01

This study aimed to systematically evaluate safety of probiotics and synbiotics in children ageing 0-18 years. This study is the third and final part in a safety trilogy and an update is provided using the most recent available clinical data (2008-2013) by means of the Common Terminology Clinical Adverse Events (CTCAE version 4.0) classification. Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. Analysis of 74 clinical studies indicated that probiotic and/or synbiotic administration in children is safe with regard to the specific evaluated strains, dosages and duration. The population of children include healthy, immune compromised and obese subjects, as well as subjects with intestinal disorders, infections and inflammatory disorders. This study revealed no major safety concerns, as the adverse events (AEs) were unrelated, or not suspected to be related, to the probiotic or synbiotic product. In general the study products were well tolerated. Overall, AEs occurred more frequent in the control arm compared to children receiving probiotics and/or synbiotics. Furthermore, the results indicate inadequate reporting and classification of AEs in the majority of the studies. In addition, generalizability of conclusions are greatly limited by the inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes.

The Icelandic Child Mental Health Study. An epidemiological study of Icelandic children 2-18 years of age using the child behaviour checklist as a screening instrument.

PubMed

Hannesdóttir, H; Einarsdóttir, S

1995-10-01

The purpose of this study was to test the applicability of a standardised procedure for assessing Icelandic children's behaviour/emotional problems and competencies, and to identify differences related to demographic variables. This study focuses upon the method of using the Child Behavior Checklist (CBCL) by Achenbach to estimate the reported prevalence of parents and adolescents of emotional and behaviour problems in children from 2-16 years of age and self-reported prevalence of adolescents from 11-18 years, selected at random from the general population, both in urban and rural areas. The information was obtained by mailing checklists with a letter to parents of children 2-10 years of age. The checklists for adolescents 11-18 years of age were distributed by teachers in school. Those adolescents who were not in school received the checklists by mail at their homes. The Child Behavior Checklists used for analyses were completed by 109 parents of 2-3 year old children; 943 parents of 4-16 year old children, and 545 non-referred adolescents from the general population. The rate of response was lowest for the youngest age group 47%, but increased to 62% with increasing age of the child. The response rate among the adolescents answering the Youth Self Report was 64%. Comparisons with the Child Behavior Checklists from this study are presented with Dutch, American, French, Canadian, German and Chilean samples and show striking similarities in four of these countries on the behaviour/emotional problems reported.

Relationship Between the Remaining Years of Healthy Life Expectancy in Older Age and National Income Level, Educational Attainment, and Improved Water Quality.

PubMed

Kim, Jong In; Kim, Gukbin

2016-10-01

The remaining years of healthy life expectancy (RYH) at age 65 years can be calculated as RYH (65) = healthy life expectancy-aged 65 years. This study confirms the associations between socioeconomic indicators and the RYH (65) in 148 countries. The RYH data were obtained from the World Health Organization. Significant positive correlations between RYH (65) in men and women and the socioeconomic indicators national income, education level, and improved drinking water were found. Finally, the predictors of RYH (65) in men and women were used to build a model of the RYH using higher socioeconomic indicators (R(2 )= 0.744, p < .001). Overall country-level educational attainment, national income level, and improved water quality influenced the RYH at 65 years. Therefore, policymaking to improve these country-level socioeconomic factors is expected to have latent effects on RYH in older age. © The Author(s) 2016.

An Intervention Study on Screening for Breast Cancer Among Single African-American Women Aged 65 and Older

DTIC Science & Technology

1999-09-01

Since the single constitute 75% of African-American women aged 65 and older , and the incidence and mortality of cancer are especially high in elderly ...Breast Cancer Among Single African-American Women Aged 65 and Older PRINCIPAL INVESTIGATOR: Kangmin Zhu, M.D., Ph.D. CONTRACTING ORGANIZATION: Meharry...to improve the breast screening behavior among single African-American women ages 65 and older . During the period, we (1) finished post-intervention

The incidence and survival of acute de novo leukaemias in Estonia and in a well-defined region of western Sweden during 1982-1996: a survey of patients aged > or =65 years.

PubMed

Luik, E; Palk, K; Everaus, H; Varik, M; Aareleid, T; Wennström, L; Juntikka, E-L; Safai-Kutti, S; Stockelberg, D; Holmberg, E; Kutti, J

2004-07-01

To compare the incidence and survival of acute de novo leukaemias with particular reference to political/socio-economic and environmental factors in two neighbouring countries over the three 5-year periods (1982-1996). The present report covers only patients diagnosed when aged > or =65 years. A well-defined area of Sweden, the so-called Western Swedish Health Care Region and Estonia. Population-wise, the western Swedish Region and Estonia are very similar; area-wise they are also well comparable. The number of acute de novo leukaemias was quite dissimilar in the two countries (Estonia, n = 137, Sweden, n = 354). The age standardized incidence rates regarding the total number of acute de novo leukaemias was 5.31 per 100,000 inhabitants/year for Estonia and 7.99 for Sweden, this difference being statistically significant. However, the difference was merely attributable to incidence rates as regards acute myeloblastic leukaemias (AML); on the contrary, differences as regards acute lymphoblastic leukaemias (ALL) and non-classifiable, undifferentiated or biphenotypic acute leukaemias (uAL) were negligible. The relative survival for the total material of patients was significantly higher for Swedish when compared with Estonian patients (P < 0.001). Thus, the relative survival for the total material of patients aged > or =65 years in Estonia at 1 year was 8.5% and at 3 years 3.5% respectively. The corresponding figures for the Swedish patients were considerably higher, 22.7 and 7.7% respectively. This difference, however, applied only for patients with AML (P < 0.001), whereas the results for patients with ALL and uAL were equally dismal. The results clearly reflect how political and socio-economic factors may influence the survival of acute leukemia patients in two neighbouring countries.

Psychopathic personality development from ages 9 to 18: Genes and environment

PubMed Central

TUVBLAD, CATHERINE; WANG, PAN; BEZDJIAN, SERENA; RAINE, ADRIAN; BAKER, LAURA A.

2015-01-01

The genetic and environmental etiology of individual differences was examined in initial level and change in psychopathic personality from ages 9 to 18 years. A piecewise growth curve model, in which the first change score (G1) influenced all ages (9–10, 11–13, 14–15, and 16–18 years) and the second change score (G2) only influenced ages 14–15 and 16–18 years, fit the data better did than the standard single slope model, suggesting a turning point from childhood to adolescence. The results indicated that variations in levels and both change scores were mainly due to genetic (A) and nonshared environmental (E) influences (i.e., AE structure for G0, G1, and G2). No sex differences were found except on the mean values of level and change scores. Based on caregiver ratings, about 81% of variance in G0, 89% of variance in G1, and 94% of variance in G2 were explained by genetic factors, whereas for youth self-reports, these three proportions were 94%, 71%, and 66%, respectively. The larger contribution of genetic variance and covariance in caregiver ratings than in youth self-reports may suggest that caregivers considered the changes in their children to be more similar as compared to how the children viewed themselves. PMID:25990131

Sick leave among people in paid work after age 65: A Swedish population-based study covering 1995, 2000, 2005 and 2010.

PubMed

Farrants, K; Marklund, S; Kjeldgård, L; Head, J; Alexanderson, K

2018-05-01

Extending working life into older age groups is discussed in many countries. However, there is no knowledge about how this affects rates of sick leave. The aim of this work was to investigate rates of sick leave among people in paid work after retirement age and if such rates have changed over time. Swedish nationwide register data on people aged >65 years and living in Sweden in 1995, 2000, 2005 and 2010 were analysed. All people with a sufficiently high work income to be eligible for public sick leave benefits were included. The proportions in paid work and compensated rates of sick leave for people aged 66-70 and ≥71 were analysed by sex, educational level, country of birth, living area, and employment type and sector. The percentage of people in paid work at ages 66-70 years increased from <10% in 1995 to 24% in 2010 and among those aged ≥71 years from 2.7% in 1995 to 3.5% in 2010. The rates of sick leave among working people aged 66-70 years were 3.3% in 1995 and 2.4% in 2010 and for people aged ≥71 years the rates of sick leave were 2.2% in 1995 and 0.2% in 2010. Women had higher rates of sick leave than men in 2005 and 2010, but lower in 1995 and 2000. In 2010, the rates of sick leave were similar between employees and the self-employed, and higher among employees in the public sector than among employees in the private sector. Rates of sick leave among workers aged >65 years were lower in 2010 than in 1995, despite much higher rates of labour market participation in 2010.

Cross-sectional and longitudinal factors influencing physical activity of 65 to 75-year-olds: a pan European cohort study based on the survey of health, ageing and retirement in Europe (SHARE).

PubMed

Lübs, Lena; Peplies, Jenny; Drell, Carina; Bammann, Karin

2018-04-16

The promotion of physical activity (PA) plays a major role for healthy ageing even in older age. There is a lack of cross-sectional and longitudinal studies explicitly dealing with barriers and drivers to PA in older adults. Therefore the aims of this study are a) to determine the prevalence of insufficient physical activity (IPA) in 65 to 75-year-olds in Europe and to identify factors associated with IPA in cross-section and b) to identify longitudinal risk factors for IPA in prior active persons. This study is using data of the Survey of Health, Ageing and Retirement in Europe (SHARE). SHARE is a cross-national panel database including individual data of the non-institutionalised population aged 50+ from 27 European countries. For the present paper, we included a cohort that participated in all first four waves of SHARE (2004-2011) aged 65-to-75-years at wave four (male n = 1761, female n = 2085) from 10 European countries. To identify cross-sectional and longitudinal associations, we calculated prevalence odds ratios and hazard ratios with 95% confidence intervals. The prevalence of IPA in 65-75-year-olds varied widely between countries, ranging from 55.4% to 83.3% in women and from 46.6% to 73.7% in men. IPA was associated with several intrapersonal factors and strength of association was similar for men and women for almost all investigated factors. Statistically significant associated with IPA were socioeconomic factors as low educational level (own and parental) and financial difficulties (male: POR: 1.60: 95%-CI: 1.26-2.03; female: POR: 1.58; 95%-CI: 1.26-1.97) and health-related factors as e.g. number of chronic diseases (male: POR: 1.34: 95%-CI: 1.23-1.45; female: POR: 1.31; 95%-CI: 1.21-1.42). Interpersonal only the size of social network was associated with IPA (male and female: POR: 0.88, 95%-CI: 0.81-0.95). Longitudinally in a fully adjusted model, only grip strength (HR: 0.99; CI-95%: 0.98-0.99) and BMI (HR: 1.02; CI-95%: 1.00-1.04) were

20 CFR 10.537 - What reports are needed when compensation payments continue for children over age 18?

Code of Federal Regulations, 2010 CFR

2010-04-01

... payments continue for children over age 18? 10.537 Section 10.537 Employees' Benefits OFFICE OF WORKERS... What reports are needed when compensation payments continue for children over age 18? (a) Compensation payable on behalf of a child that would otherwise end when the child reaches 18 years of age will continue...

11 CFR 110.18 - Voting age population.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 11 Federal Elections 1 2010-01-01 2010-01-01 false Voting age population. 110.18 Section 110.18 Federal Elections FEDERAL ELECTION COMMISSION GENERAL CONTRIBUTION AND EXPENDITURE LIMITATIONS AND... population of the United States, of each State, and of each Congressional district. The term voting age...

Retail impact of raising tobacco sales age to 21 years.

PubMed

Winickoff, Jonathan P; Hartman, Lester; Chen, Minghua L; Gottlieb, Mark; Nabi-Burza, Emara; DiFranza, Joseph R

2014-11-01

The majority of tobacco use emerges in individuals before they reach 21 years of age, and many adult distributors of tobacco to youths are young adults aged between 18 and 20 years. Raising the tobacco sales minimum age to 21 years across the United States would decrease tobacco retailer and industry sales by approximately 2% but could contribute to a substantial reduction in the prevalence of youths' tobacco use and dependency by limiting access.

Similar Antibody Levels in 3-Year-Old Children Vaccinated Against Measles, Mumps, and Rubella at the Age of 12 Months or 18 Months.

PubMed

Kontio, Mia; Palmu, Arto A; Syrjänen, Ritva K; Lahdenkari, Mika; Ruokokoski, Esa; Davidkin, Irja; Vaarala, Outi; Melin, Merit

2016-06-15

Measles-mumps-rubella (MMR) vaccinations have been offered to Finnish children at 14-18 months and 6 years of age. In May 2011, the recommended age for the first vaccine dose was lowered to 12 months because of the European measles epidemic. Fingertip capillary blood samples were collected from 3-year-old Finnish children vaccinated once with MMR vaccine at 11-19 months of age. The immunoglobulin G (IgG) antibodies to all 3 MMR antigens were measured with enzyme-linked immunosorbent assay. Neutralizing antibodies and the avidity of antibodies were measured for measles virus. From April through October 2013, 187 children were enrolled. Equally high proportions of the samples were seropositive for measles virus, mumps virus, or rubella virus antibodies, and there were no significant differences in the IgG antibody concentrations in children vaccinated at 11-13 months of age, compared with those vaccinated at 17-19 months of age. However, among children vaccinated at 11-13 months of age, boys had lower antibody concentrations than girls. Neutralizing measles virus antibody titers were above the threshold for protective immunity in all 78 samples analyzed. The measles virus antibody avidity indexes were high for all children. MMR induces similar antibody responses in 12-month-old children as compared to 18-month-old children, but in boys increasing age appears to improve the antibody responses. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Efficacy of Desvenlafaxine Compared With Placebo in Major Depressive Disorder Patients by Age Group and Severity of Depression at Baseline.

PubMed

Mosca, Daniel; Zhang, Min; Prieto, Rita; Boucher, Matthieu

2017-04-01

This post hoc meta-analysis evaluated the efficacy and safety of desvenlafaxine 50 and 100 mg versus placebo across age groups and severity of depression at baseline in patients with major depressive disorder. Data from placebo and desvenlafaxine 50-mg and 100-mg dose arms were pooled from 9 short-term, placebo-controlled, major depressive disorder studies (N = 4279). Effects of age (18-40 years, >40 to <55 years, 55-<65 years, and ≥65 years) and baseline depression severity (mild, 17-item Hamilton Rating Scale for Depression total score [HAM-D17] ≤18; moderate, HAM-D17 >18 to <25; severe, HAM-D17 ≥25) on desvenlafaxine efficacy were assessed using analysis of covariance for continuous end points and logistic regression for categorical end points. Desvenlafaxine-treated (50 or 100 mg/d) patients had significantly (P < 0.05, 2-sided) greater improvement in most measures of depression and function compared with placebo for patients 18 to 40 years, older than 40 to younger than 55 years, and 55 to younger than 65 years, with no significant evidence of an effect of age. Desvenlafaxine significantly improved most measures of depression and function in moderately and severely depressed patients. There was a significant baseline severity by treatment interaction for HAM-D17 total score only (P = 0.027), with a larger treatment effect for the severely depressed group. Desvenlafaxine significantly improved depressive symptoms in patients younger than 65 years and in patients with moderate or severe baseline depression. Sample sizes were not adequate to assess desvenlafaxine efficacy in patients 65 years or older or with mild baseline depression.

Interplay of Filaggrin Loss-of-Function Variants, Allergic Sensitization, and Eczema in a Longitudinal Study Covering Infancy to 18 Years of Age

PubMed Central

Ziyab, Ali H.; Karmaus, Wilfried; Yousefi, Mitra; Ewart, Susan; Schauberger, Eric; Holloway, John W.; Zhang, Hongmei; Arshad, Syed Hasan

2012-01-01

Background Immune specific genes as well as genes regulating the formation of skin barrier are major determinants for eczema manifestation. There is a debate as to whether allergic sensitization and filaggrin gene (FLG) variants lead to eczema or FLG variants and eczema increase the risk of allergic sensitization. To investigate the time-order between eczema and allergic sensitization with respect to FLG variants, data from a large prospective study covering infancy to late adolescence were analyzed. Methodology/Principal Findings Repeated measurements of eczema and allergic sensitization (documented by skin prick tests) at ages 1, 2, 4, 10, and 18 years were ascertained in the Isle of Wight birth cohort (n = 1,456). Three transition periods were analyzed: age 1-or-2 to 4, 4 to 10, and 10 to 18 years. FLG variants were genotyped in 1,150 participants. Over the three transition periods, in temporal sequence analyses of initially eczema-free participants, the combined effect of FLG variants and allergic sensitization showed a 2.92-fold (95% CI: 1.47–5.77) increased risk ratio (RR) of eczema in subsequent examinations. This overall risk was more pronounced at a younger age (transition period 1-or-2 to 4, RR = 6.47, 95% CI: 1.96–21.33). In contrast, FLG variants in combination with eczema showed a weaker, but significant, risk ratio for subsequent allergic sensitization only up to 10 years of age. Conclusions/Significance Taking the time order into account, this prospective study demonstrates for the first time, that a combination of FLG variants and allergic sensitization increased the risk of eczema in subsequent years. Also FLG variants interacted with eczema and increased the risk of subsequent allergic sensitization, which, was limited to the younger age. Hence, early restoration of defective skin barrier could prevent allergic sensitization and subsequently reduce the risk of eczema development. PMID:22403702

38 CFR 18.511 - Rules against age discrimination.

Code of Federal Regulations, 2013 CFR

2013-07-01

... discrimination. 18.511 Section 18.511 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Determining Age Discrimination § 18.511 Rules against age discrimination. The rules in this section are... benefits of, or be subjected to discrimination under, any program or activity receiving Federal financial...

Post-licensure surveillance of 13-valent pneumococcal conjugate vaccine (PCV13) in adults aged ⩾19years old in the United States, Vaccine Adverse Event Reporting System (VAERS), June 1, 2012-December 31, 2015.

PubMed

Haber, Penina; Arana, Jorge; Pilishvili, Tamara; Lewis, Paige; Moro, Pedro L; Cano, Maria

2016-12-07

The 13-valent pneumococcal conjugate vaccine (PCV13) was first recommended for use in adults aged ⩾19years with immunocompromising conditions in June 2012. On August 2014, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of PCV13 among adults aged ⩾65years. We assessed adverse events (AEs) reports following PCV13 in adults aged ⩾19years reported to the Vaccine Adverse Event Reporting System (VAERS) from June 2012 to December 2015. VAERS is a national spontaneous reporting system for monitoring AEs following vaccination. Our assessment included automated data analysis, clinical review of all serious reports and reports of special interest. We conducted empirical Bayesian data mining to assess for disproportionate reporting. VAERS received 2976 US PCV13 adult reports; 2103 (71%) of these reports were from PCV13 administered alone. Fourteen percent were in persons aged 19-64years and 86% were in persons aged ⩾65years. Injection site erythema (28%), injection site pain (24%) and fever (22%) were the most frequent AEs among persons aged 19-64years; injection site erythema (30%), erythema (20%) and injection site swelling (18%) were the most frequent among persons aged ⩾65years who were given the vaccine alone. The most frequently reported AEs among non-death serious reports were injection site reactions and general malaise among persons 19-64years old; injection site reactions, general malaise and Guillain-Barré syndrome among those ⩾65years (Table 2). Data mining did not detect disproportional reporting for any unexpected AE. The results of this study were consistent with safety data from pre-licensure studies of PCV13. We did not detect any new or unexpected AEs. Published by Elsevier Ltd.

Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol.

PubMed

Pérula-de-Torres, Luis Á; Martínez-Adell, Miguel Á; González-Blanco, Virginia; Baena-Díez, José M; Martín-Rioboó, Enrique; Parras-Rejano, Juan M; González-Lama, Jesús; Martín-Alvarez, Remedios; Ruiz-Moral, Roger; Fernández-García, José Á; Pérez-Díaz, Modesto; Ruiz-de-Castroviejo, Joaquin; Pérula-de-Torres, Carlos; Valero-Martín, Antonio; Roldán-Villalobos, Ana; Criado-Larumbe, Margarita; Burdoy-Joaquín, Emili; Coma-Solé, Montserrat; Cervera-León, Mercè; Cuixart-Costa, Lluís

2012-10-30

Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. The study is registered as NCT01291953 (ClinicalTrials.gob).

Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol

PubMed Central

2012-01-01

Background Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. Methods/design An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). Discussion If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. Trial registration The study is registered as NCT01291953 (ClinicalTrials.gob) PMID:23130754

Cervical spine fractures in patients 65 years or older: a 3-year experience at a level I trauma center.

PubMed

Damadi, Amir A; Saxe, Andrew W; Fath, John J; Apelgren, Keith N

2008-03-01

Cervical spine fractures in the elderly carry a mortality as high as 26%. We reviewed our experience to define the level of injury, prevalence of neurologic deficits, treatments employed, and the correlation between patients' pre- and posthospital residences. Also, we correlated the prevalence of advanced directives with length of stay. We queried the data collected prospectively at an American College of Surgeons verified Level I hospital (National TRACS, American College of Surgeons) regarding patients aged 65 years or older presenting with cervical spine fractures (International Classification of Diseases-9 code 805.X) in calendar years 2000 through 2003. We identified 58 patients (ages 65-94). Mortality was 24%. Twelve patients had quadriplegia or paraplegia and seven of these patients died. Respiratory failure was the primary cause of death. Application of rigid collars and a halo brace were the most commonly employed therapies. Mortality rates for halo stabilization and rigid collar and halo stabilization were similar (23% vs. 29%). Despite having a higher mean Injury Severity Score, the 16 patients with advanced directives had an intensive care unit length of stay similar to that of patients without advanced directives but a statistically significant shorter overall length of stay (13 vs. 6.9 days). Eighteen of 45 patients living at home at the time of injury returned home. Cervical spine injury in the elderly does not inevitably relegate patients to a setting of more acute nursing care. The health and social factors that allowed many to return to living at home warrant investigation, as support of these factors may assist others with this injury.

42 CFR 406.11 - Individual age 65 or over who is not eligible as a social security or railroad retirement...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Individual age 65 or over who is not eligible as a... Without Monthly Premiums § 406.11 Individual age 65 or over who is not eligible as a social security or... certain individuals who were age 65 or would soon attain age 65 but would not be able to qualify for...

Co-existence of severe coarctation of the aorta and aortic valve stenosis in a 65-year-old woman: a case report.

PubMed

Onohara, Daisuke; Sato, Aiko; Tasaki, Yuichi; Yamada, Takafumi

2014-01-01

Coarctation of the aorta is usually diagnosed and corrected early in life. Survival to more than 60 years of age of a patient with unrepaired coarctation of the aorta is extremely unusual, and the optimal management strategies for such patients are controversial. We describe the case of a woman who was first diagnosed as having coarctation of the aorta and aortic valve stenosis at the age of 65 years and underwent successful aortic valve replacement.

Allometric modelling of peak oxygen uptake in male soccer players of 8-18 years of age.

PubMed

Valente-Dos-Santos, João; Coelho-E-Silva, Manuel J; Tavares, Óscar M; Brito, João; Seabra, André; Rebelo, António; Sherar, Lauren B; Elferink-Gemser, Marije T; Malina, Robert M

2015-03-01

Peak oxygen uptake (VO2peak) is routinely scaled as mL O2 per kilogram body mass despite theoretical and statistical limitations of using ratios. To examine the contribution of maturity status and body size descriptors to age-associated inter-individual variability in VO2peak and to present static allometric models to normalize VO2peak in male youth soccer players. Total body and estimates of total and regional lean mass were measured with dual energy X-ray absorptiometry in a cross-sectional sample of Portuguese male soccer players. The sample was divided into three age groups for analysis: 8-12 years, 13-15 years and 16-18 years. VO2peak was estimated using an incremental maximal exercise test on a motorized treadmill. Static allometric models were used to normalize VO2peak. The independent variables with the best statistical fit explained 72% in the younger group (lean body mass: k = 1.07), 52% in mid-adolescent players (lean body mass: k = 0.93) and 31% in the older group (body mass: k = 0.51) of variance in VO2peak. The inclusion of the exponential term pubertal status marginally increased the explained variance in VO2peak (adjusted R(2 )= 36-75%) and provided statistical adjustments to the size descriptors coefficients. The allometric coefficients and exponents evidenced the varying inter-relationship among size descriptors and maturity status with aerobic fitness from early to late-adolescence. Lean body mass, lean lower limbs mass and body mass combined with pubertal status explain most of the inter-individual variability in VO2peak among youth soccer players.

[A comparison of characteristics of pathologic hobbies in schizophrenic patients of different age].

PubMed

Sergeev, I I; Deych, R V; Malinochka, S A

2016-01-01

To analyze age-related pathologic hobbies in patients with schizophrenia spectrum disorders. Forty-three inpatients, aged from 4 to 16 years, and 31 patients, aged from 18 to 65 years, were studied. Clinical/psychopathological analysis, psychological experiment and clinical statistics were used. Pathological hobbies substantially differed depending on the age (3-6, 7-15 and 18-65 years). In preschool age, hobbies were immature and infantile, arose autochthonously, their course was relatively stable and they had limited maladaptive effects. In junior school/teenager age, hobbies were more distinct and were associated with more diverse and mature realization patterns. Their origin was more depended on environmental factors, the course was persistent or attack-like with more pronounced and steady maladaptive effects. In some cases, there was a trend to pathological hobby progression. Abnormal hobbies in patients of mature age were the most diverse in their subjects and forms of realization as well as in their clinical variants and dynamic types. In the group of mature patients with schizophrenic spectrum disorders, there was a significantly higher percentage of psychotic forms of pathological hobbies.

Health Services Utilization Among Fee-for-Service Medicare and Medicaid Patients Under Age 65 with Behavioral Health Illness at an Urban Safety Net Hospital.

PubMed

Cancino, Ramon S; Jack, Brian W; Jarvis, John; Cummings, Alice Kate; Cooper, Ellie; Cremieux, Pierre-Yves; Burgess, James F

2017-07-01

In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011. We compared patients with and without behavioral health illness. The main outcome measures were hospital admission and ED use. Chi-square and Wilcoxon rank-sum tests were used for descriptive statistics on categorical and continuous variables, respectively. Greedy propensity score matching was used to control for confounding factors. Rate ratios (RR) and 95% confidence intervals (CI) were determined after matching and after adjusting for those variables that remained significantly different after matching. In 2011, 10% of all fee-for-service dual eligible patients aged less than 65 years in Massachusetts were seen at Boston Medical Center. Data before propensity score matching showed significant differences in age, sex, race/ethnicity, marital status, education, employment, physical comorbidities, and Charlson Comorbidity Index score between patients with and without behavioral health illness. Analysis after propensity score matching found significant differences in sex, Hispanic race, and other education and employment status. Compared with patients without behavioral health illness, patients with behavioral health illness had a higher RR for hospital admissions (RR = 2.07; 95% CI = 1.81-2.38; P < 0.001) and ED use (RR = 1.61; 95% CI = 1.46-1.77; P < 0.001). Results were robust after adjusting for characteristics that remained statistically significantly different after propensity score matching. Adult dual eligible patients aged less than 65 years with behavioral health

Community-acquired bacterial meningitis in elderly patients: experience over 30 years.

PubMed

Cabellos, Carmen; Verdaguer, Ricard; Olmo, Montse; Fernández-Sabé, Nuria; Cisnal, Maria; Ariza, Javier; Gudiol, Francesc; Viladrich, Pedro F

2009-03-01

Clinical characteristics, etiologies, evolution, and prognostic factors of community-acquired bacterial meningitis in elderly patients are not well known. To improve this knowledge, all episodes of community-acquired bacterial meningitis were prospectively recorded and cases occurring in patients >or=65 years old were selected. During the period 1977-2006, 675 episodes in adults (aged >or=18 yr) were recorded, with 185 (27%) in patients aged >or=65 years old; 76 were male and 109 were female, with a mean age of 73 +/- 6 years (range, 65-93 yr). Causative microorganisms were Streptococcus pneumoniae 74, Neisseria meningitidis 49, Listeria monocytogenes 17, other streptococcal 9, Escherichia coli 6, Haemophilus influenzae 4, Klebsiella pneumoniae and Staphylococcus aureus 2 each, Capnocytophaga canimorsus and Enterococcus faecalis 1 each, and unknown in 20. On admission 91% had had fever, 32% were in a coma (Glasgow Coma Scale aged 18-65 years, there were significant differences among older patients (aged >or=65 yr), who showed a higher frequency of diabetes and malignancy as underlying disease; pneumonia, otitis, and pericranial fistula as predisposing factors; and S. pneumoniae and L. monocytogenes as etiology. There were also differences in clinical presentation, complications, sequelae, and mortality. Factors independently related with mortality were age, pneumonia as a predisposing factor, coma on admission, and heart failure and seizures after therapy. Dexamethasone therapy was a protective factor. In conclusion, bacterial meningitis in elderly patients is associated with greater diagnostic difficulties and neurologic severity and more complications, as well as with increased mortality. Antiseizure prophylaxis might be useful in these patients.

Consumer Needs Assessment: A Qualitative Study of the Needs of People with Disabilities. Consumer Needs Assessment Project Year 1: Results of the First Year of a Five Year Study.

ERIC Educational Resources Information Center

Phillips, Lynn

This paper describes the first year of a 5-year study which, when completed, will identify the needs and concerns of disabled consumers from virtually all categories of functional limitations and all walks of life. The participants will include men and women between the ages of 18 and 65 from a variety of socioeconomic and geographical…

NK cells modulate the cytotoxic activity generated by Mycobacterium leprae-hsp65 in leprosy patients: role of IL-18 and IL-13

PubMed Central

DE LA BARRERA, S; FINIASZ, M; FINK, S; ILARREGUI, J; ALEMÁN, M; OLIVARES, L; FRANCO, M C; PIZZARIELLO, G; DEL CARMEN SASIAIN, M

2004-01-01

Protection against intracellular pathogens such as Mycobacterium leprae is critically dependent on the function of NK cells at early stages of the immune response and on Th1 cells at later stages. In the present report we evaluated the role of IL-18 and IL-13, two cytokines that can influence NK cell activity, in the generation of M. leprae-derived hsp65-cytotoxic T lymphocytes (CTL) from peripheral blood mononuclear cells (PBMC) of leprosy patients. We demonstrated that IL-18 modulates hsp65-induced CTL generation and collaborates with IL-12 for this effect. In paucibacillary (PB) patients and normal controls (N) depletion of NK cells reduces the cytolytic activity. Under these conditions, IL-12 cannot up-regulate this CTL generation, while, in contrast, IL-18 increases the cytotoxic activity both in the presence or absence of NK cells. IL-13 down-regulates the hsp65-induced CTL generation and counteracts the positive effect of IL-18. The negative effect of IL-13 is observed in the early stages of the response, suggesting that this cytokine affects IFNγ production by NK cells. mRNA coding for IFNγ is induced by IL-18 and reduced in the presence of IL-13, when PBMC from N or PB patients are stimulated with hsp65. Neutralization of IL-13 in PBMC from multibacillary (MB) leprosy patients induces the production of IFNγ protein by lymphocytes. A modulatory role on the generation of hsp65 induced CTL is demonstrated for IL-18 and IL-13 and this effect takes place through the production of IFNγ. PMID:14678270

[Prevalence of osteoporosis and osteopenia among women over fifty years of age, from the city of Durango, Mexico, diagnosed by forearm-DEXA].