Cost-effectiveness of vaccination against herpes zoster in adults aged over 60 years in Belgium.

PubMed

Bilcke, Joke; Marais, Christiaan; Ogunjimi, Benson; Willem, Lander; Hens, Niel; Beutels, Philippe

2012-01-11

To assess the cost-effectiveness of vaccinating all or subgroups of adults aged 60 to 85 years against herpes zoster. A deterministic compartmental static model was developed (in freeware R), in which cohorts can acquire herpes zoster according to their age in years. Surveys and database analyses were conducted to obtain as much as possible Belgian age-specific estimates for input parameters. Direct costs and Quality-Adjusted Life-Year (QALY) losses were estimated as a function of standardised Severity Of Illness (SOI) scores (i.e. as a function of the duration and severity of herpes zoster disease). Uncertainty about the average SOI score for a person with herpes zoster, the duration of protection from the vaccine, and the population that can benefit from the vaccine, exerts a major impact on the results: under assumptions least in favour of vaccination, vaccination is not cost-effective (i.e. incremental cost per QALY gained >€48,000 for all ages considered) at the expected vaccine price of €90 per dose. At the same price, but under assumptions most in favour of vaccination, vaccination is found to be cost-effective (i.e. incremental cost per QALY gained <€5500 for all ages considered). Vaccination of age cohort 60 seems more cost-effective than vaccination of any older age cohort in Belgium. If the vaccine price per dose drops to €45, HZ vaccination of adults aged 60-64 years is likely to be cost-effective in Belgium, even under assumptions least in favour of vaccination. Unlike previous studies, our analysis acknowledged major methodological and model uncertainties simultaneously and presented outcomes for 26 different target ages at which vaccination can be considered (ages 60-85). Copyright © 2011 Elsevier Ltd. All rights reserved.

Safety and efficacy of non-cemented femoral fixation in patients 75 years of age and older.

PubMed

Meftah, Morteza; John, Mario; Lendhey, Matin; Khaimov, Aleksandr; Ranawat, Amar S; Ranawat, Chitranjan S

2013-09-01

The aim of this study was to assess peri-operative complications, safety and efficacy of non-cemented femoral fixation in total hip arthroplasty (THA) as compared to cemented femoral fixation in the elderly population. Fifty-two matched pair analysis of patients with 75 years of age and older (104 patients), who underwent primary THA from June 1997 to December 2004, was performed based on age, sex, BMI, and Charnley classification. Mean age was 81 years (75-101) and the average follow up was 3.1 ± 2.9 years (1.2-6.4). There was no difference in peri-operative cardiopulmonary complications, pulmonary failures, deep venous thrombosis, pulmonary embolus, length of stay, or discharge deposition between the two groups. Non-cemented fixation is safe and effective in patients older than 75 years of age. Copyright © 2013 Elsevier Inc. All rights reserved.

Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico.

PubMed

Ortiz, Genaro G; Arias-Merino, Elva D; Flores-Saiffe, María E; Velázquez-Brizuela, Irma E; Macías-Islas, Miguel A; Pacheco-Moisés, Fermín P

2012-01-01

Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31-4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60.

Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

PubMed Central

Ortiz, Genaro G.; Arias-Merino, Elva D.; Flores-Saiffe, María E.; Velázquez-Brizuela, Irma E.; Macías-Islas, Miguel A.; Pacheco-Moisés, Fermín P.

2012-01-01

Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60. PMID:23243421

Physical activity level and physical functionality in nonagenarians compared to individuals aged 60-74 years.

PubMed

Frisard, Madlyn I; Fabre, Jennifer M; Russell, Ryan D; King, Christina M; DeLany, James P; Wood, Robert H; Ravussin, Eric

2007-07-01

Functional dependence and the risks of disability increase with age. The loss of independence is thought to be partially due to a decrease in physical activity. However, in populations, accurate measurement of physical activity is challenging and may not provide information on functional impairment. This study therefore assessed physical functionality and physical activity level in a group of nonagenarians (11 men/11 women; 93+/-1 years, 66.6+/-2.4 kg, body mass index [BMI]=24+/-1 kg/m2) and a group of participants aged 60-74 years (17 men/15 women; 70+/-1 years, 83.3+/-3.0 kg, BMI=29+/-1 kg/m2) from the Louisiana Healthy Aging Study. Physical activity level was calculated from total energy expenditure (TEE) and resting metabolic rate (RMR). Physical functionality was assessed using the Reduced Continuous Scale Physical Functional Performance Test (CS-PFP10). Nonagenarians had lower absolute (p<.001) and adjusted (p<.007) TEE compared to participants aged 60-74 years which was attributed to a reduction in both RMR and physical activity level. Nonagenarians also had reduced functional performance (p<.001) which was correlated with activity level (r=0.68, p<.001). When compared to individuals aged 60-74 years, 73% of the reduction in TEE in nonagenarians can be attributed to a reduction in physical activity level, the remaining being accounted for by a reduction in RMR. The reduced physical activity in nonagenarians is associated with less physical functionality. This study provides the first objective comparison of physical functionality and actual levels of physical activity in older individuals.

Medium-term survival after primary angioplasty for myocardial infarction complicated by cardiogenic shock after the age of 75 years.

PubMed

Samadi, A; Le Feuvre, C; Allali, Y; Collet, J-P; Barthélémy, O; Beygui, F; Helft, G; Montalescot, G; Metzger, J-P

2008-03-01

To assess mortality in people > or =75 years of age 6 months after myocardial infarction complicated by cardiogenic shock and treated by angioplasty with complete revascularisation and optimal anti-thrombotic treatment; to compare results to those of younger patients with or without shock and to analyse predictive factors for death. The study is based on 1011 consecutive patients with myocardial infarction admitted for primary angioplasty, subdivided into four groups by age and the presence or absence of cardiogenic shock: group 1 (<75 years of age without shock, n=733), group 2 (<75 years of age with shock, n=49), group 3 (> or =75 years of age without shock, n=208) and group 4 (> or =75 years of age with shock, n=20). These four patient groups were compared for mortality rates and predictive factors for in-hospital and 6 month mortality. In-hospital mortality in groups 1 to 4 was 1.7%, 30.6%, 9.1%, and 70% (p<0.0001) respectively and 6-month mortality was 3.1%, 40%, 16% and 78% (P<0.0001). By univariate analysis renal failure was a predictive factor for death at 6 months in patients without cardiogenic shock (groups 1 and 3), and left ventricular function in patients in group 2. No predictive factors were found in group 4 patients. The independent predictive factors for death at 6 months were: age >75 years of age (P<0.0003), cardiogenic shock (P<0.0001), triple vessel lesions (P<0.01) and creatinine clearance (P=0.004). Mortality after angioplasty remains high in people > or =75 years with cardiogenic shock despite all the advances in the management of myocardial infarction. These disappointing results should encourage us to assess the role of surgical revascularisation and circulatory assistance.

Safety and Effectiveness of Mirabegron in Patients with Overactive Bladder Aged ≥75 Years: Analysis of a Japanese Post-Marketing Study.

PubMed

Yoshida, Masaki; Nozawa, Yumiko; Kato, Daisuke; Tabuchi, Hiromi; Kuroishi, Kentarou

2017-09-12

A 12-week post-marketing study was conducted to provide real-world data on Japanese patients with overactive bladder (OAB) initiating treatment with mirabegron. This post-hoc analysis focused on safety and effectiveness of mirabegron in patients aged ≥75 versus <75 years. Incidence of adverse drug reactions (ADR) was assessed following 12 weeks' mirabegron treatment. Overactive Bladder Symptom Score (OABSS) and International-Prostate Symptom Score Quality of Life (I-PSS QoL) were completed at baseline and at the end of treatment (EoT). A reduction of ≥3 points in total OABSS was defined as a minimal clinically important change (MCIC). Of 9795 patients, a greater proportion aged ≥75 versus <75 years had a lower body mass index (BMI; BMI < 18.5: 4.2% vs 3.2%), longer OAB duration (≥3 years: 24.6% vs 20.3%) and more severe OAB symptoms (severe: 17.0% vs 11.2%). A significantly greater percentage of patients aged ≥75 versus <75 years had comorbidities (77.8% vs 66.0%) and used concomitant drugs (58.3% vs 48.7%; P < 0.001). Incidence of ADR was observed in 7.00% and 5.19% of patients aged ≥75 versus <75 years, respectively. At EoT, mirabegron treatment was reported 'effective' in 79.3% versus 82.1% of patients aged ≥75 versus <75 years, respectively. Mean total OABSS decreased significantly from baseline, and exceeded the MCIC in 61.0% and 65.9% of patients aged ≥75 and <75 years, respectively. Similar changes were observed for I-PSS QoL in both groups. In a real-world clinical setting, mirabegron was well-tolerated and effective in patients aged ≥75 and <75 years. © 2017 John Wiley & Sons Australia, Ltd.

34 CFR 75.250 - Project period can be up to 60 months.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Project period can be up to 60 months. 75.250 Section... Are Made Approval of Multi-Year Projects § 75.250 Project period can be up to 60 months. The Secretary may approve a project period of up to 60 months. (Authority: 20 U.S.C. 1221e-3 and 3474) [45 FR 22497...

46 CFR 2.75-60 - Hazardous ships' stores.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Hazardous ships' stores. 2.75-60 Section 2.75-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC VESSEL... Personnel § 2.75-60 Hazardous ships' stores. Hazardous ships' stores, as defined in § 147.3 of this chapter...

46 CFR 2.75-60 - Hazardous ships' stores.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Hazardous ships' stores. 2.75-60 Section 2.75-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC VESSEL... Personnel § 2.75-60 Hazardous ships' stores. Hazardous ships' stores, as defined in § 147.3 of this chapter...

46 CFR 2.75-60 - Hazardous ships' stores.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Hazardous ships' stores. 2.75-60 Section 2.75-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC VESSEL... Personnel § 2.75-60 Hazardous ships' stores. Hazardous ships' stores, as defined in § 147.3 of this chapter...

46 CFR 2.75-60 - Hazardous ships' stores.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Hazardous ships' stores. 2.75-60 Section 2.75-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC VESSEL... Personnel § 2.75-60 Hazardous ships' stores. Hazardous ships' stores, as defined in § 147.3 of this chapter...

46 CFR 2.75-60 - Hazardous ships' stores.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Hazardous ships' stores. 2.75-60 Section 2.75-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC VESSEL... Personnel § 2.75-60 Hazardous ships' stores. Hazardous ships' stores, as defined in § 147.3 of this chapter...

Is Bilateral Internal Mammary Arterial Grafting Beneficial for Patients Aged 75 Years or Older?

PubMed

Itoh, Satoshi; Kimura, Naoyuki; Adachi, Hideo; Yamaguchi, Atsushi

2016-07-25

Although bilateral internal mammary artery (BIMA) grafting is performed with increasing regularity in elderly patients, whether it is truly beneficial, and therefore indicated, in these patients remains uncertain. We retrospectively investigated early and late outcomes of BIMA grafting in patients aged ≥75 years. We identified 460 patients aged ≥75 years from among 2,618 patients who underwent either single internal mammary artery (SIMA) grafting (n=293) or BIMA grafting (n=107). Early outcomes did not differ between the SIMA and BIMA patients (30-day mortality: 1.7% vs. 0%, P=0.39; sternal wound infection: 1.0% vs. 4.7%; P=0.057). Late outcomes, 10-year survival in particular, were improved in the BIMA group (36.6% vs. 48.1%, P=0.033). In the analysis of the results in propensity score-matched groups (196 patients in the SIMA group, 98 patients in the BIMA group), improved 10-year survival was documented in the BIMA group (34.8% vs. 47.6%, P=0.030). Cox proportional regression analysis showed SIMA usage (non-use of BIMA) to be a predictor for late mortality (hazard ratio: 0.65, 95% confidence interval: 0.43-0.98, P=0.042). We further compared outcomes between the total non-elderly patients (n=2,158) and total elderly patients (n=460). BIMA usage was similar, as was 30-day mortality (1.0% vs. 1.3%, respectively). A survival advantage, with no increase in early mortality, can be expected from BIMA grafting in patients aged ≥75 years. (Circ J 2016; 80: 1756-1763).

Role of bicyclol in preventing chemotherapeutic agent-induced liver injury in patients over 60 years of age with cancer.

PubMed

Li, Xiaoyuan; Zhou, Jianfeng; Chen, Shuchang; Guan, Mei; Wang, Yingyi; Zhao, Lin; Ying, Hongyan; Zhou, Yanping

2014-08-01

To evaluate the efficacy of bicyclol in preventing chemotherapy-induced liver damage. Patients ≥60 years of age with cancer were equally randomized into control (chemotherapy alone) or prophylactic (chemotherapy supplemented with 75 mg bicyclol, oral, daily) groups. Liver function indices were assessed immediately before treatment, during each therapy cycle and following treatment. Of 306 patients enrolled, 300 patiets completed the study (n = 147 and n = 153; prophylactic and control groups, respectively). Incidence of grade I-IV elevation of serum transaminase and/or bilirubin was significantly lower in the prophylactic group (17.1%) compared with the control group (47.1%). Incidence of grade II-IV hepatic injury was also significantly lower in the prophylactic group (0.7%) than in the control group (12.4%). Prophylactic bicyclol (75 mg daily) could significantly reduce the incidence and degree of chemotherapeutic agent-induced liver damage in elderly patients with cancer. Further studies are recommended with larger sample sizes and long-term follow up. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Age >or=75 years is associated with greater resource utilization following coronary artery bypass grafting.

PubMed

Toor, Iqbal; Bakhai, Ameet; Keogh, Bruce; Curtis, Miles; Yap, John

2009-11-01

We examined whether complication rates and resource utilization among elderly patients undergoing coronary artery bypass grafting (CABG) differed from their younger counterparts. A retrospective review of prospectively collected data was conducted of 2936 patients undergoing first-time isolated CABG. Demographic and baseline clinical characteristics were collected, and patients grouped according to age into those <75 years (n=2424, younger) and >or=75 years (n=512, older). Major postoperative complications were recorded and data collected on indicators of resource utilization, which included intensive care unit (ICU) length of stay (LOS), postoperative LOS and total hospital LOS. In comparison with younger patients, older patients were more likely to be female (26.6% vs. 18.1%, P<0.0001) and require an urgent procedure (46.4% vs. 33.3%, P<0.0001). Postoperative complications were significantly higher in elderly patients (43.7% vs. 23.0%; odds ratio (OR)=2.5, 95% confidence interval (CI) [2.0-3.1]; P<0.0001). Older patients incurred longer intensive care stays (2 days interquartile range (IQR) [1-3] vs. 1 day IQR [1-2]; P<0.0001) and a longer postoperative stay (8 days IQR [6-11] vs. 6 days IQR [5-8]; P<0.0001). Multivariate logistic regression analysis showed age >or=75 years was an independent predictor of postoperative LOS (OR=1.23, 95% CI [0.49-1.96]; P=0.001). Older patients aged >or=75 years undergoing CABG had significantly higher rates of postoperative complications and greater resource utilization than their younger counterparts.

Physical Activity and Mental Well-being in a Cohort Aged 60–64 Years

PubMed Central

Black, Stephanie V.; Cooper, Rachel; Martin, Kathryn R.; Brage, Soren; Kuh, Diana; Stafford, Mai

2015-01-01

Introduction Although evidence suggests physical activity (PA) may be associated with mental well-being at older ages, it is unclear whether some types of PA are more important than others. The purpose of this study is to investigate associations of monitored total PA under free-living conditions, self-reported leisure-time PA (LTPA), and walking for pleasure with mental well-being at age 60–64 years. Methods Data on 930 (47%) men and 1,046 (53%) women from the United Kingdom Medical Research Council (MRC) National Survey of Health and Development collected in 2006–2011 at age 60–64 were used in 2013–2014 to test the associations of PA (PA energy expenditure and time spent in different intensities of activity assessed using combined heart rate and acceleration monitors worn for 5 days, self-reported LTPA, and walking for pleasure) with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS; range, 14–70). Results In linear regression models adjusted for gender, long-term limiting illness, smoking, employment, socioeconomic position, personality, and prior PA, those who walked for >1 hour/week had mean WEMWBS scores 1.47 (95% CI=0.60, 2.34) points higher than those who reported no walking. Those who participated in LTPA at least five times/month had WEMWBS scores 1.25 (95% CI=0.34, 2.16) points higher than those who did not engage in LTPA. There were no statistically significant associations between free-living PA and WEMWBS scores. Conclusions In adults aged 60–64 years, participation in self-selected activities such as LTPA and walking are positively related to mental well-being, whereas total levels of free-living PA are not. PMID:26070782

Arthroscopic treatment of femoroacetabular impingement in patients older than 60 years.

PubMed

Mardones, Rodrigo; Via, Alessio Giai; Rivera, Alvaro; Tomic, Alexander; Somarriva, Marcelo; Wainer, Mauricio; Camacho, Daniel

2016-01-01

The indications of hip arthroscopy increased over the past decade. Although mostly recommended for treatment of femoroacetabular impingement (FAI) in young patients, well-selected older patients (> 60 years old) may benefit from this surgery. However, the role of hip arthroscopy for the management of older patients is controversial. The aim of the study is to evaluate the clinical outcomes of a series of patients aged 60 years and older who underwent hip arthroscopy for FAI at mid-term follow-up. Sixty-year-old patients and older, with a joint space greater than 2 mm, and a grade I and II hip osteoarthrosis (OA) according Tönnis scale were included into the study. Twenty-three patients (28 hips) met the inclusion criteria. The T-Student test was used to detect for differences between variables (p<0.05). The mean age of the patients was 63.4 years, and the mean follow-up was 4.4 years (2-9 years). We found an improvement in mHHS and VAS score from the baseline to the final follow-up in 87% of patients (p<0.05). Three patients (13%) were submitted to a THA at a mean of 12 months, while the survivorship rate at the final follow-up was 75%. No major complications have been reported. Arthroscopic treatment of FAI in patients over 60 years old, with no signs of advanced osteoarthrosis, showed a significant improvement of functional score and pain in most of cases, and it can be consider a reasonable option in well selected patients. Level of evidence: IV case series.

Mortality predictors in a 60-year follow-up of adolescent males: exploring delinquency, socioeconomic status, IQ, high-school drop-out status, and personality.

PubMed

Trumbetta, Susan L; Seltzer, Benjamin K; Gottesman, Irving I; McIntyre, Kathleen M

2010-01-01

To examine whether socioeconomic status (SES), high school (HS) completion, IQ, and personality traits that predict delinquency in adolescence also could explain men's delinquency-related (Dq-r) mortality risk across the life span. Through a 60-year Social Security Death Index (SSDI) follow-up of 1812 men from Hathaway's adolescent normative Minnesota Multiphasic Personality Inventory (MMPI) sample, we examined mortality risk at various ages and at various levels of prior delinquency severity. We examined SES (using family rent level), HS completion, IQ, and MMPI indicators simultaneously as mortality predictors and tested for SES (rent level) interactions with IQ and personality. We ascertained 418 decedents. Dq-r mortality peaked between ages 45 years to 64 years and continued through age 75 years, with high delinquency severity showing earlier and higher mortality risk. IQ and rent level failed to explain Dq-r mortality. HS completion robustly conferred mortality protection through ages 55 years and 75 years, explained IQ and rent level-related risk, but did not fully explain Dq-r risk. Dq-r MMPI scales, Psychopathic Deviate, and Social Introversion, respectively, predicted risk for and protection from mortality by age 75 years, explaining mortality risk otherwise attributable to delinquency. Wiggins' scales also explained Dq-r mortality risk, as Authority Conflict conferred risk for and Social Maladjustment and Hypomania conferred protection from mortality by age 75 years. HS completion robustly predicts mortality by ages 55 years and 75 years. Dq-r personality traits predict mortality by age 75 years, accounting, in part, for Dq-r mortality.

Health behaviours and quality of life in independently living South Australians aged 75 years or older.

PubMed

Amarasena, N; Keuskamp, D; Balasubramanian, M; Brennan, D S

2018-06-01

This study evaluated the associations between oral and general health behaviours, self-reported health and quality of life of adults aged 75 years or older living independently in South Australia. A cross sectional study based on a self-report mailed questionnaire was conducted in 590 independently living adults aged 75 years or older. Self-ratings of oral health and general health were assessed using single-item global ratings. Quality of life was measured using the Oral Health Impact Profile and the EuroQol instrument for health utility. The overall response rate was 78%. The current analyses were restricted to 354 dentate older adults. Increasing age and being female were negatively associated with EuroQol scores. Good self-rated oral and general health were more prevalent in participants with higher social status who also had lower oral health impact and higher EuroQol scores. Good self-rated oral and general health were less prevalent while oral health impact was greater in participants who ate few fruits, vegetables or dairy products. Self-rated health and quality of life were poor in older adults with inadequate fruit/vegetables/dairy intake and lower social status. These findings suggest that nutrition and socioeconomic factors may be important to the oral and general health of adults aged 75 years or older. © 2018 Australian Dental Association.

Childhood Weight Gain and Thyroid Autoimmunity at Age 60–64 Years: The 1946 British Birth Cohort Study

PubMed Central

Kuh, Diana; Pierce, Mary; Franklyn, Jayne A.

2013-01-01

Background: Complex bidirectional relationships have been described between body weight, thyroid function, and risk of thyroid disorders, including thyroid autoimmunity. We used a life-course approach to examine the potential association of childhood or adult body weight with the risk of thyroid autoimmunity and other thyroid disorders at age 60–64 years in a large population-based birth cohort study. Methods: In the UK Medical Research Council 1946 British Birth Cohort study, at age 60–64 years, 1277 women and 1185 men (78% of the target sample) responded to a postal questionnaire, which included questions on thyroid disease and thyroid medication. Circulating antithyroid peroxidase antibodies, free T4, and TSH concentrations were measured in 1057 women and 997 men at a subsequent clinic visit. Birth weight was recorded, and height and weight were measured at ages 2, 4, 6, 7, 11, 15 years and also repeatedly in adulthood. Results: At age 60–64 years, 10.9% of women (139 of 1277) and 2.3% of men (27 of 1185) reported they were taking T4, and 11.5% of women (122 of 1057) and 3.3% of men (33 of 997) had positive anti-TPO antibodies (>100 IU/mL), consistent with thyroid autoimmunity. Among women, both T4 use and positive anti-TPO antibodies at age 60–64 years were positively associated with childhood body weight, childhood overweight, and adult body mass index. Childhood weight gain between 0 and 14 years of age was positively associated with later T4 use (odds ratio 1.21, 95% confidence interval 1.03–1.42) and positive anti-TPO antibodies (1.21, 1.00–1.47). Women who were overweight or obese at age 14 years (127 of 972) had a higher risk of later positive anti-TPO antibodies (2.05, 1.12–3.76). In men and women without any thyroid disorders, serum free T4 concentrations were inversely associated with concurrent body mass index (P = .002). Conclusions: Childhood weight gain and childhood overweight conferred an increased susceptibility to later

Prevalence of protein-energy malnutrition in hospital patients over 75 years of age admitted for hip fracture.

PubMed

Drevet, S; Bioteau, C; Mazière, S; Couturier, P; Merloz, P; Tonetti, J; Gavazzi, G

2014-10-01

One percent of falls in over-75 years old cause hip fracture (HF). Protein-energy malnutrition (PEM) is associated with falls and fracture. PEM screening and perioperative nutritional management are recommended by the European Society of Parenteral and Enteral Nutrition, yet data on nutritional status in elderly HF patients are sparse. The Mini Nutritional Assessment (MNA) score is presently the most effective screening tool for PEM in over-75 years old. The principal objective of the present study was to determine the prevalence on MNA of PEM in patients aged over 75 years admitted for HF. Secondary objectives were to identify factors associated with PEM and its role as a factor of evolution. A prospective observational epidemiological study included 50 patients aged over 75 years admitted for HF in an 8-bed orthopedic surgery department with a geriatric follow-up unit. PEM was defined by MNA<17/30. Assessment systematically comprised associated comorbidity (Cumulative Illness Rating Scale-Geriatric [CIRS-G]), cognitive status on the Mini Mental State Examination (MMSE), functional status on activities of daily life (ADL), and mean hospital stay (MHS). Scores were compared on quantitative tests (Student t) with the significance threshold set at P<0.05. Mean age for the 50 patients was 86.1 years (range, 77-94 years). Prevalence of PEM was 28%; a further 58% of patients were at risk for PEM. PEM was associated with elevated CIRS-G (P<0.006), greater numbers of severe comorbidities (P=0.006), more severe cognitive disorder (P=0.005) and functional dependence (P=0.002), and 8 days' longer MHS (P=0.012). The present study confirmed the high prevalence of PEM in HF patients aged over 75 years, supporting longer hospital stay. MNA is a diagnostic gold standard, not to be replaced by albuminemia or body-mass index in this perioperative clinical situation. Given the present economic stakes relating to geriatric trauma patients' hospital stay, it is essential to prevent

Trends in AIDS-related mortality among people aged 60 years and older in Brazil: a nationwide population-based study.

PubMed

Lima, Mauricélia da Silveira; Firmo, Andréa Acioly Maia; Martins-Melo, Francisco Rogerlândio

2016-12-01

The success of antiretroviral therapy has led to an increase in the number of older people living with human immunodeficiency virus worldwide. This study analyzed the epidemiological patterns and time trends of acquired immunodeficiency syndrome (AIDS) related mortality in people aged 60 and older in Brazil from 2000 to 2011. Secondary mortality data from the Brazilian Mortality Information System was used to perform a nationwide population-based study, which included all AIDS-related deaths among people aged 60 years and older in Brazil from 2000 to 2011. Crude and age-adjusted mortality rates (per 100,000 inhabitants) were calculated by sex, age group and place of residence. Trends over time were assessed using joinpoint regression analysis. In the 12-year study period, 12,491,280 deaths were recorded in Brazil, of which 144,175 were AIDS-related deaths. A total of 8194 AIDS-related deaths was identified in people aged 60 years and older (0.12% of all deaths and 5.7% of AIDS-related deaths). The overall age-adjusted mortality rate for the period was 4.30 deaths/100,000 inhabitants (95% confidence interval: 3.99-4.64). Males (6.45 deaths/100,000 inhabitants), aged 60-64 years (6.63 deaths/100,000 inhabitants) and residing in the South region (5.94 deaths/100,000 inhabitants) had the highest mortality rates. We observed a significant increase in mortality at the national level and in all the Brazilian regions, with a sharper increase in the most socioeconomically disadvantaged regions of the country, such as the North and Northeast. The findings show that AIDS in older people is an increasing public health problem in Brazil, and reinforce the need to establish public policies for the prevention, early diagnosis and appropriate clinical treatment of this age group.

Transplantation With Livers From Deceased Donors Older Than 75 Years.

PubMed

Thorsen, Trygve; Aandahl, Einar Martin; Bennet, William; Olausson, Michael; Ericzon, Bo-Göran; Nowak, Greg; Duraj, Frans; Isoniemi, Helena; Rasmussen, Allan; Karlsen, Tom H; Foss, Aksel

2015-12-01

The availability of donor organs limits the number of patients in need who are offered liver transplantation. Measures to expand the donor pool are crucial to prevent on-list mortality. The aim of this study was to evaluate the use of livers from deceased donors who were older than 75 years. Fifty-four patients who received a first liver transplant (D75 group) from 2001 to 2011 were included. Donor and recipient data were collected from the Nordic Liver Transplant Registry and medical records. The outcome was compared with a control group of 54 patients who received a liver graft from donors aged 20 to 49 years (D20-49 group). Median donor age was 77 years (range, 75-86 years) in the D75 group and 41 years (range, 20-49 years) in the D20-49 group. Median recipient age was 59 years (range, 31-73 years) in the D75 group and 58 years (range, 31-74 years) in the D20-49 group. The 1-, 3-, and 5-year patient/graft survival values were 87/87%, 81/81%, and 71/67% for the D75 group and 88/87%, 75/73%, and 75/73% for the D20-49 group, respectively. Patient (P = 0.89) and graft (P = 0.79) survival did not differ between groups. The frequency of biliary complications was higher in the D75 group (29.6/13%, P = 0.03). Selected livers from donors over age 75 years should not be excluded based on age, which does not compromise patient or graft survival despite a higher frequency of biliary complications.

Post-recurrence survival of elderly patients 75 years of age or older with surgically resected non-small cell lung cancer.

PubMed

Takenaka, Tomoyoshi; Inamasu, Eiko; Yoshida, Tsukihisa; Toyokawa, Gouji; Nosaki, Kaname; Hirai, Fumihiko; Yamaguchi, Masafumi; Seto, Takashi; Takenoyama, Mitsuhiro; Ichinose, Yukito

2016-04-01

The purpose of this study was to evaluate the outcomes of elderly patients 75 years of age or older with recurrent non-small cell lung cancer (NSCLC). A total of 1237 consecutive patients with NSCLC underwent pulmonary resection at our institution. Of these patients, 280 experienced postoperative recurrence. The rate of the post-recurrence survival and predictors were analyzed independently in a group of younger patients (<75 years) and a group of elderly patients (≥75 years). There were 215 younger patients (<75 years) and 65 elderly (≥75 years) patients at the time of diagnosis of recurrence. The median post-recurrence survival time and the five-year survival rate of all cases were 25 months and 20.8%, respectively. There were no significant survival differences between the younger and elderly groups (p = 0.20). A univariate analysis determined that gender, Eastern Cooperative Oncology Group performance status, smoking status, histological type and epithelial growth factor receptor (EGFR) mutation status were factors influencing the post-recurrence survival among the elderly patients. In addition, a multivariate analysis determined the EGFR mutation status to be an independent prognostic factor for the post-recurrence survival. Elderly patients 75 years of age or older in this study achieved satisfactory long-term outcomes.

Sentinel Lymph Node Biopsy Use Among Melanoma Patients 75 Years of Age and Older.

PubMed

Sabel, Michael S; Kozminski, David; Griffith, Kent; Chang, Alfred E; Johnson, Timothy M; Wong, Sandra

2015-07-01

While SLN biopsy is recommended for melanoma ≥1 mm in depth, its use among the elderly population is more controversial. We reviewed our experience at the University of Michigan with melanoma patients ≥75 years of age. A total of 952 melanoma patients ≥75 years of age from 1996 to 2011 were identified from our institutional review board-approved database. In addition to clinicopathologic features and outcome data, comorbidity data were collected to calculate the Charlson comorbidity index (CCI). Univariate and multivariate Cox regression analysis was performed to characterize predictors of outcome. Kaplan-Meier analysis was used to generate survival curves. Among 553 clinically node-negative patients with melanoma ≥1 mm in Breslow thickness, 213 had wide excision alone, whereas 340 had excision and SLN biopsy, with 83 (24 %) having a positive SLN. SLN biopsy was less likely with older age (p < 0.0001) and H&N location (p = 0.007), but not CCI. SLN involvement was associated with female gender [odds ratio (OR) 2.15, p = 0.009], Breslow thickness [OR 1.23/mm increase, p = 0.004], and satellitosis (OR 4.43, p = 0.004). Distant disease-specific survival was negatively associated with male gender (OR 1.5, p = 0.007), increasing age (OR 1.05/year, p < 0.001), increasing Breslow thickness (OR 1.07/year, p = 0.013), ulceration (OR 1.51, p = 0.004), a positive SLN (OR 2.61, p < 0.001), and not having a SLN biopsy (OR 1.72, p < 0.001). CCI did not predict worse disease-free or melanoma-specific survival. WLE and SLN biopsy was not only strongly prognostic, but compared with WLE alone was associated with improved outcome, even after factoring for age and comorbidities. If otherwise healthy, SLN biopsy should be strongly considered for this population.

Survival benefits of metabolic syndrome among older men aged 75 years and over in Taiwan.

PubMed

Chiang, P-H; Liu, C-L; Lin, M-H; Peng, L-N; Chen, L-K; Chen, J-D; Hou, S-M

2012-01-01

Metabolic syndrome (MetS) was common in the elderly, but its prognostic significance in older old population remained unclear. The main purpose of this study was to evaluate the survival impact of MetS among older men aged 75 and over in Taiwan. From 2008, residents aged 75 years and older of Banciao Veterans Home were invited for study and were followed for 3 years. All participants received history taking, physical examinations, and laboratory tests. Mortality was determined by Veteran Affairs Death Registry, which was linked to the National Death Registry. Overall, 680 men (mean age: 82.5±4.7 years) were enrolled for study and the prevalence of MetS was 31.6%. During the follow-up period, 140 (20.6%) participants died, and the causes of death included infectious diseases (62, 9.1%), cardiovascular disease (37, 5.4%), cancer (20, 2.9%), and others (21, 3.1%). MetS subjects had a significantly higher prevalence of hypertension, diabetes mellitus, and having higher body mass index, waist circumferences, systolic blood pressure, fasting blood glucose, serum triglyceride and lower HDL-C level than non-MetS subjects. However, MetS subjects were less likely to die during study period (16.3% vs. 22.6%, P=0.059). Multivariate logistic regression showed that older age (OR:1.04, 95% C.I.: 1.00-1.08, P=0.04), diabetes mellitus (OR: 2.10, 95% CI: 1.34-3.30, P=0.001) were independent risk factors for mortality; and serum total cholesterol and triglyceride were protective factors (OR: 0.99, 95% CI: 0.99-1.00, P=0.037 for cholesterol; OR: 0.99, 95% CI: 0.99-1.00, P=0.013 for triglyceride). Adjusted for age, diabetes mellitus, serum levels of total cholesterol, and triglyceride, MetS played a potential trend of survival benefits among study subjects (HR: 0.71, 95% CI: 0.45-1.12, P=0.144). The prevalence of MetS among men aged 75 years and over was 31.6%, and the 3-year mortality rate was 20.6%. Older age, diabetes mellitus, lower serum cholesterol and lower serum triglyceride

Treatment strategies and outcomes in diffuse large B-cell lymphoma among 1011 patients aged 75 years or older: A Danish population-based cohort study.

PubMed

Juul, Maja Bech; Jensen, Pernille Hammershoej; Engberg, Henriette; Wehberg, Sonja; Dessau-Arp, Andriette; Haziri, Donika; Kristensen, Helene Bjoerg; Baech, Joachim; Schurmann, Lene; Clausen, Michael Roost; Valentin, Rebecca; Knudsen, Lene Meldgaard; Munksgaard, Lars; El-Galaly, Tarec Christoffer; Frederiksen, Henrik; Larsen, Thomas Stauffer

2018-06-20

Optimal treatment strategy for the oldest patients with diffuse large B-cell lymphoma (DLBCL) remains controversial, as this group often is precluded from clinical trials, and population-based studies are limited. All Danish DLBCL-patients ≥75 years diagnosed from 2003 to 2012 were identified, using the Danish National Lymphoma Registry (LYFO). Information regarding baseline characteristics, treatment, comorbidities and outcomes was retrieved from LYFO, the Danish National health registries and medical records. Patients were stratified by age (75-79; 80-84 and 85 + years), comorbidity score and treatment modality (standard treatment [R-CHOP/CHOP-like], less intensive regimens or palliative treatment). A total of 1011 patients were included. Standard treatment was initiated in 64%, ranging from 83% among patients aged 75-79 years to 32% among patient aged 85 + years. With standard treatment, median overall survival (OS) estimates were 4·6, 2·6, and 1·9 years for the age groups 75-79, 80-84 and 85+ years. Among patient aged 75-79 and 80-84 years, OS was superior with standard treatment, although high comorbidity scores attenuated this association. Among patients aged 85+ years, survival was not influenced by treatment intensity. Patients ≥80 years had similar OS regardless of intended (R-)CHOP dosing, whereas patients of 75-79 years scheduled for full dose had higher OS. Standard treatment was not associated with increased hospitalisation. Standard treatment is feasible with good outcomes in a large proportion of elderly DLBCL-patients. Planned dose reduction in patients aged ≥80 years had no negative impact on OS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Study of Mini-Mental State Exam evolution in community-dwelling subjects aged over 60 years without dementia.

PubMed

Watfa, G; Husson, N; Buatois, S; Laurain, M C; Miget, P; Benetos, A

2011-12-01

In recent years, the Mini-Mental State Examination (MMSE) has been widely used and has been proposed for cognitive decline screening in the framework of a systematic geriatric evaluation in health centers. The aim of the present longitudinal study was to identify the potential determinants of MMSE score and its evolution over a 4-year period in a population aged over sixty years with good general health without dementia and consulting for a health check-up. Longitudinal study. The preventive medical center (CMP) in Nancy. 687 subjects over 60 years of age (mean age 65.6 ± 5.07 years) were included from the Senior health examination study. All subjects underwent 2 visits over a period of 4 years. MMSE measurement and a self-administered questionnaire of emotional and psychological state were evaluated at baseline and at the follow-up visit. The major components of total variance of baseline MMSE were represented by education level, practice of regular physical activity, nervousness and despair. Multivariate analysis identified 3 variables at baseline visit that independently predicted annual changes in MMSE: MMSE score, education level and "Difficulty in social relations" (r= -0.222, 0.154 and -0.255 respectively). Education level and several psychological factors may influence MMSE score and its evolution over time in community-dwelling subjects aged over 60 years without dementia. In these subjects, a low MMSE score does not predict cognitive decline over a period of 4 years. Therefore, the reliability of MMSE in this type of population is questionable.

The effects of age and gender on sleep EEG power spectral density in the middle years of life (ages 20-60 years old)

NASA Technical Reports Server (NTRS)

Carrier, J.; Land, S.; Buysse, D. J.; Kupfer, D. J.; Monk, T. H.

2001-01-01

The effects of age and gender on sleep EEG power spectral density were assessed in a group of 100 subjects aged 20 to 60 years. We propose a new statistical strategy (mixed-model using fixed-knot regression splines) to analyze quantitative EEG measures. The effect of gender varied according to frequency, but no interactions emerged between age and gender, suggesting that the aging process does not differentially influence men and women. Women had higher power density than men in delta, theta, low alpha, and high spindle frequency range. The effect of age varied according to frequency and across the night. The decrease in power with age was not restricted to slow-wave activity, but also included theta and sigma activity. With increasing age, the attenuation over the night in power density between 1.25 and 8.00 Hz diminished, and the rise in power between 12.25 and 14.00 Hz across the night decreased. Increasing age was associated with higher power in the beta range. These results suggest that increasing age may be related to an attenuation of homeostatic sleep pressure and to an increase in cortical activation during sleep.

A Frailty Instrument for primary care for those aged 75 years or more: findings from the Survey of Health, Ageing and Retirement in Europe, a longitudinal population-based cohort study (SHARE-FI75+)

PubMed Central

Romero-Ortuno, Roman; Soraghan, Christopher

2014-01-01

Objective To create and validate a frailty assessment tool for community-dwelling adults aged ≥75 years. Design Longitudinal, population-based study. Setting The Survey of Health, Ageing and Retirement in Europe (SHARE). Participants 4001 women and 3057 men aged ≥75 years from the second wave of SHARE. 3325 women and 2587 men had complete information for the frailty indicators: fatigue, low appetite, weakness, observed gait (walking without help, walking with help, chairbound/bedbound, unobserved) and low physical activity. Main outcome measures The internal validity of the frailty indicators was tested with latent class analysis, by modelling an underlying variable with three ordered categories. The predictive validity of the frailty classification was tested against 2-year mortality and 4-year disability. The mortality prediction of SHARE-FI75+ was compared with that of previously operationalised frailty scales in SHARE (SHARE-FI, 70-item index, phenotype, FRAIL). Results In both genders, all frailty indicators significantly aggregated into a three-category ordinal latent variable. After adjusting for baseline age, comorbidity and basic activities of daily living (BADL) disability, the frail had an OR for 2-year mortality of 2.2 (95% CI 1.2 to 3.8) in women and 4.2 (2.6 to 6.8) in men. The mortality prediction of SHARE-FI75+ was similar to that of the other SHARE frailty scales. By wave 4, 49% of frail women (78 of 159) had at least one more limitation with BADL (compared with 18% of non-frail, 125 of 684; p<0.001); in men, these proportions were 39% (26 of 66) and 18% (110 of 621), respectively (p<0.001). A calculator is supplied for point-of-care use, which automatically replicates the frailty classification for any given measurements. Conclusions SHARE-FI75+ could help frailty case finding in primary care and provide a focus for personalised community interventions. Further validation in trials and clinical programmes is needed. PMID:25537787

Salivary flow rate and periodontal infection - a study among subjects aged 75 years or older.

PubMed

Syrjälä, A-M H; Raatikainen, L; Komulainen, K; Knuuttila, M; Ruoppi, P; Hartikainen, S; Sulkava, R; Ylöstalo, P

2011-05-01

To analyse the relation of stimulated and unstimulated salivary flow rates to periodontal infection in home-dwelling elderly people aged 75 years or older. This study was based on a subpopulation of 157 (111 women, 46 men) home-dwelling, dentate, non-smoking elderly people (mean age 79.8, SD 3.6 years) from the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly Study). The data were collected by interview and oral clinical examination. Persons with very low (< 0.7 ml min⁻¹) and low stimulated salivary flow rates (0.7- < 1.0 ml min⁻¹) had a decreased likelihood of having teeth with deepened (≥ 4 mm) periodontal pockets, RR: 0.7, CI: 0.5-0.9 and RR: 0.7, CI: 0.5-0.9, respectively, when compared with those with normal stimulated salivary flow. Persons with a very low unstimulated salivary flow rate (< 0.1 ml min⁻¹) had a decreased likelihood of having teeth with deepened (≥ 4 mm) periodontal pockets, RR 0.8, CI: 0.6-1.0, when compared with subjects with low/normal unstimulated salivary flow. In a population of dentate, home-dwelling non-smokers, aged 75 years or older, low stimulated and unstimulated salivary flow rates were weakly associated with a decreased likelihood of having teeth with deep periodontal pockets. © 2010 John Wiley & Sons A/S.

Associations between social inequality and tooth loss in a household sample of elderly Thai people aged ≥60 years old.

PubMed

Srisilapanan, Patcharawan; Korwanich, Narumanas; Lalloo, Ratilal

2016-06-01

To assess the relationship between social inequality and the number of remaining teeth in an elderly Thai population. Having twenty or more remaining teeth is an important indicator of optimal oral health in the elderly. The data for this study were derived from the Survey of Older Persons in Thailand, conducted by the National Statistical Office, based on face-to-face interviews with people aged ≥60. The total sample was 30 427. The oral health measure was self-reported remaining number of teeth. Income, education and possession of durable goods were utilised as measures of social inequality. More than half of the sample (57.0%) was women. The majority (73.2%) was in the age range 60-74 years old. Less than a fifth (15.5%) had 7 or more years of education. A third earned <20 000 Thai Baht (THB) per annum (defined as poor). More than half (52.8%) of the sample had <20 remaining teeth. There was a link between social inequalities and tooth loss. In the adjusted model, elderly people, who were older than 75, who were not under a married status, had a lower level of education, had a lower income, and who did not own luxury goods, were 2.84 (CI 95% 2.66-3.03), 1.31 (CI 95% 1.21-1.41), 1.44 (CI 95% 1.34-1.56), 1.12 (CI 95% 1.13-1.29) and 1.21 (CI 95% 1.13-1.29) times more likely to have 19 or fewer teeth remaining, respectively. Social inequality is related to the number of remaining teeth in elderly Thai people. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Conservative care as a treatment option for patients aged 75 years and older with CKD stage V: a National survey in the Netherlands.

PubMed

Susanto, Christopher; Kooman, J; Courtens, A M; Konings, C J A M

2018-01-01

Conservative care for patients aged 75 years and older with CKD stage 5 as a treatment option besides dialysis was proposed officially in the Netherlands in October 2016. This national survey showed the current implementation of this option in Netherlands nephrology departments. A web-based survey was sent to medical managers of 60 nephrology departments in the Netherlands in August 2016. Twenty-one medical managers (35%) completed the survey. The term "conservative care" is frequently used and well known. The estimated number of patients in whom the decision for maximal conservative care was made in 2015 was 310 of 2249 patients with CKD stage 5 age 75 years and older (range 5-50 patients per department). 164 patients became symptomatic and received no dialysis. There is no official registration for this treatment option and patient category. The practice patterns vary widely. Only one of 21 respondents reported a conservative care outpatient clinic. Formal training or education regarding conservative care is not available in most of departments. 95% of respondents discussed this treatment option with their patients. General practitioners are always being informed about their patient's decision. Their main role is providing or organizing palliative care support at the end of life and discussing advance care planning. Most respondents (86%) considered to include their patients in a prospective multicentre observational study, conservative care versus dialysis. Conservative care as a treatment option for patients with CKD stage 5 aged 75 years and older is well established. The practice patterns are varied in the Netherlands. Follow-up studies are needed to see whether the new multidisciplinary guideline facilitates harmonization of practice pattern. Funding is needed to optimize the implementation of conservative care.

Obstructive Sleep Apnea in a Danish Population of Men and Women Aged 60-80 Years with Nocturia

PubMed Central

Bing, Mette Hornum; Jennum, Poul; Moller, Lars Alling; Mortensen, Svend; Lose, Gunnar

2012-01-01

Introduction and Hypothesis: The aim of the present study was in a case-control design to evaluate the association between nocturia and obstructive sleep apnea, in men and women who had nocturia ≥ 2 per night (nocturics) compared to those without nocturia (controls). Methods: Participants were randomly selected among respondents in a population study of 4000 elderly individuals. Nocturia was assessed using the validated Nocturia, Nocturnal Enuresis, and Sleep-interruption Questionnaire (NNES-Q). Nocturia (≥ 2 voids/night) or control (< 1 void/night) status was assessed by a 3-day frequency volume chart (FVC). Furthermore, all participants completed an overnight ambulatory polygraphic recording to identify obstructive sleep apnea (OSA). Results: Of 1111 eligible individuals, a total of 75 nocturics and 75 controls (13.5%) were included. Overall, the prevalence and severity of OSA among nocturics and controls was not significantly different. In a sub-analysis we found that 22 nocturics with OSA (69%) had nocturnal polyuria. This led to a significantly increased risk of having OSA (OR 2.8, 95% CI: 1.1-7.3, p < 0.05) when having nocturnal polyuria compared to other pathophysiological causes of nocturia (polyuria, low bladder capacity, a combination of nocturnal polyuria/low bladder capacity, and neither nocturnal polyuria/low bladder capacity). Conclusions: Nocturia twice or more was not significantly associated with OSA. However, nocturics with nocturnal polyuria had a significantly higher risk of having OSA than nocturics with other pathophysiologies. Citation: Bing MH; Jennum P; Moller LA; Mortensen S; Lose G. Obstructive sleep apnea in a danish population of men and women aged 60-80 years with nocturia. J Clin Sleep Med 2012;8(5):515-520. PMID:23066362

Prevalence of primary headache disorders in a population aged 60 years and older in a rural area of Northern China.

PubMed

Zhang, Yajing; Shi, Zhihong; Hock, Duncan; Yue, Wei; Liu, Shuling; Zhang, Ying; Liu, Shuai; Zhao, Lei; Lu, Hui; Guan, Yalin; Wang, Xiaodan; Wsiniewski, Thomas; Ji, Yong

2016-12-01

Primary headache disorders are among the most common neurological complaints worldwide, and are significant causes of disability. Data are limited on the prevalence of primary headaches among individuals aged 60 years and older in China. The purpose of our study was to investigate the prevalence and characteristics of primary headaches among people aged 60 years and older in a rural area of northern China. A door-to-door survey was conducted in Ji County of Tianjin Province. A total of 5248 residents aged 60 years and older were visited from 2014 to 2015, unannounced, and basic sociodemographic and headache diagnostic information was collected via a questionnaire. Primary headache was classified tension-type headaches, migraines, chronic headache, and unclassified headache. The 1-year prevalence for primary headaches in Ji county is 10.30 %. The 1-year prevalence of tension-type headaches, migraines, chronic headache, and unclassified headache is 2.02 %, 0.85 %, 3.79 %, and 3.63 %. The 1-year prevalence of primary headache was higher in women than in men. The 1-year prevalence of primary headache was decreased with increasing age. The 1-year prevalence of tension-type headaches and chronic headache were decreased with higher education. Headache in the elderly was mild to moderate and not serious. In a population older than 60 years of age in rural, northern China, we found the 1-year prevalence of primary headache was 10.30 %, of tension-type headaches was 2.02 %, of migraines was 0.85 %, of chronic headache was 3.79 %, and of unclassified headache was 3.63 %. The prevalence of all of these was much lower than those observed in previous studies examining prevalence rates in the general population. The results of our study also indicated that women are more likely to have primary headache than men. We also found that chronic headache was frequent among the elderly. Participants with higher education levels were more predisposed than healthy

[The effects of moderate physical exercise on cognition in adults over 60 years of age].

PubMed

Sanchez-Gonzalez, J L; Calvo-Arenillas, J I; Sanchez-Rodriguez, J L

2018-04-01

Clinical evidence gathered in recent years indicates that elderly individuals more frequently display cognitive changes. These age-related changes refer, above all, to memory functions and to the speed of thinking and reasoning. A number of studies have shown that physical activity can be used as an important mechanism for protecting the cognitive functions. To test the hypothesis that physical exercise is able to bring about changes in the cognitive functions of healthy elderly adults without cognitive impairment, thereby improving their quality of life. The study population included participants in the University of Salamanca geriatric revitalisation programme. The sample initially consisted of a total of 44 subjects of both sexes, with a mean age of 74.93 years. The neuropsychological evaluation of the subjects included a series of validated neuropsychological tests: Mini-Mental State Examination, Benton Visual Retention Test, Rey Auditory Verbal Learning Test, Stroop Test and Trail Making Test. The results show that more physical activity is related to better performance in the cognitive functions of the subjects included in this study, after applying the geriatric revitalisation programme. The geriatric revitalisation programme can be a valuable tool for improving cognition in adults over 60 years of age, resulting in enhanced well-being in their quality of life.

Breast cancer among women over 75 years: an important public health problem?

PubMed

van Schoor, Guido; Otten, Johannes D M; den Heeten, Gerard J; Holland, Roland; Broeders, Mireille J M; Verbeek, André L M

2012-06-01

Women aged >75 years are not invited for mammographic screening; if diagnosed with breast cancer, due to their anticipated short-life expectancy, they are expected to die of other causes. To describe the breast cancer health problem in women aged >75 years, we estimated breast cancer incidence in this age group and the risk of breast cancer death in patients diagnosed after 75 years of age in Nijmegen, the Netherlands. Our findings demonstrate that in this age group, 3.3% of the women will be diagnosed with breast cancer, and that one in three of these incident cases die of this disease. These patients could have benefited from continued screening.

Long-term (60-month) results for the implantable miniature telescope: efficacy and safety outcomes stratified by age in patients with end-stage age-related macular degeneration

PubMed Central

Boyer, David; Freund, K Bailey; Regillo, Carl; Levy, Marc H; Garg, Sumit

2015-01-01

Background The purpose of this study was to evaluate the long-term results of an implantable miniature telescope (IMT) in patients with bilateral, end-stage, age-related macular degeneration (AMD). Methods A prospective, open-label, multicenter clinical trial with fellow eye controls enrolled 217 patients (mean age 76 years) with AMD and moderate-to-profound bilateral central visual acuity loss (20/80–20/800) resulting from untreatable geographic atrophy, disciform scars, or both. A subgroup analysis was performed with stratification for age (patient age 65 to <75 years [group 1; n=70] and patient age ≥75 years [group 2; n=127]), with a comparative evaluation of change in best-corrected distance visual acuity (BCDVA), quality of life, ocular complications from surgery, adverse events, and endothelial cell density (ECD). Follow-up in an extension study was 60 months. Results Data were available for 22, 38, and 31 patients in group 1 and 42, 46, and 32 patients in group 2 at 36, 48, and 60 months, respectively. Mean BCDVA improvement from baseline to 60 months was 2.41±2.69 lines in all patients (n=76), with 2.64±2.55 lines in group 1 and 2.09±2.88 lines in group 2. Quality of life scores were significantly higher in group 1. The most common significant surgery-related ocular complications in group 1 were iritis >30 days after surgery (7/70; 10%) and persistent corneal edema (3/70; 4.3%); and in group 2 were a decrease in BCDVA in the implanted eye or IMT removal (10/127 each; 7.9%), corneal edema >30 days after surgery (9/127; 7.1%), and persistent corneal edema (6/127; 4.7%). Significant adverse events included four corneal transplants, comprising two (2.9%) in group 1 and two (1.6%) in group 2. At 60 months, one patient in group 1 (3.2%) and three patients in group 2 (9.4%) had lost ≥2 lines of vision. The IMT was removed in one (1.4%) and ten (7.9%) patients in group 1 and group 2, respectively. Mean ECD loss was 20% at 3 months. Chronic loss was 3% per

Prevalence and Burden of Gait Disorders in Elderly Men and Women Aged 60–97 Years: A Population-Based Study

PubMed Central

Mahlknecht, Philipp; Kiechl, Stefan; Bloem, Bastiaan R.; Willeit, Johann; Scherfler, Christoph; Gasperi, Arno; Rungger, Gregorio; Poewe, Werner; Seppi, Klaus

2013-01-01

Background Although gait disorders are common in the elderly, the prevalence and overall burden of these disorders in the general community is not well defined. Methods In a cross-sectional investigation of the population-based Bruneck Study cohort, 488 community-residing elderly aged 60–97 years underwent a thorough neurological assessment including a standardized gait evaluation. Gait disorders were classified according to an accepted scheme and their associations to falls, neuropsychological measures, and quality of life were explored. Results Overall, 32.2% (95% confidence interval [CI] 28.2%–36.4%) of participants presented with impaired gait. Prevalence increased with age (p<0.001), but 38.3% (95%CI 30.1%–47.3%) of the subjects aged 80 years or older still had a normally preserved gait. A total of 24.0% (95%CI 20.4%–28.0%) manifested neurological gait disorders, 17.4% (14.3%–21.0%) non-neurological gait problems, and 9.2% (6.9%–12.1%) a combination of both. While there was no association of neurological gait disorders with gender, non-neurological gait disorders were more frequent in women (p = 0.012). Within the group of neurological gait disorders 69.2% (95%CI 60.3%–76.9%) had a single distinct entity and 30.8% (23.1%–39.7%) had multiple neurological causes for gait impairment. Gait disorders had a significant negative impact on quantitative gait measures, but only neurological gait disorders were associated with recurrent falls (odds ratio 3.3; 95%CI 1.4–7.5; p = 0.005 for single and 7.1; 2.7–18.7; p<0.001 for multiple neurological gait disorders). Finally, we detected a significant association of gait disorders, in particular neurological gait disorders, with depressed mood, cognitive dysfunction, and compromised quality of life. Conclusions Gait disorders are common in the general elderly population and are associated with reduced mobility. Neurological gait disorders in particular are associated with recurrent falls, lower

Effects of comprehensive geriatric intervention on physical performance among people aged 75 years and over.

PubMed

Lihavainen, Katri; Sipilä, Sarianna; Rantanen, Taina; Seppänen, Jarmo; Lavikainen, Piia; Sulkava, Raimo; Hartikainen, Sirpa

2012-08-01

We studied the effects of comprehensive geriatric assessment and multifactorial intervention on physical performance among older people. In a 3-year geriatric development project with an experimental design, 668 participants aged 75-98 were assigned to intervention (n=348) or control (n=320) groups. The intervention group received comprehensive geriatric assessment with an individually targeted intervention for 2 years. The outcome measures - performance in the Timed Up-and-Go (TUG), 10-meter walking and Berg Balance Scale tests - were gathered annually during the intervention and the 1-year follow-up after it. With linear mixed models, over the 2-year intervention period, the intervention group was found to be improved in the balance (p<0.001) and walking speed (p<0.001) tests, and maintained performance in the TUG test (p<0.001), compared with the control group. The results remained significant 1 year post-intervention. Comprehensive geriatric assessment and individually targeted multifactorial intervention had positive effects on physical performance, potentially helping to maintain mobility and prevent disability in old age.

Medical costs in the US of clinical events associated with oral anticoagulant (OAC) use compared to warfarin among non-valvular atrial fibrillation patients ≥75 and <75 years of age, based on the ARISTOTLE, RE-LY, and ROCKET-AF trials.

PubMed

Deitelzweig, Steve; Amin, Alpesh; Jing, Yonghua; Makenbaeva, Dinara; Wiederkehr, Daniel; Lin, Jay; Graham, John

2013-09-01

Based on clinical trials the oral anticoagulants (OACs) apixaban, dabigatran, and rivaroxaban are efficacious for reducing stroke risk for non-valvular atrial fibrillation (NVAF) patients. Based on the clinical trials, this study evaluated the medical costs for clinical events among NVAF patients ≥75 and <75 years of age treated with individual OACs vs warfarin. Rates for primary and secondary efficacy and safety outcomes (i.e., clinical events) among NVAF patients receiving warfarin or each of the OACs were determined for NVAF populations aged ≥75 years and <75 years of age from the OAC vs warfarin trials. One-year incremental costs among patients with clinical events were obtained from published literature and inflation adjusted to 2010 costs. Medical costs, excluding medication costs, for clinical events associated with each OAC and warfarin were then estimated and compared. Among NVAF patients aged ≥75, compared to warfarin, use of either apixaban or rivaroxaban was associated with a reduction in medical costs per patient year (apixaban = -$825, rivaroxaban =-$23), while dabigatran use was associated with increased medical costs of $180 per patient year. Among NVAF patients <75 years of age medical costs per patient year were estimated to be reduced -$254, -$367, and -$88, for apixaban, dabigatran, and rivaroxaban, respectively, in comparison to warfarin. This economic analysis was based on clinical trial data and, therefore, the direct application of the results to routine clinical practice will require further assessment. Difference in medical costs between OAC and warfarin treated NVAF patients vary by age group and individual OACs. Although reductions in medical costs for NVAF patients aged ≥75 and <75 were observed for those using either apixaban or rivaroxaban vs warfarin, the reductions were greater per patient year for both the older and younger NVAF populations using apixaban.

The age 60 rule.

PubMed

2004-08-01

The impetus for amending the Age 60 Rule compels the review of recent scientific literature pertinent to pilot age and performance. The Rule has been the subject of extensive debate among policymakers and the aviation community. The aviation medical community is in a position to continue research and discussion that may provide additional evidence for the development of future policy decisions. Those addressing the future of the Age 60 Rule may benefit from understanding the nature and limitations of these studies, whether their outcomes are conclusive or not. Hopefully, some measure of guidance may be achieved as they address pilot age limits and related safety, economic, and operational issues of the aviation industry.

Observational study of once-daily insulin detemir in people with type 2 diabetes aged 75 years or older: a sub-analysis of data from the Study of Once daily LeVEmir (SOLVE).

PubMed

Karnieli, Eddy; Baeres, Florian M M; Dzida, Grzegorz; Ji, Qiuhe; Ligthelm, Robert; Ross, Stuart; Svendsen, Anne Louise; Yale, Jean-François

2013-03-01

Older patients are particularly vulnerable to hypoglycaemia. The aim of this study was to evaluate the response to initiation of once-daily insulin detemir in patients aged ≥75 years with type 2 diabetes mellitus (T2DM) treated with one or more oral antidiabetic drugs (OADs). A sub-analysis was conducted using data from SOLVE (Study of Once daily LeVEmir), a 24-week observational study involving 3,219 investigators and 2,817 project sites from ten countries. Routine clinical practice was followed; there were no study-prescribed procedures. The total cohort comprised 17,374 participants, of whom 2,398 (14 %) were aged ≥75 years. The physicians collected information from patient recall, the patients' medical records and their self-monitored blood glucose diaries (if kept). Pre-insulin glycated haemoglobin (HbA(1c)) was similar between participants aged ≥75 years and those aged <75 years (HbA(1c) 8.8 ± 1.5 % vs. 8.9 ± 1.6 % [mean ± SD], respectively). After 24 weeks of treatment, similar reductions in HbA(1c) were observed in the two subgroups: 7.6 ± 1.1 % and 7.5 ± 1.2 % in participants aged ≥75 years and those aged <75 years, respectively. The incidence of severe hypoglycaemia (episodes per patient-year) decreased during the study in both age groups (from 0.057 to 0.007 in patients aged ≥75 years; from 0.042 to 0.005 in patients aged <75 years), while minor hypoglycaemia increased from 1.1 to 2.0 and from 1.7 to 1.8 episodes per patient-year in the older and younger age groups, respectively. Average weight reduction was similar in both groups: -0.5 kg (≥75 years) and -0.6 kg (<75 years). In both the older and younger age groups, the addition of once-daily insulin detemir to existing OAD regimens was effective and safe. In older patients, an improvement in HbA(1c) of 1.2 % was not associated with an increased risk of severe hypoglycaemia or weight gain.

Characteristics and outcomes of patients with multiple myeloma aged 21-40 years versus 41-60 years: a multi-institutional case-control study.

PubMed

Jurczyszyn, Artur; Nahi, Hareth; Avivi, Irit; Gozzetti, Alessandro; Niesvizky, Ruben; Yadlapati, Sujitha; Jayabalan, David S; Robak, Paweł; Pika, Tomas; Andersen, Kristian T; Rasche, Leo; Mądry, Krzysztof; Woszczyk, Dariusz; Raźny, Małgorzata; Usnarska-Zubkiewicz, Lidia; Knopińska-Posłuszny, Wanda; Wojciechowska, Małgorzata; Guzicka-Kazimierczak, Renata; Joks, Monika; Grosicki, Sebastian; Ciepłuch, Hanna; Rymko, Marcin; Vesole, David H; Castillo, Jorge J

2016-12-01

We compared the outcomes of multiple myeloma (MM) patients aged 21-40 and 41-60 years in the novel agent era. This case-control study included 1089 patients between 2000 and 2015. Cases and controls were matched for sex, International Staging System (ISS) stage and institution. There were 173 patients in the younger group and 916 patients in the older group. Younger patients presented with a higher incidence of lytic lesions (82% vs. 72%; P = 0·04) and high-risk cytogenetic abnormalities (83% vs. 68%; P = 0·007), but lower rate of elevated lactate dehydrogenase (21% vs. 44%; P < 0·001). Five- and 10-year overall survival (OS) in younger versus older patients was 83% vs. 67% and 56% vs. 39%, respectively (P < 0·001). Similar results were seen when studying the subset of 780 patients who underwent autologous transplantation. Younger patients with ISS stage 1 had a better OS than older patients (P < 0·001). There was no survival difference between younger and older patients with ISS stage 2 or 3. Younger MM patients, aged 21-40 years, treated in the era of novel agents have a better OS than their counterparts aged 41-60 years, but the survival advantage observed in younger patients was lost in more advanced stages of MM. © 2016 John Wiley & Sons Ltd.

Malnutrition, functional ability and mortality among older people aged ⩾ 60 years: a 7-year longitudinal study.

PubMed

Naseer, M; Forssell, H; Fagerström, C

2016-03-01

This study aimed to assess the association between risk of malnutrition and 7-year mortality, controlling for functional ability, socio-demographics, lifestyle behavior and diseases, and investigate the interaction between risk of malnutrition and functional ability on the risk of mortality. A longitudinal study on home-living and special-housing residents aged ⩾ 60 years was conducted. Of 2312 randomly invited participants, 1402 responded and 1203 provided information on both nutritional status and functional ability. The risk of malnutrition was estimated by the occurrence of at least one anthropometric measure (BMI, MAC and CC) below cut-off in addition to the presence of at least one subjective measure (decreased food intake, weight loss and eating difficulty). At baseline, 8.6% of subjects were at risk of malnutrition and during the 7-year follow-up 34.6% subjects died. The risk of malnutrition was independently associated with 7-year mortality (hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.28-2.65). Additional independent predictors were dementia (HR 2.76, 95% CI 1.85-4.10), activity of daily living (ADL) dependence (HR 2.08, 95% CI 1.62-2.67), heart disease (HR 1.44, 95% CI 1.16-1.78), diabetes (HR 1.41, 95% CI 1.03-1.93) and older age (HR 1.09, 95% CI 1.07-1.10). Moreover, the risk of malnutrition and ADL dependence in combination predicted the poorest survival rate (18.7%, P<0.001). The risk of malnutrition significantly increases the risk of mortality in older people. Moreover, risk of malnutrition and ADL dependence together explain a significantly poorer survival rate; however, the importance of this interaction decreased in the multivariable model and risk of malnutrition and ADL dependence independently explained a significant risk of mortality.

Cost-Effectiveness Analysis of Universal Vaccination of Adults Aged 60 Years with 23-Valent Pneumococcal Polysaccharide Vaccine versus Current Practice in Brazil.

PubMed

de Soárez, Patrícia Coelho; Sartori, Ana Marli Christovam; Freitas, Angela Carvalho; Nishikawa, Álvaro Mitsunori; Novaes, Hillegonda Maria Dutilh

2015-01-01

To evaluate the cost-effectiveness of introducing universal vaccination of adults aged 60 years with the 23-valent pneumococcal polysaccharide vaccine (PPV23) into the National Immunization Program (NIP) in Brazil. Economic evaluation using a Markov model to compare two strategies: (1) universal vaccination of adults aged 60 years with one dose of PPV23 and 2) current practice (vaccination of institutionalized elderly and elderly with underlying diseases). The perspective was from the health system and society. Temporal horizon was 10 years. Discount rate of 5% was applied to costs and benefits. Clinical syndromes of interest were invasive pneumococcal disease (IPD) including meningitis, sepsis and others and pneumonia. Vaccine efficacy against IPD was obtained from a meta-analysis of randomized control trials and randomized studies, whereas vaccine effectiveness against pneumonia was obtained from cohort studies. Resource utilization and costs were obtained from the Brazilian Health Information Systems. The primary outcome was cost per life year saved (LYS). Univariate and multivariate sensitivity analysis were performed. The universal vaccination strategy avoided 7,810 hospitalizations and 514 deaths, saving 3,787 years of life and costing a total of USD$31,507,012 and USD$44,548,180, respectively, from the health system and societal perspective. The universal immunization would result in ICERs of USD$1,297 per LYS, from the perspective of the health system, and USD$904 per LYS, from the societal perspective. The results suggest that universal vaccination of adults aged 60 years with the 23-valent pneumococcal polysaccharide vaccine (PPV23) is a very cost-effective intervention for preventing hospitalization and deaths for IPD and pneumonia is this age group in Brazil.

How are the ancient cystic fibrosis patients? Cystic fibrosis diagnosed over 60 years-old.

PubMed

Prados, C; Lerín, M; Cabanillas, J J; Gómez-Carrera, L; Álvarez-Sala, R

2017-01-01

To specify the prevalence of patients diagnosed with CF at age of ≥60 year-old and to analyze their characteristics. Observational study of CF patients which were diagnosed at age ≥60 year-old. The analyzed variables were: age, sex, nationality, lung function parameters, conditions present at diagnosis, microbiological characteristics and genetic findings. eight patients were included. 7 patients were female (87.5%) with a mean age of 70.6 years (median 71.5 years, range 60-78 years). The most important findings were: sweat test >60 mEq/l; heterozygotes F508del; bronchiectasis in CT; methicillin-sensitive Staphylococcus aureus (50%) in sputum. The most patients presented a normal or mild obstructive lung function. CF must also be considered a disease diagnosed in adulthood, incorporating the sweat test within the usual techniques of differential diagnosis in patients with different diseases associated with CF, because genetic counselling is esencial.

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

Body mass index gain between ages 20-40 years and lifestyle characteristics of men at ages 40-60 years: The Adventist Health Study-2

PubMed Central

Japas, Claudio; Knutsen, Synnøve; Dehom, Salem; Dos Santos, Hildemar; Tonstad, Serena

2014-01-01

Background Obesity increases risk of premature disease, and may be associated with unfavorable lifestyle changes that add to risk. This study analyzed the association of midlife BMI change with current lifestyle patterns among multiethnic men. Methods Men aged 40-60 years (n=9864) retrospectively reported body weight between ages 20-40 years and current dietary, TV, physical activity and sleep practices in the Adventist Health Study II, a study of church-goers in the US and Canada. In multivariate logistic regression analysis, odds ratios for BMI gain were calculated for each lifestyle practice controlling for sociodemographic and other lifestyle factors and current BMI. Results Men with median or higher BMI gain (2.79 kg/m2) between ages 20-40 years were more likely to consume a non-vegetarian diet, and engage in excessive TV watching and little physical activity and had a shorter sleep duration compared to men with BMI gain below the median (all p<0.001). In multivariate logistic analysis current BMI was significantly associated with all lifestyle factors in multivariate analyses (all p≤0.005). BMI gain was associated with lower odds of vegetarian diet (odds ratio [OR] 0.939; 95% confidence interval [CI] 0.921-0.957) and of physical activity ≥150 minutes/week (OR 0.979, 95% CI 0.960-0.999). Conclusions These findings imply that diet and less physical activity are associated with both gained and attained BMI, while inactivity (TV watching) and short sleep duration correlated only with attained BMI. Unhealthy lifestyle may add risk to that associated with BMI. Longitudinal and intervention studies are needed to infer causal relationships. PMID:25434910

[Silhouettes at different age of life: Retrospective appreciation of corpulence and his impact on prevalence of hypertension at 60years].

PubMed

Thomas, F; Empana, J P; Charles, M A; Boutouyrie, P; Jouven, X; Pannier, B; Danchin, N

2017-06-01

In epidemiological studies, recall of weight and height are not readily available at different ages of life. In order to improve the knowledge of the weight history, Sörensen et al. in 1983, developed a tool from silhouettes allowing an individual to evaluate his corpulence at different ages of life. Validity studies showed that measured weight and size were correlated to 80% in the reported silhouette. Studies have also shown that silhouettes are a good way to trace the weight history in an individual's life. Very few epidemiological studies have used this tool. A French study revealed a decrease of the risk of breast cancer in obese girls between the age of 8 and adolescence. Another study showed that a low birth weight or a thin silhouette before adulthood was associated with an increased risk of diabetes. On the basis of these findings, it was interesting to evaluate the relationship between the silhouette at 20years and the risk of hypertension at the age of 60years. It was shown that the prevalence of hypertension at age 60 was higher among obese subjects at 20years than among thin subjects (45.3% vs 36.7% (P<0.05). The classification between slimness and obesity is relevant using this tool. The history of corpulence is an important element to consider in the determinants of pathology, especially in hypertension. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The association between dentition status and sarcopenia in Japanese adults aged ≥75 years.

PubMed

Iwasaki, M; Kimura, Y; Ogawa, H; Wada, T; Sakamoto, R; Ishimoto, Y; Fujisawa, M; Okumiya, K; Ansai, T; Miyazaki, H; Matsubayashi, K

2017-01-01

Sarcopenia is an age-related loss of muscle mass and muscle strength or physical performance. There are limited data on the association between oral health and sarcopenia. To test the hypothesis that impaired dentition status was associated with sarcopenia, we conducted a cross-sectional study. A total of 272 community-dwelling Japanese adults aged ≥75 years for whom data were available from comprehensive health examinations conducted in 2015 were included in this study. During dental examination, the number of natural teeth and occluding pairs of natural teeth was counted. In denture wearers, the fit of the removable dentures was also evaluated. The criteria proposed by the Asian Working Group for Sarcopenia were used to define sarcopenia. A multivariable logistic regression model was used to evaluate the association between dentition status and the presence of sarcopenia. The prevalence of sarcopenia was 25·7% (70/272). Compared to individuals with ≥10 occluding pairs of natural teeth, those with no occluding pairs of natural teeth had significantly higher risk of having sarcopenia (adjusted odds ratio, 3·37; 95% confidence interval, 1·07-10·61), after adjusting for possible confounders. In addition, compared to individuals with well-fitting dentures, those with ill-fitting dentures had significantly higher risk of having sarcopenia (adjusted odds ratio, 5·07; 95% confidence interval, 1·59-16·19). Our findings suggest that impaired dentition status is significantly associated with sarcopenia among community-dwelling Japanese adults aged ≥75 years. Future longitudinal studies with larger, more diverse populations are necessary to validate our findings. © 2016 John Wiley & Sons Ltd.

Effectiveness of cervical screening after age 60 years according to screening history: Nationwide cohort study in Sweden.

PubMed

Wang, Jiangrong; Andrae, Bengt; Sundström, Karin; Ploner, Alexander; Ström, Peter; Elfström, K Miriam; Dillner, Joakim; Sparén, Pär

2017-10-01

The relatively high incidence of cervical cancer in women at older ages is a continuing concern in countries with long-established cervical screening. Controversy remains on when and how to cease screening. Existing population-based studies on the effectiveness of cervical screening at older ages have not considered women's screening history. We performed a nationwide cohort study to investigate the incidence of cervical cancer after age 60 years and its association with cervical screening at age 61-65, stratified by screening history at age 51-60. Using the Total Population Register, we identified 569,132 women born between 1 January 1919 and 31 December 1945, resident in Sweden since age 51. Women's cytological screening records, cervical cancer occurrence, and FIGO stage (for those diagnosed with cancer) were retrieved from national registers and medical charts. We calculated the cumulative incidence of cervical cancer from age 61 to age 80 using a survival function considering competing risk, and estimated the hazard ratio (HR) of cervical cancer in relation to screening status at age 61-65 from Cox models, adjusted for birth cohort and level of education, conditioning on women's screening history in their 50s. In women unscreened in their 50s, the cumulative incidence up to age 80 was 5.0 per 1,000 women, and screening at age 61-65 was associated with a lower risk for cervical cancer (HR = 0.42, 95% CI 0.24-0.72), corresponding to a decrease of 3.3 cancer cases per 1,000 women. A higher cumulative incidence and similarly statistically significant risk decrease was seen for women with abnormal smears in their 50s. In women adequately or inadequately screened with only normal results between age 51 and age 60, the cumulative incidence of cervical cancer from age 61 to 80 was 1.6 and 2.5 per 1,000 women, respectively, and further screening at age 61-65 was not associated with statistically significant decreases of cervical cancer risk up to age 80, but with fewer

Association between sarcopenia and nutritional status and physical activity among community-dwelling Chinese adults aged 60 years and older.

PubMed

Hai, Shan; Cao, Li; Wang, Hui; Zhou, Jianghua; Liu, Ping; Yang, Ying; Hao, Qiukui; Dong, Birong

2017-11-01

The aim of the present study was to examine the association between sarcopenia and nutritional status and physical activity among community-dwelling Chinese people aged 60 years and older. This study was carried out on 836 community-dwelling Chinese individuals aged ≥60 years to evaluate sarcopenia using the Asian Working Group for Sarcopenia criteria. Sociodemographic characteristics and lifestyle habits were collected using a general questionnaire. Nutritional status was assessed using the Mini Nutritional Assessment and biochemical parameters, whereas physical activity was assessed using the long form of the International Physical Activity Questionnaire. In addition, univariate and multivariate analysis was used to analyze the association between sarcopenia with nutritional status and physical activity. The total prevalence rate of sarcopenia was 10.5%, 47 (11.3%) men and 41 (9.7%) women who were classified as sarcopenia. The prevalence of sarcopenia was significantly lower among the participants of normal nutrition status. Compared with the participants with sarcopenia, those without sarcopenia had higher levels of prealbumin (P < 0.05) and hemoglobin (P < 0.05) for both sexes. In the multivariate model, after adjustment for all covariates, the Mini Nutritional Assessment score (adjusted OR 0.769, 95% CI 0.689-0.859, P < 0.05) was statistically significantly associated with sarcopenia, but the relationship between physical activity and sarcopenia was not significant. The prevalence of sarcopenia in the Chinese community-dwelling population aged 60 years and older was high. There was a significant association between sarcopenia and nutritional status, but not with physical activity, based on a questionnaire. Further studies should evaluate whether maintaining a good nutritional status might be effective in lowering the risk of sarcopenia. Geriatr Gerontol Int 2017; 17: 1959-1966. © 2017 Japan Geriatrics Society.

Sleep disturbances and sexual function among men aged 45–75 years in an urban area of Iran

PubMed Central

Charandabi, Sakineh Mohammadalizadeh; Rezaei, Nazanin; Hakimi, Sevil; Khatami, Shiva; valizadeh, Reza; Azadi, Arman

2016-01-01

Background and aims Aging in men is associated with various physical and mental symptoms, including sleep problems and sexual dysfunction. The aim of this study was to determine the status of sleep disorders and sexual dysfunction in men aged 45–75 years in Ilam, Iran. Materials and methods In this population-based cross-sectional study, 390 men aged 45–75 years were selected by cluster randomization in Ilam–Iran. Data were collected using 0–100 brief sexual function inventory and the sleep disorder questionnaires. Results Totally, 34.6% of men complained about sleep disorders: 17.4% about falling asleep, 12.8% about frequent nocturnal awakenings, 12.8% about waking up in the early hours in the morning and problem in falling asleep again, and 24.9% about fatigue and tiredness despite getting enough sleep. There was a significant relationship between all aspects of sexual function and the common problems related to sleep (p<0.001). The older, unemployed, illiterate men, those with inadequate income, those affected by chronic diseases, and/or urinary incontinence had significantly inferior sexual function compared with the others. Conclusion According to the high prevalence of sleep disorders in men as well as its association with sexual dysfunction, adopting health measures in this regard is necessary. PMID:27217906

Does the prognostic value of dobutamine stress echocardiography differ among different age groups?

PubMed

Bernheim, Alain M; Kittipovanonth, Maytinee; Takahashi, Paul Y; Gharacholou, S Michael; Scott, Christopher G; Pellikka, Patricia A

2011-04-01

Age is associated with reduced exercise capacity and greater prevalence of coronary artery disease. Whether the prognostic information obtained from dobutamine stress echocardiography (DSE), a stress test commonly used for patients unable to perform an exercise test, provides differential information based on age is not well known. We studied 6,655 consecutive patients referred for DSE. Patients were divided into 3 age groups: (1) <60 years (n = 1,389), (2) 60 to 74 years (n = 2,978), and (3) ≥75 years (n = 2,288). Mean follow-up was 5.5 ± 2.8 years. End points included all-cause mortality and cardiac events, including myocardial infarction and late (>3 months) coronary revascularization. Peak stress wall motion score index was an independent predictor of cardiac events in all age groups (<60 years: hazard ratio [HR] 1.14, P = .02; 60-74 years: HR 1.70, P < .0001; ≥75 years: HR 1.10, P = .006). In patients ≥75 years, peak wall motion score index (HR 1.10, P < .0001) and abnormal left ventricular end-systolic volume response (HR 1.25, P = .03) were independent predictors of death. In patients aged 60 to 74 years, abnormal left ventricular end-systolic volume response (HR 1.43, P = .0003) was independently related to death, whereas in patients <60 years, the echocardiographic data assessed during stress were not a predictor. Dobutamine stress echocardiography provided independent information predictive of cardiac events among all age groups and death in patients ≥60 years. However, among patients <60 years, stress-induced echocardiographic abnormalities were not independently associated with mortality. Comorbidities, which have precluded exercise testing, may be most relevant in predicting mortality in patients <60 years undergoing DSE. Copyright © 2011 Mosby, Inc. All rights reserved.

Cadmium, follicle-stimulating hormone, and effects on bone in women age 42-60 years, NHANES III

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gallagher, Carolyn M., E-mail: 2crgallagher@optonline.net; Department of Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York; Moonga, Baljit S.

Background: Increased body burden of environmental cadmium has been associated with greater risk of decreased bone mineral density (BMD) and osteoporosis in middle-aged and older women, and an inverse relationship has been reported between follicle-stimulating hormone (FSH) and BMD in middle-aged women; however, the relationships between cadmium and FSH are uncertain, and the associations of each with bone loss have not been analyzed in a single population. Objectives: The objective of this study was to evaluate the associations between creatinine-adjusted urinary cadmium (UCd) and FSH levels, and the associations between UCd and FSH with BMD and osteoporosis, in postmenopausal andmore » perimenopausal women aged 42-60 years. Methods: Data were obtained from the Third National Health Examination and Nutrition Survey, 1988-1994 (NHANES III). Outcomes evaluated were serum FSH levels, femoral bone mineral density measured by dual energy X-ray absorptiometry, and osteoporosis indicated by femoral BMD cutoffs based on the international standard. Urinary cadmium levels were analyzed for association with these outcomes, and FSH levels analyzed for association with bone effects, using multiple regression. Subset analysis was conducted by a dichotomous measure of body mass index (BMI) to proxy higher and lower adipose-synthesized estrogen effects. Results: UCd was associated with increased serum FSH in perimenopausal women with high BMI (n=642; {beta}=0.45; p{<=}0.05; R{sup 2}=0.35) and low BMI (n=408; {beta}=0.61; p{<=}0.01; R{sup 2}=0.34). Among perimenopausal women with high BMI, BMD was inversely related to UCd ({beta}=-0.04; p{<=}0.05) and FSH ({beta}=-0.03; p{<=}0.05). In postmenopausal women with low BMI, an incremental increase in FSH was associated with 2.78 greater odds for osteoporosis (109 with and 706 without) (OR=2.78; 95% CI=1.43, 5.42; p{<=}0.01). Conclusion: Long-term cadmium exposure at environmental levels is associated with increased serum FSH, and

Sexual dysfunction among Chinese married men aged 30-60 years: a population-based study in Hong Kong.

PubMed

Zhang, Huiping; Yip, Andrew W C; Fan, Susan; Yip, Paul S F

2013-02-01

To estimate the prevalence of, and risk factors associated with, sexual dysfunction among Hong Kong Chinese married men aged 30-60 years. The present study was a part of the Ninth Knowledge, Attitude, and Practice survey conducted in 2007 by the Family Planning Association of Hong Kong. The data set consisted of 728 face-to-face interviews with Hong Kong Chinese married men aged 30-60 years living in the community. The classification of sexual dysfunction in the "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition" was used to measure male sexual dysfunction (MSD). Regarding MSD prevalence, approximately 15% of men reported ≥ 1 form of MSD, with a lack of sexual interest, erectile dysfunction, and premature ejaculation present in 11.1%, 4.3%, and 4.7%, respectively. Multivariate analysis showed that age (odds ratio 2.39), employment status (odds ratio 3.62), having a wife who sought medical help for sexual problems (odds ratio 4.47), liberal attitudes toward female sexual initiation (odds ratio 2.07), and marital dissatisfaction (odds ratio 2.35) were all statistically significant risk factors for MSD and its specific components among the sample. However, having traditional attitudes toward female sexual refusal was a protective factor for MSD (odds ratio 0.51) and lack of sexual interest (odds ratio 0.51). The prevalence of MSD was low among young and middle-age married men in Hong Kong. Factors contributing to the risk of MSD spanned the domains of socioeconomic status, attitudes toward sex, and relationship factors. These findings suggest future directions for public health policies and the delivery of services that address the prevention and treatment of MSD. Copyright © 2013 Elsevier Inc. All rights reserved.

Average grip strength: a meta-analysis of data obtained with a Jamar dynamometer from individuals 75 years or more of age.

PubMed

Bohannon, Richard W; Bear-Lehman, Jane; Desrosiers, Johanne; Massy-Westropp, Nicola; Mathiowetz, Virgil

2007-01-01

Although strength diminishes with age, average values for grip strength have not been available heretofore for discrete strata after 75 years. The purpose of this meta-analysis was to provide average values for the left and right hands of men and women 75-79, 80-84, 85-89, and 90-99 years. Contributing to the analysis were 7 studies and 739 subjects with whom the Jamar dynamometer and standard procedures were employed. Based on the analysis, average values for the left and right hands of men and women in each age stratum were derived. The derived values can serve as a standard of comparison for individual patients. An individual whose grip strength is below the lower limit of the confidence intervals of each stratum can be confidently considered to have less than average grip strength.

[The relationship between prevalence of hypertension and dietary factors among the elderly aged 60 years old and over in China during 2010-2012].

PubMed

Liu, Z; Man, Q Q; Li, Y Q; Wang, J Z; Zhang, J; Zhao, W H

2018-06-06

Objective: To analyze the status of hypertension and isolated systolic hypertension and to investigate the relationship between the prevalence of hypertension and dietary factors among Chinese elderly aged 60 yea and over during 2010-2012. Methods: Using a multi-stage stratified probability proportional to size cluster randomization sampling method during 2010-2012, a total of 14 791 old people aged 60 years old and over were investigated at 150 counties (districts) from 31 provinces (autonomous regions and municipalities) in China. Information on demographic socio-economic status and the physical activities was collected through questionnaires. Blood pressure measurement and physical examination were carried out by standard methods. The 3 days consecutive individual 24 hours dietary investigation was used to calculate food and nutrients intake of the subjects. Multiple logistic regression was used to investigate the possible related dietary factors for the hypertension and isolated systolic hypertension. Results: The prevalence of hypertension among the elderly aged 60 years old and over was 54.6% (95 %CI: 52.8%-56.4%), of which isolated systolic hypertension was 24.5% (95 %CI: 23.0%-26.1%). Compared with the lowest intake level, the OR (95 %CI ) of hypertension for higher tuber consumption (≥43.34 g/d) and milk intake (>0 g/d) with were 0.89 (0.83-0.97) and 0.88 (0.81-0.97), respectively. The OR (95 %CI ) of hypertension for higher dietary potassium (≥1 747.69 mg/d), folate acid (28.42-56.88 μg/d), vitamin B(1)2 (0.22-0.58 μg/d) and vitamin B(2) (0.61-0.81 mg/d) intake were 0.87 (0.77-0.98), 0.89 (0.81-0.98), 0.88 (0.80-0.97) and 0.89 (0.80-0.99). The OR (95 %CI ) of isolated systolic hypertension for higher tuber (≥43.34 g/d), milk intake (>0 g/d) and higher dietary potassium (≥1 747.69 mg/d), folate acid (≥99.89 μg/d), vitamin B(12) intake (≥1.48 μg/d) were 0.84 (0.75-0.93), 0.85 (0.76-0.95), 0.82 (0.71-0.96), 0.87 (0.76-0.99) and 0.87 (0

Coronary artery calcium for the prediction of mortality in young adults <45 years old and elderly adults >75 years old.

PubMed

Tota-Maharaj, Rajesh; Blaha, Michael J; McEvoy, John W; Blumenthal, Roger S; Muse, Evan D; Budoff, Matthew J; Shaw, Leslee J; Berman, Daniel S; Rana, Jamal S; Rumberger, John; Callister, Tracy; Rivera, Juan; Agatston, Arthur; Nasir, Khurram

2012-12-01

To determine if coronary artery calcium (CAC) scoring is independently predictive of mortality in young adults and in the elderly population and if a young person with high CAC has a higher mortality risk than an older person with less CAC. We studied a cohort of 44 052 asymptomatic patients referred for CAC scans for cardiovascular risk stratification. All-cause mortality rates (MRs) were calculated after stratifying by age groups (<45, 45-54, 55-64, 65-74, and ≥75) and CAC score (0, 1-100, 100-400, and >400). Multivariable Cox regression models were constructed to assess the independent value of CAC for predicting all-cause mortality in the <45- and ≥75-year-old age groups. The MR increased in both the <45- and ≥75-year-old age groups with an increasing CAC group. After multivariable adjustment, increasing CAC remained independently predictive of increased mortality compared with CAC = 0 [<45 age group, hazard ratio (95% confidence interval): CAC = 1-100, 2.3 (1.2-4.2); CAC = 100-400, 7.4 (3.3-16.6); CAC > 400, 34.6 (15.5-77.4); ≥75 age group: CAC = 1-100, 7.0 (2.4-20.8); CAC = 100-400, 9.2 (3.2-26.5); CAC > 400, 16.1 (5.8-45.1)]. Persons <45 years old with CAC = 100-400 and CAC > 400 had 2- and 10-fold increased MRs, respectively, compared with persons ≥75 with no CAC. Individuals ≥75 years old with CAC = 0 had a 5.6-year survival rate of 98%, similar to those in other age groups with CAC = 0 (5.6-year survival, 99%). The value of CAC for predicting mortality extends to both elderly patients and those <45 years old. Elderly persons with no CAC have a lower MR than younger persons with high CAC.

[Urologic and reproductive health status of 30 - 60 years old males: investigation among 1006 men in Shijingshan District of Beijing].

PubMed

He, Li-Jun; Wang, Yi; Zhou, Zhe; Na, Yan-Qun

2012-04-01

To know and find some evidence for the improvement of the urologic and reproductive health of men between 30 and 60 years old. Using stratified random sampling, we conducted a questionnaire investigation on the urologic and reproductive health status of 1 006 men aged from 30 to 60 years old in the Shijingshan District of Beijing, including the unemployed, taxi drivers and office workers. Of the 1006 males investigated, BMI > or = 24 kg/m2 was found in 72.7%, hypertension in 40.0%, abnormal IPSS in 85.5%, abnormal NIH-CPSI in 75.6%, abnormal IIEF-5 in 66.3%, aging male symptoms (AMS) in 10.7%, anxiety in 17.1%, depression in 25.1%, fasting blood-glucose >6.1 mmol/L in 34.9%, total cholesterol >5.07 mmol/L in 44.3% and triglyceride > 1.71 mmol/L in 46.6%; the level of total testosterone was (17.9 +/- 7.2) nmol/L, < 12 nmol/L in 21.3% and <8 nmol/L in 3.4%, and the level of free testosterone was (6.5 +/- 15.1) pmol/L. The urologic and reproductive health status of 30 to 60 years old males in Beijing deserves serious attention from medical workers.

Age-related change and sex difference over 60s in disc-fovea angle in Japanese population: the Nagahama Study.

PubMed

Miyata, Manabu; Yoshikawa, Munemitsu; Ohtsuki, Hiroshi; Muraoka, Yuki; Hata, Masayuki; Yokota, Satoshi; Fujimoto, Masahiro; Miyake, Masahiro; Tabara, Yasuharu; Matsuda, Fumihiko; Yoshimura, Nagahisa

2018-01-25

To analyse the disc-fovea angle (DFA) by age group and to compare sex differences in each age group in a large cohort population. This community-based cross-sectional cohort study included 9682 eyes of 9682 volunteers (aged 30-75 years). We measured the DFA, which is the angle between a horizontal line and a line connecting the fovea with the centroid of an optic disc on fundus photographs of the right eye. We manually marked the fovea and surrounded the optic disc. The centroid of an optic disc and the DFA was automatically calculated using originally developed software. We compared the DFA between age groups in 10-year increments and investigated sex differences of DFA in each age group. Overall mean DFA was 6.32 ± 3.53°. The DFA of older subjects was significantly larger than that of younger subjects (p < 0.001). The DFA of women was larger than that of men in their 60s and 70s (p < 0.001 for both), but not in subjects in their 30s, 40s and 50s. Larger DFA in women than in men in their 60s and 70s suggests the possibility that age-related excyclo-shift occurs more easily in postmenopausal women compared to men of the same age. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Relationship of Blood Pressure With Mortality and Cardiovascular Events Among Hypertensive Patients aged ≥60 years in Rural Areas of China

PubMed Central

Zheng, Liqiang; Li, Jue; Sun, Zhaoqing; Zhang, Xingang; Hu, Dayi; Sun, Yingxian

2015-01-01

Abstract The Eighth Joint National Committee (JNC-8) panel recently recommended a systolic blood pressure (BP) threshold of ≥150 mmHg for the initiation of drug therapy and a therapeutic target of <150/90 mmHg in patients ≥60 years of age. However, results from some post-hoc analysis of randomized controlled trials and observational studies did not support these recommendations. In the prospective cohort study, 5006 eligible hypertensive patients aged ≥60 years from rural areas of China were enrolled for the present analysis. The association between the average follow-up BP and outcomes (all-cause and cardiovascular death, incident coronary heart disease [CHD], and stroke), followed by a median of 4.8 years, were evaluated using Cox proportional hazards models adjusting for other potential confounders. The relationship between BP (systolic or diastolic) showed an increased or J-shaped curve association with adverse outcomes. Compared with the reference group of BP <140/90 mmHg, the risk of all-cause death (hazard ratio [HR]: 2.698; 95% confidence interval [CI]: 1.989–3.659), cardiovascular death (HR: 2.702; 95% CI: 1.855–3.935), incident CHD (HR: 3.263; 95% CI: 2.063–5.161), and stroke (HR: 2.334; 95% CI: 1.559–3.945) was still significantly increased in the group with BP of 140–149/<90 mmHg. Older hypertensive patients with BP of 140–149/<90 mmHg were at higher risk of developing adverse outcomes, implying that lenient BP control of 140–149/<90 mmHg, based on the JNC-8 guidelines, may not be appropriate for hypertensive patients aged ≥60 years in rural areas of China. PMID:26426621

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers

PubMed Central

Dobie, Robert A; Wojcik, Nancy C

2015-01-01

Objectives The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999–2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Methods Regression analysis was used to derive new age-correction values using audiometric data from the 1999–2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20–75 years. Results The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20–75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61–75 years. Conclusions Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by

Biological age and tempos of aging in women over 60 in connection with their morphofunctional characteristics.

PubMed

Negasheva, Marina; Lapshina, Natalia; Okushko, Rostislav; Godina, Elena

2014-05-19

The study of aging processes and the changes in morphological, physiological, and functional characteristics that are associated with aging is of great interest not only for researchers, but also for the general public. The aim of the present paper is to study the biological age and tempos of aging in women older than 60 years, including long-lived females (over 90-years-old), and their associations with morphofunctional characteristics. Somatic traits, body mass components, and functional characteristics were investigated in 119 elderly (between 60 and 74-years-old) and long-lived (over 90-years-old) women in Tiraspol. With the special PC software 'Diagnostics of Aging: BioAge' (National Gerontological Center, Moscow, Russia) the biological age and tempos of aging were evaluated in the study participants. The results show close connections between morphofunctional changes, particularly in body mass components, and biological age. The software demonstrated its validity in the estimation of biological age in the group of elderly women. In the homogenous (according to their chronological age) group of women, three subgroups were separated with different tempos of aging: those with lower rates of aging (biological age less than chronological age by two years or more); those consistent with their chronological age, and those with accelerated tempos of aging (biological age higher than chronological age by two years or more). Morphofunctional characteristics in the studied groups of women demonstrate the trends of age-involutive changes which can be traced through all groups, from those with slow rates of aging, to those with average rates, to those with accelerated tempos of aging, and finally in long-lived women. The results of comparative analysis show that women with accelerated aging are characterized with such traits as lower skeletal muscle mass, lower hand grip strength, and higher metabolic rate. Canonical discriminant analysis revealed a number of

Costs, yields, and revenues associated with thinning and clearcutting 60-year-old cherry-maple stands

Treesearch

Gary W. Miller; Raymond L. Sarles; Raymond L. Sarles

1986-01-01

Logging costs, product yields, and harvest revenues were determined for three thinning treatments (75, 60, and 45 percent residual stocking) and clearcutting in 60-year-old cherry-maple stands. The study area was logged by a three-man crew using chain saws and a wheeled skidder. Time study and yield data indicated that production rates and costs were similar among the...

Biological age and tempos of aging in women over 60 in connection with their morphofunctional characteristics

PubMed Central

2014-01-01

Background The study of aging processes and the changes in morphological, physiological, and functional characteristics that are associated with aging is of great interest not only for researchers, but also for the general public. The aim of the present paper is to study the biological age and tempos of aging in women older than 60 years, including long-lived females (over 90-years-old), and their associations with morphofunctional characteristics. Results Somatic traits, body mass components, and functional characteristics were investigated in 119 elderly (between 60 and 74-years-old) and long-lived (over 90-years-old) women in Tiraspol. With the special PC software ‘Diagnostics of Aging: BioAge’ (National Gerontological Center, Moscow, Russia) the biological age and tempos of aging were evaluated in the study participants. The results show close connections between morphofunctional changes, particularly in body mass components, and biological age. The software demonstrated its validity in the estimation of biological age in the group of elderly women. In the homogenous (according to their chronological age) group of women, three subgroups were separated with different tempos of aging: those with lower rates of aging (biological age less than chronological age by two years or more); those consistent with their chronological age, and those with accelerated tempos of aging (biological age higher than chronological age by two years or more). Conclusions Morphofunctional characteristics in the studied groups of women demonstrate the trends of age-involutive changes which can be traced through all groups, from those with slow rates of aging, to those with average rates, to those with accelerated tempos of aging, and finally in long-lived women. The results of comparative analysis show that women with accelerated aging are characterized with such traits as lower skeletal muscle mass, lower hand grip strength, and higher metabolic rate. Canonical discriminant

Lifelong patterns of BMI and cardiovascular phenotype in individuals aged 60-64 years in the 1946 British birth cohort study: an epidemiological study.

PubMed

Charakida, Marietta; Khan, Tauseef; Johnson, William; Finer, Nick; Woodside, John; Whincup, Peter H; Sattar, Naveed; Kuh, Diana; Hardy, Rebecca; Deanfield, John

2014-08-01

Excess body fat is associated with an increase in risk of type 2 diabetes and hypertension in adulthood and these risks can adversely affect progression of arterial disease. We aimed to assess the impact of lifelong patterns of adiposity on cardiovascular risk factors and carotid intima media thickness (cIMT) in later life in participants in the 1946 British birth cohort study. The National Survey of Health and Development Study was a nationally representative sample of 5362 singleton births to married parents in England, Scotland, and Wales, stratified by social class, during 1 week in March 1946. Our present study is based on the 60% of participants still alive and with a known present address in England, Scotland, or Wales who attended a clinic assessment after invitation aged 60-64 years. We included participants with lifetime adiposity measures, cardiovascular risk factors, and cIMT measured at 60-64 years. Participants were classified as normal weight or overweight or obese at each age (36, 43, 53, and 60-64 years) in adulthood, and childhood overweight was defined. Patterns of BMI change were identified and we used BMI to define adiposity status. We used multivariable linear regression to establish the cross-sectional association of BMI category at age 60-64 years with cIMT, adjusted for various confounders. We included 1273 (45%) of 2856 participants eligible in 2006-10 (at age 60-64 years) in this study. Compared with normal weight, overweight and obesity were associated with higher cIMT (0·029 mm, 95% CI 0·014-0·043) and systolic blood pressure (7·95 mm Hg, 5·86-10·0). Increased cIMT, systolic blood pressure, leptin, prevalence of diabetes, and reduced adiponectin were all associated with duration of exposure to adult adiposity (p<0·0001 for all). We noted little additional effect of childhood overweight. Individuals who dropped a BMI category in adulthood had lower cIMT (-0·034 mm, -0·056 to -0·013) and leptin concentrations (-0·4 ng/mL, -0�

The Contribution of Youth Sport Football to Weekend Physical Activity for Males Aged 9 to 16 Years: Variability Related to Age and Playing Position.

PubMed

Fenton, Sally A; Duda, Joan L; Barrett, Timothy

2015-05-01

The aims of this study were (1) to determine minutes of moderate-to-vigorous physical activity (PA) and vigorous PA accrued in youth sport football (also internationally referred to as soccer), and the contribution toward daily weekend moderate-to-vigorous PA and vigorous PA for males aged 9-16 years, and (2) to investigate variability in these outcomes related to age and playing position. One hundred and nine male grassroots footballers (Mean age = 11.98 ± 1.75 years) wore a GT3× accelerometer for 7 days. Weekend youth sport football participation and playing position were recorded. Youth sport football moderate-to-vigorous PA (M = 51.51 ± 17.99) and vigorous PA (M = 27.78 ± 14.55) contributed 60.27% and 70.68% toward daily weekend moderate-to-vigorous PA and vigorous PA, respectively. Overall, 36.70% of participants accumulated ≥60 min moderate-to-vigorous PA and 69.70% accrued ≥ 20 min of vigorous PA during youth sport. For participants aged 13 to16 years, youth sport football moderate-to-vigorous PA and vigorous PA were significantly higher, and contributed a greater amount toward daily weekend moderate-to-vigorous PA and vigorous PA than for participants aged 9-12 years (p = <.01). Youth sport football is an important source of moderate-to-vigorous PA and vigorous PA at the weekend for male youth, and particularly for adolescents. Participation may offer opportunity for weekend engagement in vigorous PA toward health enhancing levels.

Efficacy and safety of tadalafil 5 mg once daily in the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia in men aged ≥75 years: integrated analyses of pooled data from multinational, randomized, placebo-controlled clinical studies.

PubMed

Oelke, Matthias; Wagg, Adrian; Takita, Yasushi; Büttner, Hartwig; Viktrup, Lars

2017-05-01

To assess efficacy and safety of tadalafil in men aged ≥75 years with lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) and additional safety in men aged ≥75 years with erectile dysfunction (ED). We conducted an integrated analysis of 12 phase II-III randomized, double-blind and/or open-label extension studies to evaluate short-term (12-26 weeks) efficacy and short- and longer-term (42-52 weeks) safety in men aged <75 years vs men aged ≥75 years. All men received once-daily tadalafil 5 mg or placebo. The efficacy outcome was International Prostate Symptom Score (IPSS). Safety measurements included treatment-emergent adverse events (TEAEs), adverse events (AEs) leading to discontinuation, serious AEs (SAEs), and cardiovascular AEs. All analyses were intention-to-treat. Changes from baseline to efficacy endpoint and differences in changes between treatment groups were estimated as least-squares means using analysis of covariance models. Change in the mean IPSS was significantly different in men aged <75 years vs those aged ≥75 years across tadalafil and placebo groups (treatment-by-age interaction P = 0.034). Tadalafil was not statistically significantly better than placebo in men aged ≥75 years, but effect size varied between studies. Maintenance of efficacy with tadalafil was observed across age groups. Short-term tadalafil safety findings for men aged <75 vs ≥75 years included: TEAEs (52 [33.8%] vs 503 [30.1%]), AEs leading to discontinuation (3 [1.9%] vs 50 [3.0%]), SAEs (4 [2.6%] vs 15 [0.9%]) and cardiovascular AEs (4 [2.6%] vs 30 [1.8%]). Long-term tadalafil safety data did not reveal clinically relevant differences between age groups. Limitations include exclusion of men with serious co-existing conditions and limited sample sizes of men aged ≥75 years. Efficacy with once-daily tadalafil 5 mg in the treatment of LUTS/BPH differed between men aged <75 vs ≥75 years, with significant efficacy in the <75-year age

41 CFR 102-75.60 - What are landholding agencies' responsibilities concerning real property surveys?

Code of Federal Regulations, 2010 CFR

2010-07-01

... agencies' responsibilities concerning real property surveys? 102-75.60 Section 102-75.60 Public Contracts... What are landholding agencies' responsibilities concerning real property surveys? A landholding agency's responsibilities concerning real property utilization surveys are to— (a) Survey real property...

A 60-year-old asymptomatic woman with pulmonary lesions and cervical lymphadenopathy.

PubMed

Yamagishi, Tomoko; Ochi, Nobuaki; Yamane, Hiromichi; Kuribayashi, Futoshi; Takigawa, Nagio

2015-02-01

A 60-year-old asymptomatic woman was referred to our hospital because of an abnormal chest roentgenogram during a routine medical checkup. The patient had no history of memorable infectious diseases, except a liver abscess caused by Serratia marcescens at age 46 years. Her son was diagnosed with chronic granulomatous disease at the age of 1 year. She had never smoked cigarettes and drank only occasionally.

Clinical Diagnoses before Age 75 and Men's Survival to Their 85th Birthday: The Manitoba Follow-Up Study

ERIC Educational Resources Information Center

Tate, Robert B.; Michaels, Leon; Cuddy, T. Edward; Bayomi, Dennis J.

2013-01-01

Purpose: Of all Canadian and American men who live to age 75 years, about half can expect to live to age 85. Our objective is to examine how clinical diagnoses made before age 75 relate to a man's survival to age 85 years. Design and Methods: Since 1948, a cohort of 3,983 young men (mean age of 31 years at entry) has been followed with routine…

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

Declining Effectiveness of Herpes Zoster Vaccine in Adults Aged ≥60 Years.

PubMed

Tseng, Hung Fu; Harpaz, Rafael; Luo, Yi; Hales, Craig M; Sy, Lina S; Tartof, Sara Y; Bialek, Stephanie; Hechter, Rulin C; Jacobsen, Steven J

2016-06-15

Understanding long-term effectiveness of herpes zoster (HZ) vaccine is critical for determining vaccine policy. 176 078 members of Kaiser Permanente ≥60 years vaccinated with HZ vaccine and three matched unvaccinated members were included. Hazard ratios and 95% confidence intervals (CIs) associated with vaccination at each year following vaccination were estimated by Cox regression model. The effectiveness of HZ vaccine decreased from 68.7% (95% CI, 66.3%-70.9%) in the first year to 4.2% (95% CI, -24.0% to 25.9%) in the eighth year. This rapid decline in effectiveness of HZ vaccine suggests that a revaccination strategy may be needed, if feasible. © 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.

Baseline prostate-specific antigen compared with median prostate-specific antigen for age group as predictor of prostate cancer risk in men younger than 60 years old.

PubMed

Loeb, Stacy; Roehl, Kimberly A; Antenor, Jo Ann V; Catalona, William J; Suarez, Brian K; Nadler, Robert B

2006-02-01

Limited data are available concerning the extent to which the initial prostate-specific antigen (PSA) measurement in men younger than age 60 predicts for the risk of prostate cancer (CaP) and how this compares to other known risk factors. From 1991 to 2001, 13,943 men younger than 60 years old participated in a CaP screening study. Men aged 40 to 49 years were eligible for the study if they had a positive family history or African-American heritage, and men older than 50 years were screened without respect to risk factors. The CaP detection rate, PSA velocity, pathologic features, and treatment outcomes were evaluated as a function of the baseline PSA level. The median PSA level was 0.7 ng/mL for men aged 40 to 49 years and 0.9 ng/mL for men aged 50 to 59. A baseline PSA level between the median and 2.5 ng/mL was associated with a 14.6-fold and 7.6-fold increased risk of CaP in men aged 40 to 49 and 50 to 59 years, respectively. A greater baseline PSA value was also associated with a significantly greater PSA velocity, more aggressive tumor features, a greater biochemical progression rate, and a trend toward a greater cancer-specific mortality rate. In men younger than 60, a baseline PSA value between the age-specific median and 2.5 ng/mL was a significant predictor of later CaP and was associated with a significantly greater PSA velocity. A young man's baseline PSA value was a stronger predictor of CaP than family history, race, or suspicious digital rectal examination findings. A greater baseline PSA level was associated with significantly more adverse pathologic features and biochemical progression.

The intention of Dutch general practitioners to offer vaccination against pneumococcal disease, herpes zoster and pertussis to people aged 60 years and older.

PubMed

Lehmann, Birthe A; Eilers, Renske; Mollema, Liesbeth; Ferreira, José; de Melker, Hester E

2017-06-07

Increasing life expectancy results in a larger proportion of older people susceptible to vaccine preventable diseases (VPDs). In the Netherlands, influenza vaccination is routinely offered to people aged 60 years and older. Vaccination against pneumococcal disease, herpes zoster and pertussis is rarely used. These vaccines will be evaluated by the Dutch Health Council and might be routinely offered to older people in the near future. Possible expansion of the program depends partly on the willingness of general practitioners (GPs) to endorse additional vaccinations. In this study, we assessed predictors of GPs' attitude and intention to vaccinate people aged 60 years and older. GPs (N = 12.194) were invited to fill in an online questionnaire consisting of questions about social cognitive factors that can influence the willingness of GPs to vaccinate people aged 60 years and older, including underlying beliefs, practical considerations of adding more vaccines to the national program, demographics, and GPs' patient population characteristics. The questionnaire was filled in by 732 GPs. GPs were positive both about vaccination as a preventive tool and the influenza vaccination program, but somewhat less positive about expanding the current program. Prediction analysis showed that the intention of GPs to offer additional vaccination was predicted by their attitude towards offering additional vaccination, towards vaccination as a preventive tool, towards offering vaccination during an outbreak and on GPs opinion regarding suitability to offer additional vaccination (R 2  = 0.60). The attitude of GPs towards offering additional vaccination was predicted by the perceived severity of herpes zoster and pneumonia, as well as the perceived incidence of herpes zoster. Severity of diseases was ranked as important argument to recommend vaccination, followed by effectiveness and health benefits of vaccines. Providing GPs with evidence-based information about the severity

Early and mid-term results of lung transplantation with donors 60 years and older.

PubMed

López, Iker; Zapata, Ricardo; Solé, Juan; Jaúregui, Alberto; Deu, María; Romero, Laura; Pérez, Javier; Bello, Irene; Wong, Manuel; Ribas, Montse; Masnou, Nuria; Rello, Jordi; Roman, Antonio; Canela, Mercedes

2015-01-01

There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years. We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated. We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1-3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28). Our results support the idea that lungs from donors aged 60-70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Correlation of objectively measured light exposure and serum vitamin D in men aged over 60 years

PubMed Central

Fields, Alison J; Linnville, Steven E; Hoyt, Robert E

2016-01-01

Diminished vitamin D is common among older individuals. Sunlight contributes more to vitamin D synthesis than diet or supplementation. This study examined associations between objectively measured light exposure, vitamin D serum levels, and bone biomarkers in 100 men aged over 60 years. Light exposure was measured in lux via Actigraph monitors for 1 week. Significantly, greater levels of vitamin D were observed in participants with higher light exposure. Seasonal differences in lux were also noted. Significant differences in bone markers were not found. Objective measurement of light exposure is an inexpensive, simple, and effective way to address vitamin D deficiency. PMID:28070400

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers.

PubMed

Dobie, Robert A; Wojcik, Nancy C

2015-07-13

The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to

Clinical Outcomes of Hip Arthroscopy in Patients 60 or Older: A Minimum of 2-Year Follow-up.

PubMed

Capogna, Brian M; Ryan, Michael K; Begly, John P; Chenard, Kristofer E; Mahure, Siddharth A; Youm, Thomas

2016-12-01

To examine clinical outcomes and survivorship in patients aged 60 years or older who underwent hip arthroscopy for management of hip pain. Prospectively collected data for patients 60 or older undergoing hip arthroscopy were obtained. All patients were indicated for hip arthroscopy based on standard preoperative examination as well as routine and advanced imaging. Demographic data, diagnosis, and details regarding operative procedures were collected. Baseline preoperative modified Harris Hip Scores (mHHS) and Non-arthritic Hip Scores (NAHS) were compared to mHHS and NAHS at the 2-year follow-up. Survivorship was assessed to determine failure rates, with failure defined as any subsequent ipsilateral revision arthroscopic surgery and/or hip arthroplasty. Forty-two patients met inclusion criteria. Mean age (standard deviation) and body mass index were 65.8 years (4.5 years) and 26.1 (4.7), respectively. Baseline mean mHHS and NAHS for all patients improved from 47.8 (±12.5) and 47.3 (±13.6) to 75.6 (±17.6) and 78.3 (±18.6), respectively (P < .001 for both). Five patients (11.9%) met failure criteria and underwent additional surgery at an average of 14.8 (8-30) months. Three underwent conversion to total hip arthroplasty (7.1%), whereas 2 had revision arthroscopy with cam/pincer resection and labral repair for recurrent symptoms (4.7%). One- and 2-year survival rates were 95.2% and 88.9%, respectively. Our results suggest that in patients 60 or older with Tonnis grade 0 or 1 osteoarthritic changes on initial radiographs-treatment with hip arthroscopy can lead to reliable improvement in early outcomes. As use of hip arthroscopy for treatment of mechanical hip pain increases, additional studies with long-term follow-up are needed. Level IV, therapeutic case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial.

PubMed

El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline; Dargent-Molina, Patricia

2015-07-22

To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Pragmatic multicentre, two arm, parallel group, randomised controlled trial. 20 study sites in 16 medium to large cities throughout France. 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a "shared frailty" model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group sessions attended was 53 (interquartile range 16-71). Five injurious falls

Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial

PubMed Central

El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline

2015-01-01

Objective To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Design Pragmatic multicentre, two arm, parallel group, randomised controlled trial. Setting 20 study sites in 16 medium to large cities throughout France. Participants 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Intervention Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. Outcome measures A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a “shared frailty” model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. Results There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group

Health-Related Quality of Life among Older Related Hematopoietic Stem Cell Donors (>60 Years) Is Equivalent to That of Younger Related Donors (18 to 60 Years): A Related Donor Safety Study.

PubMed

Switzer, Galen E; Bruce, Jessica; Kiefer, Deidre M; Kobusingye, Hati; Drexler, Rebecca; Besser, RaeAnne M; Confer, Dennis L; Horowitz, Mary M; King, Roberta J; Shaw, Bronwen E; Riches, Marcie; Hayes-Lattin, Brandon; Linenberger, Michael; Bolwell, Brian; Rowley, Scott D; Litzow, Mark R; Pulsipher, Michael A

2017-01-01

The increasing number of older adults with blood-related disorders and the introduction of reduced-intensity conditioning regimens has led to increases in hematopoietic stem cell (HSC) transplantation among older adults and a corresponding increase in the age of siblings who donate HSCs to these patients. Data regarding the donation-related experiences of older donors are lacking. The Related Donor Safety Study aimed to examine/compare health-related quality of life (HRQoL) of older versus younger HSC donors. Sixty peripheral blood stem cell (PBSC) donors ages 18 to 60 years and 104 PBSC donors age >60 years completed validated questionnaires before donation and 4 weeks and 1 year after donation. Before donation, older donors had poorer general physical health (t = -3.27; P = .001) but better mental health (t = 2.11; P < .05). There were no age differences in multiple other donation-related factors. At 4 weeks after donation, there were no group differences in general physical/mental health, but older donors were less likely to report donation-related pain (t = -2.26; P < .05) and concerns (t = -3.38; P = .001). At both 4 weeks and 1 year after donation, there were no significant differences in the percentage of each age group feeling physically back to normal or in the number of days it took donors to feel completely well. There was no evidence that increasing age within the older donor group was associated with poorer donation-related HRQoL. Taken together, these data support the current practice of HSC donation by sibling donors above age 60, providing no evidence of worsening HRQoL up to 1 year after donation in individuals up to age 76. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

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.

Results of Liver Transplantation With Donors Older than 75 Years: A Case-Control Study.

PubMed

León Díaz, F J; Fernández Aguilar, J L; Sánchez Pérez, B; Montiel Casado, C; Aranda Narváez, J M; Pérez Daga, J A; Suárez Muñoz, M Á; Santoyo Santoyo, J

2016-09-01

The inclusion of elderly donors can increase the pool of organs available for transplantation. The objective of this study was to compare clinical outcomes and survival rates of patients who received livers from donors aged ≥75 years versus younger donors. We considered all liver transplantations performed in our unit from January 2006 to January 2015. Thirty-two patients received a liver from a cadaveric donor aged ≥75 years (study group), and their outcomes were compared with those of patients who received a liver from a younger donor (control group) immediately before and after each transplantation in the study group. This is a descriptive, retrospective, case-control study carried out to analyze the characteristics of donors and recipients as well as the clinical course and survival of recipients of older and younger donors. Statistically significant differences were observed according to donors' age (53.3 ± 13.6 vs 79 ± 3.4 years; P < .001). In total, 6.2% of the recipients of a liver from a donor aged <75 years required retransplantation versus 15.6% of recipients of donors ≥75 years. Patient survivals at 1, 3, and 5 years, respectively, were 89%, 78.6%, and 74.5% for recipients of donors <75 years versus 83.4%, 79.4%, and 59.6% for the study group. Livers from older donors can be safely used for transplantation with acceptable survival rates. However, survival rates are lower for recipients of livers from older donors compared with younger donors, and survival only increased with retransplantation. Copyright © 2016 Elsevier Inc. All rights reserved.

Association between Serum Uric Acid Level and Carotid Atherosclerosis in Chinese Individuals Aged 75 Years or Older: A Hospital-Based Case-Control Study.

PubMed

Feng, L; Hua, C; Sun, H; Qin, L-Y; Niu, P-P; Guo, Z-N; Yang, Y

2018-01-01

To investigate the association between serum uric acid level and the presence and progression of carotid atherosclerosis in Chinese individuals aged 75 years or older. Case-control study. In a teaching hospital. Five hundred and sixty-four elderlies (75 years or above) who underwent general health screening in our hospital were enrolled. The detailed carotid ultrasound results, physical examination information, medical history, and laboratory test results including serum uric acid level were recorded, these data were used to analyze the relationship between serum uric acid level and carotid atherosclerosis. Then, subjects who underwent the second carotid ultrasound 1.5-2 years later were further identified to analyzed the relationship between serum uric acid and the progression of carotid atherosclerosis. A total of 564 subjects were included, carotid plaque was found in 482 (85.5%) individuals. Logistic regression showed that subjects with elevated serum uric acid (expressed per 1 standard deviation change) had significantly higher incidence of carotid plaque (odds ratio, 1.37; 95% confidence interval, 1.07-1.75; P= 0.012) after controlling for other factors. A total of 236 subjects underwent the follow-up carotid ultrasound. Linear regression showed that serum uric acid level (expressed per 1 standard deviation change; 1 standard deviation = 95.5 μmol/L) was significantly associated with percentage of change of plaque score (P = 0.008). Multivariable linear regression showed that 1 standard deviation increase in serum uric acid levels was expected to increase 0.448% of plaque score (P = 0.023). The elevated serum uric acid level may be independently and significantly associated with the presence and progression of carotid atherosclerosis in Chinese individuals aged 75 years or older.

77 FR 34784 - Removal of Six Month Line Check Requirement for Pilots Over Age 60; Technical Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

...-0486; Amdt. No. 121-359] Removal of Six Month Line Check Requirement for Pilots Over Age 60; Technical... years of age that applied to air carriers engaged in part 121 operations. This technical amendment... December 13, 2007. This legislation raised the upper age limit for pilots in part 121 from age 60 to age 65...

Maternal identification of dental caries lesions in their children aged 1-3 years.

PubMed

Fernandes, I B; Sá-Pinto, A C; Silva Marques, L; Ramos-Jorge, J; Ramos-Jorge, M L

2017-06-01

To analyse the maternal identification of different stages of dental caries in children aged 1-3 years. A cross-sectional study was conducted with 274 children and their mothers. The mothers answered a questionnaire on the occurrence of dental caries in their children and completed questions addressing their demographic/socio-economic status. The oral examination of the children was performed using the International Caries Detection and Assessment System. Descriptive, Chi square test and Poisson regression statistical analyses were performed. The prevalence of initial and established/severe dental caries lesions by age were: 1 year (23.2 and 24.2%), 2 years (17.9 and 55.7%) and 3 years (23.3 and 60.3%) respectively. Significant associations between clinical examinations and the mothers' reports were observed among children aged 1 year old who had initial stage caries lesions (p = 0.006) and in children aged 1, 2 and 3 years old who had established/severe stage caries lesions (p < 0.001). After adjustment for confounding variables it was found that mothers were more able to identify dental caries both at initial (PR 4.01, 95% CI 1.35-11.94) and established/severe stages (PR 9.14, 95% CI 2.49-33.56) in children aged 1 year old. In children aged 2 and 3 years, this identification was more evident in the established/severe stage (2 years, PR 2.98, 95% CI 1.42-6.26; 3 years, PR 2.75, 95% CI 1.09-6.93). Mothers of children aged 1 year old identified dental caries at initial and established/severe stages. Mothers of children aged 2 and 3 years identified dental caries only at established/severe stages.

Preoperative Chemoradiotherapy for Rectal Cancer in Patients Aged 75 Years and Older: Acute Toxicity, Compliance with Treatment, and Early Results.

PubMed

Guimas, Valentine; Boustani, Jihane; Schipman, Benjamin; Lescut, Nicolas; Puyraveau, Marc; Bosset, Jean François; Servagi-Vernat, Stéphanie

2016-06-01

Treatment of locally advanced rectal cancer (T3-T4 or N+) is based on short-course radiotherapy (RT) or chemoradiotherapy (CRT) followed by surgery. It is estimated that 30-40 % of rectal cancer occurs in patients aged 75 years or more. Data on adherence to neoadjuvant CRT and its safety remain poor owing to the under-representation of older patients in randomized clinical trials and the discordance in the results from retrospective studies. The aim of this study was to assess adherence with preoperative CRT and tolerability in older patients with a stage II/III unresectable rectal cancer. Patients aged 75 years or more with stage II/III rectal cancer treated with preoperative CRT at the University Hospital of Besancon from 1993 to 2011 were included. Feasibility, toxicities, overall survival, and local recurrence rates were studied. Fifty-six patients with a Charlson score from 2 to 6 were included. The mean age was 78 years. The compliance rates for RT and chemotherapy were 91 and 41.1 %, respectively. Two patients stopped CRT; one for hemostatic surgery, and one for severe sepsis. For CRT, the rate of grade ≥3 toxicity was 14.29 %, mainly the digestive type. Fifty-two patients underwent tumor resection, including 76.79 % total mesorectal excision resection with 84.6 % complete resection, and a rate of postoperative complications of 39.6 %. At 2 years, the overall survival and local recurrences rates were 87.3 and 7.8 %, respectively. In older patients, selected preoperative CRT, with an adapted chemotherapy dose, is well tolerated. The main toxicity was gastrointestinal. Adherence to RT is comparable to that of younger patients.

Age 60 rule research, part I : bibliographic database.

DOT National Transportation Integrated Search

1994-10-01

This document is one of four products completed as a part of the Age 60 Rule research contract monitored by Pam Della Rocco, Civil Aerospace Medical Institute. As part of their research contract with the FAA to study issues related to the "Age 60 Rul...

Significance of Age in Japanese Patients Receiving Sunitinib as First-line Systemic Therapy for Metastatic Renal Cell Carcinoma: Comparative Assessment of Efficacy and Safety between Patients Aged <75 and ≥75 Years.

PubMed

Miyake, Hideaki; Aki, Ryota; Matsushita, Yuto; Tamura, Keita; Motoyama, Daisuke; Ito, Toshiki; Sugiyama, Takayuki; Otsuka, Atsushi

2018-06-01

To date, it has not been well characterized whether sunitinib is effective in elderly patients with metastatic renal cell carcinoma (mRCC). The objective of this study was to investigate the impact of age on clinical outcomes of mRCC patients receiving sunitinib. The efficacy and safety of first-line sunitinib in 154 consecutive mRCC patients were retrospectively compared between patients aged <75 (n=125) and ≥75 (n=29) years. There were no significant differences in the major clinicopathological characteristics between younger and older patients; however, the reduction of the initial dose of sunitinib was significantly more frequent in older than younger patients. No significant difference in response rate, clinical benefit rate or proportion of patients going on to receive second-line therapy was noted between these two groups. Furthermore, there was no significant difference in progression-free survival (PFS) or overall survival (OS) between the two groups, and no significant impact of age on PFS or OS was documented by the Cox proportional hazards regression analyses. Of several adverse events, only anemia and fatigue were significantly more frequently observed in older than younger patients. Although there was no significant difference in the incidence of dose reduction or discontinuation of sunitinib between the two groups, the interruption of sunitinib was more frequently required in older than younger patients. These findings suggest that advanced age alone should not be regarded as a contraindication to the introduction of sunitinib as first-line systemic therapy for mRCC patients. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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

Post-remission treatment with allogeneic stem cell transplantation in patients aged 60 years and older with acute myeloid leukaemia: a time-dependent analysis.

PubMed

Versluis, Jurjen; Hazenberg, Carin L E; Passweg, Jakob R; van Putten, Wim L J; Maertens, Johan; Biemond, Bart J; Theobald, Matthias; Graux, Carlos; Kuball, Jurgen; Schouten, Harry C; Pabst, Thomas; Löwenberg, Bob; Ossenkoppele, Gert; Vellenga, Edo; Cornelissen, Jan J

2015-10-01

Acute myeloid leukaemia mainly affects elderly people, with a median age at diagnosis of around 70 years. Although about 50-60% of patients enter first complete remission upon intensive induction chemotherapy, relapse remains high and overall outcomes are disappointing. Therefore, effective post-remission therapy is urgently needed. Although often no post-remission therapy is given to elderly patients, it might include chemotherapy or allogeneic haemopoietic stem cell transplantation (HSCT) following reduced-intensity conditioning. We aimed to assess the comparative value of allogeneic HSCT with other approaches, including no post-remission therapy, in patients with acute myeloid leukaemia aged 60 years and older. For this time-dependent analysis, we used the results from four successive prospective HOVON-SAKK acute myeloid leukaemia trials. Between May 3, 2001, and Feb 5, 2010, a total of 1155 patients aged 60 years and older were entered into these trials, of whom 640 obtained a first complete remission after induction chemotherapy and were included in the analysis. Post-remission therapy consisted of allogeneic HSCT following reduced-intensity conditioning (n=97), gemtuzumab ozogamicin (n=110), chemotherapy (n=44), autologous HSCT (n=23), or no further treatment (n=366). Reduced-intensity conditioning regimens consisted of fludarabine combined with 2 Gy of total body irradiation (n=71), fludarabine with busulfan (n=10), or other regimens (n=16). A time-dependent analysis was done, in which allogeneic HSCT was compared with other types of post-remission therapy. The primary endpoint of the study was 5-year overall survival for all treatment groups, analysed by a time-dependent analysis. 5-year overall survival was 35% (95% CI 25-44) for patients who received an allogeneic HSCT, 21% (17-26) for those who received no additional post-remission therapy, and 26% (19-33) for patients who received either additional chemotherapy or autologous HSCT. Overall survival at 5

Bariatric Surgery in Septuagenarians: a Comparison with <60 Year Olds.

PubMed

Parmar, Chetan; Mahawar, Kamal K; Carr, William R J; Schroeder, Norbert; Balupuri, Shlok; Small, Peter K

2017-12-01

There is reluctance amongst many healthcare professionals to offer bariatric surgery to septuagenarians. There is only one study in the scientific literature specifically describing any experience with this group of patients and none that compares the outcomes in this group with younger patients. We retrospectively examined our prospective database to identify all those who were >70 years old at the time of bariatric surgery. This group was then compared with a matched (for sex, body mass index, surgical procedure, and time of surgery) cohort of younger (<60 year old) patients. Information was obtained from our database, case notes, hospital electronic records, by interviewing team members, and from general practitioners. A total of 10 septuagenarians were compared with 10 younger patients (mean age 41 years). There were one early complication and 1 late complication in the over 70 group as opposed to no early complication and 2 late complications in the younger group. There was no mortality or early reoperation in either group. Excess weight loss of 50.4, 67.4, and 74.0% in the >70 age group at 6, 12, and 24 months, respectively, was no different to 51.3, 70.8, and 73.9% in <60 year olds. The effect on the co-morbidity resolution was similar in the two groups. In carefully selected septuagenarians, bariatric surgery can be performed with safety and efficacy comparable to those <60 years old.

Update on herpes zoster vaccine: licensure for persons aged 50 through 59 years.

PubMed

2011-11-11

Herpes zoster vaccine (Zostavax, Merck & Co., Inc.) was licensed and recommended in 2006 for prevention of herpes zoster among adults aged 60 years and older. In March 2011, the Food and Drug Administration (FDA) approved the use of Zostavax in adults aged 50 through 59 years. In June 2011, the Advisory Committee on Immunization Practices (ACIP) declined to recommend the vaccine for adults aged 50 through 59 years and reaffirmed its current recommendation that herpes zoster vaccine be routinely recommended for adults aged 60 years and older.

Association between sarcopenia with lifestyle and family function among community-dwelling Chinese aged 60 years and older.

PubMed

Hai, Shan; Wang, Hui; Cao, Li; Liu, Ping; Zhou, Jianghua; Yang, Ying; Dong, Birong

2017-08-18

Sarcopenia is defined as the age-related decline in skeletal muscle mass and function. The risk factors and causes of sarcopenia must be identified to develop prevention and treatment strategies for this syndrome. Our aim was to examine the association between sarcopenia with lifestyle and family function among community-dwelling Chinese people aged 60 years and older. We conducted this study to evaluate sarcopenia among 834 community-dwelling Chinese individuals aged ≥60 years using the Asian Working Group for Sarcopenia (AWGS) criteria. The sociodemographic characteristics, food consumption patterns, habits of smoking, and alcohol consumption of the participants were collected using a general questionnaire, whereas physical activity was assessed using the International Physical Activity Questionnaire (IPAQ; long-form version). Family function was assessed using the Family APGAR scale. In addition, the association of sarcopenia with lifestyle and family function was examined using univariate and multivariate analyses. The total prevalence rate of sarcopenia was 10.6%. Female participants with sarcopenia had a lower frequency per week of nut consumption than those without sarcopenia (p < 0.05), whereas, for male participants, the differences in food consumption patterns of those with sarcopenia versus those without sarcopenia were not significant. Among the participants, the mean Family APGAR score was 8 (standard deviation [SD] = 0.92). For both sexes, participants with sarcopenia had lower family function scores than those without sarcopenia. In the multivariate model, after adjustment for all covariates, frequency per week of nut consumption (adjusted OR 0.724, 95% CI 0.532-0.985, P < 0.05) and Family APGAR score (adjusted OR 0.683, 95% CI 0.496-0.940, P = 0.019) were statistically significantly associated with sarcopenia. The relationship between other lifestyle habits and sarcopenia was not significant. There was significant association between

Emotion Dialogues between Mothers and Children at 4.5 and 7.5 Years: Relations with Children's Attachment at 1 Year

ERIC Educational Resources Information Center

Oppenheim, David; Koren-Karie, Nina; Sagi-Schwartz, Abraham

2007-01-01

It was examined whether secure infant-mother attachment contributes to emotionally congruent and organized mother-child dialogues about emotions in later years. The attachment of 99 children was assessed using the Strange Situation at the age of 1 year and their emotion dialogues with their mothers were assessed at the ages of 4.5 and 7.5 years.…

The Impact of In Vitro Accelerated Aging, Approximating 30 and 60 Years In Vivo, on Commercially Available Zirconia Dental Implants.

PubMed

Monzavi, Mona; Noumbissi, Sammy; Nowzari, Hessam

2017-04-01

Despite increased popularity of Zirconia dental implants, concerns have been raised regarding low temperature degradation (LTD) and its effect on micro-structural integrity. This study evaluated the effect of LTD on four types of Zirconia dental implants at 0, 30, and 60 years of artificial aging. The impact of aging on t-m transformation and micro crack formation was measured. Accelerated aging at 15 and 30 hours, approximating 30 and 60 years in vivo, aged 36 Zirconia dental implants: Z systems ® (A), Straumann ® (B), Ceraroot ® (C), and Zeramex ® (D). Focused ion beam-scanning electron microscopic analysis determined the micro structural features, phase transformation, and the formation of micro cracks. At 15 hours, type A implant presented with micro cracks and t-m transformation of 0.9 µm and 3.1 µm, respectively. At 30 hours, micro cracks remained shallow (1 µm). At 15 hours, type B implant presented micro cracks (0.7 µm) and grain transformation (1.2 µm). At 30 hours, these features remained superficial at 0.6 and 1.5 µm, respectively. Type C implant presented surface micro cracks of 0.3 µm at 15 hours. The depth of t-m transformation slightly increased to 1.4 µm. At 30 hours, number of micro cracks increased at the surface to an average depth of 1.5 µm. Depth of t-m transformation increased to an average of 2.5 µm. At 15 hours, micro cracks remained superficial (0.8 µm) for type D implant and depth of t-m transformation increased to 2.3 µm. At 30 hours, the depth of micro cracks increased to an average of 1.3 µm followed by increased t-m transformation to a depth of 4.1 µm. Depth of grain transformation remained within 1-4 µm from the surface. The effect of aging was minimal for all Zirconia implants. © 2016 Wiley Periodicals, Inc.

Mindfulness-based stress reduction for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial.

PubMed

Zhang, Jia-Xu; Liu, Xiao-Hui; Xie, Xin-Hui; Zhao, Dan; Shan, Mo-Shui; Zhang, Xi-Liang; Kong, Xiao-Ming; Cui, Hong

2015-01-01

To assess the effectiveness of mindfulness-based stress reduction (MBSR) for chronic insomnia and combined depressive or anxiety symptoms of older adults aged 75 years and over. A randomized, controlled, single-blind clinical trial. Participants included 60 adults aged 75 years and over with chronic insomnia. Participants were randomly assigned to the eight-week MBSR group or the wait-list control group. Assessments using the Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Sale (SAS), and Geriatric Depression Scale (GDS) were taken at baseline and post-treatment. For each outcome measure, a repeated measures analysis of variance was used to detect changes across assessments. There was a significant time × group interaction for the PSQI global score (P = .006); the MBSR group had a decrease in the PSQI global score (Cohen׳s d = 1.12), while the control group did not (Cohen׳s d = -0.06). Among the PSQI components, there was a significant time × group interaction for daytime dysfunction (P = .048); Cohen׳s d of the MBSR group was 0.76, while Cohen׳s d of control group was -0.04. There was no significant time × group interaction for the SAS score (P = .116), while for the GDS there was a significant time × group interaction (P = .039); the Cohen׳s d value for the MBSR group was 1.20, and it was 0.12 for the control group. This study demonstrated that the MBSR program could be a beneficial treatment for chronic insomnia in adults aged 75 years and older. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

[Occupational satisfaction and quality of life in women aged 45-60 years in the Silesia voivodeship].

PubMed

Kowalska, Małgorzata; Marcinkowska, Urszula; Jośko, Jadwiga

2010-01-01

Quality of life is an important issue of public health. It becomes essential in the population of active workers, especially women who besides their occupational activity have to perform other important roles, such as care of their children or older parents. The presented study is an attempt to answer the question on whether occupational activity, especially job satisfaction, provides better quality of live in the population of women aged 45-60 years. The obtained results confirm that a better quality of live, measured by the status of physical and mental health, is characteristic of occupationally active women with a higher level of education, who also experience job satisfaction. Care of children or older parents has no impact on the decline of quality of life. The improvement of qualifications and occupational activity can contribute to a better quality of live in the population of women.

Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States: effect of different methods of case classification.

PubMed

Rasch, Elizabeth K; Hirsch, Rosemarie; Paulose-Ram, Ryne; Hochberg, Marc C

2003-04-01

To determine prevalence estimates for rheumatoid arthritis (RA) in noninstitutionalized older adults in the US. Prevalence estimates were compared using 3 different classification methods based on current classification criteria for RA. Data from the Third National Health and Nutrition Examination Survey (NHANES-III) were used to generate prevalence estimates by 3 classification methods in persons 60 years of age and older (n = 5,302). Method 1 applied the "n of k" rule, such that subjects who met 3 of 6 of the American College of Rheumatology (ACR) 1987 criteria were classified as having RA (data from hand radiographs were not available). In method 2, the ACR classification tree algorithm was applied. For method 3, medication data were used to augment case identification via method 2. Population prevalence estimates and 95% confidence intervals (95% CIs) were determined using the 3 methods on data stratified by sex, race/ethnicity, age, and education. Overall prevalence estimates using the 3 classification methods were 2.03% (95% CI 1.30-2.76), 2.15% (95% CI 1.43-2.87), and 2.34% (95% CI 1.66-3.02), respectively. The prevalence of RA was generally greater in the following groups: women, Mexican Americans, respondents with less education, and respondents who were 70 years of age and older. The prevalence of RA in persons 60 years of age and older is approximately 2%, representing the proportion of the US elderly population who will most likely require medical intervention because of disease activity. Different classification methods yielded similar prevalence estimates, although detection of RA was enhanced by incorporation of data on use of prescription medications, an important consideration in large population surveys.

Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment?

PubMed

de Kruijf, Marjolein; Vroemen, J P A M; de Leur, K; van der Voort, E A M; Vos, D I; Van der Laan, L

2014-06-01

Over 75 % of patients presenting with a proximal humerus fracture are 70 years or older. Very little is known about the outcome after operative treatment of these fractures in very old patients. This study was performed to gain more insight in safety and functional outcome of surgical treatment of proximal humerus fractures in the elderly. In this observational study, we analyzed all operatively treated patients, aged 75 or older, with a proximal humerus fracture between January 2003 and December 2008 in our center. Patient selection was on clinical grounds, based on physical, mental, and social criteria. Complications were evaluated. We used the DASH Questionnaire to investigate functional outcome, pain, and ADL limitations. Sixty-four patients were treated surgically for a displaced proximal fracture of the humerus: 15 two-part, 32 three-part, and 17 four-part fractures. Mean DASH scores were 37.5, 36.9, and 48.6, respectively. Regarding the operative methods, overall good results were obtained with the modern locked plate osteosynthesis (mean DASH 34.4). Prosthetic treatment, mostly used in highly comminuted fractures, often resulted in poor function (mean DASH 72.9). Persistent pain and ADL limitations were more present in more comminuted fractures (64 and 50 % in patients with 4-part fractures vs. 14 % in 2-part fractures). There were no postoperative deaths within 3 months of surgery, and fracture-related and non-fracture-related complication rates were low (non-union 3 %; 1 myocardial infarction). This study shows that it is safe and justifiable to consider surgical treatment of a severely dislocated proximal humerus fracture in selected patients aged 75 and older. According to OCEBM Working Group,Level IV.

Sexual Behaviors, Healthcare Interactions, and HIV-Related Perceptions Among Adults Age 60 Years and Older: An Investigation by Race/Ethnicity.

PubMed

Glaude-Hosch, Jonathan A; Smith, Matthew Lee; Heckman, Timothy G; Miles, Toni P; Olubajo, Babatunde A; Ory, Marcia G

2015-01-01

Older adults are remaining sexually active for longer periods of time, underscoring the need to assess sexual activity patterns in this group and identify differences by race/ethnicity, some of which may have implications for the development and implementation of sexual risk reduction interventions. Using data from the 2010 National Social Life, Health, and Aging Project, this study examined responses from 1,429 adults aged 60 years and older. Multinomial logistic regression compared sexual behaviors, health-related indicators, interactions with healthcare professionals, and HIV-related perceptions across participants' race/ethnicity. Approximately 81% of participants self-reported as non-Hispanic white, 10.59% as African American, and 8.05% as Hispanic. On average, participants were 69.9 years of age. In the previous year, 49.3% of participants engaged in sexual intercourse; only 3% used condoms. The majority of participants (83.1%) visited a physician at least twice in the previous year, 30.9% had discussed sex with a physician since turning 50, and 14.2% had been tested for HIV. Relative to non-Hispanic whites, African Americans were more likely to be divorced (OR=3.23, P<0.001) or widowed (OR=2.90, P<0.001); have more lifetime sexually transmitted infection (STI) diagnoses (OR=1.67, P=0.030); and have paid for sex (OR=2.83, P=0.002). Although African Americans had greater perceived risk for HIV infection (OR=1.66, P=0.046), they were less likely to have discussed sex with a physician since turning 50 (OR=0.45, P=0.009). Contextualized interventions to improve patient-provider communication and proactive screening behaviors in sexually-active and aging African Americans are needed.

Access to kidney transplantation in European adults aged 75-84 years and related outcomes: an analysis of the European Renal Association-European Dialysis and Transplant Association Registry.

PubMed

Pippias, Maria; Stel, Vianda S; Kramer, Anneke; Abad Diez, Jose M; Aresté-Fosalba, Nuria; Ayav, Carole; Buturovic, Jadranka; Caskey, Fergus J; Collart, Frederic; Couchoud, Cécile; De Meester, Johan; Heaf, James G; Helanterä, Ilkka; Hemmelder, Marc H; Kostopoulou, Myrto; Noordzij, Marlies; Pascual, Julio; Palsson, Runolfur; Reisaeter, Anna Varberg; Traynor, Jamie P; Massy, Ziad; Jager, Kitty J

2018-05-01

To what extent access to, and allocation of kidney transplants and survival outcomes in patients aged ≥75 years have changed over time in Europe is unclear. We included patients aged ≥75-84 years (termed older adults) receiving renal replacement therapy in thirteen European countries between 2005 and 2014. Country differences and time trends in access to, and allocation of kidney transplants were examined. Survival outcomes were determined by Cox regression analyses. Between 2005 and 2014, 1392 older adult patients received 1406 transplants. Access to kidney transplantation varied from ~0% (Slovenia, Greece and Denmark) to ~4% (Norway and various Spanish regions) of all older adult dialysis patients, and overall increased from 0.3% (2005) to 0.9% (2014). Allocation of kidney transplants to older adults overall increased from 0.8% (2005) to 3.2% (2014). Seven-year unadjusted patient and graft survival probabilities were 49.1% (95% confidence interval, 95% CI: 43.6; 54.4) and 41.7% (95% CI: 36.5; 46.8), respectively, with a temporal trend towards improved survival outcomes. In conclusion, in the European dialysis population aged ≥75-84 years access to kidney transplantation is low, and allocation of kidney transplants remains a rare event. Though both are increasing with time and vary considerably between countries. The trend towards improved survival outcomes is encouraging. This information can aid informed decision-making regarding treatment options. © 2018 Steunstichting ESOT.

Attitudes and beliefs to the uptake and maintenance of physical activity among community-dwelling South Asians aged 60-70 years: a qualitative study.

PubMed

Horne, M; Skelton, D A; Speed, S; Todd, C

2012-05-01

To identify the attitudes and beliefs associated with the uptake and adherence of physical activity among community-dwelling South Asians aged 60-70 years. A qualitative research study using an ethnographic approach. Focus groups and in-depth interviews were conducted to explore motivational factors associated with initiating and maintaining physical activity. Data analysis followed the framework approach. Health, maintaining independence and social support were important in terms of initiating physical activity. Social support, psychosocial elements of activity, health and integrating physical activity within everyday activities were important for adherence to physical activity. The need for gendered physical activity sessions was important to initiating exercise among Muslim South Asians aged 60-70 years. Promoting active lifestyles and building physical activity in and around day-to-day activities are important strategies in increasing activity levels. However, the needs for culturally appropriate facilities, peer mentors who could assist those with language barriers, specific tailored advice, advice on integrating physical activity in everyday life and general social support could promote uptake and subsequent adherence among this population group. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians.

PubMed

Qaseem, Amir; Wilt, Timothy J; Rich, Robert; Humphrey, Linda L; Frost, Jennifer; Forciea, Mary Ann

2017-03-21

The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) jointly developed this guideline to present the evidence and provide clinical recommendations based on the benefits and harms of higher versus lower blood pressure targets for the treatment of hypertension in adults aged 60 years or older. This guideline is based on a systematic review of published randomized, controlled trials for primary outcomes and observational studies for harms only (identified through EMBASE, the Cochrane Database of Systematic Reviews, MEDLINE, and ClinicalTrials.gov), from database inception through January 2015. The MEDLINE search was updated through September 2016. Evaluated outcomes included all-cause mortality, morbidity and mortality related to stroke, major cardiac events (fatal and nonfatal myocardial infarction and sudden cardiac death), and harms. This guideline grades the evidence and recommendations using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method. The target audience for this guideline includes all clinicians, and the target patient population includes all adults aged 60 years or older with hypertension. ACP and AAFP recommend that clinicians initiate treatment in adults aged 60 years or older with systolic blood pressure persistently at or above 150 mm Hg to achieve a target systolic blood pressure of less than 150 mm Hg to reduce the risk for mortality, stroke, and cardiac events. (Grade: strong recommendation, high-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient. ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in adults aged 60 years or older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mm Hg to

Long-term persistence of humoral and cellular immune responses induced by an AS03A-adjuvanted H1N1 2009 influenza vaccine: an open-label, randomized study in adults aged 18-60 years and older.

PubMed

Van Damme, Pierre; Kafeja, Froukje; Bambure, Vinod; Hanon, Emmanuel; Moris, Philippe; Roman, François; Gillard, Paul

2013-07-01

This manuscript presents data on the persistence of Hemagglutination Inhibition (HI) immune response against the A/California/7/2009 strain, six and 12 mo after adults received one dose (n = 138) or two doses (n = 102; 21 d apart) of a 3.75 µg Hemagglutinin antigen AS03-adjuvanted H1N1 2009 vaccine (NCT00968526). Two hundred forty subjects (18-60 y: 120;>60 y: 120) were vaccinated. Immunogenicity end points were based on the European licensure criteria for pandemic influenza vaccines. Exploratory analyses assessed the cell-mediated immune response (CMI) up to Month 12 and the influence of previous influenza vaccination on persistence of immune response. At Month 6, the CHMP criteria were met in subjects aged 18-60 y who received one or two vaccine doses and in subjects aged>60 y who received two vaccine doses. At Month 12, the CHMP criteria were met only in subjects aged 18-60 y who received two vaccine doses. Persistence of HI immune response against the vaccine strain was higher in subjects without prior influenza vaccination. Exploratory analyses showed that two doses of the H1N1 2009 vaccine induced persistence of H1N1-specific CD4+ T cells up to Month 6 and memory B cells up to Month 12. In conclusion, HI immune responses persisted up to 12 mo after vaccination with one-dose and two-dose regimens of the AS03-adjuvanted 3.75 µg HA H1N1 2009 pandemic influenza vaccine, although not all three CHMP guidance criteria for both groups were met at Month 6 and Month 12. The CD4+ T cell and B cell responses also persisted up to Month 12.

Midlife muscle strength and human longevity up to age 100 years: a 44-year prospective study among a decedent cohort.

PubMed

Rantanen, Taina; Masaki, Kamal; He, Qimei; Ross, G Webster; Willcox, Bradley J; White, Lon

2012-06-01

We studied prospectively the midlife handgrip strength, living habits, and parents' longevity as predictors of length of life up to becoming a centenarian. The participants were 2,239 men from the Honolulu Heart Program/Honolulu-Asia Aging Study who were born before the end of June 1909 and who took part in baseline physical assessment in 1965-1968, when they were 56-68 years old. Deaths were followed until the end of June 2009 for 44 years with complete ascertainment. Longevity was categorized as centenarian (≥100 years, n = 47), nonagenarian (90-99 years, n = 545), octogenarian (80-89 years, n = 847), and ≤79 years (n = 801, reference). The average survival after baseline was 20.8 years (SD = 9.62). Compared with people who died at the age of ≤79 years, centenarians belonged 2.5 times (odds ratio (OR) = 2.52, 95% confidence interval (CI) = 1.23-5.10) more often to the highest third of grip strength in midlife, were never smokers (OR = 5.75 95% CI = 3.06-10.80), had participated in physical activity outside work (OR = 1.13 per daily hour, 95% CI = 1.02-1.25), and had a long-lived mother (≥80 vs. ≤60 years, OR = 2.3, 95% CI = 1.06-5.01). Associations for nonagenarians and octogenarians were parallel, but weaker. Multivariate modeling showed that mother's longevity and offspring's grip strength operated through the same or overlapping pathway to longevity. High midlife grip strength and long-lived mother may indicate resilience to aging, which, combined with healthy lifestyle, increases the probability of extreme longevity.

Physical functions, health-related outcomes, nutritional status, and blood markers in community-dwelling cancer survivors aged 75 years and older.

PubMed

Ihira, Hikaru; Mizumoto, Atsushi; Makino, Keitarou; Yasuda, Keisuke; Yoko, Yoko; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Furuna, Taketo

2014-01-01

A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of their life. The purpose of this study was to examine whether physical functions, health-related outcomes, nutritional status and blood markers in community-dwelling cancer survivors aged 75 years and older are different from those who do not have cancer Two hundred seventy-five participants were asked by physicians, nurses, and physical therapists, questions regarding cancer history in a face-to-face interview. Data were collected for demographic information, physical functions, such as handgrip strength, knee extension power, abdominal muscle strength, static standing balance, walking speed and the timed-up-and-go test, health-related outcomes, nutritional status, and blood markers. The measured parameters of survivor diagnosed with cancer were compared with those without a history of cancer. Thirty-seven older adults were previously diagnosed with cancer. Female cancer survivors had lower knee extension power (p<0.05), abdominal muscle strength (p<0.05), walking speed (p<0.05), timed-up-and-go test score (p<0.05), and time to spend on walking per day (p<0.05) than older women without a history of cancer. In men, none of the measured parameters were significantly different between cancer survivors and older men with no history of cancer. The present study shows that partial physical function of women cancer survivors aged 75 years and older differs from that in women with no history of cancer.

Reference intervals and percentiles for carotid-femoral pulse wave velocity in a healthy population aged between 9 and 87 years.

PubMed

Diaz, Alejandro; Zócalo, Yanina; Bia, Daniel; Wray, Sandra; Fischer, Edmundo Cabrera

2018-04-01

There is little information regarding age-related reference intervals (RIs) of carotid-femoral pulse wave velocity (cfPWV) for large healthy populations in South America. The aims of this study were to determine cfPWV RIs and percentiles in a cohort of healthy children, adolescents, and adults and to generate year-to-year percentile curves and body-height percentile curves for children and adolescents. cfPWV was measured in 1722 healthy participants with no cardiovascular risk factors (9-87 years, 60% men). First, RIs were evaluated for males and females through correlation and covariate analysis. Then, mean and standard deviation age-related equations were obtained for cfPWV using parametric regression methods based on fractional polynomials and age-specific (year-to-year) percentile curves that were defined using the standard normal distribution. Age-specific first, 2.5th, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97.5th, and 99th percentile curves were calculated. Finally, height-related cfPWV percentile curves for children and adolescents (<21 years) were established. After adjusting for age and blood pressure differences with respect to females, males showed higher cfPWV levels (6.60 vs 6.45 m/s; P < .01). Thus, specific RIs for males and females were reported. The study provides the largest database to date concerning cfPWV in healthy people from Argentina. Specific RIs and percentiles of cfPWV are now available according to age and sex. Specific percentiles of cfPWV according to body height were reported for people younger than 21 years. ©2018 Wiley Periodicals, Inc.

Cementless Total Knee Arthroplasty in Patients Older Than 75 Years.

PubMed

Newman, Jared M; Khlopas, Anton; Chughtai, Morad; Gwam, Chukwuweike U; Mistry, Jaydev B; Yakubek, George A; Harwin, Steven F; Mont, Michael A

2017-11-01

Some surgeons have been hesitant to use cementless fixation for total knee arthroplasty (TKA) in elderly patients due to concerns regarding successful bone biological fixation. Therefore, this study evaluated: (1) implant survivorship, (2) functional outcomes, (3) radiographic outcomes, and (4) complications in patients over 75 years of age who underwent cementless total knee arthroplasty. A total of 134 patients (142 TKAs) older than 75 years at a single institution between June 2008 and June 2014 were retrospectively reviewed. Their mean follow-up was 4 years (range: 2-8 years). The cohort consisted of 91 women and 43 men who had a mean age of 80 years (range: 76 to 88 years). The preoperative diagnoses were osteoarthritis ( n  = 107 patients), rheumatoid arthritis ( n  = 21 patients), and osteonecrosis ( n  = 6 patients). Descriptive statistics were used to calculate the means and ranges and a Kaplan-Meier analysis was performed to determine the aseptic and all cause implant survivorship. Radiographic evaluation was performed using the new Knee Society Radiographic Evaluation and Scoring System. Functional outcomes at the final follow-up as well as all medical and surgical complications were recorded for each patient. The aseptic implant survivorship was 99.3% (95% CI: 7.9-8.1), and the all cause implant survivorship was 98.6% (95% CI: 7.9-8.1). There was one aseptic revision and one septic revision. At the latest follow-up the mean Knee Society pain score was 93 points (range, 80-100 points), and the mean Knee Society function score was 84 points (range, 70-90 points). On radiographic evaluation, there were no progressive radiolucencies, subsidence, and loosening of prostheses at the latest follow-up. The use of cementless TKA demonstrated excellent survivorship, mid-term clinical and functional outcomes, as well as no progressive radiolucencies or subsidence in patients older than 75 years. In addition, there was a low rate of surgical and medical

Mid- to long-term outcome comparison of the Medtronic Hancock II and bi-leaflet mechanical aortic valve replacement in patients younger than 60 years of age: a propensity-matched analysis.

PubMed

Wang, Yin; Chen, Si; Shi, Jiawei; Li, Geng; Dong, Nianguo

2016-03-01

This study aims to compare mid-long-term clinical outcomes between patients younger than 60 years of age undergoing bioprosthetic and mechanical aortic valve replacement. From January 2002 to December 2009, patients younger than 60 years of age who received Medtronic Hancock II porcine bioprostheses were selected and compared with those who received mechanical bi-leaflet valves in the aortic position. A stepwise logistic regression propensity score identified a subset of 112 evenly matched patient-pairs. Mid-long-term outcomes of survival, valve-related reoperations, thromboembolic events and bleeding events were assessed. The follow-up was only 95.1% complete. Fourteen measurable variables were statistically similar for the matched cohort. Postoperative in-hospital mortality was 3.6% (bioprosthetic valves) and 2.7% (mechanical valves) (P = 0.700). Survival at 5 and 10 years was 96.3 and 88.7% for patients receiving bioprosthetic valve replacement versus 96.3 and 87.9% for patients receiving mechanical valve replacement (P = 0.860), respectively. At 5 and 10 years after operations, freedom from valve-related reoperation was 97.2 and 94.8% for patients receiving mechanical valve replacement, and 96.3 and 90.2% for patients receiving bioprosthetic valve replacement (P = 0.296), respectively. There was no difference between freedom from thromboembolic events (P = 0.528) and bleeding events (P = 0.128) between the matched groups during the postoperative 10 years. In patients younger than 60 years of age undergoing aortic valve replacement, mid-long-term survival rate was similar for patients receiving bioprosthetic versus mechanical valve replacement. Bioprosthetic valves were associated with a trend for a lower risk of anticoagulation treatment and did not have significantly greater likelihood of a reoperation. These findings suggest that a bioprosthetic valve may be a reasonable choice for AVR in patients younger than 60 years of age. © The Author 2015. Published by

Age Effects on Upper Limb Kinematics Assessed by the REAplan Robot in Healthy Subjects Aged 3 to 93 Years.

PubMed

Gilliaux, Maxime; Lejeune, Thierry M; Sapin, Julien; Dehez, Bruno; Stoquart, Gaëtan; Detrembleur, Christine

2016-04-01

Kinematics is recommended for the quantitative assessment of upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish normative values in healthy subjects. Three hundred and seventy healthy subjects, aged 3-93 years, participated in the study. They performed two unidirectional and two geometrical tasks ten consecutive times with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-six kinematic indices were computed for the four tasks. For the four tasks, nineteen of the computed kinematic indices showed an age effect. Seventeen indices (the accuracy, speed and smoothness indices and the reproducibility of the accuracy, speed and smoothness) improved in young subjects aged 3-30 years, showed stabilization in adults aged 30-60 years and declined in elderly subjects aged 60-93 years. Additionally, for both geometrical tasks, the speed index exhibited a decrease throughout life. Finally, a principal component analysis provided the relations between the kinematic indices, tasks and subjects' age. This study is the first to assess age effects on upper limb kinematics and establish normative values in subjects aged 3-93 years.

Differential Effects of the Factor Structure of the Wechsler Memory Scale-Revised on the Cortical Thickness and Complexity of Patients Aged Over 75 Years in a Memory Clinic Setting.

PubMed

Kinno, Ryuta; Shiromaru, Azusa; Mori, Yukiko; Futamura, Akinori; Kuroda, Takeshi; Yano, Satoshi; Murakami, Hidetomo; Ono, Kenjiro

2017-01-01

The Wechsler Memory Scale-Revised (WMS-R) is one of the internationally well-known batteries for memory assessment in a general memory clinic setting. Several factor structures of the WMS-R for patients aged under 74 have been proposed. However, little is known about the factor structure of the WMS-R for patients aged over 75 years and its neurological significance. Thus, we conducted exploratory factor analysis to determine the factor structure of the WMS-R for patients aged over 75 years in a memory clinic setting. Regional cerebral blood flow (rCBF) was calculated from single-photon emission computed tomography data. Cortical thickness and cortical fractal dimension, as the marker of cortical complexity, were calculated from high resolution magnetic resonance imaging data. We found that the four factors appeared to be the most appropriate solution to the model, including recognition memory, paired associate memory, visual-and-working memory, and attention as factors. Patients with mild cognitive impairments showed significantly higher factor scores for paired associate memory, visual-and-working memory, and attention than patients with Alzheimer's disease. Regarding the neuroimaging data, the factor scores for paired associate memory positively correlated with rCBF in the left pericallosal and hippocampal regions. Moreover, the factor score for paired associate memory showed most robust correlations with the cortical thickness in the limbic system, whereas the factor score for attention correlated with the cortical thickness in the bilateral precuneus. Furthermore, each factor score correlated with the cortical fractal dimension in the bilateral frontotemporal regions. Interestingly, the factor scores for the visual-and-working memory and attention selectively correlated with the cortical fractal dimension in the right posterior cingulate cortex and right precuneus cortex, respectively. These findings demonstrate that recognition memory, paired associate memory

Colorectal cancer mortality reduction is associated with having at least 1 colonoscopy within the previous 10 years among a population-wide cohort of screening age.

PubMed

Stock, David; Paszat, Lawrence F; Rabeneck, Linda

2016-07-01

Colonoscopy has been demonstrated to be effective in colorectal cancer (CRC) mortality reduction, although current screening guidelines have yet to be evaluated. We assessed the protective benefit of colonoscopy within the previous 10 years and whether this effect is maintained with age. We used administrative data to compare risk of CRC death (CCD) across colonoscopy utilization among a population-wide cohort comprising individuals aged 60 to 80 years (N = 1,509,423). Baseline and time-dependent colonoscopy exposure models were assessed in the context of competing "other causes of death" (OCDs). Cumulative incidence of CCD and OCD across colonoscopy exposure, over follow-up, was estimated. Relative hazards were computed by age strata (60-69 years, 70-74 years, 75+ years) and proximal and distal cancer subsites. At least 1 colonoscopy during 10 years before baseline was estimated to provide a 51% reduced hazard of CCD (hazard ratio [HR] 0.49; 95% confidence interval [CI], 0.45-0.54) over the following 8 years. When colonoscopy was modeled as a time-dependent covariate, the risk of CCD was further diminished (multivariable-adjusted HR 0.36; 95% CI, 0.33-0.38). Stratified analyses suggested moderately attenuated CCD risk reduction among the oldest age group; however, consideration of OCDs suggest that this is related to competing risks. CCD risk reduction related to colonoscopy was lower for proximal cancers. Colonoscopy within the previous 10 years provides substantial protective benefit for average-risk individuals over 60 years. CCD risk reduction may be maintained well beyond 74 years, a common upper age limit recommended by screening guidelines. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Managing Appalachian hardwood stands using four management practices: 60-year results

Treesearch

Thomas M. Schuler; Melissa Thomas-Van Gundy; John P. Brown; Jan Wiedenbeck

2017-01-01

A long-term forest management case study on the Fernow Experimental Forest in West Virginia referred to as the Cutting Practice Level study is evaluated after 60 years. Treatments include a commercial clearcut (one time application), a 39 cm diameter-limit (applied 4 times), uneven-aged management using two variations of single-tree selection (applied 7 and 8 times,...

Hypertension in african americans aged 60 to 79 years: statement from the international society of hypertension in blacks.

PubMed

Egan, Brent M; Bland, Veita J; Brown, Angela L; Ferdinand, Keith C; Hernandez, German T; Jamerson, Kenneth A; Johnson, Wallace R; Kountz, David S; Li, Jiexiang; Osei, Kwame; Reed, James W; Saunders, Elijah

2015-04-01

A 2014 hypertension guideline raised goal systolic blood pressure (SBP) from <140 mm Hg to <150 mm Hg for adults 60 years and older without diabetes mellitus (DM) or chronic kidney disease (CKD). The authors aimed to define the status of hypertension in black adults 60 to 79 years from the National Health and Nutrition Examination Survey 2005-2012 and provide practical guidance. Black patients were more often aware and treated (P≤.005) for hypertension than whites and had higher rates of DM/CKD (P<.001), similar control to <140/<90 mm Hg with DM/CKD (P=.59), and lower control without DM/CKD (<140/<90 mm Hg and <150/<90 mm Hg, P≤.01). Limited awareness (<30%) and infrequent health care (>30% 0-1 health-care visits per year) occurred in untreated black and white hypertensive patients without DM/CKD and BP ≥140/<90 mm Hg. The literature suggests benefits of treated SBP <140 mm Hg in adults 60 to 79 years without DM/CKD. The International Society of Hypertension in Blacks recommends: (1) continuing efforts to achieve BP <140/<90 mm Hg in those with DM/CK, and (2) identifying hypertensive patients without DM/CKD and BP ≥140/<90 mm Hg and treat to an SBP <140 mm Hg in black adults 60-79 years. © 2015 Wiley Periodicals, Inc.

Liver resections in over-75-year-old patients: surgical hazard or current practice?

PubMed

Aldrighetti, Luca; Arru, Marcella; Catena, Marco; Finazzi, Renato; Ferla, Gianfranco

2006-03-01

To assess the safety of hepatic resections in the very old patient by comparing the outcome in patients younger and older than 75 years. Thirty-two resections in 31 patients > or =75 years (Over-75 Group) were compared with 164 resections in 162 patients <75 years (Control Group). Indications for resection, concomitant diseases, previous abdominal surgery, type of resection, associated surgical procedures, use/length of portal clamping, intra-operative blood losses and transfusions, and length of operation were preliminarily compared. The outcome was evaluated in terms of post-operative mortality, morbidity, transfusions, and postoperative hospitalization. Mean age was 76.0 +/- 2.3 years (range 75-83) in the Over-75 Group and 58.4 +/- 10.7 years (range 23-74) in the Control Group. The over-75 group included more hepatomas (43.8% vs. 26.8%, P = 0.09), chronic liver disease (31.3% vs. 28.7%, P = 0.03) and concomitant diseases (62.5% vs. 32.9%, P = 0.002). The two groups were comparable (P = n.s.) when evaluated for all other variables. The 30-day mortality rate was 3.6% in the Control Group and none in the Over-75 Group. Postoperative surgical complications occurred in 37 patients (22.6%) in the Control Group and 1 patient (3.1%) in the Over-75 Group, with statistically significant differences (P = 0.01), and incidence of medical complications was 13.4% in the Control Group and 3.1% in the Over-75 Group. Median postoperative hospitalization and transfusions were not statistically different. Hepatic resections in over-75-year-old patients are not a surgical hazard and may be carried out relatively safely as long as an accurate selection of the patient is performed.

Better health-related quality of life (mental component summary), having a higher level of education, and being less than 75 years of age are predictors of hospital admission among cognitively intact nursing home residents: a 5-year follow-up study

PubMed Central

Drageset, Jorunn; Eide, Geir Egil; Ranhoff, Anette Hylen

2016-01-01

Objective To study whether health-related quality of life (HRQOL), activities of daily living (ADL), and anxiety and depression symptoms affect the risk of hospital admission and potential interactions with having a cancer diagnosis. Methods This study was a prospective observational study with 5-year follow-up and analyzed the follow-up data on hospital admissions until 2010 using baseline data from 227 cognitively intact nursing home (NH) residents (60 of whom had cancer) in 2004–2005. Data on HRQOL were collected by using the Short Form-36 Health Survey, divided into physical component summary (PCS) and mental component summary (MCS), and symptoms of anxiety and depression were collected by using the Hospital Anxiety and Depression Scale (HADS). ADL were obtained from registered observation and sociodemographic variables, diagnoses, and hospital admissions from the NH records. Personal identification numbers were linked to the record systems of the hospitals, thereby registering all hospital admissions. We analyzed the time elapsing between inclusion and the first hospital admission. Results Residents with higher HRQOL (MCS) had significantly more hospital admissions after adjustment for age, sex, marital status, education, and comorbidity. HRQOL (PCS), ADL, depression, and anxiety symptoms were not associated with hospital admissions. Cancer increased the risk after adjustment for all other risk factors but did not increase the effects of MCS, PCS, ADL, or depression or anxiety symptoms. Having a higher level of education and being less than 75 years of age were associated with hospitalization. The residents diagnosed with cancer had the most days in hospital related to diseases of the respiratory system and cancer, and diseases of the circulatory and respiratory systems were more frequent among the residents without a cancer diagnosis. Conclusion Better self-reported HRQOL (MCS) was associated with hospital admissions, whereas self-reported HRQOL (PCS), ADL

[SOS-repair--60 years].

PubMed

Zavil'gel'skiĭ, G B

2013-01-01

This review integrates 60 years of research on SOS-repair and SOS-mutagenesis in procaryotes and eucaryotes, from Jean Weigle experiment in 1953 year (mutagenesis of lambda bacteriophage in UV-irradiated bacteria) to the latest achievements in studying SOS-mutagenesis on all living organisms--Eukarya, Archaea and Bacteria. A key role in establishing of a biochemical basis for SOS-mutagenesis belonges to the finding in 1998-1999 years that specific error-prone DNA polymerases (PolV and others) catalysed translesion synthesis on damaged DNA. This review focuses on recent studies addressing the new models for SOS-induced mutagenesis in Escherichia coli and Home sapiens cells.

Communication Education: The Next 75 Years.

ERIC Educational Resources Information Center

Taylor, Anita

Basic similarities in the communication industry of 75 years ago and that of today suggest that much will not change in communication in the next 75 years. Future thinkers such as J. Naisbitt and A. Toffler, however, believe that major economic and technological changes will place a high priority on effective communication. Information, Toffler…

Physical activity and the 15-year incidence of age-related macular degeneration.

PubMed

Gopinath, Bamini; Liew, Gerald; Burlutsky, George; Mitchell, Paul

2014-11-11

There is uncertainty in the published literature as to whether physical activity should be advocated for age-related macular degeneration (AMD) prevention. We aimed to assess prospectively the association between physical activity and the 15-year incidence of AMD in older adults. We assessed AMD from retinal photographs. Participants provided details of walking exercise and the performance of moderate or vigorous activities, which were used to calculate metabolic equivalents (METs). After adjusting for age, adults aged ≥ 75 years in the highest tertile (the most physically active) compared to those in the lowest tertile (least physically active) were 79% less likely to have incident late AMD over the 15 years (odds ratio [OR], 0.21; 95% confidence intervals [CI], 0.05-0.95). However, after further adjusting for sex, body mass index, smoking, fish consumption, and white cell count, this association was no longer statistically significant (OR, 0.26; 95% CI, 0.06-1.28). Significant associations were not found in those aged <75 or with the 15-year cumulative incidence of early AMD. Physical activity did not influence the risk of AMD over 15 years in older adults, independent of diet, smoking, white cell count, and body mass index. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Daydreaming in 40- to 60-Year-Old Women: Menopause, Health, Values, and Sexuality.

ERIC Educational Resources Information Center

Giambra, Leonard M.

1983-01-01

Investigated midlife influences on daydreaming for 477 women from 40 to 60 years of age. Examined 42 variables including health status, symptom presence, menstruation difficulties, sexual activities, and effects of menopause. Results indicated daydreaming was more prevalent among women with various psychological symptoms. (PAS)

Shoulder dislocation in patients older than 60 years of age

PubMed Central

Rapariz, Jose M.; Martin-Martin, Silvia; Pareja-Bezares, Antonio; Ortega-Klein, Jose

2010-01-01

Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation. Materials and Methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test) and by imaging testing (X-ray, MRI). Results: Nine (31.03%) out of 29 patients had a recurrent dislocation. Four of them required reconstructive surgery to maintain joint stability. Injury to the anterior support (anterior labrum, anterior glenoid rim) showed a statistically significant relation to the recurrence of dislocations. The occurrence or non-occurrence of a rotator cuff tear does have an impact on the shoulder function. The degree of rotator cuff involvement on the coronal plane does not significantly affect the shoulder’s functional outcome. The tear extension on the sagittal plane does cause impairment on the Constant test. Conclusions: Labrum and/or anterior glenoid involvement should be suspected in elderly patients presenting with recurrent shoulder dislocation. Recurrence is due to an injury in the anterior support or both (anterior and posterior), even though shoulder function gets impaired when a rotation cuff tear occurs with anterior extension on the sagittal plane. Evidence level: IV Case series. PMID:21655003

Prostate Cancer Screening In Men Ages 75 And Older Fell By 8 Percentage Points After Task Force Recommendation

PubMed Central

Howard, David H.; Tangka, Florence K.; Guy, Gery P.; Ekwueme, Donatus U.; Lipscomb, Joseph

2016-01-01

In 2008 the US Preventive Services Task Force recommended against screening men ages 75 and older for prostate cancer. Using Medicare Current Beneficiary Survey Access to Care files and linked claims, we compared trends in prostate-specific antigen (PSA) testing rates between men ages 75 and older and men ages 65–74. We estimate that the revised recommendation led to a 7.9-percentage-point decline in annual PSA testing rates over two years among men ages 75 and older. Although 42 percent of men in this age group continue to receive PSA tests, our results highlight the potential of guidelines with negative recommendations to reduce the use of low-value medical care. PMID:23459740

[Idiopathic normal pressure hydrocephalus: High incidence in people over 80 years of age].

PubMed

Aragonès, Josep Maria; Altimiras, Jacint; Alonso, Francisco; Roura, Pere; Alfonso, Sebastián; Bajo, Lorena

Idiopathic normal pressure hydrocephalus is usually observed in adults over 60 years of age. The highest incidence of cases is between 70 and 80 years-old, and it could be under-diagnosed in over 80 year-olds. A description is presented on the overall incidence and age group incidence, the delay in the diagnosis, and main outcomes. A descriptive study was performed on patients with idiopathic normal pressure hydrocephalus, in the population of Osona County during the years 2010-2015. The annual incidence rate was 4.43 per 100,000 inhabitants. The incidence increased with age; from 8.09 per 100,000 in the 60 to 69 years age group, to 23.61 per 100,000 in the 70-79 years age group of, and to 37.02 per 100,000 in the 80-89 years age. The delay in the diagnosis was 15.01 ± 10.35 months. All the patients improved after surgery, but only 73.3% of the patients maintained the improvement after one year. Idiopathic normal pressure hydrocephalus is an age related disease and probably underdiagnosed in the elderly. An early diagnosis and a clinical suspicion are essential in patients over 80 years old. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Comparison of two high-dose cyclophosphamide, doxorubicin, vincristine, and prednisone derived regimens in patients aged under 60 years with low-intermediate risk aggressive lymphoma: a final analysis of the multicenter LNH93-2 protocol.

PubMed

Morel, Pierre; Munck, Jean-Nicolas; Coiffier, Bertrand; Gisselbrecht, Christian; Ranta, Dana; Bosly, Andre; Tilly, Hervé; Quesnel, Bruno; Thyss, Antoine; Mounier, Nicolas; Brière, Josette; Molina, Thierry; Reyes, Felix

2010-09-01

One-third of patients aged 60 years with aggressive lymphoma are at low-intermediate risk (LIR). Before the rituximab era, we prospectively compared ACVBP with ECVBP, a similar regimen including epirubicin instead of doxorubicin and increased dose intensity of cyclophosphamide, followed by conventional consolidation with an increased amount and dose intensity of cytosine-arabinoside, methotrexate, etoposide, and ifosfamide, in 652 patients with LIR aggressive lymphoma. The overall response rate, 5-year event-free survival (EFS), and survival were estimated to be 86%, 60%, and 74%, respectively, with no differences between the two arms. In patients with diffuse large B-cell lymphoma (DLBCL) who received ACVBP, the 5-year EFS and survival were estimated at 69% and 82%. These findings do not support the use of a chemotherapy regimen more intensive than ACVBP in patients aged 60 years with LIR aggressive lymphoma. The results in the control arm, without rituximab, have led to a randomized comparison of R-ACVBP and R-CHOP in this patient population.

Sexual health and relationships after age 60.

PubMed

Minkin, Mary Jane

2016-01-01

A commonly used phrase describing aging is "60 is the new 40". Although in many aspects of life this may be correct, in discussing sexual health, challenges to maintaining excellent sexual health become more common around age 60. Biological aging challenges physical sexual activity and responsiveness. We commence by briefly surveying the extensive coverage of 'normal' physiological aging. We primarily focus on issues that arise in distinct disease and or pathophysiological states, including gynecological and breast cancer, as well as those associated with partners of men who are either prostate cancer survivors or who have taken therapy for erectile dysfunction (ED). Regrettably, there is a very modest literature on sexual health and associated possible interventions in older patients in these cohorts. We discuss a variety of interventions and approaches, including those that we have developed and applied in a clinic at our host university, which have generally produced successful outcomes. The extended focus to sexual relationship dynamics in partners of men with either prostate cancer or ED in particular is virtually unexplored, yet is especially timely given the large numbers of women who encounter this situation. Finally, we briefly discuss cross-cultural distinctions in older couples' expectations, which exhibit remarkable variation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Alcohol Use among Abused and Non-Abused Older Persons Aged 60-84 Years: An European Study

ERIC Educational Resources Information Center

Tredal, Ingrid; Soares, Joaquim J. F.; Sundin, Orjan; Viitasara, Eija; Melchiorre, Maria Gabriella; Torres-Gonzales, Francisco; Stankunas, Mindaugas; Lindert, Jutta; Ioannidi-Kapolou, Elisabeth; Barros, Henrique

2013-01-01

Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression). Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60-84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with…

The association between depressive disorder and cardiac autonomic control in adults 60 years and older.

PubMed

Licht, Carmilla M M; Naarding, Paul; Penninx, Brenda W J H; van der Mast, Roos C; de Geus, Eco J C; Comijs, Hannie

2015-04-01

Altered cardiac autonomic control has often been reported in depressed persons and might play an important role in the increased risk for cardiovascular disease (CVD). A negative association between cardiac autonomic control and depression might become specifically clinically relevant in persons 60 years or older as CVD risk increases with age. This study included data of 321 persons with a depressive disorder and 115 controls participating in the Netherlands Study of Depression in Older Persons (mean age = 70.3 years, 65.7% female). Respiratory sinus arrhythmia (RSA), heart rate (HR), and preejection period (PEP) were measured and compared between depressed persons and controls. In addition, the role of antidepressants and clinical characteristics (e.g., age of depression onset and comorbid anxiety) was examined. Compared with controls, depressed persons had lower RSA (mean [standard error of the mean] = 23.5 [1.2] milliseconds versus 18.6 [0.7] milliseconds, p = .001, d = 0.373) and marginally higher HR (73.1 [1.1] beats/min versus 75.6 [0.6] beats/min, p = .065, d = 0.212), but comparable PEP (113.9 [2.1] milliseconds versus 112.0 [1.2] milliseconds, p = .45, d = 0.087), fully adjusted. Antidepressants strongly attenuated the associations between depression and HR and RSA. Antidepressant-naïve depressed persons had similar HR and RSA to controls, whereas users of antidepressants showed significantly lower RSA. In addition, tricyclic antidepressant users had higher HR (p < .001, d = 0.768) and shorter PEP (p = .014, d = 0.395) than did controls. Depression was not associated with cardiac autonomic control, but antidepressants were in this sample. All antidepressants were associated with low cardiac parasympathetic control and specifically tricyclic antidepressants with high cardiac sympathetic control.

School-Aged Outcomes following Prenatal Methamphetamine Exposure: 7.5-Year Follow-Up from the Infant Development, Environment, and Lifestyle Study.

PubMed

Eze, Nwando; Smith, Lynne M; LaGasse, Linda L; Derauf, Chris; Newman, Elana; Arria, Amelia; Huestis, Marilyn A; Della Grotta, Sheri A; Dansereau, Lynne M; Neal, Charles; Lester, Barry M

2016-03-01

To assess the relationship between prenatal methamphetamine exposure (PME) and behavior problems at age 7.5 years and the extent to which early adversity mediated this relationship. The multicenter, longitudinal Infant Development, Environment, and Lifestyle study enrolled 412 mother-infant pairs at 4 sites. Methamphetamine-exposed participants (n = 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched participants (n = 208) denied methamphetamine use and had a negative meconium screen. At the 7.5-year follow-up, 290 children with complete Child Behavior Checklist data and an early adversity index score were available for analysis (n = 146 exposed). PME was significantly associated with an increased early adversity index score (P < .001) and with increased externalizing, rule-breaking behavior, and aggressive behavior (P < .05). Early adversity was also associated with higher externalizing behavior scores. Early adversity significantly mediated the relationship between PME and behavioral problems. After adjusting the mediation model for sex, prenatal tobacco, alcohol, and marijuana exposures, and study site, the association of PME with early adversity remained significant. Though PME is associated with behavioral problems, early adversity may be a strong determinant of behavioral outcome for children exposed to methamphetamine in utero. Early adversity significantly mediated the relationship between PME and behavioral problems. Copyright © 2016 Elsevier Inc. All rights reserved.

Factors associated with decisions to attend cervical cancer screening among women aged 30-60 years in Chatapadung Contracting Medical Unit, Thailand.

PubMed

Budkaew, Jiratha; Chumworathayi, Bandit

2014-01-01

This study aimed to identify factors associated with women's decisions to attend cervical cancer screening and to explore those linked with intention to attend in the coming year and to continue regular screening. A community based case-control study was conducted among woman 30-60 years of age in catchment area of Chatapadung Contracting Medical Unit (CCMU), networking of Khon Kaen Center Hospital, Thailand. Self-administered questionnaires were used to collect data, and in-depth interviews were then performed to explore in greater detail. There were 195 participants. Only one third (32.3 %) had been screened for cervical cancer within the past 5 years. Some 67.7% reported that they had not been screened because they had no abnormal symptoms, single marital status, and no children. Only 10.6% of those never had screening intent to be screened within the next 12 months. High family income (adjusted OR=2.16, 95%CI=1.13-4.14), good attitude towards a Pap test (OR=1.87, 95%CI=1.09-4.23), and having received a recommendation from health care providers were important factors associated with decisions to attend cervical cancer screening (OR=1.73, 95%CI=1.01-4.63). From in-depth interviews, there were five reasons of their decisions to attend cervical cancer screening including yearly check-up, postpartum check-up, having abnormal symptom, encouragement by health care providers, and request from workplace. High family income, good attitude towards a Pap test, and receiving proper recommendation by health care providers, were important factors associated with decision to have cervical cancer screening among women 30-60 years old. Trying to enhance these factors and reduce barriers regarding screening, may increase the coverage rate for cervical cancer screening in Thailand.

Diet quality of urban older adults age 60 to 99 years: the Cardiovascular Health of Seniors and Built Environment Study.

PubMed

Deierlein, Andrea L; Morland, Kimberly B; Scanlin, Kathleen; Wong, Sally; Spark, Arlene

2014-02-01

There are few studies that evaluate dietary intakes and predictors of diet quality in older adults. The objectives of this study were to describe nutrient intakes and examine associations between demographic, economic, behavioral, social environment, and health status factors and diet quality. Cross-sectional data were from black, white, and Hispanic adults, age 60 to 99 years, living independently in New York City and participating in the Cardiovascular Health of Seniors and the Built Environment Study, 2009-2011 (n=1,306). Multivariable log-linear regression estimated associations between selected factors and good diet quality, defined as a Healthy Eating Index score more than 80 (based on the 2005 Dietary Guidelines for Americans [HEI-2005]). Dietary intakes were similar for men and women; intakes of energy, fiber, and the majority of micronutrients were less than recommendations, whereas intakes of fats, added sugar, and sodium were within the upper range or exceeded recommendations. Hispanic ethnicity (relative risk [RR]=1.37; 95% CI 1.07 to 1.75), energy intake <∼ 1,500 kcal/day (RR=1.93; 95% CI, 1.37 to 2.71), adherence to a special diet (RR=1.23; 95% CI: 1.02 to 1.50), purchasing food at supermarkets at least once/week (RR=1.34; 95% CI, 1.04 to 1.74), and being married/living with a partner (RR=1.37; 95% CI, 1.10 to 1.71) were positively associated with HEI-2005 score more than 80. Consuming at least one restaurant meal/day was negatively associated with HEI-2005 score more than 80 (RR=0.69; 95%CI, 0.50-0.94). These findings identify specific groups of older adults, such as blacks or those who live alone, who may benefit from dietary interventions, as well as specific modifiable behaviors among older adults, such as eating restaurant meals or shopping at supermarkets, which may be targeted through interventions. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

HLA-Matched Sibling versus Unrelated versus Haploidentical Related Donor Allogeneic Hematopoietic Stem Cell Transplantation for Patients Aged Over 60 Years with Acute Myeloid Leukemia: A Single-Center Donor Comparison.

PubMed

Devillier, Raynier; Legrand, Faezeh; Rey, Jérôme; Castagna, Luca; Fürst, Sabine; Granata, Angela; Charbonnier, Aude; Harbi, Samia; d'Incan, Evelyne; Pagliardini, Thomas; Faucher, Catherine; Lemarie, Claude; Saillard, Colombe; Calmels, Boris; Mohty, Bilal; Maisano, Valerio; Weiller, Pierre-Jean; Chabannon, Christian; Vey, Norbert; Blaise, Didier

2018-02-12

Haploidentical related donor (HRD) allogeneic hematopoietic stem cell transplantation (allo-HSCT) was developed as a valid option for the treatment of acute myeloid leukemia (AML) in the absence of a matched donor. However, many investigators are reluctant to consider the use of this alternative in elderly patients, anticipating high morbidity. Here, we report a single-center comparison of HRD versus matched sibling donor (MSD) and unrelated donor (UD) allo-HSCT for patients with AML aged ≥60 years. Ninety-four patients (MSD: n = 31; UD: n = 30; HRD: n = 33) were analyzed. The median age was 65 (range, 60 to 73) years. We observed a higher cumulative incidence of grade 3 to 4 acute graft-versus-host disease (GVHD) after UD allo-HSCT (MSD versus UD versus HRD: 3% versus 33% versus 6%, respectively; P = .006). Two-year cumulative incidence of moderate or severe chronic GVHD was 17%, 27%, and 16% in the MSD, UD, and HRD groups, respectively (P = .487). No difference was observed in the 2-year cumulative incidence of relapse or nonrelapse mortality (NRM) (relapse: MSD versus UD versus HRD: 32% versus 25% versus 25%, respectively; P = .411; NRM: MSD versus UD versus HRD: 19% versus 27% versus 24%, respectively; P = .709). At 2 years, progression-free survival, overall survival, and GVHD- and relapse-free survival were 48%, 50%, and 39%, respectively, in the MSD group; 48%, 51%, and 23%, respectively, in the UD group; and 50%, 52%, and 32%, respectively, in the HRD group, without statistically significant differences between the groups. We conclude that HRD allo-HSCT is highly feasible and no less efficient than MSD or UD allo-HSCT in patients with AML aged ≥60 years. Thus, the absence of a HLA-identical donor should not limit the consideration of allo-HSCT for the treatment of AML. Copyright © 2018 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Mathematics Anxiety: What Have We Learned in 60 Years?

PubMed

Dowker, Ann; Sarkar, Amar; Looi, Chung Yen

2016-01-01

The construct of mathematics anxiety has been an important topic of study at least since the concept of "number anxiety" was introduced by Dreger and Aiken (1957), and has received increasing attention in recent years. This paper focuses on what research has revealed about mathematics anxiety in the last 60 years, and what still remains to be learned. We discuss what mathematics anxiety is; how distinct it is from other forms of anxiety; and how it relates to attitudes to mathematics. We discuss the relationships between mathematics anxiety and mathematics performance. We describe ways in which mathematics anxiety is measured, both by questionnaires, and by physiological measures. We discuss some possible factors in mathematics anxiety, including genetics, gender, age, and culture. Finally, we describe some research on treatment. We conclude with a brief discussion of what still needs to be learned.

Seat belt use and fit among drivers aged 75 years and older in their own vehicles.

PubMed

Fong, Cameron K; Keay, Lisa; Coxon, Kristy; Clarke, Elizabeth; Brown, Julie

2016-01-01

This article aims to describe seat belt wearing patterns and quality of seat belt fit among drivers aged 75 years and older. A secondary aim is to explore associations between body shape, comfort, and seat belt use patterns. This is an observation and survey study of a cohort of 380 drivers aged 75 years and over. During home visits, photographs were taken of the drivers in their vehicles for later analysis of belt fit and a short survey was also administered to collect demographic data and information about seat belt use and comfort. Seat belt fit and use of belt and seat accessories were analyzed from the photographs. Data from 367 participants with photographs were analyzed. Whereas 97% reported using a seat belt and 90% reported their seat belt to be comfortable, 21% reported repositioning their seat belt to improve comfort. Good sash and lap belt fit were achieved in 53 and 59% of participants, respectively, but only 35% achieved overall good fit. Both poor sash and lap belt fit were observed in 23% of participants. Drivers who were in the obese category had over twice the odds (95% confidence interval [CI], 1.2-4.1) of having a poor lap belt fit than those in the normal body mass index [BMI] range, and drivers who were overweight had 1.8 times the odds (95% CI, 1.1-2.9) of having poor lap belt fit. Older females also had twice the odds (95% CI, 1.3-3.5) of poor lap belt fit compared to older males, regardless of BMI. Sash belt fit did not vary significantly by BMI, stature, or gender. However older drivers who reported that they had not made any adjustments to the D-ring height had 1.7 times the odds of having poor sash belt fit than those who made adjustments (1.2-2.9). Females were 7.3 times more likely to report comfort problems than males (95% CI, 3.2, 16.3) but there was no association between reported comfort and BMI or seat belt fit. Drivers who reported comfort problems had 6 times the odds (3.2-13.6) of also reporting active repositioning of the belt

Relationship between age and elite marathon race time in world single age records from 5 to 93 years

PubMed Central

2014-01-01

Background The aims of the study were (i) to investigate the relationship between elite marathon race times and age in 1-year intervals by using the world single age records in marathon running from 5 to 93 years and (ii) to evaluate the sex difference in elite marathon running performance with advancing age. Methods World single age records in marathon running in 1-year intervals for women and men were analysed regarding changes across age for both men and women using linear and non-linear regression analyses for each age for women and men. Results The relationship between elite marathon race time and age was non-linear (i.e. polynomial regression 4th degree) for women and men. The curve was U-shaped where performance improved from 5 to ~20 years. From 5 years to ~15 years, boys and girls performed very similar. Between ~20 and ~35 years, performance was quite linear, but started to decrease at the age of ~35 years in a curvilinear manner with increasing age in both women and men. The sex difference increased non-linearly (i.e. polynomial regression 7th degree) from 5 to ~20 years, remained unchanged at ~20 min from ~20 to ~50 years and increased thereafter. The sex difference was lowest (7.5%, 10.5 min) at the age of 49 years. Conclusion Elite marathon race times improved from 5 to ~20 years, remained linear between ~20 and ~35 years, and started to increase at the age of ~35 years in a curvilinear manner with increasing age in both women and men. The sex difference in elite marathon race time increased non-linearly and was lowest at the age of ~49 years. PMID:25120915

Mammography interval and breast cancer mortality in women over the age of 75.

PubMed

Simon, Michael S; Wassertheil-Smoller, Sylvia; Thomson, Cynthia A; Ray, Roberta M; Hubbell, F Allan; Lessin, Lawrence; Lane, Dorothy S; Kuller, Lew H

2014-11-01

The purpose of this study is to evaluate the relationship between mammography interval and breast cancer mortality among older women with breast cancer. The study population included 1,914 women diagnosed with invasive breast cancer at age 75 or later during their participation in the Women's health initiative, with an average follow-up of 4.4 years (3.1 SD). Cause of death was based on medical record review. Mammography interval was defined as the time between the last self-reported mammogram 7 or more months prior to diagnosis, and the date of diagnosis. Multivariable adjusted hazard ratios (HR) and 95 % confidence intervals (CIs) for breast cancer mortality and all-cause mortality were computed from Cox proportional hazards analyses. Prior mammograms were reported by 73.0 % of women from 7 months to ≤2 year of diagnosis (referent group), 19.4 % (>2 to <5 years), and 7.5 % (≥5 years or no prior mammogram). Women with the longest versus shortest intervals had more poorly differentiated (28.5 % vs. 22.7 %), advanced stage (25.7 % vs. 22.9 %), and estrogen receptor negative tumors (20.9 % vs. 13.1 %). Compared to the referent group, women with intervals of >2 to <5 years or ≥5 years had an increased risk of breast cancer mortality (HR 1.62, 95 % CI 1.03-2.54) and (HR 2.80, 95 % CI 1.57-5.00), respectively, p trend = 0.0002. There was no significant relationship between mammography interval and other causes of death. These results suggest a continued role for screening mammography among women 75 years of age and older.

Beverage Consumption Patterns at Age 13 to 17 Years Are Associated with Weight, Height, and Body Mass Index at Age 17 Years.

PubMed

Marshall, Teresa A; Van Buren, John M; Warren, John J; Cavanaugh, Joseph E; Levy, Steven M

2017-05-01

Sugar-sweetened beverages (SSBs) have been associated with obesity in children and adults; however, associations between beverage patterns and obesity are not understood. Our aim was to describe beverage patterns during adolescence and associations between adolescent beverage patterns and anthropometric measures at age 17 years. We conducted a cross-sectional analyses of longitudinally collected data. Data from participants in the longitudinal Iowa Fluoride Study having at least one beverage questionnaire completed between ages 13.0 and 14.0 years, having a second questionnaire completed between 16.0 and 17.0 years, and attending clinic examination for weight and height measurements at age 17 years (n=369) were included. Beverages were collapsed into four categories (ie, 100% juice, milk, water and other sugar-free beverages, and SSBs) for the purpose of clustering. Five beverage clusters were identified from standardized age 13 to 17 years mean daily beverage intakes and named by the authors for the dominant beverage: juice, milk, water/sugar-free beverages, neutral, and SSB. Weight, height, and body mass index (BMI; calculated as kg/m 2 ) at age 17 years were analyzed. We used Ward's method for clustering of beverage variables, one-way analysis of variance and χ 2 tests for bivariable associations, and γ-regression for associations of weight or BMI (outcomes) with beverage clusters and demographic variables. Linear regression was used for associations of height (outcome) with beverage clusters and demographic variables. Participants with family incomes <$60,000 trended shorter (1.5±0.8 cm; P=0.070) and were heavier (2.0±0.7 BMI units; P=0.002) than participants with family incomes ≥$60,000/year. Adjusted mean weight, height, and BMI estimates differed by beverage cluster membership. For example, on average, male and female members of the neutral cluster were 4.5 cm (P=0.010) and 4.2 cm (P=0.034) shorter, respectively, than members of the milk cluster. For

A Diffusion Model Analysis of the Effects of Aging on Recognition Memory

ERIC Educational Resources Information Center

Ratcliff, Roger; Thapar, Anjali; McKoon, Gail

2004-01-01

The effects of aging on response time were examined in a recognition memory experiment with young, college age subjects and older, 60-75 year old subjects. The older subjects were slower than the young subjects but almost as accurate. Ratcliff's (1978) diffusion model was fit to the data and it provided a good account of response times, their…

Clinical chemistry reference values for 75-year-old apparently healthy persons.

PubMed

Huber, Klaus Roland; Mostafaie, Nazanin; Stangl, Gerhard; Worofka, Brigitte; Kittl, Eva; Hofmann, Jörg; Hejtman, Milos; Michael, Rainer; Weissgram, Silvia; Leitha, Thomas; Jungwirth, Susanne; Fischer, Peter; Tragl, Karl-Heinz; Bauer, Kurt

2006-01-01

Clinical chemistry reference values for elderly persons are sparse and mostly intermixed with those for younger subjects. To understand the links between metabolism and aging, it is paramount to differentiate between "normal" physiological processes in apparently healthy elderly subjects and metabolic changes due to long-lasting diseases. The Vienna Transdanube Aging (VITA) study, which began in 2000 and is continuing, will allow us to do just that, because more than 600 male and female volunteers aged exactly 75 years (to exclude any influence of the "aging" factor in this cohort) are participating in this study. Extensive clinical, neurological, biochemical, psychological, genetic, and radiological analyses, with a special emphasis on consumption of medication and abuse of drugs, were performed on each of the probands. The multitude of data and questionnaires obtained made possible an a posteriori approach to select individuals fulfilling criteria for a reference sample group of apparently healthy 75-year-old subjects for our study. Specific analytes were quantified on automated clinical analyzers, while manual methods were used for hormonal analytes. All clinical chemistry analytes were evaluated using in-depth statistical analyses with SPSS for Windows. In all, reference intervals for 45 analytes could be established. These include routine parameters for the assessment of organ functions, as well as hormone concentrations and hematological appraisals. Because all patients were reevaluated after exactly 30 months in the course of this study, we had the opportunity to reassess their health status at the age of 77.5 years. This was very useful for validation of the first round data set. Data of the second round evaluation corroborate the reference limits of the baseline analysis and further confirm our inclusion and exclusion criteria. In summary, we have established a reliable set of reference data for hormonal, hematological, and clinical chemistry analytes for

Mathematics Anxiety: What Have We Learned in 60 Years?

PubMed Central

Dowker, Ann; Sarkar, Amar; Looi, Chung Yen

2016-01-01

The construct of mathematics anxiety has been an important topic of study at least since the concept of “number anxiety” was introduced by Dreger and Aiken (1957), and has received increasing attention in recent years. This paper focuses on what research has revealed about mathematics anxiety in the last 60 years, and what still remains to be learned. We discuss what mathematics anxiety is; how distinct it is from other forms of anxiety; and how it relates to attitudes to mathematics. We discuss the relationships between mathematics anxiety and mathematics performance. We describe ways in which mathematics anxiety is measured, both by questionnaires, and by physiological measures. We discuss some possible factors in mathematics anxiety, including genetics, gender, age, and culture. Finally, we describe some research on treatment. We conclude with a brief discussion of what still needs to be learned. PMID:27199789

The Impact of a Teaching or Singing Career on the Female Vocal Quality at the Mean Age of 67 Years: A Pilot Study.

PubMed

D'haeseleer, Evelien; Claeys, Sofie; Bettens, Kim; Leemans, Laura; Van Calster, Ann-Sophie; Van Damme, Nina; Thijs, Zoë; Daelman, Julie; Leyns, Clara; Van Lierde, Kristiane

2017-07-01

The purpose of this study was to measure the objective and subjective vocal quality in women aged between 60 and 75 years. Secondly, the impact of a teaching or singing career on the vocal quality was investigated by comparing the vocal quality of retired women with different careers. This is a case-control study. Seventy-three retired women between 60 and 75 years (mean age: 67 years, standard deviation: 4.49) participated in the study and were divided into three groups: women with a teaching career (n = 21), choir singers with a singing career (n = 12), and women with a non-vocal career (n = 40). All subjects underwent the same assessment protocol consisting of objective (aerodynamic, maximum performance, vocal range, acoustic measurements, and the Dysphonia Severity Index) and subjective (the Voice Handicap Index, auditory-perceptual evaluations by three listeners) voice measurements. In all three groups, objective and perceptual voice analysis showed a mild dysphonia. No differences in the Dysphonia Severity Index were found between the three groups. The voices of choir singers with a singing career were perceived significantly less rough than voices of the women with a non-vocal career. Additionally, the lowest frequency of the frequency range was significantly lower in the retired teachers and choir singers than in the controls. The results of this study prudently suggest that a singing or a teaching career compared with a non-vocal career has a positive impact on the vocal frequency range, and that singing has a positive impact on the perceptual vocal quality of the older female voice. Copyright © 2017 The Voice Foundation. Published by 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.

[The relationship between executive functions, physical and functional capability in people over 60 years old].

PubMed

Rajtar-Zembaty, Anna; Sałakowski, Andrzej; Rajtar-Zembaty, Jakub

Nowadays it is believed that cognitive decline may contribute to the formation of gait disturbance and increased risk of falls. Currently the importance of executive functions to maintain proper control of gait is emphasized. The aim of the study was to assess the relationship between the level of executive function, functional and physical capability in patients over 60 years of age. The study included 300 patients (199 women and 101 men) aged 60-88 years. In order to screening for cognitive function Mini-Mental State Examination (MMSE) was used. The following researchers tools were used to conduct functional assessment: a) Short Physical Performance Battery (SPPB), b) Timed “Up and Go” (TUG) and c) Fast Walking Test. To assess executive fucntion Trail Making Test (TMT) was selected. The relationship between the speed of information processing (part A, TMT), executive functions (Part B, TMT), level of functional and physical capability was observed. The strongest positive correlation was noted between the time of TUG test and TMT part B (r=0.32; p<0.01), and also between Fast Gait Test and TMT part A (r=0.27; p<0.01). It has been proven that the level of executive function is related to the level of functional capability (β=0.18; p=0.001). It was found that 15% of variation in the level of the TUG test was explained by age, TMT- B, GDS and BMI. There is a relationship between level of executive functions, functional and physical capability in patients over 60 years of age. Cognitive processes play an important role in the control of motor functions therefore it is important to incorporate examination of cognitive functions in the early geriatric diagnosis.

School-Aged Outcomes following Prenatal Methamphetamine Exposure: 7.5 Year Follow-Up From The Infant Development, Environment, and Lifestyle (IDEAL) Study

PubMed Central

Eze, Nwando; Smith, Lynne M; LaGasse, Linda L; Derauf, Chris; Newman, Elana; Arria, Amelia; Huestis, Marilyn A.; Della Grotta, Sheri A; Dansereau, Lynne M; Neal, Charles; Lester, Barry M

2016-01-01

Objective To assess the relationship between prenatal methamphetamine exposure (PME) and behavior problems at age 7.5 years, and the extent to which early adversity mediated this relationship. Study design The multicenter, longitudinal IDEAL study enrolled 412 mother-infant pairs at 4 sites. Methamphetamine-exposed participants (n= 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched participants (n = 208) denied methamphetamine use and had a negative meconium screen. At the 7.5 year follow-up, 290 children with complete Child Behavior Checklist (CBCL) data and an early adversity index score were available for analysis (n=146 exposed). Results PME was significantly associated with an increased early adversity index score (P<0.001) and with increased externalizing, rule-breaking behavior, and aggressive behavior (P<0.05). Early adversity was also associated with higher externalizing behavior scores. Early adversity significantly mediated the relationship between PME and behavioral problems. After adjusting the mediation model for sex, prenatal tobacco, alcohol, and marijuana exposures, and study site, the association of PME with early adversity remained significant. Conclusion Though PME is associated with behavioral problems, early adversity may be a strong determinant of behavioral outcome for children exposed to methamphetamine in utero. Early adversity significantly mediated the relationship between PME and behavioral problems. PMID:26781836

Efficacy and Safety of a Once-Yearly Intravenous Zoledronic Acid 5 mg for Fracture Prevention in Elderly Postmenopausal Women with Osteoporosis Aged 75 and Older

PubMed Central

Boonen, Steven; Black, Dennis M.; Colón-Emeric, Cathleen S.; Eastell, Richard; Magaziner, Jay S.; Eriksen, Erik Fink; Mesenbrink, Peter; Haentjens, Patrick; Lyles, Kenneth W.

2013-01-01

OBJECTIVES To determine the efficacy of once-yearly intravenous zoledronic acid (ZOL) 5 mg in reducing risk of clinical vertebral, nonvertebral, and any clinical fractures in elderly osteoporotic postmenopausal women. DESIGN A post hoc subgroup analysis of pooled data from the Health Outcome and Reduced Incidence with Zoledronic Acid One Yearly (HORIZON) Pivotal Fracture Trial and the HORIZON Recurrent Fracture Trial. SETTING Multicenter, randomized, double-blind, placebo-controlled trials. PARTICIPANTS Postmenopausal women (aged ≥75) with documented osteoporosis (T-score ≤ −2.5 at femoral neck or ≥1 prevalent vertebral or hip fracture) or a recent hip fracture. INTERVENTION Patients were randomized to receive an intravenous infusion of ZOL 5 mg (n =1,961) or placebo (n =1,926) at baseline and 12 and 24 months. MEASUREMENTS Primary endpoints were incidence of clinical vertebral and nonvertebral and any clinical fracture after treatment. RESULTS At 3 years, incidence of any clinical, clinical vertebral, and nonvertebral fracture were significantly lower in the ZOL group than in the placebo group (10.8% vs 16.6%, 1.1% vs 3.7%, and 9.9% vs 13.7%, respectively) (hazard ratio (HR) =0.65, 95% confidence interval (CI) =0.54–0.78, P<.001; HR =0.34, 95% CI =0.21–0.55, P<.001; and HR =0.73, 95% CI =0.60–0.90, P =.002, respectively). The incidence of hip fracture was lower with ZOL but did not reach statistical significance. The incidence rate of postdose adverse events were higher with ZOL, although the rate of serious adverse events and deaths was comparable between the two groups. CONCLUSION Once-yearly intravenous ZOL 5 mg was associated with a significant reduction in the risk of new clinical fractures (vertebral and nonvertebral) in elderly postmenopausal women with osteroporosis. PMID:20070415

Blood pressure and falls in community-dwelling people aged 60 years and older in the VHM&PP cohort.

PubMed

Klein, Diana; Nagel, Gabriele; Kleiner, Andrea; Ulmer, Hanno; Rehberger, Barbara; Concin, Hans; Rapp, Kilian

2013-05-21

Falls are one of the major health problems in old people. Different risk factors were identified but only few epidemiological studies analysed the influence of conventionally measured blood pressure on falls. The objective of our study was to investigate the relationship between systolic and diastolic blood pressure and falls. In 3,544 community-dwelling Austrian women and men aged 60 years and older, data on falls within the previous three months were collected by questionnaire. Blood pressure was measured by general practitioners within the Vorarlberg Health Monitoring and Prevention Programme (VHM&PP) 90 to 1095 days before the fall assessment. A multiple logistic regression analysis was conducted. The models were stratified by gender and adjusted by age, number of medical conditions and subjective feeling of illness. In total, 257 falls in 3,544 persons were reported. In women, high systolic and diastolic blood pressure was associated with a decreased risk of falls. An increase of systolic blood pressure by 10 mmHg and of diastolic blood pressure by 5 mmHg reduced the risk of falling by 9% (OR 0.91, 95% Cl 0.84-0.98) and 8% (OR 0.92, 95% Cl 0.85-0.99), respectively. In men, an increased risk of falls was observed in participants with low systolic or low diastolic blood pressure. Blood pressure was associated with the risk of falls. Hypertensive values decreased the risk in women and low blood pressure increased the risk in men.

Addition of sorafenib versus placebo to standard therapy in patients aged 60 years or younger with newly diagnosed acute myeloid leukaemia (SORAML): a multicentre, phase 2, randomised controlled trial.

PubMed

Röllig, Christoph; Serve, Hubert; Hüttmann, Andreas; Noppeney, Richard; Müller-Tidow, Carsten; Krug, Utz; Baldus, Claudia D; Brandts, Christian H; Kunzmann, Volker; Einsele, Hermann; Krämer, Alwin; Schäfer-Eckart, Kerstin; Neubauer, Andreas; Burchert, Andreas; Giagounidis, Aristoteles; Krause, Stefan W; Mackensen, Andreas; Aulitzky, Walter; Herbst, Regina; Hänel, Mathias; Kiani, Alexander; Frickhofen, Norbert; Kullmer, Johannes; Kaiser, Ulrich; Link, Hartmut; Geer, Thomas; Reichle, Albert; Junghanß, Christian; Repp, Roland; Heits, Frank; Dürk, Heinz; Hase, Jana; Klut, Ina-Maria; Illmer, Thomas; Bornhäuser, Martin; Schaich, Markus; Parmentier, Stefani; Görner, Martin; Thiede, Christian; von Bonin, Malte; Schetelig, Johannes; Kramer, Michael; Berdel, Wolfgang E; Ehninger, Gerhard

2015-12-01

months (IQR 35·5-38·1), median event-free survival was 9 months (95% CI 4-15) in the placebo group versus 21 months (9-32) in the sorafenib group, corresponding to a 3-year event-free survival of 22% (95% CI 13-32) in the placebo group versus 40% (29-51) in the sorafenib group (hazard ratio [HR] 0·64, 95% CI; 0·45-0·91; p=0·013). The most common grade 3-4 adverse events in both groups were fever (71 [53%] in the placebo group vs 73 [54%] in the sorafenib group), infections (55 [41%] vs 46 [34%]), pneumonia (21 [16%] vs 20 [14%]), and pain (13 [10%] vs 15 [11%]). Grade 3 or worse adverse events that were significantly more common in the sorafenib group than the placebo group were fever (relative risk [RR] 1·54, 95% CI 1·04-2·28), diarrhoea (RR 7·89, 2·94-25·2), bleeding (RR 3·75, 1·5-10·0), cardiac events (RR 3·46, 1·15-11·8), hand-foot-skin reaction (only in sorafenib group), and rash (RR 4·06, 1·25-15·7). In patients with acute myeloid leukaemia aged 60 years or younger, the addition of sorafenib to standard chemotherapy has antileukaemic efficacy but also increased toxicity. Our findings suggest that kinase inhibitors could be a useful addition to curative treatment for acute myeloid leukaemia. Overall survival after long-term follow-up and strategies to reduce toxicity are needed to determine the future role of sorafenib in treatment of this disease. Bayer HealthCare. Copyright © 2015 Elsevier Ltd. All rights reserved.

[The long term (15 years) evolution after valvular replacement with mechanical prosthesis or bioprosthesis between the age of 60 and 70 years].

PubMed

Hanania, G; Michel, P L; Montély, J M; Warembourg, H; Nardi, O; Leguerrier, A; Agnino, A; Despins, P; Legault, B; Petit, H; Bouraindeloup, M

2004-01-01

the aim of this study was to document the choice between prosthesis and bioprosthesis in cases of valvular replacement during the seventh decade of life. a retrospective and cooperative study linking eleven cardiac surgical teams and five medical cardiology teams combined 497 subjects born between 1915 and 1925 (average age 64.4 years) who underwent aortic (313 cases) or mitral (184 cases) valvular replacement with mechanical prosthesis (259 cases) or bioprosthesis (238 cases). Information was collected at each centre during the year 2000 on the long term evolution (going back 15 years), in particular on the mortality, non-fatal complications linked to the valve, cardiac complications and extra-cardiac events. These results were subjected to statistical analysis. the operative mortality of this group was 4.8%. The 15 year survival was 46% for the aortic mechanical prostheses, 32% for the aortic bioprostheses (p=0.04). 34% for the mitral bioprostheses and 33% for the mitral mechanical prostheses. Events linked to the valve were more frequent for the mitral valvulopathies than for the aortic valves (49% vs 26%, p<0.001). The absence of events linked to the valve at 15 years was 69% for the aortic mechanical prostheses and 68% for the aortic bioprostheses. This was the case in only 57% of mitral mechanical prostheses and 36% of the mitral bioprostheses (p=0.11). Thromboembolic accidents were three times more frequent in the mitrals than in the aortics (11.5 vs 3.8%, p=0.002). Haemorrhage was four times more frequent for the mechanical prostheses than for the bioprostheses (7.7 vs 2%, p=0.01). The risk of degeneration for the aortic bioprostheses was 20% at 15 years, three times less so after 65 years of age (p=0.03). At 48% it was much higher in the mitral valves at 15 years with no significant difference before and after 65 years of age (p=0.3). the current life expectancy of subjects in their seventh decade is important. The greatly elevated risk of bioprosthesis

U.S. Social Security at 75 years: an international perspective.

PubMed

Hoskins, Dalmer D

2010-01-01

Is the historical development of the Old-Age, Survivors, and Disability Insurance (OASDI) program unique or similar to the development of social security programs in other industrialized countries? The U.S. Social Security program was adopted some 40 to 50 years after those of most Western European nations. The United States thus had the opportunity to choose from a number of models and clearly chose to follow the classic social insurance path of such countries as Austria, France, and Germany, which in 1935 already had considerable experience administering earnings-related, employer/worker-financed old-age pension programs. Although based on the traditional social insurance model, OASDI evolved in certain unique ways, including the rejection over the course of succeeding decades of any reliance on general revenue financing, the importance attached to long-range (75-year) actuarial projections, and the relative generosity of benefits for survivors and dependents.

Population-based incidence of exudative age-related macular degeneration and ranibizumab treatment load.

PubMed

Geirsdottir, Asbjorg; Jonsson, Oskar; Thorisdottir, Sigridur; Helgadottir, Gudleif; Jonasson, Fridbert; Stefansson, Einar; Sigurdsson, Haraldur

2012-03-01

The use of intravitreal vascular endothelial growth factor antibodies for exudative age-related macular degeneration (AMD) has stressed ophthalmology services and drug budgets throughout the world. The authors study the population-based incidence of exudative AMD in Iceland and the use of intravitreal ranibizumab in a defined population. This is a prospective study of 439 consecutive patients aged 60 years and older with exudative AMD starting intravitreal ranibizumab for exudative AMD in Iceland from March 2007 to December 2009. All patients initially received three consecutive ranibizumab injections, with regular follow-up visits and re-treatment as needed. In total, 517 eyes from 439 patients received treatment for exudative AMD (mean age 79 years). The annual incidence of exudative AMD in the population 60 years and older is 0.29%. The incidence increased with advancing age, double for patients 85 years and older compared with those 75-79 years. Approximately 2400 ranibizumab injections per 100,000 persons aged 60 years and older were given each year for exudative AMD. These data allow an estimation of the incidence of exudative AMD in a Caucasian population and the treatment load with ranibizumab, which may help plan anti-vascular endothelial growth factor treatment programmes and estimate costs.

QuickStats: Percentage* of Adults Aged ≥20 Years Who Ever Told A Doctor That They Had Trouble Sleeping,† by Age Group and Sex - National Health and Nutrition Examination Survey, 2013-2014.

PubMed

2016-11-25

In 2013-2014, 28.0% of U.S. adults reported that they had told a doctor or other health professional that they had trouble sleeping. A smaller percentage of adults aged 20-39 years (19.2%) reported having trouble sleeping compared with persons aged 40-59 years (32.8%) and ≥60 years (33.2%). This pattern by age group was observed for both men and women, although larger percentages of women aged 40-59 years and ≥60 years reported trouble sleeping compared with men in those age groups.

Cost-effectiveness analysis of pneumococcal polysaccharide vaccination from age 60 in São Paulo State, Brazil.

PubMed

Neto, Joao Tonolio; de Araujo, Gabriela Tannus Branco; Gagliardi, Anna; Pinho, Amanda; Durand, Laure; Fonseca, Marcelo

2011-10-01

Vaccination of adults aged 60 years and older against Streptococcus pneumonia is not recommended in Brazil. The 23-valent polysaccharide pneumococcal vaccine (PPV23) is only available for institutionalized persons or with underlying diseases despite the substantial medical and economic burden related to pneumococcal infections in adults over than 59 years. The study aimed at evaluating the cost effectiveness of implementing a large PPV program in this population. This analysis was performed using a static decision tree model. Demographic and epidemiological data were obtained from Brazilian official sources and international literature. Economic data were obtained from a study performed in 2007 in a public and a private hospital located in Sao Paulo. Vaccination was assumed to protect for 5 years with 60% effectiveness against bacteremic pneumococcal pneumonia (BPP) and 21% effectiveness against non bacteremic pneumococcal pneumonia (NBPP). Deterministic and sensitivity analyses were performed. The pneumococcal polysaccharide vaccination saved 5,218 life year gained (LYG). The vaccination program was found to be cost effective in the social security and public health care perspectives with a mean incremental cost-effectiveness ratio of R$10,887 and R$8,281 per LYG respectively. Results were sensitive to the vaccine effectiveness against NBPP, the incidence and case-fatality rate of NBPP. From a societal perspective, PPV23 program for adults 60 and older was found to be cost-saving. Pneumococcal polysaccharide vaccination is clinically and economically favored over the present vaccination strategy, in which persons aged over 59 years in Sao Paulo, have not been vaccinated.

Malnutrition at Age 3 Years and Lower Cognitive Ability at Age 11 Years

PubMed Central

Liu, Jianghong; Raine, Adrian; Venables, Peter H.; Dalais, Cyril; Mednick, Sarnoff A.

2014-01-01

Background Early malnutrition is linked to poor cognition, but long-term effects have not been extensively examined and psychosocial confounds have not always been controlled. Objective To test the hypothesis that malnutrition at age 3 years will be associated with poorer cognitive ability at age 11 years independent of psychosocial confounds. Design A prospective, longitudinal study of a birth cohort of 1559 children originally assessed at age 3 years for malnutrition (low hemoglobin level, angular stomatitis, kwashiorkor, and sparse, thin hair) and followed up to age 11 years. Setting and Participants A community sample of 1559 children (51.4% boys and 48.6% girls) born between September 1, 1969, and August 31, 1970, in 2 towns in the island of Mauritius, with 68.7% Indians and 25.7% Creoles (African origin). Main Outcome Measures Verbal and spatial ability measured at ages 3 and 11 years and reading, scholastic ability, and neuropsychologic performance measured at age 11 years. Results Malnourished children had poorer cognition at both ages. Deficits were stable across time, applied to all sex and ethnic groups, and remained after controlling for multiple measures of psychosocial adversity. Children with 3 indicators of malnutrition had a 15.3-point deficit in IQ at age 11 years. Conclusions Malnutrition at age 3 years is associated with poor cognition at age 11 years independent of psychosocial adversity. Promoting early childhood nutrition could enhance long-term cognitive development and school performance, especially in children with multiple nutritional deficits. PMID:12796242

Analysis of oxybutynin treatment for hyperhidrosis in patients aged over 40 years

PubMed Central

Wolosker, Nelson; Krutman, Mariana; Teivelis, Marcelo Passos; de Paula, Rafael Pessanha; Kauffman, Paulo; de Campos, Jose Ribas Milanez; Puech-Leão, Pedro

2014-01-01

ABSTRACT Objective: Our aim was to analyze the effectiveness of oxybutynin for hyperhidrosis treatment in patients over 40 years. Methods: Eighty-seven patients aged over 40 years were divided into two groups. One group consisted of 48 (55.2%) patients aged between 40 and 49 years, and another was composed of 39 (44.8%) patients aged over 50 years (50 to 74 years). A comparative analysis of Quality of Life and level of hyperhidrosis between the groups was carried out 6 weeks after a protocol treatment with oxybutynin. A validated clinical questionnaire was used for evaluation. Results: In the younger age group, 75% of patients referred a “partial” or “great” improvement in level of hyperhidrosis after treatment. This number was particularly impressive in patients over 50 years, in which 87.2% of the cases demonstrated similar levels of improvement. Over 77% of patients in both groups demonstrated improvement in Quality of Life. Excellent outcomes were observed in older patients, in which 87.1% of patients presented “slightly better” (41%) or “much better” (46.1%) improvement. Conclusion: Patients aged over 40 years with hyperhidrosis presented excellent results after oxybutynin treatment. These outcomes were particularly impressive in the age group over 50 years, in which most patients had significant improvement in Quality of Life and in level of hyperhidrosis. PMID:24728245

Complete remission and early death after intensive chemotherapy in patients aged 60 years or older with acute myeloid leukaemia: a web-based application for prediction of outcomes.

PubMed

Krug, Utz; Röllig, Christoph; Koschmieder, Anja; Heinecke, Achim; Sauerland, Maria Cristina; Schaich, Markus; Thiede, Christian; Kramer, Michael; Braess, Jan; Spiekermann, Karsten; Haferlach, Torsten; Haferlach, Claudia; Koschmieder, Steffen; Rohde, Christian; Serve, Hubert; Wörmann, Bernhard; Hiddemann, Wolfgang; Ehninger, Gerhard; Berdel, Wolfgang E; Büchner, Thomas; Müller-Tidow, Carsten

2010-12-11

About 50% of patients (age ≥60 years) who have acute myeloid leukaemia and are otherwise medically healthy (ie, able to undergo intensive chemotherapy) achieve a complete remission (CR) after intensive chemotherapy, but with a substantially increased risk of early death (ED) compared with younger patients. We verified the association of standard clinical and laboratory variables with CR and ED and developed a web-based application for risk assessment of intensive chemotherapy in these patients. Multivariate regression analysis was used to develop risk scores with or without knowledge of the cytogenetic and molecular risk profiles for a cohort of 1406 patients (aged ≥60 years) with acute myeloid leukaemia, but otherwise medically healthy, who were treated with two courses of intensive induction chemotherapy (tioguanine, standard-dose cytarabine, and daunorubicin followed by high-dose cytarabine and mitoxantrone; or with high-dose cytarabine and mitoxantrone in the first and second induction courses) in the German Acute Myeloid Leukaemia Cooperative Group 1999 study. Risk prediction was validated in an independent cohort of 801 patients (aged >60 years) with acute myeloid leukaemia who were given two courses of cytarabine and daunorubicin in the Acute Myeloid Leukaemia 1996 study. Body temperature, age, de-novo leukaemia versus leukaemia secondary to cytotoxic treatment or an antecedent haematological disease, haemoglobin, platelet count, fibrinogen, and serum concentration of lactate dehydrogenase were significantly associated with CR or ED. The probability of CR with knowledge of cytogenetic and molecular risk (score 1) was from 12% to 91%, and without knowledge (score 2) from 21% to 80%. The predicted risk of ED was from 6% to 69% for score 1 and from 7% to 63% for score 2. The predictive power of the risk scores was confirmed in the independent patient cohort (CR score 1, from 10% to 91%; CR score 2, from 16% to 80%; ED score 1, from 6% to 69%; and ED score 2

Celebrating 75 years of research

USDA-ARS?s Scientific Manuscript database

The USDA Ag Lab in Peoria helps bridge the gap between agricultural producers and commercial manufacturers. In 2015, the Ag Lab, officially known as the Agricultural Research Service (ARS) National Center for Agricultural Utilization Research (NCAUR), is celebrating 75 years of research in Peoria. T...

A randomized trial to evaluate the effectiveness of an individual, education-based safe transport program for drivers aged 75 years and older

PubMed Central

2013-01-01

Background There are concerns over safety of older drivers due to increased crash involvement and vulnerability to injury. However, loss of driving privileges can dramatically reduce independence and quality of life for older members of the community. The aim of this trial is to examine the effectiveness of a safe transport program for drivers aged 75 years and older at reducing driving exposure but maintaining mobility. Methods and design A randomised trial will be conducted, involving 380 drivers aged 75 years and older, resident in urban and semi-rural areas of North-West Sydney. The intervention is an education program based on the Knowledge Enhances Your Safety (KEYS) program, adapted for the Australian context. Driving experience will be measured objectively using an in-vehicle monitoring device which includes a global positioning system (GPS) to assess driving exposure and an accelerometer to detect rapid deceleration events. Participation will be assessed using the Keele Assessment of Participation (KAP). Data will be analysed on an intention-to-treat basis; the primary outcomes include driving exposure, rapid deceleration events and scores for KAP. Secondary outcomes include self-reported measures of driving, socialisation, uptake of alternative forms of transport, depressive symptoms and mood. A detailed process evaluation will be conducted, including examination of the delivery of the program and uptake of alternative forms of transport. A subgroup analysis is planned for drivers with reduced function as characterized by established cut-off scores on the Drivesafe assessment tool. Discussion This randomised trial is powered to provide an objective assessment of the efficacy of an individually tailored education and alternative transportation program to promote safety of older drivers but maintain mobility. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612000543886. PMID:23379593

Household food insecurity is not associated with BMI for age or weight for height among Brazilian children aged 0-60 months.

PubMed

Kac, Gilberto; Schlüssel, Michael M; Pérez-Escamilla, Rafael; Velásquez-Melendez, Gustavo; da Silva, Antônio Augusto Moura

2012-01-01

We examined the association between Household Food Insecurity (HFI), weight for height z-score (WHZ) and Body Mass Index for age z-score (BMI-Z) in a representative sample of children 0-60 months of age (n = 3,433) in five Brazilian geographical regions. Data were derived from the 2006-07 Brazilian Demographic and Health Survey. HFI was measured with the Brazilian Food Insecurity Scale. Associations were estimated using multiple linear regression models (β coefficients and 95% CI) taking into account the complex sampling design. Interaction terms between HFI and geographical region and HFI and child sex and child age were assessed. The weighted prevalence of any level of HFI was 48.6%. Severe food insecurity was more prevalent among children from the North region (16.8%), born from mothers with <4 years of schooling (15.9%) and those from families with ≥3 children (18.8%). The interaction between HFI and geographical region was non-significant for BMI-Z (P = 0.119) and WHZ (P = 0.198). Unadjusted results indicated that HFI was negatively associated with BMI-Z (moderate to severe HFI: β = -0.19, 95% CI: -0.35 - -0.03, P = 0.047), and WHZ (moderate to severe HFI: β = -0.26, 95% CI: -0.42 - -0.09, P = 0.009). Estimates lost significance after adjustments for key confounders such as mothers' skin color, mothers' years of schooling, place of household, household income quartiles, mothers' smoking habit, mothers' marital status, number of children 0-60 months in the household, and birth order. HFI is unrelated to weight outcomes among Brazilian children 0-60 months.

Reference values of thirty-one frequently used laboratory markers for 75-year-old males and females

PubMed Central

Ryden, Ingvar; Lind, Lars

2012-01-01

Background We have previously reported reference values for common clinical chemistry tests in healthy 70-year-old males and females. We have now repeated this study 5 years later to establish reference values also at the age of 75. It is important to have adequate reference values for elderly patients as biological markers may change over time, and adequate reference values are essential for correct clinical decisions. Methods We have investigated 31 frequently used laboratory markers in 75-year-old males (n = 354) and females (n = 373) without diabetes. The 2.5 and 97.5 percentiles for these markers were calculated according to the recommendations of the International Federation of Clinical Chemistry. Results Reference values are reported for 75-year-old males and females for 31 frequently used laboratory markers. Conclusion There were minor differences between reference intervals calculated with and without individuals with cardiovascular diseases. Several of the reference intervals differed from Scandinavian reference intervals based on younger individuals (Nordic Reference Interval Project). PMID:22300333

Prevalence of Self-Treatment Practice and Related Factors Among Workers Aged 15 to 60 Years in Chi Linh Town, Hai Duong Province, Vietnam.

PubMed

Quynh Nguyen, Thuy; Tran, Thi Thu Thuy; Le, Thi Vui; Quyen, Thi Tu Bui; Trinh, Van Hung; Tran, Huu Bich

2017-07-01

Self-treatment is particularly prevalent in Vietnam. However, the prevalence of this practice among the working population is unclear. This study aims to describe the prevalence of self-treatment and related factors among workers aged 15 to 60 years in the suburban area of Chi Linh, Hai Duong, Vietnam. Secondary data of 3128 respondents was retrieved from the CHILILAB HDSS 2016 survey for analysis using logistic regression with a significance level of .05. Results show that 47.5% of respondents treated themselves at least once during one previous year. While rural residence and the presence of acute health symptoms and chronic diseases significantly associate with the choice of self-treatment among all investigated workers, lower education level and health insurance status only significantly relate to this practice among the formally employed workers. The findings imply the need for specific measures to manage self-treatment practices among different groups of workers.

Health coaching and pedometers to enhance physical activity and prevent falls in community-dwelling people aged 60 years and over: study protocol for the Coaching for Healthy AGEing (CHAnGE) cluster randomised controlled trial.

PubMed

Tiedemann, Anne; Rissel, Chris; Howard, Kirsten; Tong, Allison; Merom, Dafna; Smith, Stuart; Wickham, James; Bauman, Adrian; Lord, Stephen R; Vogler, Constance; Lindley, Richard I; Simpson, Judy M; Allman-Farinelli, Margaret; Sherrington, Catherine

2016-05-10

Prevention of falls and promotion of physical activity are essential for maximising well-being in older age. However, there is evidence that promoting physical activity among older people without providing fall prevention advice may increase fall rates. This trial aims to establish the impact of a physical activity and fall prevention programme compared with a healthy eating programme on physical activity and falls among people aged 60+ years. This cluster randomised controlled trial will involve 60 groups of community-dwelling people aged 60+ years. Participating groups will be randomised to: (1) a physical activity and fall prevention intervention (30 groups), involving written information, fall risk assessment and prevention advice, a pedometer-based physical activity tracker and telephone-based health coaching; or (2) a healthy eating intervention (30 groups) involving written information and telephone-based dietary coaching. Primary outcomes will be objectively measured physical activity at 12 months post-randomisation and self-reported falls throughout the 12-month trial period. Secondary outcomes include: the proportion of fallers, the proportion of people meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and health and community service use. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will be preplanned, conducted while masked to group allocation, will take into account cluster randomisation, and will use an intention-to-treat approach. Protocol has been approved by the Human Research

[Prevalence of Elevated Lipoprotein (a) Levels in Patients < 60 Years of Age with Retinal Vein Occlusion].

PubMed

Kuhli-Hattenbach, C; Hellstern, P; Miesbach, W; Kohnen, T; Hattenbach, L-O

2018-01-01

The potential impact of elevated Lipoprotein (a) [Lp(a)] levels on retinal venous occlusive (RVO) diseases with regard to age and various risk factors has not been studied extensively. In a retrospective case-control study, thrombophilia data of 106 young patients (< 60 years at the time of the RVO or a previous thromboembolic event) with RVO and 76 healthy subjects were evaluated. Elevated Lp(a) plasma levels were significantly more prevalent among RVO patients (29.2 %) than among controls (9.2 %; p = 0.0009). Lp(a) levels were found to be significantly (p = 0.012) different between patients and controls. Moreover, we found that an unusual personal or family history of thromboembolism was a strong predictor of elevated Lp(a) (p = 0.03). We observed a significant correlation between elevated Lp(a) and other coagulation disorders (p = 0.005). Multivariate analysis showed that elevated lipoprotein(a) levels (OR: 3.5; p = 0.003) were an independent risk factor for the development of RVO. Elevated plasma levels of Lp(a) are associated with the development of RVO. Selective screening of young patients and subjects with a personal or family history of thromboembolism may be helpful in identifying RVO patients with elevated Lp(a). Georg Thieme Verlag KG Stuttgart · New York.

Association of leisure-time physical activity with cognition by apolipoprotein-E genotype in persons aged 60 years and over: the National Health and Nutrition Examination Survey (NHANES-III).

PubMed

Obisesan, Thomas O; Umar, Nisser; Paluvoi, Nivedh; Gillum, Richard F

2012-01-01

To test the hypothesis that aerobic-related leisure-time physical activity (PA) is associated with better cognitive function and that the effect varies among apolipoprotein E (APOE) genotype groups. Cross-sectional study of persons examined in the Third National Health and Nutrition Examination Survey (NHANES-III; 1988-1994). US noninstitutionalized population. From a sample of 7159, aged ≥60 years, we analyzed data for 1799 older American men and women who had information on PA, a short mental status examination (SMSE), and were genotyped at the apolipoprotein E gene locus. In the initial bivariate analysis, non-ɛ4 carriers and ɛ4-heterozygotes performed better than ɛ4-homozygotes in the 60-69 age group. After controlling for multiple confounders including mobility limitation, PA correlated with a higher SMSE score in non-ɛ4 carriers (P = 0.014), but not in ɛ4 carriers (P = 0.887). At ≥70 years, PA also correlated with higher adjusted SMSE scores in non-ɛ4 carriers (P = 0.02); but this association became nonsignificant after controlling for mobility limitation (P = 0.12). In a nationally representative sample, PA was associated with enhanced cognition, an effect that was differentially influenced by apolipoprotein E genotype. Experimental studies are needed to determine whether or not PA can attenuate cognitive decline.

Educational inequalities in smoking among Japanese adults aged 25-94 years: Nationally representative sex- and age-specific statistics.

PubMed

Tabuchi, Takahiro; Kondo, Naoki

2017-04-01

Few studies have investigated differences in age- and gender-specific educational gradients in tobacco smoking among the whole range of adult age groups. We examined educational inequality in smoking among Japanese adults aged 25-94 years. Using a large nationally representative sample (167,925 men and 186,588 women) in 2010, prevalence of current smoking and heavy smoking among daily smokers and their inequalities attributable to educational attainment were analyzed according to sex and age groups. Among men aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 68.4% (95% confidence interval [CI], 66.0%-70.6%), and graduate school graduates had the lowest at 19.4% (95% CI, 17.2%-21.9%). High school graduates had the second highest current smoking prevalence (e.g., 55.9%; 95% CI, 54.9%-56.8% in men aged 25-34 years). Among men aged 75-94 years, the difference in current smoking across educational categories was small. A similar but steeper educational gradient in current smoking was observed among women. Among women aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 49.3% (95% CI, 46.3%-52.3%), and graduate school graduates had the lowest at 4.8% (95% CI, 2.9%-7.4%). Compared with older age groups, such as 65-94 years, younger age groups, such as 25-54 years, had higher estimates of inequality indicators for educational inequality in both current and heavy smoking in both sexes. Educational inequalities in current and heavy smoking were apparent and large in the young population compared with older generations. The current study provides basic data on educational inequalities in smoking among Japanese adults. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Multivessel disease in patients over 75years old with ST elevated myocardial infarction. Current management strategies and related clinical outcomes in the ESTROFA MI+75 nation-wide registry.

PubMed

de La Torre Hernandez, Jose M; Gomez Hospital, Joan A; Baz, Jose A; Brugaletta, Salvatore; Perez de Prado, Armando; Linares, Jose A; Lopez Palop, Ramón; Cid, Belen; Garcia Camarero, Tamara; Diego, Alejandro; Gutierrez, Hipolito; Fernandez Diaz, Jose A; Sanchis, Juan; Alfonso, Fernando; Blanco, Roberto; Botas, Javier; Navarro Cuartero, Javier; Moreu, Jose; Bosa, Francisco; Vegas, Jose M; Elizaga, Jaime; Arrebola, Antonio L; Hernandez, Felipe; Salvatella, Neus; Monteagudo, Marta; Gomez Jaume, Alfredo; Carrillo, Xavier; Martin Reyes, Roberto; Lozano, Fernando; Rumoroso, Jose R; Andraka, Leire; Dominguez, Antonio J

2017-12-06

In elderly patients with ST elevated myocardial infarction (STEMI) and multivessel disease (MVD the outcomes related with different revascularization strategies are not well known. Subgroup-analysis of a nation-wide registry of primary angioplasty in the elderly (ESTROFA MI+75) with 3576 patients over 75years old from 31 centers. Patients with MVD were analyzed to describe treatment approaches and 2years outcomes. Of 1830 (51%) with MVD, 847 (46%) underwent multivessel revascularization either in acute (51%), staged (44%) or both procedures (5%). Patients with previous myocardial infarction and those receiving drug-eluting stents or IIb-IIIa inhibitors were more prone to be revascularized, whereas older patients, females and those with Killip III-IV, renal failure and higher ejection fraction were less likely. Survival free of cardiac death and infarction at 2years was better for those undergoing multivessel PCI (85.8% vs. 80.4%, p<0.0008), regardless of Killip class. Multivessel PCI was protective of cardiac death and infarction (HR 0.60, 95% CI 0.40-0.89; p=0.011). Complete revascularization made no difference in outcomes among those patients undergoing multivessel PCI. The best prognosis corresponded to those undergoing multivessel PCI in staged procedures (p<0.001). A propensity score matching analysis (514 patients in each group) yielded similar results. In elderly patients with STEMI and MVD, multivessel PCI was related with better outcomes especially after staged procedures. Among those undergoing multivessel PCI, anatomically defined completeness of revascularization had not prognostic influence. We sought to investigate the revascularization strategies applied and their prognostic implications in patients aged over 75years with ST elevated myocardial infarction showing multivessel disease. Of 1830 patients, 847 (46%) underwent multivessel PCI either in acute (51%), staged (44%) or both procedures (5%). Multivessel PCI was independent predictor of cardiac

Body weight change since menopause and percentage body fat mass are predictors of subsequent bone mineral density change of the proximal femur in women aged 75 years and older: results of a 5 year prospective study.

PubMed

Blain, H; Carrière, I; Favier, F; Jeandel, C; Papoz, L

2004-07-01

Few studies have evaluated risk factors for bone loss in elderly women. We examined risk factors associated with a 5-year longitudinal change in bone mineral density (BMD) at the hip in healthy women aged 75 years and older. The BMD of 276 women from the French EPIDOS (Epidémiologie des Osteoporoses) study was assessed in Montpellier from 1992 to 1993 and again from 1997 to 1998. BMD was measured at the femoral neck, trochanter, and Ward's area using the same Lunar densitometer. We examined the relationship between clinical and behavioral factors at baseline and their variations during follow-up, with percentage BMD change adjusted for baseline BMD. Depending on the femur subregion studied, a significant decrease in BMD (exceeding the least significant difference, i.e., > 2.8 CV) was observed in 36.2% to 51.1% of women. Multivariate analysis showed that both postmenopausal weight change before baseline and baseline percentage of fat mass were positively correlated with BMD change at the Ward's triangle and the trochanter. Yearly absolute and relative weight changes over the follow-up period were significantly associated with change of trochanter and femoral neck BMD. Our results show that maintenance of body weight throughout the postmenopause period and body fat mass play protective roles against bone loss at the proximal femur in women aged 75 years and older and suggest the value in including assessment of weight change throughout postmenopause and percentage body fat mass in screening programs for elderly women who are at higher risk of accelerated bone loss.

Cognitive impairment and risk factor prevalence in a population over 60 in Argentina

PubMed Central

Arizaga, Raul L; Gogorza, Roxana E; Allegri, Ricardo F; Baumann, Patricia D; Morales, María C; Harris, Paula; Pallo, Vicente; Cegarra, María M

2014-01-01

Epidemiological data on dementia and cognitive impairment are scarce in South America. In Argentina, no dementia/cognitive impairment population-based epidemiological studies are available. The Ceibo Study is a population-based epidemiological study of dementia and cognitive impairment in individuals over 60 to be conducted. The present paper reports the results of the pilot phase (survey of cognitive impairment) conducted in Cañuelas (province of Buenos Aires). Methods In a door-to-door survey, trained high school students evaluated 1453 individuals aged 60 years and over in one day using a demographic data and risk factors questionnaire, the Mini-Mental State Examination (MMSE) and the 15-item Geriatric Depression Scale (GDS). Results Mean age of the individuals was 70.9 (±7.5) years, 61.4% were women, mean schooling was 5.5 (±3.5) years. Mean MMSE score was 24.5 (±4.7) and mean GDS 3.1 (±2.7). Risk factors of higher prevalence in the population under study were: hypertension (40.6%), smoking (35.1%), alcohol consumption (32.8%), high cholesterol (16.1%), diabetes (12.5%), cranial trauma with loss of consciousness (12.5%), 7 points or more on the GDS (11.7%). Prevalence of cognitive impairment for the whole sample was 23%, and 16.9% in subjects aged 60-69, 23.3% in 70-79 and 42.5% in subjects aged 80 or over . A significant correlation of cognitive impairment with age, functional illiteracy, cranial trauma, high blood pressure, inactivity and depression was found. Conclusion In this pilot study, the prevalence of cognitive impairment was comparable with previous international studies. PMID:29213927

[Macrovascular diseases-based on the data of Japanese cohort study (JCDM) including 1,016 very elderly diabetic individuals older than 75 years old].

PubMed

Hayashi, Toshio

2013-11-01

LDL-cholesterol and glucose are risk for ischemic heart disease (IHD) in middle-aged diabetic individuals; however, the risk among elderly, especially very elderly, is not well-known. We performed a prospective cohort study (JCDM) with 5.5 years of follow-up. Four thousand fourteen type 2 diabetic patients without previous IHD or cerebrovascular attack (CVA) (1,936 women: 67.4 +/- 9.5 years, > or = 75 years, n = 1,016) were recruited. One hundred fifty-three IHDs and 104 CVAs occurred over 5.5 years. Lower HDL-cholesterol (HDL-C) was correlated with IHD in patients > or = 75 years old. In contrast, systolic BP, HbA1c, LDL-C and non-HDL-C were correlated in subjects < 65 years old, and LDL-C/HDL-C ratio was correlated in all subjects. HDL-C was correlated with CVA in patients > or = 75 years old. These age-dependent differences in risk are important for developing individualized strategies to prevent atherosclerotic disease.

Preschool Gender-Typed Play Behavior at Age 3.5 Years Predicts Physical Aggression at Age 13 Years.

PubMed

Kung, Karson T F; Li, Gu; Golding, Jean; Hines, Melissa

2018-05-01

Gender differences in play behavior and physical aggression have been consistently reported. Theoretical perspectives concerning evolutionary, social, and social-cognitive mechanisms suggest that male-typical play behavior during childhood increases subsequent physical aggression. The evidence supporting these connections is limited, however. The present study investigated the association between gender-typed play behavior in early childhood and physical aggression in early adolescence using a sample drawn from a longitudinal, population study, the Avon Longitudinal Study of Parents and Children. Based on gender-typed play behavior as measured by the Pre-School Activities Inventory at age 3.5 years, samples of masculine (64 boys, 60 girls), feminine (80 boys, 66 girls), and randomly selected control children (55 boys, 67 girls) were recruited at age 13 years and administered the Reinisch Aggression Inventory. After controlling for a range of sociodemographic variables, maternal characteristics, and behavioral problems, including hyperactivity and conduct problems at age 3.5, significant group differences in physical aggression at age 13 were found among children classified as masculine, control, and feminine at age 3.5. Masculine children exhibited significantly more physical aggression than control children or feminine children, and control children exhibited significantly more physical aggression than feminine children. The association between gender-typed play behavior and physical aggression was not moderated by sex. These results suggest that the degree of childhood gender-typed play behavior independently predicts the degree of physical aggression at adolescence in boys and in girls.

Prevalence and Determinants of Glaucoma in Citizens of Qatar Aged 40 Years or Older: A Community-Based Survey

PubMed Central

Al-Mansouri, Fatma A.; Kanaan, Aida; Gamra, Hamad; Khandekar, Rajiv; Hashim, Shakeel P.; Al Qahtani, Omar; Ahmed, Mohd. Farouk

2011-01-01

Background: We present the prevalence and determinants of glaucoma among subjects 40 years of age and older in Qatar. Materials and Methods: This community-based survey was held in 2009 at 49 randomly selected clusters. Demographic details and history of glaucoma was collected by the nurses. Ophthalmologists evaluated the optic disc and retina using a digital camera housed in a mobile van. Visual field was tested with an automated perimeter, the intraocular pressure with an applanation tonometer and the angle of the anterior chamber by gonioscopy. A panel of glaucoma experts diagnosed subjects with glaucoma. Results: This survey enrolled 3,149 (97.3%) participants. The age- and sex-adjusted prevalence of glaucoma in the population aged 40 years and older was 1.73% (95% confidence intervals [CI] 1.69-1.77). Accordingly, 5,641 individuals in this age group in Qatar would have glaucoma. Chronological age of 60 years and older (Odds ratio [OR] 11.1) and the presence of myopia (OR 1.78) were predictors of glaucoma. Open-angle glaucoma was diagnosed in 44 (65.7%) individuals with glaucoma. In nine (13.4%) and 15 (20.9%) subjects, angle closure glaucoma and other (post-traumatic, pseudoexfoliation) glaucoma were present. Bilateral blindness (vision <3/60) and severe visual impairment (<6/60) were found in four (6%) and three (4.5%) subjects with glaucoma, respectively. Glaucoma was treated in 36 (54%) subjects. Conclusions: The prevalence of glaucoma among citizens of Qatar aged 40 years and older was 1.71%. Glaucoma was associated with the age of 60 years and older and the presence of myopia. PMID:21731325

Urban Residence and Higher Education Do Not Protect against Cognitive Decline in Aging and Dementia: 10-Year Follow-Up of the Canadian Study of Health and Aging

ERIC Educational Resources Information Center

Helmes, Edward; Van Gerven, Pascal W. M.

2017-01-01

The construct of cognitive reserve has primarily been defined in terms of a single proxy measure, education. There may, however, be alternative, potentially additive, proxy measures of cognitive reserve, such as rural or urban residence. Using a large sample of 10,263 older Canadians, ranging in age between 64 and 99 years (mean age = 75.7 years,…

Prevalence of vitamin D inadequacy in European women aged over 80 years.

PubMed

Bruyère, Olivier; Slomian, Justine; Beaudart, Charlotte; Buckinx, Fanny; Cavalier, Etienne; Gillain, Sophie; Petermans, Jean; Reginster, Jean-Yves

2014-01-01

Inadequate vitamin D status is associated with secondary hyperparathyroidism and increased bone turnover and bone loss, which in turn increases fracture risk. The objective of this study is to assess the prevalence of inadequate vitamin D status in European women aged over 80 years. Assessments of serum 25-hydroxyvitamin D levels (25(OH)D) were performed on 8532 European women with osteoporosis or osteopenia of which 1984 were aged over 80 years. European countries included in the study were: France, Belgium, Denmark, Italy, Poland, Hungary, United Kingdom, Spain and Germany. Two cut-offs of 25(OH)D inadequacy were fixed: <75 nmol/L (30 ng/ml) and <50 nmol/L (20 ng/ml). Mean (SD) age of the patients was 83.4 (2.9) years, body mass index was 25.0 (4.0) kg/m(2) and level of 25(OH)D was 53.3 (26.7) nmol/L (21.4 [10.7] ng/ml). There was a highly significant difference of 25(OH)D level across European countries (p<0.0001). In these women aged over 80 years, the prevalence of 25(OH)D inadequacy was 80.9% and 44.5% when considering cut-offs of 75 and 50 nmol/L, respectively. In the 397 (20.0%) patients taking supplemental vitamin D with or without supplemental calcium, the mean serum 25(OH)D level was significantly higher than in the other patients (65.2 (29.2) nmol/L vs. 50.3 (25.2) nmol/L; P<0.001). This study indicates a high prevalence of vitamin D (25(OH)D) inadequacy in old European women. The prevalence could be even higher in some particular countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Randomised trial of LHRH analogue treatment on final height in girls with onset of puberty aged 7.5-8.5 years

PubMed Central

Cassio, A.; Cacciari, E.; Balsamo, A.; Bal, M.; Tassinari, D.

1999-01-01

OBJECTIVE—To study the effectiveness of luteinising hormone releasing hormone (LHRH) analogues in improving final height in girls affected by early puberty.
PATIENTS—Forty six consecutive girls with onset of puberty aged 7.5-8.5 years randomly divided into two groups: one treated with 3.75 mg triptorelin intramuscularly every four weeks (group 1); and the other with no treatment (group 2).
RESULTS—Mean (SD) chronological age at onset of menarche was significantly higher in group 1 than in group 2 (11.9 (1.0) v 10.8 (0.7) years). However, mean (SD) height at menarche (152.7 (7.2) v 152.5(5.7) cm) and mean (SD) growth after menarche (4.9 (3.0) v 5.4(2.2) cm) were similar in both groups. The mean (SD) final height was similar in the two groups (group 1, 158.1 (6.2) cm; group 2, 158.6 (6.0) cm) and not significantly different from target height. Fourteen of 20 patients in group 1 and 12 of 18 patients in group 2 showed final height equal to or higher than target height. Final heights of girls with poor initial height prognosis were significantly lower than those of girls with good prognosis, but in patients with the same initial height prognosis, both groups showed final heights similar and not significantly different from their target heights.
CONCLUSIONS—LHRH analogue has no apparent effect on final height in subjects with onset of puberty between 7.5 and 8.5years.

 PMID:10490438

Prevalence of low bone health using quantitative ultrasound in Indian women aged 41-60 years: Its association with nutrition and other related risk factors.

PubMed

Shenoy, Shweta; Chawla, Jasmine Kaur; Gupta, Swati; Sandhu, Jaspal Singh

2017-01-01

The purpose of this study was to find the prevalence of low bone health conditions and assess associated nutritional and other risk factors in Indian women aged 41-60 years. A total of 1,911 women participated in this cross-sectional study. Bone health was assessed using an Omnisense multisite quantitative ultrasound bone densitometer on two sites (radius and tibia). Crude prevalence of osteopenia and osteoporosis was found to be 30.09% and 19.89%, respectively. The Indian women were deficient in a majority of nutrients. Postmenopause, hysterectomy, hyperthyroid, hypothyroid, hypertension, low physical activity, low sun exposure, high stress levels, and low calcium levels were found to be independent risk factors of low bone health.

Effectiveness of Herpes Zoster Vaccine in Patients 60 Years and Older With End-stage Renal Disease.

PubMed

Tseng, Hung Fu; Luo, Yi; Shi, Jiaxiao; Sy, Lina S; Tartof, Sara Y; Sim, John J; Hechter, Rulin C; Jacobsen, Steven J

2016-02-15

Unlike in a healthy population, the protection of herpes zoster (HZ) vaccine in end-stage renal disease (ESRD) patients might be insufficient, considering data demonstrating suboptimal response to other vaccines. The study evaluates the association between HZ vaccination and the subsequent HZ risk among ESRD patients. This cohort study included ESRD patients age ≥60 years who were enrolled in Kaiser Permanente Southern California. The vaccinated cohort included 582 patients who received HZ vaccine during 01/01/2007 through 12/31/2013. Each vaccinated patient was matched to five unvaccinated patients on age, sex, and dialysis duration. Subjects were passively followed through their electronic health records to identify HZ incidence. Cox regression was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) associated with vaccination. Kaplan-Meier estimates of the cumulative incidence were generated. The number of HZ cases was 16 in 1373 person-years (11.7 per 1000 person-years; 95% CI, 7.1-19.0) among the vaccinated and 126 in 5644 person-years (22.3 per 1000 person-years; 95% CI, 18.7-26.6) among the unvaccinated. The 36-month cumulative risk of incident HZ was 4.1% and 6.6%, respectively. HZ vaccination was associated with a reduced risk of HZ (adjusted HR = 0.49; 95% CI, .29-.85). The reduced risk seems more prominent if the vaccine is given within two years of dialysis initiation. Among ESRD patients age ≥60 years, receipt of HZ vaccine was associated with a lower incidence of HZ. In addition, HZ vaccination soon after the initiation of dialysis may provide greater protection. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Proposition of decision limits for serum lipids in Brazilian children aged one to 13 years.

PubMed

Slhessarenko, Natasha; Fontes, Cor J F; Slhessarenko, Maria Eduarda; Azevedo, Raymundo S; Andriolo, Adagmar

2018-03-09

To determine decision limits for total cholesterol, LDL-cholesterol, non-HDL cholesterol, HDL-cholesterol, and triglycerides in healthy children and adolescents from Cuiabá, Brazil. This was a cross-sectional study of 1866 healthy children and adolescents randomly selected from daycare centers and public schools in Cuiabá. The desirable levels of serum lipids were defined using the classic criteria, i.e., total cholesterol, LDL-cholesterol, non-HDL cholesterol, and triglycerides levels below the P75 percentile, and HDL-c above the P10 percentile. For CT, P75 was: 160mg/dL for the age range of 1 to <3 years, 170mg/dL for ≥3 to <9 years, and 176mg/dL for ≥9 to <13 years. For non-HDL cholesterol, it was 122mg/dL for the age range of 1 to <13 years. For LDL-c, it was 104mg/dL at the age range of 1 to <9 years and 106mg/dL from ≥9 to <13 years. For TG, it was 127mg/dL from 1 to <2 years; 98mg/dL from ≥2 to <6 years; and 92mg/dL from ≥6 to <13 years. As for HDL-cholesterol, P10 was 24mg/dL, 28mg/dL, 32mg/dL, and 36mg/dL, for the age ranges of 1 to <2 years, ≥2 to <3 years, ≥3 to <4 years, and ≥4 to <13 years, respectively. The decision limits for the serum lipid levels defined in this study differed from those observed in the current Brazilian and North-American guidelines, especially because it differentiates between the age ranges. Using these decision limits in clinical practice will certainly contribute to improve the diagnostic accuracy for dyslipidemia in this population group. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Exercise capacity and all-cause mortality in male veterans with hypertension aged ≥70 years.

PubMed

Faselis, Charles; Doumas, Michael; Pittaras, Andreas; Narayan, Puneet; Myers, Jonathan; Tsimploulis, Apostolos; Kokkinos, Peter

2014-07-01

Aging, even in otherwise healthy subjects, is associated with declines in muscle mass, strength, and aerobic capacity. Older individuals respond favorably to exercise, suggesting that physical inactivity plays an important role in age-related functional decline. Conversely, physical activity and improved exercise capacity are associated with lower mortality risk in hypertensive individuals. However, the effect of exercise capacity in older hypertensive individuals has not been investigated extensively. A total of 2153 men with hypertension, aged ≥70 years (mean, 75 ± 4) from the Washington, DC, and Palo Alto Veterans Affairs Medical Centers, underwent routine exercise tolerance testing. Peak workload was estimated in metabolic equivalents (METs). Fitness categories were established based on peak METs achieved, adjusted for age: very-low-fit, 2.0 to 4.0 METs (n=386); low-fit, 4.1 to 6.0 METs (n=1058); moderate-fit, 6.1 to 8.0 METs (n=495); high-fit >8.0 METs (n=214). Cox proportional hazard models were applied after adjusting for age, body mass index, race, cardiovascular disease, cardiovascular medications, and risk factors. All-cause mortality was quantified during a mean follow-up period of 9.0 ± 5.5 years. There were a total of 1039 deaths or 51.2 deaths per 1000 person-years of follow-up. Mortality risk was 11% lower (hazard ratio, 0.89; 95% confidence interval, 0.86-0.93; P<0.001) for every 1-MET increase in exercise capacity. When compared with those achieving ≤4.0 METs, mortality risk was 18% lower (hazard ratio, 0.82; 95% confidence interval, 0.70-0.95; P=0.011) for the low-fit, 36% for the moderate-fit (hazard ratio, 0.64; 95% confidence interval, 0.52-0.78; P<0.001), and 48% for the high-fit individuals (hazard ratio, 0.52; 95% confidence interval, 0.39-0.69; P<0.001). These findings suggest that exercise capacity is associated with lower mortality risk in elderly men with hypertension. © 2014 American Heart Association, Inc.

PROPERTIES OF THE NEARBY BROWN DWARF WISEP J180026.60+013453.1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gizis, John E.; Burgasser, Adam J.; Vrba, Frederick J.

2015-12-15

We present new spectroscopy and astrometry to characterize the nearby brown dwarf WISEP J180026.60+013453.1. The optical spectral type, L7.5, is in agreement with the previously reported near-infrared spectral type. The preliminary trigonometric parallax places it at a distance of 8.01 ± 0.21 pc, confirming that it is the fourth closest known late-L (L7–L9) dwarf. The measured luminosity, our detection of lithium, and the lack of low surface gravity indicators indicates that WISEP J180026.60+013453.1 has a mass 0.03 < M < 0.06 M{sub ⊙} and an age between 300 million and 1.5 billion years according to theoretical substellar evolution models. Themore » low space motion is consistent with this young age. We have measured the rotational broadening (v sin i = 13.5 ± 0.5 km s{sup −1}), and use it to estimate a maximum rotation period of 9.3 hr.« less

Parental influences on cardiovascular risk factors in Swedish children aged 5-14 years.

PubMed

Khanolkar, Amal R; Byberg, Liisa; Koupil, Ilona

2012-12-01

Precursors of cardiovascular diseases (CVD) originate in childhood. We investigated relationships of children's CVD risk factors with parent's socio-economic position (SEP) and lifestyle and how CVD risk factors correlate within families. We studied 602 families with 2141 individuals comprising two full sibs; aged 5-14 years, and their biological parents (Uppsala Family Study). Parental SEP (occupational class and education) and lifestyle habits [smoking, physical activity (PA), alcohol consumption] were taken from questionnaires. Associations with cholesterol, ApoB/ApoA1, leptin, adiponectin, blood pressure, body mass index (BMI) and overweight/obesity (OW/OB) were analysed by linear/logistic regression. Results were adjusted for child's age, gender, pubertal stage and family clustering. We observed no consistent associations between parental SEP and children's CVD risk factors. Parental lifestyle had stronger effects, independent of parental SEP. Children of smoking fathers had higher BMI (4%, 95% CI 1-7%) and leptin levels (27%, 95% CI 1.00-61.60%). Children of mothers reporting vigorous PA had lower BMI, cholesterol and decreased odds for OW/OB with a possible dose effect. Compared with mothers reporting no vigorous activity, mothers with ≤75 min and 76-150 min/week of vigorous activity had 43% (OR 0.57, 95% CI 0.22-0.89) and 72% (OR 0.28, 95% CI 0.14-0.60) lower risk of having an OW/OB child, respectively, after adjustment for confounders. Independent, consistently stronger and significant associations were found between all studied parents' and children's CVD risk factors. Parental behaviours: smoking, alcohol consumption, low PA are associated with higher levels of CVD risk factors (BMI, OW/OB, cholesterol) in children. Strong correlations in CVD risk factors within families not related to parental SEP/lifestyle suggest a role of genetics in influencing children's CVD risk factors. Public health policies should target families with unhealthy lifestyles.

Exsanguination cardiac arrest in rats treated by 60 min, but not 75 min, emergency preservation and delayed resuscitation is associated with intact outcome.

PubMed

Drabek, Tomas; Stezoski, Jason; Garman, Robert H; Han, Fei; Henchir, Jeremy; Tisherman, Samuel A; Stezoski, S William; Kochanek, Patrick M

2007-10-01

Emergency preservation and resuscitation (EPR) is a new approach for resuscitation of exsanguination cardiac arrest (CA) victims to buy time for surgical hemostasis. EPR uses a cold aortic flush to induce deep hypothermic preservation, followed by resuscitation with cardiopulmonary bypass (CPB). We previously reported that 20 min of EPR was feasible with intact outcome. In this report, we tested the limits for EPR in rats. Adult male isoflurane-anesthetized rats were subjected to rapid hemorrhage (12.5 ml over 5 min), followed by esmolol/KCl-induced CA and 1 min of no-flow. EPR was then induced by perfusion with 270 ml of ice-cold Plasma-Lyte to decrease body temperature to 15 degrees C. After 60 min (n=7) or 75 min (n=7) of EPR, resuscitation was attempted with CPB over 60 min, blood transfusion, correction of acid-base balance and electrolyte disturbances, and mechanical ventilation for 2h. Survival, overall performance category (OPC: 1=normal, 5=death), neurological deficit score (NDS), and histological damage score (HDS) were assessed in survivors on day 3. While all rats after 60 min EPR survived, only two out of seven rats after 75 min EPR survived (p<0.05). All rats after 60 min EPR achieved OPC 1 and normal NDS by day 3. Survivors after 75 min EPR achieved best OPC 3 (p<0.05 vs. 60 min EPR). HDS of either brain or individual viscera was not statistically different after 60 versus 75 min EPR, except for kidneys (0+/-0 vs. 1.9+/-1.3, respectively; p<0.05), with a strong trend toward greater injury in all extracerebral organs in the 75-min EPR group (p<0.06). Histological findings were dominated by cardiac lesions observed in both groups and acute renal tubular and liver necrosis in the 75-min EPR group. In conclusion, we have shown that 60 min of EPR after exsanguination CA is associated with survival and favorable neurological outcome, while 75 min of EPR results in significant mortality and neurological damage in survivors. Surprisingly, extracerebral

Listening to the Experts: The Views of Working-Aged Consumers with Disabilities. Consumer Needs Assessment Project Year Four: Results of the Fourth Year of a Five Year Study.

ERIC Educational Resources Information Center

Ward, Carolyn

This monograph details the findings from the fourth year of a 5-year Consumer Needs Assessment Project. Sixteen focus groups consisting of 133 working-aged persons (25 to 60 years old) with disabilities were convened in 3 different parts of the United States to discuss their personal and technological needs. Consumers identified problems they face…

Associations between education and brain structure at age 73 years, adjusted for age 11 IQ

PubMed Central

Dickie, David Alexander; Ritchie, Stuart J.; Karama, Sherif; Pattie, Alison; Royle, Natalie A.; Corley, Janie; Aribisala, Benjamin S.; Valdés Hernández, Maria; Muñoz Maniega, Susana; Starr, John M.; Bastin, Mark E.; Evans, Alan C.; Wardlaw, Joanna M.; Deary, Ian J.

2016-01-01

Objective: To investigate how associations between education and brain structure in older age were affected by adjusting for IQ measured at age 11. Methods: We analyzed years of full-time education and measures from an MRI brain scan at age 73 in 617 community-dwelling adults born in 1936. In addition to average and vertex-wise cortical thickness, we measured total brain atrophy and white matter tract fractional anisotropy. Associations between brain structure and education were tested, covarying for sex and vascular health; a second model also covaried for age 11 IQ. Results: The significant relationship between education and average cortical thickness (β = 0.124, p = 0.004) was reduced by 23% when age 11 IQ was included (β = 0.096, p = 0.041). Initial associations between longer education and greater vertex-wise cortical thickness were significant in bilateral temporal, medial-frontal, parietal, sensory, and motor cortices. Accounting for childhood intelligence reduced the number of significant vertices by >90%; only bilateral anterior temporal associations remained. Neither education nor age 11 IQ was significantly associated with total brain atrophy or tract-averaged fractional anisotropy. Conclusions: The association between years of education and brain structure ≈60 years later was restricted to cortical thickness in this sample; however, the previously reported associations between longer education and a thicker cortex are likely to be overestimates in terms of both magnitude and distribution. This finding has implications for understanding, and possibly ameliorating, life-course brain health. PMID:27664981

Associations between education and brain structure at age 73 years, adjusted for age 11 IQ.

PubMed

Cox, Simon R; Dickie, David Alexander; Ritchie, Stuart J; Karama, Sherif; Pattie, Alison; Royle, Natalie A; Corley, Janie; Aribisala, Benjamin S; Valdés Hernández, Maria; Muñoz Maniega, Susana; Starr, John M; Bastin, Mark E; Evans, Alan C; Wardlaw, Joanna M; Deary, Ian J

2016-10-25

To investigate how associations between education and brain structure in older age were affected by adjusting for IQ measured at age 11. We analyzed years of full-time education and measures from an MRI brain scan at age 73 in 617 community-dwelling adults born in 1936. In addition to average and vertex-wise cortical thickness, we measured total brain atrophy and white matter tract fractional anisotropy. Associations between brain structure and education were tested, covarying for sex and vascular health; a second model also covaried for age 11 IQ. The significant relationship between education and average cortical thickness (β = 0.124, p = 0.004) was reduced by 23% when age 11 IQ was included (β = 0.096, p = 0.041). Initial associations between longer education and greater vertex-wise cortical thickness were significant in bilateral temporal, medial-frontal, parietal, sensory, and motor cortices. Accounting for childhood intelligence reduced the number of significant vertices by >90%; only bilateral anterior temporal associations remained. Neither education nor age 11 IQ was significantly associated with total brain atrophy or tract-averaged fractional anisotropy. The association between years of education and brain structure ≈60 years later was restricted to cortical thickness in this sample; however, the previously reported associations between longer education and a thicker cortex are likely to be overestimates in terms of both magnitude and distribution. This finding has implications for understanding, and possibly ameliorating, life-course brain health. © 2016 American Academy of Neurology.

Volunteerism and positive aging in Hong Kong: a cultural perspective.

PubMed

Chong, Alice Ming Lin; Rochelle, Tina Louisa; Liu, Susu

2013-01-01

This study aims to examine factors related to volunteerism and explore the relationship between volunteerism and positive aging across three age groups. A total of 1,170 Hong Kong Chinese respondents aged between 15 years and 79 years were recruited for the study via a random household survey. Results found that age was negatively related to participation in voluntary work. Older adults aged 60 years to 75 years demonstrated the lowest volunteer participation rate compared with younger adults (aged 15 years to 39 years) and midlife adults (aged 40 years to 59 years). Paradoxically, older volunteers exhibited the highest frequency of volunteering, operationalized as spending 10 hours or more on volunteer work in the past month. Compared with younger and midlife adults, older adults were motivated to volunteer by societal concern and esteem enhancement. Participation in voluntary work was associated with three positive aging outcomes: good health, caring engagement with significant others, and productive engagement in the community. The findings suggest great potential in promoting volunteering in old age because older volunteers tend to contribute more hours than younger volunteers do, and volunteering is associated with positive aging.

Hypertension: diagnosis, control status and its predictors in general population aged between 15 and 75 years: a community-based study in southeastern Iran.

PubMed

Najafipour, Hamid; Nasri, Hamid Reza; Afshari, Mahdi; Moazenzadeh, Mansoor; Shokoohi, Mostafa; Foroud, Afsaneh; Etemad, Koorosh; Sadeghi, Behnam; Mirzazadeh, Ali

2014-12-01

Hypertension (HTN) is an important cause of cardiovascular related morbidity and mortality. This study aimed at providing the prevalence of pre-HTN, diagnosed and undiagnosed HTN, along with its control and associated factors in an adult population. 5,900 participants aged 15-75 years took part in the study. HTN was verified by examination, self-reported history or using anti-hypertensive drug(s). Pre-hypertension and hypertension were defined as 120-139/80-89 mmHg and >140/>90 mmHg for systolic/diastolic BP, respectively. The prevalence of hypertension was 18.4 % from which 10.5 %were diagnosed and 7.9 % were undiagnosed. The prevalence of pre-HTN was 35.5 %. HTN increased by age (2.4 % in 15-24 to 49 % in 55-64 years). The men had higher pre-HTN (42.7 vs. 28.1 %) and undiagnosed HTN (11.3 vs. 4.6 %). Of those diagnosed, 56.3 % had uncontrolled BP levels. Smoking, anxiety, obesity, and positive family history of HTN were the most significant predictors for HTN. Hypertension affected almost one-fifth of the population. Given the poor control in diagnosed hypertensive patients, it is alarming that the current health system in urban areas in Iran is not effective enough to control the epidemic spread of non-communicable diseases.

Pneumococcal pneumonia in adults 60 years or older: Incidence, mortality and prevention.

PubMed

Vila-Corcoles, Angel; Ansa, Xabier; Ochoa-Gondar, Olga; Satue, Eva; de Diego, Cinta; Rodriguez-Blanco, Teresa

2016-03-04

This study investigated the burden (incidence, mortality and serotype distribution) of pneumococcal pneumonia among older adults in the region of Tarragona (Spain). Population-based cohort study involving 27,204 individuals ≥60 years in Tarragonès county (Southern Catalonia), who were prospectively followed between 01/12/2008 and 30/11/2011. Bacteremic and nonbacteremic (positive sputum culture and/or urinary antigen test) pneumococcal pneumonias were recruited. A total of 125 pneumococcal pneumonias (16 bacteremic and 109 nonbacteremic) was observed. Incidence rates (per 1000 person-years) were 0.21 (95% confidence interval [CI]: 0.13-0.35) for bacteremic cases and 1.45 (95% CI: 1.20-1.75) for nonbacteremic cases. Case-fatality rate was 10.4% (12.5% in bacteremic and 10.1% in nonbacteremic cases). Five serotypes (types 3, 6C, 19A, 22F and 35B) were the most common serotypes, accounting for 64.3% of overall isolated serotypes. 73.1% of cases were due to the strains included in the 23-valent vaccine whereas 53.6% were due to the strains included in the 13-valent vaccine. The burden of pneumococcal pneumonia remains considerable (especially among oldest people and nursing-home residents) despite a publicly funded anti-pneumococcal vaccination program operative for several years. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Increasing incidence and importance of HIV/AIDS and gonorrhea among men aged >/= 50 years in the US in the era of erectile dysfunction therapy.

PubMed

Karlovsky, Matthew; Lebed, Brett; Mydlo, Jack H

2004-01-01

With the advent of effective pharmacotherapy for erectile dysfunction, the risk of sexually transmitted diseases is a possible consequence, especially in the older population. We wanted to review the incidence of sexually transmitted diseases in the older population in an attempt to correlate this with the advent of these new drugs. Publicly available information on the incidence of HIV, AIDS and gonorrhea was retrieved from the websites of the Centers for Disease Control (CDC), the State of Florida Department of Health, the Senior HIV Intervention Project and the National Association on HIV Over Fifty. National case incidences of HIV and AIDS in men between 1996 and 2000 were examined for trends. National and Florida state trends were compared and, in Florida, Palm Beach, Broward and Dade counties in particular were selected because of their traditionally large retiree population. In addition, the national and Florida state incidences of gonorrheal infection were examined for trends. Statistics on national sildenafil (Viagra) prescriptions were obtained via a personal communication with a regional healthcare representative from Pfizer. According to the CDC, at the end of 1998 >10% of new AIDS cases nationally were in individuals aged >50 years. In the late 1990s, new AIDS cases rose faster in middle-aged and older adults than in people aged >40 years. Many of the newly diagnosed cases of AIDS may have contracted HIV before the age of 50 years; however, many individuals are newly becoming infected above the age of 50 years. Of the reported AIDS cases in 1996 in individuals aged >/= 50 years, 48% were aged 50-54 years, 26% were aged 55-59 years, 14% were aged 60-64 years and 12% were aged >/= 65 years; 84% of these cases were male, and blacks accounted for the greatest proportion of cases (43%). In the US, 7.5 million prescriptions for sildenafil were written in 1998, 9.5 million in 1999, 12 million in 2000 and 15.5 million in 2001. The age breakdown for these

75 FR 70264 - 60-day Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES [Document Identifier OS-0990-new] 60-day Notice AGENCY: Office of the Secretary, HHS. Agency Information Collection Request, 60-Day Public Comment Request. In... must be directed to the OS Paperwork Clearance Officer at the above e-mail address within 60-days...

75 FR 6033 - Agency Information Collection Request; 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-05

... Initial Telephone Screen........ Active Control 2400 1 20 minutes 800 hours Group (ACG)/ Experimental Group (EG) In-person interview EG 1200 1 1.25 hours 1,500 hours Jump start phone call EG 1200 1 30... care insurance who are age 75 and over using a multi- tiered random experimental research design to...

Study of pruritus vulvae in geriatric age group in tertiary hospital

PubMed Central

Kaur, Jasleen; Kalsy, Jyotika

2017-01-01

Background: According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients. Methods: We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case. Results: Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus. Conclusion: Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance. PMID:28442799

Impact of rotavirus vaccination in Australian children below 5 years of age

PubMed Central

Pendleton, Annmarie; Galic, Maja; Clarke, Christopher; Ng, Su Peing; Ledesma, Emilio; Ramakrishnan, Gunasekaran; Liu, Yanfang

2013-01-01

This study was conducted to assess the impact of administration of two-dose rotavirus (RV) vaccine (RIX4414; GlaxoSmithKline Vaccines) among children aged less than 5 y in three states/territories of Australia. Aggregated and de-identified data on rotavirus gastroenteritis (RVGE) and all-cause gastroenteritis (AGE) from July 1998–June 2009 were obtained from the Australian Institute of Health and Welfare database. The baseline incidence (July 1998–June 2006) of RVGE hospitalizations before RV vaccine introduction in New South Wales (NSW), the Australian Capital Territory (ACT) and the Northern Territory (NT) were 33.75, 42.93 and 288.67 per 10 000 child-years, respectively among children aged 0–11 mo. Following RV vaccine introduction in NSW, the ACT and the NT, incidence of RVGE hospitalizations reduced to 13.06, 17.35 and 47.52 per 10 000 child-years, respectively, during July 2007–June 2008 and 3.87, 8.40 and 122.79 per 10,000 child-years, respectively, during July 2008–June 2009 among children aged 0–11 mo. Reductions in RVGE and AGE were also observed in all children below 5 y of age in NSW and the ACT. Overall reduction in hospitalizations due to RVGE and AGE was observed following RV vaccine introduction into the NIP in Australia. PMID:23733041

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

Lost productive life years caused by chronic conditions in Australians aged 45-64 years, 2010-2030.

PubMed

Schofield, Deborah J; Shrestha, Rupendra N; Cunich, Michelle; Tanton, Robert; Kelly, Simon; Passey, Megan E; Veerman, Lennert J

2015-09-21

To estimate (1) productive life years (PLYs) lost because of chronic conditions in Australians aged 45-64 years from 2010 to 2030, and (2) the impact of this loss on gross domestic product (GDP) over the same period. A microsimulation model, Health&WealthMOD2030, was used to project lost PLYs caused by chronic conditions from 2010 to 2030. The base population consisted of respondents aged 45-64 years to the Australian Bureau of Statistics Survey of Disability, Ageing and Carers 2003 and 2009. The national impact of lost PLYs was assessed with Treasury's GDP equation. Lost PLYs due to chronic disease at 2010, 2015, 2020, 2025 and 2030 (ie, whole life years lost because of chronic disease); the national impact of lost PLYs at the same time points (GDP loss caused by PLYs); the effects of population growth, labour force trends and chronic disease trends on lost PLYs and GDP at each time point. Using Health&WealthMOD2030, we estimated a loss of 347,000 PLYs in 2010; this was projected to increase to 459,000 in 2030 (32.28% increase over 20 years). The leading chronic conditions associated with premature exits from the labour force were back problems, arthritis and mental and behavioural problems. The percentage increase in the number of PLYs lost by those aged 45-64 years was greater than that of population growth for this age group (32.28% v 27.80%). The strongest driver of the increase in lost PLYs was population growth (accounting for 89.18% of the increase), followed by chronic condition trends (8.28%). Our study estimates an increase of 112 000 lost PLYs caused by chronic illness in older workers in Australia between 2010 and 2030, with the most rapid growth projected to occur in men aged 55-59 years and in women aged 60-64 years. The national impact of this lost labour force participation on GDP was estimated to be $37.79 billion in 2010, increasing to $63.73 billion in 2030.

[Study on smoking attributed death and effects of smoking cessation in residents aged 35-79 years in Tianjin, 2016].

PubMed

Li, W; Wang, D Z; Zhang, H; Xu, Z L; Xue, X D; Jiang, G H

2017-11-10

Objective: To analyze the influence of smoking on deaths in residents aged 35-79 years and the effects of smoking cessation in Tianjin. Methods: The data of 39 499 death cases aged 35-79 years in 2016 in Tianjin were collected, the risks for deaths caused by smoking related diseases and excess deaths as well as effects of smoking cessation were analyzed after adjusting 5 year old age group, education level and marital status. Results: Among the 39 499 deaths cases, 1 589 (13.56%) were caused by smoking, the percentage of the excess mortality of lung cancer caused by smoking was highest (47.60%); the risk of death due to lung cancer in smokers was 2.75 times higher than that in non-smokers (95 %CI : 2.47-3.06). Among the female deaths, 183 (7.29%) were caused by smoking, the percentage of the excess mortality of lung cancer was highest (28.90%); and the risk of death of lung cancer in smokers was 4.04 times higher than that in non-smokers (95 %CI : 3.49-4.68). The OR for disease in ex-smokers was 0.80 compared with 1.00 in smokers (95 %CI : 0.72-0.90). The OR in males who had quitted smoking for ≥10 years was lower (0.74, 95 %CI : 0.63-0.86) than that in those who had quitted smoking for 1-9 years (0.85, 95 %CI : 0.74-0.98), but the difference was not significant. Conclusion: Smoking is one of the most important risk factors for deaths in residents in Tianjin. Smoking cessation can benefit people's health.

Predictors of Independent Aging and Survival: A 16-Year Follow-Up Report in Octogenarian Men.

PubMed

Franzon, Kristin; Byberg, Liisa; Sjögren, Per; Zethelius, Björn; Cederholm, Tommy; Kilander, Lena

2017-09-01

To examine the longitudinal associations between aging with preserved functionality, i.e. independent aging and survival, and lifestyle variables, dietary pattern and cardiovascular risk factors. Cohort study. Uppsala Longitudinal Study of Adult Men, Sweden. Swedish men (n = 1,104) at a mean age of 71 (range 69.4-74.1) were investigated, 369 of whom were evaluated for independent aging 16 years later, at a mean age of 87 (range 84.8-88.9). A questionnaire was used to obtain information on lifestyle, including education, living conditions, and physical activity. Adherence to a Mediterranean-like diet was assessed according to a modified Mediterranean Diet Score derived from 7-day food records. Cardiovascular risk factors were measured. Independent aging at a mean age of 87 was defined as lack of diagnosed dementia, a Mini-Mental State Examination score of 25 or greater, not institutionalized, independence in personal activities of daily living, and ability to walk outdoors alone. Complete survival data at age 85 were obtained from the Swedish Cause of Death Register. Fifty-seven percent of the men survived to age 85, and 75% of the participants at a mean age of 87 displayed independent aging. Independent aging was associated with never smoking (vs current) (odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.05-4.60) and high (vs low) adherence to a Mediterranean-like diet (OR = 2.69, 95% CI = 1.14-6.80). Normal weight or overweight and waist circumference of 102 cm or less were also associated with independent aging. Similar associations were observed with survival. Lifestyle factors such as never smoking, maintaining a healthy diet, and not being obese at age 71 were associated with survival and independent aging at age 85 and older in men. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Age-related guideline adherence and outcome in low rectal cancer.

PubMed

Schiphorst, Anandi H W; Verweij, Norbert M; Pronk, Apollo; Hamaker, Marije E

2014-08-01

Care for elderly patients with low rectal cancer can pose dilemmas, because radical total mesorectal excision surgery comes with high morbidity and mortality rates. The purpose of this study was to analyze the treatment of patients with low rectal cancer, comparing treatment choices, guideline adherence, and outcomes for elderly patients (≥75 years) with younger patients (<75 years). Patient data were retrieved from the hospital pathology database and from the hospital prospective colorectal surgery database for surgically treated patients. Records were reviewed for nonadherence to treatment guidelines. Delivered treatment modalities for patients with stage I to III rectal cancer were compared with treatment advised by national guidelines, and reasons stated by the treating physician for nonadherence to guidelines were subsequently collected. This study was performed at a high-volume teaching hospital. Patients included were those with newly diagnosed rectal cancer (≤10 cm from the anal verge). Treatment decisions, guideline adherence, and outcome of surgical treatment were the main outcome parameters. Of 218 included patients, 75 (34%) were aged ≥75 years. Guideline adherence for all of the treatment modalities in stage I to III rectal cancer was significantly lower in elderly patients (62% versus 87% for aged <75 years; p < 0.001), and age was the primary reason mentioned for withholding treatment. Palliative anticancer treatment for stage IV disease was also initiated significantly less frequently in elderly patients (60% versus 97%; p = 0.002). Overall rates of treatment complications were similar for both patient groups (p = 0.71), but the impact of complications on survival was much greater for elderly patients (p = 0.002). Data on outcome of other treatment modalities, such as chemotherapy and radiotherapy, are lacking. Guideline adherence for all of the treatment modalities in stage I to III rectal cancer declines significantly with increasing age

Age 60 study, part III : consolidated database experiments final report.

DOT National Transportation Integrated Search

1994-10-01

This document is one of four products completed as a part of the Age 60 Rule research contract monitored by Pam Della Rocco, Civil Aerospace Medical Institute, Contracting Officer's Technical Representative. This work was performed. This report was a...

Sex-Related and Age-Related Differences in Knee Strength of Basketball Players Ages 11–17 Years

PubMed Central

Vardaxis, Vassilios G.

2003-01-01

Objective: To assess hamstrings and quadriceps strength of basketball players ages 11–13 and 15–17 years. Design and Setting: This cross-sectional study occurred during the 2000 American Youth Basketball Tour National Tournament. We investigated whether sex- or age-related strength differences existed among study participants. Subjects: Forty-one tournament participants (22 girls, 19 boys; 11–13 or 15–17 years old) who reported no history of knee sprain or surgery were recruited. Measurements: We used a Cybex II dynamometer to obtain isokinetic concentric peak torques relative to body mass (Nm/kg) at 60°/s for hamstrings and quadriceps bilaterally. From average peak torques, we determined ipsilateral hamstrings:quadriceps and homologous muscle-group ratios. Results: Correlations between hamstrings and quadriceps strength measures ranged from 0.78 to 0.97. Players 15–17 years old had greater relative hamstrings and quadriceps strength than 11- to 13-year-old athletes. Age and sex interacted significantly for quadriceps strength. The quadriceps strength of 15- to 17-year-old girls did not differ from that of 11- to 13-year-old girls, whereas 15- to 17-year-old boys had stronger quadriceps than 11- to 13-year-old boys. Boys 15–17 years old had greater quadriceps strength than girls 15–17 years old. Conclusions: This study is unique in providing normative data for the hamstrings and quadriceps strength of basketball players 11–13 and 15–17 years old. Age-related strength differences did not occur consistently between the sexes, as girls 11–13 and 15–17 years old had similar relative quadriceps strength. PMID:14608433

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.

The relationship of physical activity (PA) and walking with sarcopenia in Korean males aged 60 years and older using the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV-2, 3), 2008-2009.

PubMed

Kim, Sang-Hwan; Kim, Tae-Ho; Hwang, Hee-Jin

2013-01-01

Although a variety of studies have reported the association between age related changes in muscle mass and the functional impairments of the elderly, few have reported on the modifiable lifestyle factors that are related to sarcopenia. Three thousand five hundred ninety-eight men in nationally representative cross-sectional, population-representative sampled survey using data from the KNHANES IV aged 19 years and older who completed a body composition using a dual energy X-ray absorptiometry (DXA) were measured. To determine whether there are any associations between physical activities, nutritional status and sarcopenia were examined in 1156 men among those over 60 years of age. Appendicular skeletal muscle mass (ASM) was calculated as the sum of skeletal muscle in the arms and legs. Sarcopenia was defined as the ASM/Ht(2) of less than two standard deviations (SD) below the sex-specific normal mean for the younger reference group. The prevalence of sarcopenia in Korean men aged 60 years and older was 9.9%. Sarcopenia was negatively associated with the third quartile (OR=0.40, 95% CI=0.20-0.80) and fourth quartile of PA (OR=0.24, 95% CI=0.11-0.52), and negatively associated with the highest quartile of protein intake (OR=0.32, 95% CI=0.14-0.76). In logistic regression models, sarcopenia was negatively associated with walking PA (OR=0.49, 95% CI=0.29-0.83) after an adjustment for age, smoking habits, alcohol drinking, family income, education status and protein intake. Sarcopenia was associated with PA, especially walking PA. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

75 Years and More in Yorkshire

ERIC Educational Resources Information Center

Wood-Robinson, Valerie

2009-01-01

To celebrate the work of the Association for Science Education (ASE), the Science Masters' Association (SMA) and the Association of Women Science Teachers (AWST) in Yorkshire, the Region Committee invited Edgar Jenkins to write a celebratory history, entitled "75 years and More in Yorkshire". The booklet, locating that work in its wider…

Objective measurements of daily physical activity patterns and sedentary behaviour in older adults: Age, Gene/Environment Susceptibility-Reykjavik Study.

PubMed

Arnardottir, Nanna Yr; Koster, Annemarie; Van Domelen, Dane R; Brychta, Robert J; Caserotti, Paolo; Eiriksdottir, Gudny; Sverrisdottir, Johanna Eyrun; Launer, Lenore J; Gudnason, Vilmundur; Johannsson, Erlingur; Harris, Tamara B; Chen, Kong Y; Sveinsson, Thorarinn

2013-03-01

objectively measured population physical activity (PA) data from older persons is lacking. The aim of this study was to describe free-living PA patterns and sedentary behaviours in Icelandic older men and women using accelerometer. from April 2009 to June 2010, 579 AGESII-study participants aged 73-98 years wore an accelerometer (Actigraph GT3X) at the right hip for one complete week in the free-living settings. in all subjects, sedentary time was the largest component of the total wear time, 75%, followed by low-light PA, 21%. Moderate-vigorous PA (MVPA) was <1%. Men had slightly higher average total PA (counts × day(-1)) than women. The women spent more time in low-light PA but less time in sedentary PA and MVPA compared with men (P < 0.001). In persons <75 years of age, 60% of men and 34% of women had at least one bout ≥10 min of MVPA, which decreased with age, with only 25% of men and 9% of women 85 years and older reaching this. sedentary time is high in this Icelandic cohort, which has high life-expectancy and is living north of 60° northern latitude.

Prevalence and incidence of dementia among 75-80-year-old community-dwelling elderly in different districts of Antwerp, Belgium: the Antwerp Cognition (ANCOG) Study.

PubMed

De Deyn, P P; Goeman, J; Vervaet, A; Dourcy-Belle-Rose, B; Van Dam, D; Geerts, E

2011-11-01

To analyse the prevalence and incidence of dementia in a population of community-dwelling elderly (aged 75-80), living in socio-economically differing districts of Antwerp (Belgium), taking into account possible gender and educational differences. A longitudinal cohort study (N=825) with a 3-year follow-up period (N=363). The Mini Mental State Examination (MMSE) was used as a primary screen of cognitive functioning. Scoring 21 or below led to a second phase examination by a neurologist, including the CAMDEX-R-N and a neurological examination, to provide a tentative aetiological diagnosis of dementia. These procedures were conducted annually during a 3-year follow-up period. In accordance with international literature, the overall prevalence rate of dementia was 8.7%. The cumulative incidence rate (IR) of dementia was 36.60 per 1000Py with annual IRs ranging from 34.39 over 35.16 to 49.04 per 1000Py. Dementia of the Alzheimer type (DAT) was the most occurring prevalent and incident cause. Women appeared to be at higher risk and the occurrence of cognitive deterioration was more prominent in districts with lower socio-economic status, possibly related to a lower education level. We demonstrate dementia is a considerable health problem in an urban Belgian population of community-dwelling elderly aged between 75 and 80 years old. In order to prepare health care and social security systems for the future management of dementia, proper epidemiological insight into the current and future magnitude of the burden of dementia, taking into account socio-economic differences, to which this study contributes, are required. Copyright © 2011 Elsevier B.V. All rights reserved.

Age 60 study, part IV : experimental evaluation of pilot performance.

DOT National Transportation Integrated Search

1994-10-01

This document is one of four products completed as a part of the Age 60 Rule Research Contract monitored by Pam Della Rocco, Civil Aerospace Medical Institute. This report was a deliverable from the research contract with Hilton Systems, Inc. on the ...

Comparison of pharmacological treatment alone vs. treatment combined with implantable cardioverter defibrillator therapy in patients older than 75 years.

PubMed

Cortés, Marcelino; Palfy, Julia Anna; Lopez, Marta; Martínez, Juan; Rivero, Ana Lucia; Devesa, Ana; Franco-Peláez, Juan Antonio; Briongos, Sem; Taibo-Urquia, Mikel; Benezet, Juan; Rubio, Jose-Manuel

2018-06-24

Implantable cardioverter defibrillator (ICD) reduces mortality in selected patients. However, its role in patients older than 75 years is not well established. We performed a retrospective, non-randomized study using a historical cohort from a single centre. Between January 2008 and July 2014, we assessed patients aged ≥75 years with left ventricular ejection fraction ≤ 35%, identifying 385 patients with a Class I or IIa recommendation for ICD implantation. At the decision of the patient or attending cardiologists, 92 patients received an ICD. To avoid potential confounding factors, we used propensity-score matching. Finally, 126 patients were included (63 with ICD). The mean age was 79.1 ± 3.1 years (86.5% male). As compared with the medical therapy group, the ICD patients had a lower percentage of chronic obstructive pulmonary disease (19.0% vs. 38.1%, P < 0.05) and more frequent use of beta-blockers (BBs) (85.7 vs. 70.0%, P < 0.05). Other treatments were otherwise similar in both groups. There were no differences related to age, aetiology, or other co-morbidities. During follow-up (39.2 ± 22.4 months), total mortality was 46.0% and cardiovascular events (death or hospitalization) occurred in 66.7% of the patients. A multivariate analysis revealed that only BB therapy was shown to be an independent protective variable with respect to mortality [hazard ratio 0.4 (0.2-0.7)]. ICD therapy did not reduce overall mortality or the rate of cardiovascular events. According to our results, the use of ICD, as compared with medical therapy, in patients older than 75 years did not demonstrate any benefit. Well-designed randomized controlled studies in patients older than 75 years are needed to ascertain the value of ICD therapy. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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

Economic Burden of Herpes Zoster and Post-Herpetic Neuralgia in Adults 60 Years of Age or Older: Results from a Prospective, Physician Practice-Based Cohort Study in Kushiro, Japan.

PubMed

Nakamura, Hiroyuki; Mizukami, Akiko; Adachi, Koichi; Matthews, Sean; Holl, Katsiaryna; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Sato, Keiko; Matsuki, Taizo; Kaise, Toshihiko; Curran, Desmond

2017-12-01

Herpes zoster has a high incidence rate among people aged ≥ 60 years and can lead to serious complications such as post-herpetic neuralgia. There are currently no data on the economic burden of herpes zoster and post-herpetic neuralgia in Japan, and the objective of this study was to address this gap. A total of 412 patients aged ≥ 60 years diagnosed with herpes zoster were recruited. Demographic, clinical, and healthcare resource utilization data on patients with herpes zoster or post-herpetic neuralgia collected via case report forms were used to estimate direct medical cost. Data obtained from a questionnaire survey among patients with herpes zoster/post-herpetic neuralgia were used to estimate transportation cost and productivity loss. The mean number of outpatient visits was 5.7. Prescription medications were the main cost driver accounting for 60% of the direct medical cost. The mean direct medical and total herpes zoster-related costs per patient were ¥43,925 and ¥57,112, respectively, and were higher in patients with post-herpetic neuralgia than in those with herpes zoster without complications. Direct medical cost represented 77%, productivity loss 19%, and transportation cost 4% of the total. This is the first study of the economic burden of herpes zoster and post-herpetic neuralgia in Japan and it demonstrated substantial direct medical cost as a result of the multiple outpatient visits and prescription medications required. These findings provide baseline data for possible future economic evaluations of new herpes zoster/post-herpetic neuralgia interventions. This cost analysis is part of a prospective, physician practice-based cohort study conducted between June 2013 and February 2015 in Kushiro, Japan (Clinicaltrials.gov identifier NCT01873365, registered on 6 June, 2013).

Mini-laparoscopic cholecystectomy in children under 10 years of age with sickle cell disease.

PubMed

Seleem, Mohamed I; Al-Hashemy, Ahmed M; Meshref, Sahar S

2005-07-01

Cholelithiasis is very common in patients with sickle cell disease (SCD) and is responsible for recurrent attacks of abdominal pain. The ideal management, especially for children, remains controversial. The purpose of the present study was to evaluate the safety and outcome of mini-laparoscopic cholecystectomy (MLC) in young children under age of 10 years with SCD. A prospective study was carried out of 75 children with SCD under 10 years of age with recurrent abdominal pains seen between August 2001 and March 2004 at Armed Forces Hospital, Khamis Mushayt, Saudi Arabia, who were screened for cholelithiasis. Twelve (16%) of the 75 children were found to have gallstones. The mean age was 7.8 years (range 4-9 years). All 12 children underwent MLC. Anaemia was corrected preoperatively in all the patients. Operative time, intraoperative complications, hospital stay, and postoperative recurrent abdominal pain were recorded. The mean operating time was 46.5 min (range: 35-65 min). Intraoperative cholangiogram failed in two children due to narrow cystic ducts. The mean hospital stay was 2.1 days (range: 2-4 days). No patient required intra-abdominal drain. The mean follow-up period was 13.4 months (range: 4-24 months). The only postoperative complication was deep jaundice 1 month postoperatively due to cholestasis, and this responded to medical treatment. None of the children had recurrent abdominal pain after MLC. Mini-laparoscopic cholecystectomy is a safe surgical procedure for the management of cholelithiasis in children with SCD and leads to improvement in the quality of life by decreasing the frequency of recurrent abdominal pain.

Frontline brentuximab vedotin in combination with dacarbazine or bendamustine in patients aged ≥60 years with HL.

PubMed

Friedberg, Jonathan W; Forero-Torres, Andres; Bordoni, Rodolfo E; Cline, Vivian J M; Patel Donnelly, Dipti; Flynn, Patrick J; Olsen, Gregg; Chen, Robert; Fong, Abraham; Wang, Yinghui; Yasenchak, Christopher A

2017-12-28

Patients aged ≥60 years with treatment-naive Hodgkin lymphoma (HL) have few treatment options and inferior survival due to treatment-related toxicities and comorbidities. This phase 2, nonrandomized, open-label study evaluated brentuximab vedotin (BV) monotherapy (results previously reported), BV plus dacarbazine (DTIC), and BV plus bendamustine. Patients had classical HL and were ineligible for or declined frontline chemotherapy. Twenty-two patients received 1.8 mg/kg BV and 375 mg/m 2 DTIC for up to 12 cycles, and 20 more patients received 1.8 mg/kg BV plus 90 or 70 mg/m 2 bendamustine for up to 6 cycles (dose reduced due to toxicity). Subsequent BV monotherapy was allowed. Approximately 30 patients were to receive BV plus bendamustine; however, the incidence of serious adverse events (65%) and 2 deaths on study led to discontinuation of bendamustine and cessation of enrollment. Most patients had stage III/IV disease, and approximately half had ≥3 comorbidities or were impaired in ≥1 aspect that significantly interfered with quality of life. For BV plus DTIC, the objective response rate (ORR) was 100% and the complete remission (CR) rate was 62%. To date, the median progression-free survival (PFS) is 17.9 months. For BV plus bendamustine, the ORR was 100% and the CR rate was 88%. Neither the median PFS nor overall survival was reached. For elderly patients with HL, BV plus DTIC may be a frontline option based on tolerability and response duration. Despite activity, BV plus bendamustine is not a tolerable regimen in these patients. This trial was registered at www.clinicaltrials.gov as #NCT01716806. © 2017 by The American Society of Hematology.

Prevalence and Risk Factors for Vitamin C Deficiency in North and South India: A Two Centre Population Based Study in People Aged 60 Years and Over

PubMed Central

Ravindran, Ravilla D.; Vashist, Praveen; K. Gupta, Sanjeev; S. Young, Ian; Maraini, Giovanni; Camparini, Monica; Jayanthi, R.; John, Neena; Fitzpatrick, Kathryn E.; Chakravarthy, Usha; Ravilla, Thulasiraj D.; Fletcher, Astrid E.

2011-01-01

Background Studies from the UK and North America have reported vitamin C deficiency in around 1 in 5 men and 1 in 9 women in low income groups. There are few data on vitamin C deficiency in resource poor countries. Objectives To investigate the prevalence of vitamin C deficiency in India. Design We carried out a population-based cross-sectional survey in two areas of north and south India. Randomly sampled clusters were enumerated to identify people aged 60 and over. Participants (75% response rate) were interviewed for tobacco, alcohol, cooking fuel use, 24 hour diet recall and underwent anthropometry and blood collection. Vitamin C was measured using an enzyme-based assay in plasma stabilized with metaphosphoric acid. We categorised vitamin C status as deficient (<11 µmol/L), sub-optimal (11–28 µmol/L) and adequate (>28 µmol/L). We investigated factors associated with vitamin C deficiency using multivariable Poisson regression. Results The age, sex and season standardized prevalence of vitamin C deficiency was 73.9% (95% confidence Interval, CI 70.4,77.5) in 2668 people in north India and 45.7% (95% CI 42.5,48.9) in 2970 from south India. Only 10.8% in the north and 25.9% in the south met the criteria for adequate levels. Vitamin C deficiency varied by season, and was more prevalent in men, with increasing age, users of tobacco and biomass fuels, in those with anthropometric indicators of poor nutrition and with lower intakes of dietary vitamin C. Conclusions In poor communities, such as in our study, consideration needs to be given to measures to improve the consumption of vitamin C rich foods and to discourage the use of tobacco. PMID:22163038

23 CFR 1200.60 - Fiscal year 2013 Section 402 grants.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Fiscal year 2013 Section 402 grants. 1200.60 Section 1200.60 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURES FOR STATE HIGHWAY SAFETY PROGRAMS UNIFORM PROCEDURES FOR STATE HIGHWAY SAFETY GRANT PROGRAMS Special Provisions...

23 CFR 1200.60 - Fiscal year 2013 Section 402 grants.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Fiscal year 2013 Section 402 grants. 1200.60 Section 1200.60 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURES FOR STATE HIGHWAY SAFETY PROGRAMS UNIFORM PROCEDURES FOR STATE HIGHWAY SAFETY GRANT PROGRAMS Special Provisions...

75 FR 19976 - Agency Information Collection Request; 30-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

...) hours Initial Telephone Screen...... Experimental 240 1 20/60 80 Group. In-person interview 240 1 80/60... Telephone Screen...... Active Control 240 1 20/60 80 Group. Quarterly phone calls......... 240 4 10/60 160... private long-term care insurance who are age 75 and over using a multi- tiered random experimental...

Is definitive concurrent chemoradiotherapy effective for locally advanced head and neck cancer in the elderly aged ≥ 75 years: A single-institute, retrospective, cohort study.

PubMed

Lai, Kuan-Ming; Lin, Jen-Tsun; Lu, Hsueh-Ju; Liang, Chia-Chun; Chen, Mu-Kuan

2018-06-01

Definitive chemoradiotherapy (CRT) is the standard treatment for locally advanced head and neck cancer (HNC). However, for very elderly patients, the comparison of benefit/risk between definitive radiotherapy (RT) with and without systemic chemotherapy was equivocal. The study was a single-institute, retrospective, cohort study. Seventy patients aged ≥75 years who had a locally advanced HNC were enrolled. The patients were divided into those with CRT and those with RT alone. Survival, compliance/adverse events and independent prognostic factors were analyzed. For baseline characteristics, the patients who received RT alone had worse performance status, comorbidity score and neutrophil-to-lymphocyte ratio. However, during definitive therapy, the CRT group had more adverse events such as neutropenia, febrile neutropenia and thrombocytopenia. There were no significant differences in disease-specific survival (DSS) and overall survival (OS) (P = 0.864 and 0.788, respectively). As to OS, several independent prognostic factors were identified. Performance status (hazard ratio [HR], 2.312; confidence interval [CI], 1.176-4.546; P = 0.015), clinical T staging (HR, 2.240; 95% CI, 1.021-4.913; P = 0.004) and total RT dose (HR, 2.555; 95% CI, 1.246-5.238; P = 0.010) were independent prognostic factors of OS. Definitive RT with or without systemic chemotherapy did not significantly influence DSS and OS for very elderly patients. Therefore, for elderly patients aged ≥ 75 years who have HNC, conservative RT might be sufficient for treatment purposes. © 2017 John Wiley & Sons Australia, Ltd.

Assessment of perception of morphed facial expressions using the Emotion Recognition Task: normative data from healthy participants aged 8-75.

PubMed

Kessels, Roy P C; Montagne, Barbara; Hendriks, Angelique W; Perrett, David I; de Haan, Edward H F

2014-03-01

The ability to recognize and label emotional facial expressions is an important aspect of social cognition. However, existing paradigms to examine this ability present only static facial expressions, suffer from ceiling effects or have limited or no norms. A computerized test, the Emotion Recognition Task (ERT), was developed to overcome these difficulties. In this study, we examined the effects of age, sex, and intellectual ability on emotion perception using the ERT. In this test, emotional facial expressions are presented as morphs gradually expressing one of the six basic emotions from neutral to four levels of intensity (40%, 60%, 80%, and 100%). The task was administered in 373 healthy participants aged 8-75. In children aged 8-17, only small developmental effects were found for the emotions anger and happiness, in contrast to adults who showed age-related decline on anger, fear, happiness, and sadness. Sex differences were present predominantly in the adult participants. IQ only minimally affected the perception of disgust in the children, while years of education were correlated with all emotions but surprise and disgust in the adult participants. A regression-based approach was adopted to present age- and education- or IQ-adjusted normative data for use in clinical practice. Previous studies using the ERT have demonstrated selective impairments on specific emotions in a variety of psychiatric, neurologic, or neurodegenerative patient groups, making the ERT a valuable addition to existing paradigms for the assessment of emotion perception. © 2013 The British Psychological Society.

Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight.

PubMed

Schousboe, J T; Gourlay, M; Fink, H A; Taylor, B C; Orwoll, E S; Barrett-Connor, E; Melton, L J; Cummings, S R; Ensrud, K E

2013-01-01

We used a microsimulation model to estimate the threshold body weights at which screening bone densitometry is cost-effective. Among women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to identify those for whom bone densitometry is cost-effective. Bone densitometry may be more cost-effective for those with lower body weight since the prevalence of osteoporosis is higher for those with low body weight. Our purpose was to estimate weight thresholds below which bone densitometry is cost-effective for women and men without a prior clinical fracture at ages 55, 60, 65, 75, and 80 years. We used a microsimulation model to estimate the costs and health benefits of bone densitometry and 5 years of fracture prevention therapy for those without prior fracture but with femoral neck osteoporosis (T-score ≤ -2.5) and a 10-year hip fracture risk of ≥3%. Threshold pre-test probabilities of low BMD warranting drug therapy at which bone densitometry is cost-effective were calculated. Corresponding body weight thresholds were estimated using data from the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men (MrOS) study, and the National Health and Nutrition Examination Survey (NHANES) for 2005-2006. Assuming a willingness to pay of $75,000 per quality adjusted life year (QALY) and drug cost of $500/year, body weight thresholds below which bone densitometry is cost-effective for those without a prior fracture were 74, 90, and 100 kg, respectively, for women aged 55, 65, and 80 years; and were 67, 101, and 108 kg, respectively, for men aged 55, 75, and 80 years. For women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to select those for whom bone densitometry is cost-effective.

Handwriting in healthy people aged 65 years and over.

PubMed

van Drempt, Nadege; McCluskey, Annie; Lannin, Natasha A

2011-08-01

Handwriting is an important activity that is commonly affected by neurological and orthopaedic conditions. Handwriting research has predominantly involved children. Little is known about handwriting behaviour in healthy older adults. This study aims to describe the handwriting practices of 30 unimpaired adults aged 65 years and over. In this cross-sectional observational study, data were collected from 30 older adults using a self-report questionnaire, digital pen recordings over three days and a handwriting log. Data were analysed using descriptive statistics. The mean age of participants was 75.1 years (standard deviation=6.9). Variations in handwriting were evident in letter size, slant and spacing. Participants wrote very little--a median of 18 words per occasion (interquartile range=10.5-26.9 words). Most handwriting involved self-generated text (85%), not copied or transcribed text. Participants stood while writing for 17% of handwriting occasions. The most common reasons for handwriting were note taking (23%) and puzzles (22%). Legibility may not depend exclusively on the handwriting script that a beginning writer is taught, but may be a result of other factors as the person ages. A comprehensive adult handwriting assessment and retraining programme should be relevant to older adults, including common handwriting activities, involving self-generated text and few words. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

Routine implantation of cardioverter/defibrillator devices in patients aged 75 years and older with prior myocardial infarction and left ventricular ejection fraction < 30: antagonist viewpoint.

PubMed

Basta, Lofty L

2003-01-01

The Multicenter Automatic Defibrillator Implantation Trial (MADIT II) investigators assert that their results justify the placement of artificial implantable defibrillator cardioverter devices in patients aged 75 years and older with prior myocardial infarction and left ventricular dysfunction (ejection fraction of 30 or less). The authors claim that the results of the trial do not justify this conclusion. The majority of patients were male (84%) and aged 64+/-10 years. Also, 2.8% of patients assigned to the defibrillator group and 1.5% had their device removed. Of the latter subgroup, nine patients (1.3%) received a heart transplant. Twelve had their artificial implantable defibrillator cardioverter device deactivated mostly because of terminal illness. Although the study results show a significant reduction in mortality over the control group (absolute reduction=5.6%), almost the same percentage required hospitalization because of manifestation of congestive heart failure (absolute value 5%; p=0.09). Also, 1.8% had lead problems, 0.7% had infections, and the benefits were only seen after the first year. Caution is needed before the results of this study are applied to a much older cohort comprised mainly of women in whom heart transplant is contraindicated and who have multiple health problems, including cognitive impairment. Artificial implantable cardioverter/defibrillator devices are expensive and this study's results need to be duplicated in other comparable cohorts.

A history of alcohol dependence augments HIV-associated neurocognitive deficits in persons aged 60 and older.

PubMed

Gongvatana, Assawin; Morgan, Erin E; Iudicello, Jennifer E; Letendre, Scott L; Grant, Igor; Woods, Steven Paul

2014-10-01

Excessive alcohol use is common among people living with HIV. Given the growing prevalence of older HIV+ adults and observations indicating higher risk for neurocognitive impairment in older adults with either HIV infection or alcoholism, an increased understanding of their combined impact in the context of this increasingly aged population is crucial. We conducted comprehensive neurocognitive assessment in 112 older HIV+ individuals aged 50 to 69 years. Regression analyses were conducted to examine the interaction between age and the presence of lifetime alcohol dependence on neurocognitive measures, controlling for years of education, hepatitis C serostatus, and lifetime non-alcohol substance use disorder. Significant interactions of age and alcohol dependence history were found for global neurocognitive function, which was driven by the domains of executive function, processing speed, and semantic memory. Follow-up analyses indicated adverse effects of alcohol use history on neurocognitive measures that were evident only in HIV+ individuals 60 years and older. While mounting evidence in younger cohorts indicates adverse synergistic HIV/alcohol effects on neurocognitive function, our novel preliminary findings in this elderly HIV+ cohort demonstrated the importance of even a relatively distant alcohol use history on the expression of HIV-associated neurocognitive disorders that may not become apparent until much later in life.

The relationship of age, anxiety, and serum immunoglobulins with crystallized and fluid intelligence.

PubMed

Cohen, D; Eisdorfer, C; Vitaliano, P P; Bloom, V

1980-10-01

Serum immunoglobulin concentrations (IgG, IgA, and IgM), cognitive performance (crystallized and fluid intelligence), and self-reports of anxiety were evaluated in 24 men and women 60-75 years, and 50 men and women, 30-45 years. Trait anxiety was an important factor relating to performance differences between the young and old on crystallized and fluid subtests. IgM was inversely related to performance in the older age groups. Anxiety was not related to serum immunoglobulin levels.

Age 60 study, part II : airline pilot age and performance - a review of the scientific literature.

DOT National Transportation Integrated Search

1994-10-01

This review of the literature establishes the scientific foundation for subsequent studies on the Age 60 Rule research conducted under a contract with Hilton Systems, Inc. The scientific literature relevant to the two separate scientific approaches r...

Fetal growth restriction: relation to growth and obesity at the age of 9 years.

PubMed

Chakraborty, Supratik; Joseph, Desaline Veronica; Bankart, Michael John Gordon; Petersen, Stewart A; Wailoo, Michael P

2007-11-01

To assess growth patterns of 9-year-old children, some of whom had intrauterine growth restriction (IUGR). 75 9-year-old children (41 were IUGR infants) were weighed and measured at birth, at 1 year, at 2 years and at 9 years of age. Using general linear models for continuous data, changes in weight z scores were used to quantify growth rate between birth and 9 years of age. IUGR children were smaller at birth (weight z score -2.1 v 0.2 in normal children; p<0.001) but showed a greater increase in their weight between birth and 9 years (change of weight z score 1.5 v 0.4 in normal children; p = 0.001). At the age of 9 years the weight, height and body mass index (BMI) z scores were lower in IUGR children than the control children (weight z score -0.4 v 0.6, respectively; p<0.001, height z score -0.5 v 0, respectively; p = 0.002, BMI z score -0.2 v 0.7, respectively; p = 0.002). The predictors of these differences were IUGR, birth weight and maternal and paternal heights. IUGR infants grow faster but remain shorter and lighter than their normal counterparts-that is, they fail to fully catch up by 9 years of age.

Malnutrition at Age 3 Years and Externalizing Behavior Problems at Ages 8, 11, and 17 Years

PubMed Central

Liu, Jianghong; Raine, Adrian; Venables, Peter H.; Mednick, Sarnoff A.

2006-01-01

Objective Poor nutrition is thought to predispose to externalizing behavior problems, but to date there appear to have been no prospective longitudinal studies testing this hypothesis. This study assessed whether 1) poor nutrition at age 3 years predisposes to antisocial behavior at ages 8, 11, and 17 years, 2) such relationships are independent of psychosocial adversity, and 3) IQ mediates the relationship between nutrition and externalizing behavior problems. Method The participants were drawn from a birth cohort (N=1,795) in whom signs of malnutrition were assessed at age 3 years, cognitive measures were assessed at ages 3 and 11 years, and antisocial, aggressive, and hyperactive behavior was assessed at ages 8, 11, and 17 years. Results In relation to comparison subjects (N=1,206), the children with malnutrition signs at age 3 years (N=353) were more aggressive or hyperactive at age 8 years, had more externalizing problems at age 11, and had greater conduct disorder and excessive motor activity at age 17. The results were independent of psychosocial adversity and were not moderated by gender. There was a dose-response relationship between degree of malnutrition and degree of externalizing behavior at ages 8 and 17. Low IQ mediated the link between malnutrition and externalizing behavior at ages 8 and 11. Conclusions These results indicate that malnutrition predisposes to neurocognitive deficits, which in turn predispose to persistent externalizing behavior problems throughout childhood and adolescence. The findings suggest that reducing early malnutrition may help reduce later antisocial and aggressive behavior. PMID:15514400

Will I be able to do my work at 60? An analysis of working conditions that hinder active ageing.

PubMed

Barros, Carla; Carnide, Filomena; Cunha, Liliana; Santos, Marta; Silva, Catarina

2015-01-01

Most developed countries have considered population ageing as one of the economic challenges that need to be overcome. Managing ageing has led to consideration of a number of policies where it is essential to increase the employment rate for older workers. This study aims to analyze the working conditions which tend to be perceived as hindering continuity in the workplace at the age of 60. 1234 workers from different sectors and socio-professional categories (52% men and 48% women; 64.5% younger than 45 years old). A quantitative overview was adopted with the use of logistic regression models. The INSAT was used (Work and Health Questionnaire). Apart from factors of great physical constraint, other less visible aspects play a role in the idea of workers not being able to continue to work by the age of 60, namely factors linked to work organizational options and relationships with others. Working conditions have a great influence in the idea of inability to perform the same type of work at 60. This notion does not only apply to older workers. In fact, even younger workers under certain working conditions hold the same view, thus raising social concerns that should be taken into account by public policies.

Efficacy and safety of enzalutamide in patients 75 years or older with chemotherapy-naive metastatic castration-resistant prostate cancer: results from PREVAIL.

PubMed

Graff, J N; Baciarello, G; Armstrong, A J; Higano, C S; Iversen, P; Flaig, T W; Forer, D; Parli, T; Phung, D; Tombal, B; Beer, T M; Sternberg, C N

2016-02-01

Prostate cancer disproportionately affects older men. Because age affects treatment decisions, it is important to understand the efficacy and tolerability of therapies for advanced prostate cancer in elderly men. This analysis describes efficacy and safety outcomes in men aged ≥75 years who received enzalutamide, an androgen receptor inhibitor, in the phase III PREVAIL trial. PREVAIL was a randomised, double-blind, multinational study of oral enzalutamide 160 mg/day (N = 872) versus placebo (N = 845) in chemotherapy-naive men with metastatic castration-resistant prostate cancer. Overall survival (OS) and radiographic progression-free survival (rPFS) were coprimary end points. Subgroup analysis of men aged ≥75 years (elderly) and men aged <75 years was pre-specified for the coprimary end points and adverse events (AEs). Among 609 elderly patients (35%) who participated in PREVAIL, median treatment duration was 16.6 and 5.0 months in the enzalutamide and placebo arms, respectively. In the elderly subgroup, OS was greater with enzalutamide than with placebo [32.4 months (95% confidence interval (CI) 27.7-not yet reached] versus 25.1 months (95% CI 22.6-28.0); hazard ratio (HR) = 0.61 (95% CI 0.47-0.79); P = 0.0001], as was rPFS [not yet reached (95% CI 12.3-not yet reached) versus 3.7 months (95% CI 3.6-5.3); HR = 0.17 (95% CI 0.12-0.24); P < 0.0001]. Irrespective of treatment assignment, incidence of AEs was similar between the two age groups, except for an overall higher incidence of falls among elderly patients than younger patients [84/609 (13.8%) versus 62/1106 (5.6%)] and among elderly patients receiving enzalutamide than those receiving placebo [61/317 (19.2%) versus 23/292 (7.9%)]. Elderly men benefited from treatment with enzalutamide in terms of OS and rPFS. Enzalutamide was well tolerated in the elderly subgroup and those aged <75 years. Age and enzalutamide treatment were associated with a higher incidence of falls. NCT01212991, ClinicalTrials.gov. �

Salivary Parameters (Salivary Flow, pH and Buffering Capacity) in Stimulated Saliva of Mexican Elders 60 Years Old and Older.

PubMed

Islas-Granillo, H; Borges-Yañez, S A; Medina-Solís, C E; Galan-Vidal, C A; Navarrete-Hernández, J J; Escoffié-Ramirez, M; Maupomé, G

2014-12-01

To compare a limited array of chewing-stimulated saliva features (salivary flow, pH and buffer capacity) in a sample of elderly Mexicans with clinical, sociodemographic and socio-economic variables. A cross-sectional study was carried out in 139 adults, 60 years old and older, from two retirement homes and a senior day care centre in the city of Pachuca, Mexico. Sociodemographic, socio-economic and behavioural variables were collected through a questionnaire. A trained and standardized examiner obtained the oral clinical variables. Chewing-stimulated saliva (paraffin method) was collected and the salivary flow rate, pH and buffer capacity were measured. The analysis was performed using non-parametric tests in Stata 9.0. Mean age was 79.1 ± 9.8 years. Most of the subjects included were women (69.1%). Mean chewing-stimulated salivary flow was 0.75 ± 0.80 mL/minute, and the pH and buffer capacity were 7.88 ± 0.83 and 4.20 ± 1.24, respectively. Mean chewing-stimulated salivary flow varied (p < 0.05) across type of retirement home, tooth brushing frequency, number of missing teeth and use of dental prostheses. pH varied across the type of retirement home (p < 0.05) and marginally by age (p = 0.087); buffer capacity (p < 0.05) varied across type of retirement home, tobacco consumption and the number of missing teeth. These exploratory data add to the body of knowledge with regard to chewing-stimulated salivary features (salivary flow rate, pH and buffer capacity) and outline the variability of those features across selected sociodemographic, socio-economic and behavioural variables in a group of Mexican elders.

Efficacy and Safety of Canagliflozin in Individuals Aged 75 and Older with Type 2 Diabetes Mellitus: A Pooled Analysis.

PubMed

Sinclair, Alan J; Bode, Bruce; Harris, Stewart; Vijapurkar, Ujjwala; Shaw, Wayne; Desai, Mehul; Meininger, Gary

2016-03-01

To compare the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 inhibitor developed to treat type 2 diabetes mellitus (T2DM), in individuals younger than 75 and those aged 75 and older. Randomized Phase 3 studies. International study centers. Adults with T2DM. Changes from baseline in glycosylated hemoglobin (HbA1c ), fasting plasma glucose (FPG), blood pressure (BP), and body weight were measured. Efficacy was evaluated using pooled data from six randomized, double-blind, placebo-controlled studies (N = 4,158; n = 3,975 aged <75, n = 183 aged ≥75). Safety was assessed based on adverse event (AE) reports from eight randomized, double-blind, placebo- and active-controlled studies (N = 9,439; n = 8,949 aged <75, n = 490 aged ≥75). Canagliflozin 100 and 300 mg were associated with placebo-subtracted mean reductions in HbA1c in participants younger than 75 (-0.69% and -0.85%, respectively) and aged 75 and older (-0.65% and -0.55%, respectively). Dose-related reductions in FPG, body weight, and BP were seen with canagliflozin 100 and 300 mg in participants in both age groups. Overall AE incidence was 67.1% with canagliflozin 100 mg, 68.6% with canagliflozin 300 mg, and 65.9% with non-canagliflozin (pooled group of comparators in all studies) in participants younger than 75, and 72.4%, 79.1%, and 72.3%, respectively, in those aged 75 and older, with a similar safety profile in both groups. The incidence of volume depletion-related AEs was 2.2%, 3.1%, and 1.4% in participants younger than 75 with canagliflozin 100 and 300 mg and non-canagliflozin, respectively, and 4.9%, 8.7%, and 2.6%, respectively, in those aged 75 and older. Canagliflozin improved glycemic control, body weight, and BP in participants aged 75 and older. The overall incidence of AEs was high across treatment groups in participants aged 75 and older and higher than in those younger than 75. The safety profile of canagliflozin was generally similar in both age

Increased Neural Activation during Picture Encoding and Retrieval in 60-Year-Olds Compared to 20-Year-Olds

ERIC Educational Resources Information Center

Burgmans, S.; van Boxtel, M. P. J.; Vuurman, E. F. P. M.; Evers, E. A. T.; Jolles, J.

2010-01-01

Brain aging has been associated with both reduced and increased neural activity during task execution. The purpose of the present study was to investigate whether increased neural activation during memory encoding and retrieval is already present at the age of 60 as well as to obtain more insight into the mechanism behind increased activity.…

Malnutrition at age 3 years and lower cognitive ability at age 11 years: independence from psychosocial adversity.

PubMed

Liu, Jianghong; Raine, Adrian; Venables, Peter H; Dalais, Cyril; Mednick, Sarnoff A

2003-06-01

Early malnutrition is linked to poor cognition, but long-term effects have not been extensively examined and psychosocial confounds have not always been controlled. To test the hypothesis that malnutrition at age 3 years will be associated with poorer cognitive ability at age 11 years independent of psychosocial confounds. A prospective, longitudinal study of a birth cohort of 1559 children originally assessed at age 3 years for malnutrition (low hemoglobin level, angular stomatitis, kwashiorkor, and sparse, thin hair) and followed up to age 11 years. A community sample of 1559 children (51.4% boys and 48.6% girls) born between September 1, 1969, and August 31, 1970, in 2 towns in the island of Mauritius, with 68.7% Indians and 25.7% Creoles (African origin). Verbal and spatial ability measured at ages 3 and 11 years and reading, scholastic ability, and neuropsychologic performance measured at age 11 years. Malnourished children had poorer cognition at both ages. Deficits were stable across time, applied to all sex and ethnic groups, and remained after controlling for multiple measures of psychosocial adversity. Children with 3 indicators of malnutrition had a 15.3-point deficit in IQ at age 11 years. Malnutrition at age 3 years is associated with poor cognition at age 11 years independent of psychosocial adversity. Promoting early childhood nutrition could enhance long-term cognitive development and school performance, especially in children with multiple nutritional deficits.

An 11-year review of levetiracetam ingestions in children less than 6 years of age.

PubMed

Lewis, J C; Albertson, T E; Walsh, M J

2014-11-01

Levetiracetam is a new anticonvulsant, which works to block high-voltage-activated Ca(++) channels in children, for partial-onset seizures. Reports of clinical experience with pediatric ingestions are minimal. The purpose of this study was to characterize the toxicity of accidental levetiracetam exposures in children less than 6 years of age. This was an 11-year retrospective observational case series of pediatric (< 6 years old) levetiracetam ingestions reported to a Poison Control System from 2002 to 2013. Case narratives were individually reviewed to collect desired information on exposure and clinical course. Inclusion criteria were levetiracetam as a single ingested medication, age less than 6 years, treatment in a health care facility, and followed to a known outcome. Eighty-two cases met inclusion criteria with 55% female patients and overall median age of 2.0 years (range: 1-60 months). The levetiracetam dose ingested was reported in 69 (84.1%) cases, with exact dose (median dose, 45.0 mg/kg; range, 10.5-1429 mg/kg) reported in 33 cases (40.2%). Of these, twenty-nine cases (88%) involved the oral solution formulation and 28 cases (85%) had unintentional therapeutic error as the cause of the exposure. No dose-response relationship was demonstrated; however, the odds of a levetiracetam-naive patient, (median dose, 26.9 mg/kg; N = 15) with an unintentional exposure, developing drowsiness or ataxia was 6 times that of a patient who was not naïve to levetiracetam (median dose, 70.1 mg/kg; N = 20) (Odds ratio [OR], 6.0; 95% confidence interval [CI], 1.03-35.91).Of the 82 cases, 17 (20.7%) developed untoward clinical effects of drowsiness and/or ataxia. Eighty patients (97.6%) were treated and discharged from the emergency department, and two patients (2.4%) were admitted. The two patients admitted included a two-month old who was accidentally given a dose 10 times that of her usual dose and a 3-year old who was lethargic on arrival to the hospital after

Factors influencing the echocardiographic estimate of right ventricular systolic pressure in normal patients and clinically relevant ranges according to age.

PubMed

Armstrong, David W J; Tsimiklis, Georgios; Matangi, Murray F

2010-02-01

Previous studies have shown that in the absence of underlying cardiac pathology, the echocardiographic estimate of right ventricular systolic pressure (RVSP) increases progressively and normally with age. There are limited data in patients older than 60 years of age. To define the ranges of RVSP according to age and to include more elderly patients than have previously been reported. All patients undergoing echocardiography since May 26, 1999, at the Kingston Heart Clinic (Kingston, Ontario) have had their data entered into a locally designed cardiology database (CARDIOfile; Registered trademark, Kingston Heart Clinic). RVSP was calculated from the peak tricuspid regurgitant jet velocity (V) using the modified Bernoulli equation (RVSP = 4V2 + RAP), with the mean right atrial pressure (RAP) estimated to be 10 mmHg. Of the 22,628 patients who had undergone echocardiography, 10,905 had RVSP measured. All abnormal echocardiograms were excluded, leaving 1559 echocardiograms for analysis. Patient age ranged from 15 to 93 years. The mean age was 49 years. RVSP increased significantly only after the age of 50 years. The mean (+/- SD) RVSP for those younger than 50 years, 50 to 75 years, and older than 75 years of age was 27.3+/-5.7 mmHg, 30.2+/-7.6 mmHg and 34.8+/-8.7 mmHg, respectively (P<0.0001 among all age groups). The normal range (95% CI) of RVSP in those younger than 50 years, 50 to 75 years, and older than 75 years of age was 16 mmHg to 39 mmHg, 15 mmHg to 45 mmHg, and 17 mmHg to 52 mmHg, respectively. Multivariate analysis indicated that age, mitral diastolic early-to-late filling velocity ratio, ejection fraction, aortic size and early mitral filling velocity/ early diastolic mitral annular velocity were the only significant independent variables. There were significant changes in diastolic function with increasing age, which may have been responsible for the changes in RVSP. RVSP remains stable in both men and women until the age of 50 years. Thereafter, RVSP

An Age-Calibrated Definition of Chronic Kidney Disease: Rationale and Benefits

PubMed Central

Delanaye, Pierre; Glassock, Richard J.; Pottel, Hans; Rule, Andrew D.

2016-01-01

Defining chronic kidney disease (CKD) is the subject of intense debate in the current nephrology literature. The debate concerns the threshold value of estimated glomerular filtration rate (eGFR) used to make the diagnosis of CKD. Current recommendations argue that a universal threshold of 60 mL/min/1.73m2 should be used. This threshold has been defended by epidemiological studies showing that the risk of mortality or end-stage renal disease increases with an eGFR below 60 mL/min/1.73m2. However, a universal threshold does not take into account the physiologic decline in GFR with ageing nor does it account for the risk of mortality and end-stage renal disease being trivial with isolated eGFR levels just below 60 mL/min/1.73m2 in older subjects and significantly increased with eGFR levels just above 60 mL/min/1.73m2 among younger patients. Overestimation of the CKD prevalence in the elderly (medicalisation of senescence) and underestimation of CKD (potentially from treatable primary nephrologic diseases) in younger patients is of primary concern. An age-calibrated definition of CKD has been proposed to distinguish age-related from disease-related changes in eGFR. For patients younger than 40 years, CKD is defined by eGFR below 75 mL/min/1.73m2. For patients with ages between 40 and 65 years, CKD is defined by 60 mL/min/1.73m2. For subjects older than 65 years without albuminuria or proteinuria, CKD is defined by eGFR below 45 mL/min/1.73m2. PMID:27057075

Dosimetric Consistency of Co-60 Teletherapy Unit- a ten years Study

PubMed Central

Baba, Misba H; Mohib-ul-Haq, M.; Khan, Aijaz A.

2013-01-01

Objective The goal of the Radiation standards and Dosimetry is to ensure that the output of the Teletherapy Unit is within ±2% of the stated one and the output of the treatment dose calculation methods are within ±5%. In the present paper, we studied the dosimetry of Cobalt-60 (Co-60) Teletherapy unit at Sher-I-Kashmir Institute of Medical Sciences (SKIMS) for last 10 years. Radioactivity is the phenomenon of disintegration of unstable nuclides called radionuclides. Among these radionuclides, Cobalt-60, incorporated in Telecobalt Unit, is commonly used in therapeutic treatment of cancer. Cobalt-60 being unstable decays continuously into Ni-60 with half life of 5.27 years thereby resulting in the decrease in its activity, hence dose rate (output). It is, therefore, mandatory to measure the dose rate of the Cobalt-60 source regularly so that the patient receives the same dose every time as prescribed by the radiation oncologist. The under dosage may lead to unsatisfactory treatment of cancer and over dosage may cause radiation hazards. Our study emphasizes the consistency between actual output and output obtained using decay method. Methodology The methodology involved in the present study is the calculations of actual dose rate of Co-60 Teletherapy Unit by two techniques i.e. Source to Surface Distance (SSD) and Source to Axis Distance (SAD), used for the External Beam Radiotherapy, of various cancers, using the standard methods. Thereby, a year wise comparison has been made between average actual dosimetric output (dose rate) and the average expected output values (obtained by using decay method for Co-60.) Results The present study shows that there is a consistency in the average output (dose rate) obtained by the actual dosimetry values and the expected output values obtained using decay method. The values obtained by actual dosimetry are within ±2% of the expected values. Conclusion The results thus obtained in a year wise comparison of average output by

Dosimetric Consistency of Co-60 Teletherapy Unit- a ten years Study.

PubMed

Baba, Misba H; Mohib-Ul-Haq, M; Khan, Aijaz A

2013-01-01

The goal of the Radiation standards and Dosimetry is to ensure that the output of the Teletherapy Unit is within ±2% of the stated one and the output of the treatment dose calculation methods are within ±5%. In the present paper, we studied the dosimetry of Cobalt-60 (Co-60) Teletherapy unit at Sher-I-Kashmir Institute of Medical Sciences (SKIMS) for last 10 years. Radioactivity is the phenomenon of disintegration of unstable nuclides called radionuclides. Among these radionuclides, Cobalt-60, incorporated in Telecobalt Unit, is commonly used in therapeutic treatment of cancer. Cobalt-60 being unstable decays continuously into Ni-60 with half life of 5.27 years thereby resulting in the decrease in its activity, hence dose rate (output). It is, therefore, mandatory to measure the dose rate of the Cobalt-60 source regularly so that the patient receives the same dose every time as prescribed by the radiation oncologist. The under dosage may lead to unsatisfactory treatment of cancer and over dosage may cause radiation hazards. Our study emphasizes the consistency between actual output and output obtained using decay method. The methodology involved in the present study is the calculations of actual dose rate of Co-60 Teletherapy Unit by two techniques i.e. Source to Surface Distance (SSD) and Source to Axis Distance (SAD), used for the External Beam Radiotherapy, of various cancers, using the standard methods. Thereby, a year wise comparison has been made between average actual dosimetric output (dose rate) and the average expected output values (obtained by using decay method for Co-60.). The present study shows that there is a consistency in the average output (dose rate) obtained by the actual dosimetry values and the expected output values obtained using decay method. The values obtained by actual dosimetry are within ±2% of the expected values. The results thus obtained in a year wise comparison of average output by actual dosimetry done regularly as a part of

[A cohort study on the predictive value of factors influencing cardio-cerebro vascular death among people over 40 years of age].

PubMed

Yang, Jian-min; Lu, Fang-hong; Jin, Shi-kuan; Sun, Shang-wen; Zhao, Ying-xin; Wang, Shu-jian; Zhou, Xiao-hong

2007-02-01

To explore the factors influencing cardio-cerebro vascular death events among people over 40 years of age in Shandong area, China. Baseline survey was carried out in 1991. A total number of 11,008 adults over 40 years old had been studied in Shandong province. Data on cardiocerebro death was collected. The correlation between influencing factors and cardio-cerebro vascular death events was analyzed by Cox regression model. Totally, 434 cardio-cerebro death events occurred among the 11,008 subjects during the 8-year follow-up study. Cardio-cerebro death events were related to systolic blood pressure, diastolic blood pressure, smoking, stroke history and age. Data from Cox regression analysis showed that the relative risk (RR) for cardio-cerebro vascular death events increased by 2.862 [95% confidence interval (CI): 1.976-4.144] times for those people having stroke history. When systolic blood pressure, diastolic blood pressure increased by every 10 mm Hg, the relative risk for cardio-cerebro vascular death events increased by 1.171 (95% CI: 1.033-1.328), 1.214 (95% CI: 1.044-1.413) respectively. it was found that a 1.239 (95% CI: 1.088-1.553) times higher in smokers than non-smokers on relative risk for cardio-cerebro vascular death events. However, the predictive values of the influencing factors for cardio-cerebro vascular death were different among population of different years of age. The relative risk for cardio-cerebro vascular death events increased by 1.366 (95% CI: 1.102-1.678) times for each 10 mm Hg increase of diastolic blood pressure in 40-59 years old population. However, the effect was taken place by systolic blood pressure in 60-74 years old population,with a relative risk of 1.201 (95% CI: 1.017-1.418) for each 10 mm Hg increase. Age seemed the only significant factor for cardio-cerebro vascular death events on population aged more than 75 years old. Conclusion The predictive values of the risk factors were different among age groups. The different

Trend in otolaryngological surgeries in an era of super-aging: Descriptive statistics using a Japanese inpatient database.

PubMed

Suzuki, Sayaka; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Yamasoba, Tatsuya

2018-03-27

To reveal the age distribution and capture the longitudinal trend in otolaryngological surgeries performed in Japan, where society is rapidly aging. Using the Diagnosis Procedure Combination database, we extracted data on patients who were hospitalized and underwent any type of otolaryngological surgery in departments of otolaryngology or head and neck surgery from fiscal year 2007 to fiscal year 2013. Type of surgery, patient's age, and fiscal year were compared. We categorized >200 types of surgeries into eight specialties: ear surgery, functional endoscopic sinus surgery (FESS), other types of paranasal surgery (except for malignancy), head and neck cancer surgery, benign tumor surgery, upper airway surgery (including pharynx and larynx), removal of foreign body, and other. In total, 558,732 patients were included. The proportions of patients in each age category formed two peaks in middle age and in children aged ≤9years. The proportion of all surgeries made up by FESS, other paranasal surgery, benign tumor surgery, and head and neck cancer surgery gradually increased with age, forming a peak in patients in their 60s. The proportion of ear surgery was highest in patients aged ≤9years (34.0% of all surgeries, mostly myringotomy and transtympanic ventilation tube insertion) and formed a gradual peak in patients in their 60s (mostly tympanoplasty). The proportion of upper airway surgery (tonsillectomy and adenoidectomy) was highest in patients aged ≤9years (25.3% of all surgeries). The proportion of foreign body removal was highest in patients aged ≤9years (52.2% of all surgeries) and increased slightly with age. In 2013, compared with 2007, those aged 65-74 years and ≥75years made up a larger percentage of patients undergoing each specific surgery, including tympanoplasty, stapedectomy/stapedotomy, FESS, head and neck cancer surgery, pharyngolaryngectomy, total/subtotal glossectomy, thyroid lobectomy, parotidectomy (for a benign tumor), submandibular

Balance Training with Wii Fit Plus for Community-Dwelling Persons 60 Years and Older.

PubMed

Roopchand-Martin, Sharmella; McLean, Roshé; Gordon, Carron; Nelson, Gail

2015-06-01

This study sought to determine the effect of 6 weeks of training, using activities from the Nintendo(®) (Kyoto, Japan) "Wii™ Fit Plus" disc, on balance in community-dwelling Jamaicans 60 years and older. A single group pretest/posttest design was used. Thirty-three subjects enrolled and 28 completed the study. Participants completed 30-minute training sessions on the Nintendo "Wii Fit" twice per week for 6 weeks. Activities used included "Obstacle Course," "Penguin Slide," "Soccer Heading," "River Bubble," "Snow Board," "Tilt Table," "Skate Board," and "Yoga Single Tree Pose." Balance was assessed with the Berg Balance Scale, the Multi Directional Reach Test, the Star Excursion Balance Test and the Modified Clinical Test for Sensory Integration in Balance. There was significant improvement in the mean Berg Balance Scale score (P=0.004), Star Excursion Balance Test score (SEBT) (P<0.001 both legs), and Multi Directional Reach Test score (P=0.002). There was no significant change on the Modified Clinical Test for Sensory Integration in Balance. Balance games on the Nintendo "Wii Fit Plus" disc can be used as a tool for balance training in community-dwelling persons 60 years of age and older.

Hyperinsulinemia and metabolic syndrome at mean age of 10 years in black and white schoolgirls and development of impaired fasting glucose and type 2 diabetes mellitus by mean age of 24 years.

PubMed

Morrison, John A; Glueck, Charles J; Umar, Muhammad; Daniels, Stephen; Dolan, Lawrence M; Wang, Ping

2011-01-01

The objective of the study was to evaluate preteen insulin and metabolic syndrome (MS) as independent predictors of impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM) in black and white females by mean age of 24 years. This was a prospective cohort study. There were 8 measures of fasting glucose and insulin from mean age of 10 years through mean age of 24 years, and insulin also at mean age of 25 years. Childhood MS was defined by at least 3 abnormal values among waist circumference, triglyceride, high-density lipoprotein cholesterol, blood pressure, and glucose. Hyperinsulinemia was defined by insulin greater than or equal to race-specific 75th percentile. Patients with type 1 diabetes mellitus were excluded. The study was held in schools and in an outpatient clinical center. Participants were schoolgirls (260 white, 296 black). There was no intervention. The outcome measures were IFG (fasting glucose of at least 100 to 125 mg/dL) and T2DM (fasting glucose of at least 126 mg/dL). By the age of 24 years, there were 11 cases of T2DM (2%) and 108 cases of IFG (19%). By the age of 24 years, IFG + T2DM was present in 18% of women (73/412) who had normal insulin-no MS at the age of 10 years vs 28% (34/122) of those with high insulin-no MS at the age of 10 years (P = .014) and 67% (10/15) of those with high insulin + MS at the age of 10 years (P < .0001). By stepwise logistic regression, significant, independent, positive predictors of IFG + T2DM were first insulin measure in childhood, age at last sampling, childhood MS, change in body mass index over 15 years, and, separately, initial glucose of at least 100 mg/dL and average of all insulin quartile ranks over 15 years. The correlation between childhood insulin z score and insulin z score 15 years later was r = .30, P < .0001. Insulin and MS at a mean age of 10 years plus change in body mass index over 15 years, and 15-year average insulin rank independently predict IFG + T2DM by mean age of 24 years

High-dose cytarabine in induction treatment improves the outcome of adult patients younger than age 46 years with acute myeloid leukemia: results of the EORTC-GIMEMA AML-12 trial.

PubMed

Willemze, Roelof; Suciu, Stefan; Meloni, Giovanna; Labar, Boris; Marie, Jean-Pierre; Halkes, Constantijn J M; Muus, Petra; Mistrik, Martin; Amadori, Sergio; Specchia, Giorgina; Fabbiano, Francesco; Nobile, Francesco; Sborgia, Marco; Camera, Andrea; Selleslag, Dominik L D; Lefrère, Francois; Magro, Domenico; Sica, Simona; Cantore, Nicola; Beksac, Meral; Berneman, Zwi; Thomas, Xavier; Melillo, Lorella; Guimaraes, Jose E; Leoni, Pietro; Luppi, Mario; Mitra, Maria E; Bron, Dominique; Fillet, Georges; Marijt, Erik W A; Venditti, Adriano; Hagemeijer, Anne; Mancini, Marco; Jansen, Joop; Cilloni, Daniela; Meert, Liv; Fazi, Paola; Vignetti, Marco; Trisolini, Silvia M; Mandelli, Franco; de Witte, Theo

2014-01-20

Cytarabine plays a pivotal role in the treatment of patients with acute myeloid leukemia (AML). Most centers use 7 to 10 days of cytarabine at a daily dose of 100 to 200 mg/m(2) for remission induction. Consensus has not been reached on the benefit of higher dosages of cytarabine. The European Organisation for Research and Treatment of Cancer (EORTC) and Gruppo Italiano Malattie Ematologiche dell' Adulto (GIMEMA) Leukemia Groups conducted a randomized trial (AML-12; Combination Chemotherapy, Stem Cell Transplant and Interleukin-2 in Treating Patients With Acute Myeloid Leukemia) in 1,942 newly diagnosed patients with AML, age 15 to 60 years, comparing remission induction treatment containing daunorubicin, etoposide, and either standard-dose (SD) cytarabine (100 mg/m(2) per day by continuous infusion for 10 days) or high-dose (HD) cytarabine (3,000 mg/m(2) every 12 hours by 3-hour infusion on days 1, 3, 5, and 7). Patients in complete remission (CR) received a single consolidation cycle containing daunorubicin and intermediate-dose cytarabine (500 mg/m(2) every 12 hours for 6 days). Subsequently, a stem-cell transplantation was planned. The primary end point was survival. At a median follow-up of 6 years, overall survival was 38.7% for patients randomly assigned to SD cytarabine and 42.5% for those randomly assigned to HD cytarabine (log-rank test P = .06; multivariable analysis P = .009). For patients younger than age 46 years, survival was 43.3% and 51.9%, respectively (P = .009; multivariable analysis P = .003), and for patients age 46 to 60 years, survival was 33.9% and 32.9%, respectively (P = .91). CR rates were 72.0% and 78.7%, respectively (P < .001) and were 75.6% and 82.4% for patients younger than age 46 years (P = .01) and 68.3% and 74.8% for patients age 46 years and older (P = .03). Patients of all ages with very-bad-risk cytogenetic abnormalities and/or FLT3-ITD (internal tandem duplication) mutation, or with secondary AML benefitted from HD

Relationship of Intraoperative Cerebral Oxygen Saturation to Neurodevelopmental Outcome and Brain MRI at One Year of Age in Infants Undergoing Biventricular Repair

PubMed Central

Kussman, Barry D.; Wypij, David; Laussen, Peter C.; Soul, Janet S.; Bellinger, David C.; DiNardo, James A.; Robertson, Richard; Pigula, Frank A.; Jonas, Richard A.; Newburger, Jane W.

2010-01-01

Background Near-infrared spectroscopy (NIRS) monitoring of cerebral oxygen saturation (rSO2) has become routine in many centers, but no studies have reported the relationship of intraoperative NIRS to long-term neurodevelopmental outcomes after cardiac surgery. Methods and Results Of 104 infants undergoing biventricular repair without aortic arch reconstruction, 89 (86%) returned for neurodevelopmental testing at age 1 year. The primary NIRS variable was the integrated rSO2 (area under the curve) for rSO2 ≤ 45%; secondary variables were the average and minimum rSO2 by perfusion phase and at specific time points. Psychomotor (PDI) and Mental Development Indexes of the Bayley Scales, head circumference, neurologic examination, and abnormalities on brain MRI did not differ between subjects according to a threshold level for rSO2 of 45%. Lower PDI scores were modestly associated with lower average (r=0.23; P=0.03) and minimum rSO2 (r=0.22; P=0.04) during the 60 minute period following cardiopulmonary bypass (CPB), but not with other perfusion phases. Hemosiderin foci on brain MRI were associated with lower average rSO2 from post-induction to 60 minutes post-CPB (71±10 vs. 78±6%; P=0.01), and lower average rSO2 during the rewarming phase (72±12 vs. 83±9%; P=0.003) and during the 60 minute period following CPB (65±11 vs. 75±10%; P=0.009). In regression analyses adjusting for age ≤ 30 days, PDI score (P=0.02) and brain hemosiderin (P=0.04) remained significantly associated with rSO2 during the 60 minute period following CPB. Conclusions Perioperative periods of diminished cerebral oxygen delivery, as indicated by rSO2, are associated with one-year PDI and brain MRI abnormalities among infants undergoing reparative heart surgery. Clinical Trial Registration Information http://clinicaltrials.gov/ct2/show/NCT00006183 PMID:20606124

Obesity History and Daily Patterns of Physical Activity at Age 60-64 Years: Findings From the MRC National Survey of Health and Development.

PubMed

Cooper, Rachel; Huang, Lei; Hardy, Rebecca; Crainiceanu, Adina; Harris, Tamara; Schrack, Jennifer A; Crainiceanu, Ciprian; Kuh, Diana

2017-10-01

The aim of this study was to investigate associations of current body mass index (BMI) and obesity history with daily patterns of physical activity. At age 60-64, participants from a British birth cohort study wore accelerometers for 5 days. Accelerometry counts were log-transformed and mean log-counts were used to derive a summary variable indicating total daily log-activity counts. Among those with complete data (n = 1,388) the associations of current BMI and age of first obesity were examined with: (a) total daily log-activity counts and (b) total log-activity counts in four segments of the day. Higher current BMI and younger age at obesity were strongly associated with lower levels of total daily activity at age 60-64 even after adjustment for sex, socioeconomic factors, and health status. The fully-adjusted mean difference in total daily log-activity counts was -581.7 (95% confidence interval: -757.2, -406.3) when comparing BMI ≥35 kg/m2 with <25 kg/m2, representing an 18.4% difference. Participants who had been obese since early adulthood had the lowest levels of activity (mean difference in total daily log-activity counts was -413.1 (-638.1, -188.2) when comparing those who were obese by age 26 or 36 with those who were never obese, representing a 13.1% difference). Obese older adults may require targeted interventions and additional support to improve their daily activity levels. As younger generations with greater lifetime exposure to obesity reach old age the proportion of adults achieving sufficient levels of activity to realize its associated health benefits is likely to decline. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.

Unintentional drowning mortality, by age and body of water: an analysis of 60 countries.

PubMed

Lin, Ching-Yih; Wang, Yi-Fong; Lu, Tsung-Hsueh; Kawach, Ichiro

2015-04-01

To examine unintentional drowning mortality by age and body of water across 60 countries, to provide a starting point for further in-depth investigations within individual countries. The latest available three years of mortality data for each country were extracted from WHO Health Statistics and Information Services (updated at 13 November 2013). We calculated mortality rate of unintentional drowning by age group for each country. For countries using International Classification of Disease 10 (ICD-10) detailed 3 or 4 Character List, we further examined the body of water involved. A huge variation in age-standardised mortality rate (deaths per 100 000 population) was noted, from 0.12 in Turkey to 9.19 in Guyana. Of the ten countries with the highest age-standardised mortality rate, six (Belarus, Lithuania, Latvia, Russia, Ukraine and Moldova) were in Eastern Europe and two (Kazakhstan and Kyrgyzstan) were in Central Asia. Some countries (Japan, Finland and Greece) had a relatively low rank in mortality rate among children aged 0-4 years, but had a high rank in mortality rate among older adults. On the contrary, South Africa and Colombia had a relatively high rank among children aged 0-4 years, but had a relatively low rank in mortality rate among older adults. With regard to body of water involved, the proportion involving a bathtub was extremely high in Japan (65%) followed by Canada (11%) and the USA (11%). Of the 13 634 drowning deaths involving bathtubs in Japan between 2009 and 2011, 12 038 (88%) were older adults aged 65 years or above. The percentage involving a swimming pool was high in the USA (18%), Australia (13%), and New Zealand (7%). The proportion involving natural water was high in Finland (93%), Panama (87%), and Lithuania (85%). After considering the completeness of reporting and quality of classifying drowning deaths across countries, we conclude that drowning is a high-priority public health problem in Eastern Europe, Central Asia

Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over-75s Cohort study.

PubMed

Fleming, Jane; Matthews, Fiona E; Brayne, Carol

2008-03-17

The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data. Re-survey of over-90-year-olds in a longitudinal cohort study - cross-sectional interview and intensive 12-month follow-up. 90 women and 20 men participating in a population-based cohort (aged 91-105 years, in care-homes and community-dwelling) recruited from representative general practices in Cambridge, UKMeasurements: Prospective falls data were collected using fall calendars and telephone follow-up for one year after cross-sectional survey including fall history. 58% were reported to have fallen at least once in the previous year and 60% in the 1-year follow-up. The proportion reported to have fallen more than once was lower using retrospective recall of the past year than prospective reports gathered the following year (34% versus 45%), as were fall rates (1.6 and 2.8 falls/person-year respectively). Repeated falls in the past year were more highly predictive of falls during the following year - IRR 4.7, 95% CI 2.6-8.7 - than just one - IRR 3.6, 95% CI 2.0-6.3, using negative binomial regression. Only 1/5 reportedly did not fall during either the year before or after interview. Fall rates in this representative sample of over-90-year-olds are even higher than previous reports from octogenarians. Recalled falls last year, particularly repeated falls, strongly predicted falls during follow-up. Similar proportions of people who fell were reported by retrospective and prospective methods covering two consecutive years. Recall

Prevalence and Co-Occurrence of Geriatric Syndromes in People Aged 75 Years and Older in France: Results From the Bordeaux Three-city Study.

PubMed

Tabue-Teguo, Maturin; Grasset, Leslie; Avila-Funes, José Alberto; Genuer, Robin; Proust-Lima, Cecile; Péres, Karine; Féart, Catherine; Amieva, Hélène; Harmand, Magali González-Colaço; Helmer, Catherine; Salles, Nathalie; Rainfray, Muriel; Dartigues, Jean François

2017-12-12

Geriatric syndromes (GSs) are often the result of cumulative insults to multiple organ systems and are considered common in older adults. However, their frequency and co-occurrence are not well known in the elderly population. This study aimed to determine the prevalence of several GSs and to analyze the co-occurrence of these syndromes in a general population of elderly individuals. A cross-sectional analysis of 630 adults aged 75 years or older participating in the 10-year follow-up of the Bordeaux sample of the French Three-City Study was conducted. The following 10 GSs were assessed: physical frailty, dementia and cognitive impairment, depressive symptoms, polymedication, social isolation, thinness, falls, dependence, sensory deficit, and incontinence. The prevalence of the 10 GSs was estimated, and multiple correspondence analysis (MCA) models were used to explore the mutual associations between these GSs. The mean age of the participants was 83.3 years; 69% were women, and 80.5% [95% confidence interval (CI) = 76.3-82.7] had at least one GS. The most frequent GSs were polymedication (50.6% 95%CI = 46.7-54.5) and falls (43.1% 95%CI = 38.4-46.1). The MCA models identified two major dimensions of the 10 GSs: "Dementia-Dependence-Incontinence" and "Frailty-Depression-Isolation." GSs were very common in this French elderly population and were grouped into two major dimensions: the "Dementia-Dependence-Incontinence" and "Frailty-Depression-Isolation." © The Author 2017. 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.

Yoga-based exercise improves balance and mobility in people aged 60 and over: a systematic review and meta-analysis.

PubMed

Youkhana, Sabrina; Dean, Catherine M; Wolff, Moa; Sherrington, Catherine; Tiedemann, Anne

2016-01-01

one-third of community-dwelling older adults fall annually. Exercise that challenges balance is proven to prevent falls. We conducted a systematic review with meta-analysis to determine the impact of yoga-based exercise on balance and physical mobility in people aged 60+ years. searches for relevant trials were conducted on the following electronic databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, Allied and Complementary Medicine Database and the Physiotherapy Evidence Database (PEDro) from inception to February 2015. Trials were included if they evaluated the effect of physical yoga (excluding meditation and breathing exercises alone) on balance in people aged 60+ years. We extracted data on balance and the secondary outcome of physical mobility. Standardised mean differences and 95% confidence intervals (CI) were calculated using random-effects models. Methodological quality of trials was assessed using the 10-point Physiotherapy Evidence Database (PEDro) Scale. six trials of relatively high methodological quality, totalling 307 participants, were identified and had data that could be included in a meta-analysis. Overall, yoga interventions had a small effect on balance performance (Hedges' g = 0.40, 95% CI 0.15-0.65, 6 trials) and a medium effect on physical mobility (Hedges' g = 0.50, 95% CI 0.06-0.95, 3 trials). yoga interventions resulted in small improvements in balance and medium improvements in physical mobility in people aged 60+ years. Further research is required to determine whether yoga-related improvements in balance and mobility translate to prevention of falls in older people. PROSPERO Registration number CRD42015015872. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Trends and spatial distribution of deaths of children aged 12-60 months in São Paulo, Brazil, 1980-98.

PubMed Central

Antunes, José Leopoldo Ferreira; Waldman, Eliseu Alves

2002-01-01

OBJECTIVE: To describe trends in the mortality of children aged 12-60 months and to perform spatial data analysis of its distribution at the inner city district level in São Paulo from 1980 to 1998. METHODS: Official mortality data were analysed in relation to the underlying causes of death. The population of children aged 12-60 months, disaggregated by sex and age, was estimated for each year. Educational levels, income, employment status, and other socioeconomic indices were also assessed. Statistical Package for Social Sciences software was used for the statistical processing of time series. The Cochrane-Orcutt procedure of generalized least squares regression analysis was used to estimate the regression parameters with control of first-order autocorrelation. Spatial data analysis employed the discrimination of death rates and socioeconomic indices at the inner city district level. For classifying area-level death rates the method of K-means cluster analysis was used. Spatial correlation between variables was analysed by the simultaneous autoregressive regression method. FINDINGS: There was a steady decline in death rates during the 1980s at an average rate of 3.08% per year, followed by a levelling off. Infectious diseases remained the major cause of mortality, accounting for 43.1% of deaths during the last three years of the study. Injuries accounted for 16.5% of deaths. Mortality rates at the area level clearly demonstrated inequity in the city's health profile: there was an increasing difference between the rich and the underprivileged social strata in this respect. CONCLUSION: The overall mortality rate among children aged 12-60 months dropped by almost 30% during the study period. Most of the decline happened during the 1980s. Many people still live in a state of deprivation in underserved areas. Time-series and spatial data analysis provided indications of potential value in the planning of social policies promoting well-being, through the identification

Bronchodilator response cut-off points and FEV 0.75 reference values for spirometry in preschoolers

PubMed Central

Burity, Edjane Figueiredo; Pereira, Carlos Alberto de Castro; Jones, Marcus Herbert; Sayão, Larissa Bouwman; de Andrade, Armèle Dornelas; de Britto, Murilo Carlos Amorim

2016-01-01

ABSTRACT Objective: To determine the cut-off points for FEV1, FEV0.75, FEV0.5, and FEF25-75% bronchodilator responses in healthy preschool children and to generate reference values for FEV0.75. Methods: This was a cross-sectional community-based study involving children 3-5 years of age. Healthy preschool children were selected by a standardized questionnaire. Spirometry was performed before and after bronchodilator use. The cut-off point of the response was defined as the 95th percentile of the change in each parameter. Results: We recruited 266 children, 160 (60%) of whom were able to perform acceptable, reproducible expiratory maneuvers before and after bronchodilator use. The mean age and height were 57.78 ± 7.86 months and 106.56 ± 6.43 cm, respectively. The success rate for FEV0.5 was 35%, 68%, and 70% in the 3-, 4-, and 5-year-olds, respectively. The 95th percentile of the change in the percentage of the predicted value in response to bronchodilator use was 11.6%, 16.0%, 8.5%, and 35.5% for FEV1, FEV0.75, FEV0.5, and FEF25-75%, respectively. Conclusions: Our results provide cut-off points for bronchodilator responsiveness for FEV1, FEV0.75, FEV0.5, and FEF25-75% in healthy preschool children. In addition, we proposed gender-specific reference equations for FEV0.75. Our findings could improve the physiological assessment of respiratory function in preschool children. PMID:27812631

Spatiotemporal and plantar pressure patterns of 1000 healthy individuals aged 3-101 years.

PubMed

McKay, Marnee J; Baldwin, Jennifer N; Ferreira, Paulo; Simic, Milena; Vanicek, Natalie; Wojciechowski, Elizabeth; Mudge, Anita; Burns, Joshua

2017-10-01

The purpose of this study was to establish normative reference values for spatiotemporal and plantar pressure parameters, and to investigate the influence of demographic, anthropometric and physical characteristics. In 1000 healthy males and females aged 3-101 years, spatiotemporal and plantar pressure data were collected barefoot with the Zeno™ walkway and Emed ® platform. Correlograms were developed to visualise the relationships between widely reported spatiotemporal and pressure variables with demographic (age, gender), anthropometric (height, mass, waist circumference) and physical characteristics (ankle strength, ankle range of motion, vibration perception) in children aged 3-9 years, adolescents aged 10-19 years, adults aged 20-59 years and older adults aged over 60 years. A comprehensive catalogue of 31 spatiotemporal and pressure variables were generated from 1000 healthy individuals. The key findings were that gait velocity was stable during adolescence and adulthood, while children and older adults walked at a comparable slower speed. Peak pressures increased during childhood to older adulthood. Children demonstrated highest peak pressures beneath the rearfoot whilst adolescents, adults and older adults demonstrated highest pressures at the forefoot. Main factors influencing spatiotemporal and pressure parameters were: increased age, height, body mass and waist circumference, as well as ankle dorsiflexion and plantarflexion strength. This study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan. Copyright © 2017 Elsevier B.V. All rights reserved.

75 FR 13287 - Agency Information Collection Request: 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

...) from Institutions with Research Misconduct Allegation or Investigation in Past 5 Years. Total 75 Seleda...) proposes to do a study to determine what questions whistleblowers want answered from Research Integrity...-prepared to provide answers to the kinds of questions that complainants (whistleblowers) and potential...

Chronic kidney disease in Polish elderly population aged 75+: results of the WOBASZ Senior Survey.

PubMed

Zdrojewski, Łukasz; Król, Ewa; Rutkowski, Bolesław; Piotrowski, Walerian; Pająk, Andrzej; Drygas, Wojciech; Zdrojewski, Tomasz

2017-04-01

Kidney filtration decreases with age, which results in an increased frequency of chronic kidney disease (CKD) in the elderly population. The purpose of the study was to assess the prevalence and epidemiology of CKD in the Polish elderly population. A representative sample of the Polish elderly population, composed of 918 people (F 452, M 466) in the age of ≥75 years, was chosen. All participants had their history, anthropometric measures and biochemical parameters (creatinine, fasting glucose, complete cholesterol) evaluated. CKD was diagnosed when eGFR was <60 ml/min/1.73 m 2 . The comorbidities, anthropometric and social factors connected with the onset of CKD were also analyzed. The prevalence of CKD in the analyzed population was 26.9% (F 32.0%, M 15.8%), which gives an estimated number of 495,590 (95% CI 396,363-594,817) patients in the study subpopulation. The majority of these people were in the G3A category-70.1%, while the remaining fell under the G3B-25.7%, G4-3.1% and G5-1.1% categories. Disease awareness among the participants was found to be at 17%. Arterial hypertension (AH) was more frequent in people with CKD (91.0 vs. 80.3%, P < 0.001), whereas diabetes mellitus (DM) prevalence was comparable in both CKD and non-CKD groups (11.7 vs. 11.4%, ns). In the examined group, DM had no influence on the frequency of CKD. In contrast, the presence of cardiovascular diseases substantially increased the chances of developing CKD (OR 1.87, P < 0.05). 1. The prevalence of CKD in the Polish elderly population was 26.9%. 2. Awareness of CKD is low. 3. DM, increasing age and AH did not increase the risk of CKD. 4. Coexistence of cardiovascular diseases increased the risk of having CKD.

Exploring Career Options and Possibilities Later in Life: Adult (Age 50-75) Career Development Survey

ERIC Educational Resources Information Center

Smith, Angela Carmella

2009-01-01

A survey instrument was developed entitled the "Adult (age 50-75) Career Development Survey" (ACDS) to provide an empirical foundation for understanding the current needs of individuals age 50-75 and learning about their attitudes toward, willingness to, and experience in using career counseling and technology in making decisions on…

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.

Functional capacities of Polish adults of 60-87 years and risk of losing functional independence.

PubMed

Ignasiak, Zofia; Sławinska, Teresa; Skrzek, Anna; Rożek, Krystyna; Kozieł, Sławomir; Posłuszny, Pawel; Malina, Robert M

2017-09-01

To characterise the functional capacities of Polish men and women aged 60-87 years and evaluate their status relative to criteria for functional independence. Four hundred and thirty-one women and 125 men, aged 60-87 years, who were residents of Wrocław, southwestern Poland, were recruited. Height and weight were measured and BMI was calculated. The Fullerton Functional Fitness Test was administered to test upper and lower body strength, upper and lower body flexibility, agility-dynamic balance and aerobic endurance. The Paffenbarger physical activity questionnaire was completed. Characteristics of individuals classified by the number of tests which equalled or exceeded criterion-referenced standards for functional independence (excluding flexibility) were compared. Polish older adults compared favourably to American reference values. Percentages meeting the criteria for all four, for two or three and for one or no tests were, respectively, 21%, 54% and 25% in women and 37%, 45% and 18% in men. Adults meeting the criteria for all four tests were lighter, with a lower BMI and more physically active than those meeting the criteria on two or three tests and on one or no tests. The majority of Polish older adults were not at risk for loss of physical independence. The most functionally independent adults of both sexes had a lower BMI and less obesity, and were physically more active; the converse was true for those not meeting the criteria.

Age Discrimination and the FAA Age 60 Rule. Hearing before the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

This document presents witness testimonies and related materials from a Congressional hearing called to examine the mandatory retirement age of 60 for airline pilots. In opening remarks, Congressmen Roybal and Pepper question this ruling, citing productivity of older workers and the lack of data to support any specific age for mandatory…

Depression in women aged 75-89--predisposing factors and preventive measures.

PubMed

Chrzan, Renata; Karmowski, Andrzej; Pawelec, Małgorzata; Łatkowski, Krzysztof J; Karmowski, Mikołaj

2012-01-01

There are analyses showing the relationship between low and irregular physical activity and the risk of more frequent occurrences of depression symptoms in the future. There are studies that do not prove the connection between those two dependencies. The aim of this study was to find the relationship between physical activity before menopause and the occurrence of depression in senium. The study was comprised of 200 randomly selected women, aged 75-89 years, who were treated in the local department of general surgery and oncology from January to June 2009. The study used a 15-point Geriatric Depression Scale which is an integral part of the EASY care (Polish version 1999-2002) questionnaire to assess emotional efficiency, and the Questionnaire Survey for Research on Physical Activity in Older People which contains 8 questions. The results were statistically analyzed using a Student's test and basic probabilities calculations. The probability of depression in women aged 75-89 is 0.8. Increased physical activity in pre-menopausal women neither affects the level of depression, nor prevents it (p < 0.1). Depression was more common in people living alone, in which case the probability is 0.85. Postmenopausal women enjoy a beneficial impact on physical activity in the following areas: previous activity (p < 0.001), family support (p < 0.0001), GP support (p < 0.001), and television education (p < 0.001). Depression among elderly women is very common. In this study, depression was found in 80% of senior women. There is a relationship between depression and physical activity. Increased physical activity in premenopausal women neither affects the level of depression, nor prevents it. There was no correlation between age, weight, education, place of residence and depression. Depression was more common in people living alone.

A 20-Year Review of 75 Cases of Salivary Duct Carcinoma.

PubMed

Gilbert, Mark R; Sharma, Arun; Schmitt, Nicole C; Johnson, Jonas T; Ferris, Robert L; Duvvuri, Umamaheswar; Kim, Seungwon

2016-05-01

Salivary duct carcinoma is a rare, aggressive malignancy of the salivary glands. Owing to its rare nature, clinical data are limited, and only a few clinical studies comprise more than 50 patients. To review the University of Pittsburgh Medical Center's experience with salivary duct carcinoma over a 20-year period, focusing on demographics, presentation, treatment, and outcome. This investigation was a retrospective cohort study in a multihospital institution with tertiary referral. A pathology database was reviewed for all cases of histopathologically diagnosed salivary duct carcinoma from January 1, 1995, to October 20, 2014. Patients who were referrals for pathology review only and were never seen at the institution were excluded. In total, 75 study patients were identified. The electronic medical record was reviewed for details regarding demographics, presentation, treatment, and outcome, including overall survival (OS) and disease-free survival (DFS). This study was supplemented with a review of the institution's Head and Neck Oncology Database for further clinical details. Primary outcome measures consisted of OS and DFS. The study sample comprised 75 participants with a mean age at diagnosis of 66.0 years (age range, 33-93 years), and 29% (n = 22) were female. Most primary tumors were from the parotid gland (83%), with the next most frequent site being the submandibular gland (12%). Overall, 41% of the cases were carcinoma ex pleomorphic adenoma. Rates of other histologic features included the following: perineural invasion (69%), extracapsular spread (58%), ERBB2 (formerly HER2) positivity (31%) (62% of those who were tested), and vascular invasion (61%). The median OS was 3.1 years, and the median DFS was 2.7 years. Univariate Kaplan-Meier survival analyses demonstrated that facial nerve sacrifice and extracapsular spread were associated with lower OS (2.38 vs 5.11 years and 2.29 vs 6.56 years, respectively) and DFS (2.4 vs 3.88 years and 1.44 vs 4

Patients ≥ 75 years with acute coronary syndrome but without critical epicardial coronary disease: prevalence, characteristics, and outcome

PubMed Central

Wong, Vincent; Farah, Ahmed; von Korn, Hubertus; Memisevic, Nedim; Richter, Stefan; Tukhiashvili, Ketevan; Lauer, Bernward; Ohlow, Marc-Alexander

2015-01-01

Objective Absence of significant epicardial coronary artery disease (CAD) in patients with acute onset of chest pain and elevation of myocardial necrosis markers is occasionally observed. The aim of this study was to analyse the clinical characteristics and outcome of such patients with advanced age. Methods We retrospectively analysed 4,311 patients with acute onset of chest pain plus necrosis marker elevation. Two hundred and seventy two patients without CAD on angiogram (6.3%) were identified. Out of them, 50 (1.2%) patients ≥ 75 years (Group I) were compared with (1) 222 acute coronary syndrome (ACS) patients without CAD on angiogram < 75 years (Group II), and (2) 610 consecutive patients ≥ 75 years with Non-ST-elevation Myocardial Infarction (NSTEMI) undergoing percutaneous coronary intervention (Group III). Results Group I compared to Group III patients made up for more females (64.0% vs. 49.2%; P < 0.0001), and had more severe anginal symptoms on presentation [Canadian Cardiovascular Society (CCS) class I/II, 26.0% vs. 49.8%; P = 0.02]. Group I patients also had lower troponin levels (0.62 ± 0.8 ng/mL vs. 27 ± 74 ng/mL; P < 0.02), lower leukocyte count (9.4 ± 3.13 × 109 vs. 12 ± 5.1 × 109; P = 0.001) and better preserved left ventricular function (56.7% ± 14.3% vs. 45% ± 11%; P < 0.0001). Event-free survival (cardiac death, myocardial infarction, recurrent angina, and re-hospitalisation) was more frequent in Group I and II patients compared to Group III patients (64.9%, 66.7%, and 41.6%, respectively; P < 0.0001). Conclusions ACS in patients ≥ 75 years without CAD is very infrequent, associated with a (1) similar outcome compared to ACS patients < 75 years without CAD, and (2) significant better outcome compared to NSTEMI patients ≥ 75 years. PMID:25678899

[Evaluation of the prescription of proton pump inhibitors in persons aged 75years and older in a geriatric acute-care unit].

PubMed

Dipanda, Mélanie; Pioro, Laureline; Buttard, Maxime; d'Athis, Philippe; Asgassou, Sanaa; Putot, Sophie; Deïdda, Martha; Laborde, Caroline; Putot, Alain; Manckoundia, Patrick

2017-12-01

Proton pump inhibitors (PPI) are widely prescribed in France and could be responsible for adverse drug reactions especially in elderly persons (EP). In order to reduce the misuse of PPI and the excess cost to the Social Security Agency, the French health authorities (Haute Autorité de santé [HAS]) have published strict guidelines for their prescription. We conducted a study in EP to determine the proportion of PPI prescriptions outside HAS guidelines. This was a prospective, single-centre observational study in persons aged≥75 years admitted to a geriatric acute-care unit over a period of 6months. The prevalence of prescriptions for PPI and the proportion of prescriptions outside the guidelines were calculated. The sociodemographic and medical characteristics of EP treated with PPI were studied as were the reasons for the prescription of PPI. Among the 818 patients hospitalized during the study period, 270 were taking PPI on admission (33%). Among these prescriptions, 60% were outside the HAS guidelines. Gastro-oesophageal reflux was the leading indication for PPI (30%), followed by dyspepsia (19%). This study confirms the high prevalence of prescriptions for PPI and their misuse. As these drugs are apparently well tolerated, prescriptions are often renewed with no medical re-evaluation. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Effects of ballates, step aerobics, and walking on balance in women aged 50-75 years.

PubMed

Clary, Sarah; Barnes, Cathleen; Bemben, Debra; Knehans, Allen; Bemben, Michael

2006-01-01

This study examined the effectiveness of Ballates training (strengthening of the central core musculature by the inception of balance techniques) compared to more traditional exercise programs, such as step aerobics and walking, on balance in women aged 50- 75 years. Participants were randomly assigned to one of three supervised training groups (1 hour/day, 3 days/week, 13 weeks), Ballates (n = 12), step aerobics (n = 17), or walking (n =15). Balance was measured by four different methods (modified Clinical Test for the Sensory Interaction on Balance - mCTSIB; Unilateral Stance with Eyes Open - US-EO or Eyes Closed - US-EC; Tandem Walk - TW; Step Quick Turn - SQT) using the NeuroCom Balance Master. A 2-way (Group and Trial) repeated measures ANOVA and post-hoc Bonferroni Pair-wise Comparisons were used to evaluate changes in the dependent variables used to describe stability and balance (sway velocity, turn sway, speed, and turn time). Measures of static postural stability and dynamic balance were similar for the three groups prior to training. Following the different exercise interventions, sway velocity on firm and foam surfaces (mCTSIB) with eyes closed (p < 0.05) increased for the Ballates group while the other two exercise groups either maintained or decreased their sway velocity following the training, therefore suggesting that these two groups either maintained or improved their balance. There were significant improvements in speed during the TW test (p < 0.01), and turn time (p < 0.01) and sway (p < 0.05) during the SQT test for each of the three groups. In general, all three training programs improved dynamic balance, however, step aerobics and walking programs resulted in be better improvements in postural stability or static balance when compared to the Ballates program. Key PointsExercise training can improve balanceNeed to consider both static and dynamic aspects of balance individuallyImproved balance can reduce the risk of fall.

Molecular epidemiology of enterovirus and parechovirus infections according to patient age over a 4-year period in Spain.

PubMed

Cabrerizo, María; Díaz-Cerio, María; Muñoz-Almagro, Carmen; Rabella, Núria; Tarragó, David; Romero, María Pilar; Pena, María José; Calvo, Cristina; Rey-Cao, Sonia; Moreno-Docón, Antonio; Martínez-Rienda, Inés; Otero, Almudena; Trallero, Gloria

2017-03-01

The epidemiology and clinical association of enterovirus (EV) and parechovirus (HPeV) infections, as well as the type-distribution-according-to-age, were determined during a 4-year study period in Spain. During 2010-2013, a total of 21,832 clinical samples were screened for EV and the detection frequency was 6.5% (1,430). Of the total EV-negative samples, only 1,873 samples from 2011 to 2013 were available for HPeV testing. HPeV was detected in 42 (2%) of them. Positive samples were genotyped using PCR and sequencing. EV infections occurred in all age groups of patients: neonates (17%), children 28 days to 2 years (29%), children 2-14 years (40%), and adults (14%). Thirty-four different EV types were identified. HPeV infections were detected exclusively in infants <8 m (70% neonates, P < 0.05). All but one HPeV were HPeV-3. Differences in type frequency detection were found according to age and clinical manifestation. Coxsackievirus (CV)-B4 (61%), CV-B5 (83%), and HPeV-3 (64%) were more frequent in neonates than in older patients (P < 0.05). Echovirus (E)-3 (60%), E-18 (47%), E-25 (62%), CV-A6 (61%), CV-A16 (72%), and EV-71 (75%) were mainly detected in children 28 days to 2 years (P < 0.05), whereas, E-6 (79%), E-20 (88%), and E-30 (85%) were predominant in children >2 years and adults (P < 0.05). Clinically, meningitis was associated with EV (P < 0.01) whereas, encephalitis was more frequent in HPeV-infected patients. CV-B types were associated with myocarditis (90%; P < 0.05) and EV species A with hand-foot-mouth-disease/atypical exanthema (88%; P < 0.05). J. Med. Virol. 89:435-442, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

PubMed

Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

2015-02-01

Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P < .001). There was no significant difference for all patient-reported outcome (PRO) scores at final follow-up between both groups. When we compared the change in PRO scores (�

Salivary Parameters (Salivary Flow, pH and Buffering Capacity) in Stimulated Saliva of Mexican Elders 60 Years Old and Older

PubMed Central

Islas-Granillo, H; Borges-Yañez, SA; Medina-Solís, CE; Galan-Vidal, CA; Navarrete-Hernández, JJ; Escoffié-Ramirez, M; Maupomé, G

2014-01-01

ABSTRACT Objective: To compare a limited array of chewing-stimulated saliva features (salivary flow, pH and buffer capacity) in a sample of elderly Mexicans with clinical, sociodemographic and socio-economic variables. Subjects and Methods: A cross-sectional study was carried out in 139 adults, 60 years old and older, from two retirement homes and a senior day care centre in the city of Pachuca, Mexico. Socio-demographic, socio-economic and behavioural variables were collected through a questionnaire. A trained and standardized examiner obtained the oral clinical variables. Chewing-stimulated saliva (paraffin method) was collected and the salivary flow rate, pH and buffer capacity were measured. The analysis was performed using non-parametric tests in Stata 9.0. Results: Mean age was 79.1 ± 9.8 years. Most of the subjects included were women (69.1%). Mean chewing-stimulated salivary flow was 0.75 ± 0.80 mL/minute, and the pH and buffer capacity were 7.88 ± 0.83 and 4.20 ± 1.24, respectively. Mean chewing-stimulated salivary flow varied (p < 0.05) across type of retirement home, tooth brushing frequency, number of missing teeth and use of dental prostheses. pH varied across the type of retirement home (p < 0.05) and marginally by age (p = 0.087); buffer capacity (p < 0.05) varied across type of retirement home, tobacco consumption and the number of missing teeth. Conclusions: These exploratory data add to the body of knowledge with regard to chewing-stimulated salivary features (salivary flow rate, pH and buffer capacity) and outline the variability of those features across selected sociodemographic, socio-economic and behavioural variables in a group of Mexican elders. PMID:25867562

60 Years of Great Science (Oak Ridge National Laboratory)

DOE R&D Accomplishments Database

2003-01-01

This issue of Oak Ridge National Laboratory Review (vol. 36, issue 1) highlights Oak Ridge National Laboratory's contributions in more than 30 areas of research and related activities during the past 60 years and provides glimpses of current activities that are carrying on this heritage.

Physical activity and physical functioning in Swedish and Iranian 75-year-olds - a comparison.

PubMed

Mosallanezhad, Zahra; Hörder, Helena; Salavati, Mahyar; Nilsson-Wikmar, Lena; Frändin, Kerstin

2012-01-01

The pattern of population aging is highly complex and contextually based. Cross-national comparisons are helpful to explore related factors. Two cross-sectional studies designed to compare physical activity level, physical functioning and certain health related factors in 75-year-old women and men in Sweden and Iran. Cohorts of 637 Swedish and 851 Iranian 75-year-olds were investigated with the same methods regarding physical activity level, physical functioning and health related factors. There were differences in physical activity level (p<0.001), self-reported physical functioning (p<0.001) objective physical functioning (p<0.001), health status (p<0.001) and most socio-demographic aspects between the two countries. Here the Swedish cohort had the advantage. There was no difference between the countries regarding prevalence of vertigo or falls. The only variables where the Iranian cohort had advantage over the Swedes were grip strength and smoking habits. There were larger gender differences in walking habits, self-selected walking speed, timed chair stand, and one-leg stance in Iran, and in grip strength in Sweden, all to the disadvantage of women. Iranian 75-years-olds had a lower physical activity level, a worse lower extremity physical function but a better grip strength, a worse physical health status, but smoked less than their Swedish counterparts. Despite this, there were no differences regarding vertigo or falls. In most aspects, the magnitude of gender differences was about the same and in disadvantage of women, although there were larger differences in Iran in some lower extremity functions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Vital signs: births to teens aged 15-17 years--United States, 1991-2012.

PubMed

Cox, Shanna; Pazol, Karen; Warner, Lee; Romero, Lisa; Spitz, Alison; Gavin, Lorrie; Barfield, Wanda

2014-04-11

Teens who give birth at age 15-17 years are at increased risk for adverse medical and social outcomes of teen pregnancy. To examine trends in the rate and proportion of births to teens aged 15-19 years that were to teens aged 15-17 years, CDC analyzed 1991-2012 National Vital Statistics System data. National Survey of Family Growth (NSFG) data from 2006-2010 were used to examine sexual experience, contraceptive use, and receipt of prevention opportunities among female teens aged 15-17 years. During 1991-2012, the rate of births per 1,000 teens declined from 17.9 to 5.4 for teens aged 15 years, 36.9 to 12.9 for those aged 16 years, and 60.6 to 23.7 for those aged 17 years. In 2012, the birth rate per 1,000 teens aged 15-17 years was higher for Hispanics (25.5), non-Hispanic blacks (21.9), and American Indians/Alaska Natives (17.0) compared with non-Hispanic whites (8.4) and Asians/Pacific Islanders (4.1). The rate also varied by state, ranging from 6.2 per 1,000 teens aged 15-17 years in New Hampshire to 29.0 in the District of Columbia. In 2012, there were 86,423 births to teens aged 15-17 years, accounting for 28% of all births to teens aged 15-19 years. This percentage declined from 36% in 1991 to 28% in 2012 (p<0.001). NSFG data for 2006-2010 indicate that although 91% of female teens aged 15-17 years received formal sex education on birth control or how to say no to sex, 24% had not spoken with parents about either topic; among sexually experienced female teens, 83% reported no formal sex education before first sex. Among currently sexually active female teens (those who had sex within 3 months of the survey) aged 15-17 years, 58% used clinical birth control services in the past 12 months, and 92% used contraception at last sex; however, only 1% used the most effective reversible contraceptive methods. Births to teens aged 15-17 years have declined but still account for approximately one quarter of births to teens aged 15-19 years. These data highlight

Spirometric reference values for Hopi Native American children ages 4-13 years.

PubMed

Arnall, David A; Nelson, Arnold G; Hearon, Christopher M; Interpreter, Christina; Kanuho, Verdell

2016-04-01

Spirometry is the most important tool in diagnosing pulmonary disease and is the most frequently performed pulmonary function test. Respiratory disease is also one of the greatest causes for morbidity and mortality on the Hopi Nation, but no specific reference equations exist for this unique population. The purpose of this study was to determine if population reference equations were necessary for these children and, if needed, to create new age and race-specific pulmonary nomograms for Hopi children. Two hundred and ninety-two healthy children, ages 4-13 years, attending Hopi Nation elementary schools in Arizona, were asked to perform spirometry for a full battery of pulmonary volumes and capacities of which the following were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1 ), FEV1 % (FEV1 /FVC), FEF25-75% and peak expiratory flow rate (PEFR). Spirometric data from Navajo children living in the same geographical region as the Hopi children were compared as well as spirometric data from common reference values used for other ethnic groups in the USA. Spirometry tests from 165 girls and 127 boys met American Thoracic Society quality control standards. We found that the natural log of height, body mass and age were significant predictors of FEV1 , FVC, and FEF25-75% in the gender-specific models and that lung function values all increased with height and age as expected. The predictions using the equations derived for Navajo, Caucasian, Mexican-American, African-American youth were significantly different (P ≤ 0.05) from the predictions derived from the Hopi equations for all of the variables across both genders, with the exceptions of Hopi versus Navajo FEV1 /FVC in the males and Hopi versus Caucasians FEF25-75% in the females. Thus it would appear for this population important to have specific formulae to provide more accurate reference values. © 2015 Wiley Periodicals, Inc.

Early stages of Alzheimer's disease are alarming signs in injury deaths caused by traffic accidents in elderly people (≥60 years of age): A neuropathological study.

PubMed

Wijesinghe, Printha; Gorrie, Catherine; Shankar, S K; Chickabasaviah, Yasha T; Amaratunga, Dhammika; Hulathduwa, Sanjayah; Kumara, K Sunil; Samarasinghe, Kamani; Suh, Yoo-Hun; Steinbusch, H W M; De Silva, K Ranil D

2017-01-01

There is little information available in the literature concerning the contribution of dementia in injury deaths in elderly people (≥60 years). This study was intended to investigate the extent of dementia-related pathologies in the brains of elderly people who died in traffic accidents or by suicide and to compare our findings with age- and sex-matched natural deaths in an elderly population. Autopsy-derived human brain samples from nine injury death victims (5 suicide and 4 traffic accidents) and nine age- and sex-matched natural death victims were screened for neurodegenerative and cerebrovascular pathologies using histopathological and immunohistochemical techniques. For the analysis, Statistical Package for the Social Sciences (SPSS) version 16.0 was used. There was a greater likelihood for Alzheimer's disease (AD)-related changes in the elders who succumbed to traffic accidents (1 out of 4) compared to age- and sex-matched suicides (0 out of 5) or natural deaths (0 out of 9) as assessed by the National Institute on Aging - Alzheimer's Association guidelines. Actual burden of both neurofibrillary tangles (NFTs) and (SPs) was comparatively higher in the brains of traffic accidents, and the mean NFT counts were significantly higher in the region of entorhinal cortex ( P < 0.05). However, associations obtained for other dementia-related pathologies were not statistically important. Our findings suggest that early Alzheimer stages may be a contributing factor to injury deaths caused by traffic accidents in elderly people whereas suicidal brain neuropathologies resembled natural deaths.

Age-stratified 5-year risks of cervical precancer among women with enrollment and newly detected HPV infection.

PubMed

Gage, Julia C; Katki, Hormuzd A; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Castle, Philip E; Kinney, Walter K

2015-04-01

It is unclear whether a woman's age influences her risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) upon detection of HPV. A large change in risk as women age would influence vaccination and screening policies. Among 972,029 women age 30-64 undergoing screening with Pap and HPV testing (Hybrid Capture 2, Qiagen, Germantown, MD) at Kaiser Permanente Northern California (KPNC), we calculated age-specific 5-year CIN3+ risks among women with HPV infections detected at enrollment, and among women with "newly detected" HPV infections at their second screening visit. Women (57,899, 6.0%) had an enrollment HPV infection. Among the women testing HPV negative at enrollment with a second screening visit, 16,724 (3.3%) had a newly detected HPV infection at their second visit. Both enrollment and newly detected HPV rates declined with age (p < 0.001). Women with enrollment versus newly detected HPV infection had higher 5-year CIN3+ risks: 8.5% versus 3.9%, (p < 0.0001). Risks did not increase with age but declined slightly from 30-34 years to 60-64 years: 9.4% versus 7.4% (p = 0.017) for enrollment HPV and 5.1% versus 3.5% (p = 0.014) for newly detected HPV. Among women age 30-64 in an established screening program, women with newly detected HPV infections were at lower risk than women with enrollment infections, suggesting reduced benefit vaccinating women at older ages. Although the rates of HPV infection declined dramatically with age, the subsequent CIN3+ risks associated with HPV infection declined only slightly. The CIN3+ risks among older women are sufficiently elevated to warrant continued screening through age 65. © 2014 UICC.

Age-Stratified 5-Year Risks of Cervical Precancer among Women with Enrollment and Newly Detected HPV Infection

PubMed Central

Gage, Julia C.; Katki, Hormuzd A.; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E.; Lorey, Thomas; Cheung, Li C.; Castle, Philip E.; Kinney, Walter K.

2014-01-01

It is unclear whether a woman's age influences her risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) upon detection of HPV. A large change in risk as women age would influence vaccination and screening policies. Among 972,029 women age 30-64 undergoing screening with Pap and HPV testing (Hybrid Capture 2, Qiagen, Germantown, MD, USA) at Kaiser Permanente Northern California (KPNC), we calculated age-specific 5-year CIN3+ risks among women with HPV infections detected at enrollment, and among women with “newly detected” HPV infections at their second screening visit. 57,899 women (6.0%) had an enrollment HPV infection. Among the women testing HPV negative at enrollment with a second screening visit, 16,724 (3.3%) had a newly detected HPV infection at their second visit. Both enrollment and newly detected HPV rates declined with age (p<.001). Women with enrollment vs. newly detected HPV infection had higher 5-year CIN3+ risks: 8.5% vs. 3.9%, (p<.0001). Risks did not increase with age but declined slightly from 30-34 years to 60-64 years: 9.4% vs. 7.4% (p=0.017) for enrollment HPV and 5.1% vs. 3.5% (p=0.014) for newly detected HPV. Among women age 30-64 in an established screening program, women with newly detected HPV infections were at lower risk than women with enrollment infections, suggesting reduced benefit vaccinating women at older ages. Although the rates of HPV infection declined dramatically with age, the subsequent CIN3+ risks associated with HPV infection declined only slightly. The CIN3+ risks among older women are sufficiently elevated to warrant continued screening through age 65. PMID:25136967

Association of health-related behaviors, attitudes, and appraisals to leisure-time physical activity in middle-aged and older women.

PubMed

Holahan, Carole K; Holahan, Charles J; Li, Xiaoyin; Chen, Yen T

2017-02-01

Physical activity carries immediate and long-term benefits for middle-aged and older women; however, physical activity decreases in adulthood and aging in women. In this study, the authors investigate the relation of health behaviors, health attitudes, and health appraisals to leisure-time physical activity among middle-aged and older women in a cross-sectional analysis of the second wave of the Study of Midlife Development in the United States (MIDUS2) conducted during the period from 2004 to 2006. The sample consisted of 829 women, ranging in age from 40 to 75 years of age (Mean = 56 years). In multiple logistic regression analyses, controlling for socio-demographic factors and functional restrictions, most of the psychosocial variables examined showed unique associations with physical activity, including health behaviors of having a routine checkup and not smoking, health attitudes involving commitment to health and valuing physical fitness and strength, and the health appraisal that one's health is better compared to others of the same age. Older women (aged 61-75 years) were less active, but reported greater health commitment than middle-aged women (aged 40-60 years). Neither health commitment nor any other psychosocial variable interacted with age in relation to physical activity. Understanding characteristics of middle-aged and older women who are physically active is essential in tailoring interventions to this population.

Obesity History and Daily Patterns of Physical Activity at Age 60–64 Years: Findings From the MRC National Survey of Health and Development

PubMed Central

Cooper, Rachel; Huang, Lei; Hardy, Rebecca; Crainiceanu, Adina; Harris, Tamara; Schrack, Jennifer A; Crainiceanu, Ciprian; Kuh, Diana

2017-01-01

Abstract Background The aim of this study was to investigate associations of current body mass index (BMI) and obesity history with daily patterns of physical activity. Methods At age 60–64, participants from a British birth cohort study wore accelerometers for 5 days. Accelerometry counts were log-transformed and mean log-counts were used to derive a summary variable indicating total daily log-activity counts. Among those with complete data (n = 1,388) the associations of current BMI and age of first obesity were examined with: (a) total daily log-activity counts and (b) total log-activity counts in four segments of the day. Results Higher current BMI and younger age at obesity were strongly associated with lower levels of total daily activity at age 60–64 even after adjustment for sex, socioeconomic factors, and health status. The fully-adjusted mean difference in total daily log-activity counts was −581.7 (95% confidence interval: −757.2, −406.3) when comparing BMI ≥35 kg/m2 with <25 kg/m2, representing an 18.4% difference. Participants who had been obese since early adulthood had the lowest levels of activity (mean difference in total daily log-activity counts was −413.1 (−638.1, −188.2) when comparing those who were obese by age 26 or 36 with those who were never obese, representing a 13.1% difference). Conclusions Obese older adults may require targeted interventions and additional support to improve their daily activity levels. As younger generations with greater lifetime exposure to obesity reach old age the proportion of adults achieving sufficient levels of activity to realize its associated health benefits is likely to decline. PMID:28329086

Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over-75s Cohort study

PubMed Central

Fleming, Jane; Matthews, Fiona E; Brayne, Carol

2008-01-01

Background The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data. Methods Design: Re-survey of over-90-year-olds in a longitudinal cohort study – cross-sectional interview and intensive 12-month follow-up. Participants and setting: 90 women and 20 men participating in a population-based cohort (aged 91–105 years, in care-homes and community-dwelling) recruited from representative general practices in Cambridge, UK Measurements: Prospective falls data were collected using fall calendars and telephone follow-up for one year after cross-sectional survey including fall history. Results 58% were reported to have fallen at least once in the previous year and 60% in the 1-year follow-up. The proportion reported to have fallen more than once was lower using retrospective recall of the past year than prospective reports gathered the following year (34% versus 45%), as were fall rates (1.6 and 2.8 falls/person-year respectively). Repeated falls in the past year were more highly predictive of falls during the following year – IRR 4.7, 95% CI 2.6–8.7 – than just one – IRR 3.6, 95% CI 2.0–6.3, using negative binomial regression. Only 1/5 reportedly did not fall during either the year before or after interview. Conclusion Fall rates in this representative sample of over-90-year-olds are even higher than previous reports from octogenarians. Recalled falls last year, particularly repeated falls, strongly predicted falls during follow-up. Similar proportions of people who fell were

Thinning increases growth of 60-year-old cherry-maple stands in West Virginia

Treesearch

Neil I. Lamson; Neil I. Lamson

1985-01-01

In north-central West Virginia, previously unmanaged 60-year-old cherrymaple stands were thinned to 60 percent relative stand density. Thinning reduced mortality, redistributed growth onto fewer, larger stems, and increased individual tree growth. Five-year periodic basal-area growth per acre was 1.2 times greater in thinned stands than in unthinned stands. Periodic...

Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India.

PubMed

Kshetrimayum, Nandita; Reddy, Chavva Venkata Konda; Siddhana, Sunitha; Manjunath, Maurya; Rudraswamy, Sushma; Sulavai, Sibyl

2013-06-01

To assess whether oral health-related quality of life (OHRQoL) is associated with nutritional status in the institutionalised elderly population of Mysore. Malnutrition in the elderly has an evident impact on their general health and quality of life. Analysis of data of the Geriatric Oral Health Assessment Index (GOHAI) and their association with the Mini Nutritional Assessment (MNA) results improves our understanding of the complex relationship between oral health and malnutrition. The study was conducted among the institutionalised elderly population in Mysore city, Karnataka. Data on socio-demographic, oral health status were gathered. OHRQoL was evaluated using GOHAI, and malnutrition risk using MNA. Out of 141 elderly, 41.1% were men and 58.9% were women with mean age of 72.2 ±7.5 years. Mean GOHAI score was 47.03 ± 9.2, with 69.5% had low perception of oral health. Mean MNA score was 9.91 ± 2.4, 15.6% were malnourished, 52.5% were at risk of malnutrition and 31.9% were adequately nourished. A strong association was found between the mean GOHAI and MNA scores.  Oral health-related quality of life was associated with nutritional deficit, and it requires a greater integration between dentistry and nutrition in the health promotion of older adults. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

75 FR 43197 - Public Housing Assessment System (PHAS): Asset Management Transition Year 2 Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

...): Asset Management Transition Year 2 Information (75 FR 1632), dated January 12, 2010, for PHAs with... only. B. PHAS Scoring During Transition Year 2 The Transition Year 2 notice (75 FR 1632, January 12... System (PHAS): Asset Management Transition Year 2 Extension AGENCY: Office of the Assistant Secretary for...

INHALED HYPERTONIC SALINE IN INFANTS AND CHILDREN LESS THAN SIX YEARS OF AGE WITH CYSTIC FIBROSIS: THE ISIS RANDOMIZED TRIAL

PubMed Central

Rosenfeld, Margaret; Ratjen, Felix; Brumback, Lyndia; Daniel, Stephen; Rowbotham, Ron; McNamara, Sharon; Johnson, Robin; Kronmal, Richard; Davis, Stephanie D

2013-01-01

Context Inhaled hypertonic saline is recommended as therapy for cystic fibrosis (CF) patients 6 years of age and older, but its efficacy has never been evaluated in CF patients <6 years of age. Objective To determine if hypertonic saline reduces the rate of protocol-defined pulmonary exacerbations in CF patients <6 years of age. Design and Setting A multicenter, randomized, double-blind placebo-controlled trial was conducted from April 2009 to October 2011 at 30 CF care centers in the United States and Canada. Participants Participants had an established diagnosis of CF and were 4 to 60 months of age. A total of 344 patients were assessed for eligibility; 321 participants were randomized; 29 (9%) withdrew prematurely. Intervention The active group (n=158) received 7% hypertonic saline and the control group (n=163) received 0.9% isotonic saline nebulized twice daily for 48 weeks. Both groups received albuterol or levalbuterol prior to each study drug dose. Main Outcome Measures the rate of protocol-defined pulmonary exacerbations during the 48 week treatment period treated with oral, inhaled or intravenous antibiotics. Results The mean pulmonary exacerbation rate (events/person-year) was 2.3 (95% CI, 2.0, 2.5) in the hypertonic saline group and 2.3 (95% CI, 2.1, 2.6) in the isotonic saline group; the rate ratio was 0.98 (95% CI, 0.84, 1.14)). Among participants with pulmonary exacerbations, the mean number of total antibiotic treatment days for a pulmonary exacerbation was 60 (95% CI 49, 70) in the hypertonic saline group and 52 (95% CI 43, 61) in the isotonic saline group. There was no significant difference in secondary endpoints including height, weight, respiratory rate, oxygen saturation, cough or respiratory symptom scores. Infant pulmonary function testing performed as an exploratory outcome in a subgroup (N=73, with acceptable measurements at 2 visits in 45) did not demonstrate significant differences between groups except for the mean change in forced

Ten-Year Aging of Elastomeric Vulcanizates in Panama, Alaska, and Illinois

DTIC Science & Technology

1974-07-01

stated in the previous report on this subject, the most dramatic effect of climatic aging on rubber vulcanizates has been found with the poly- ester... Rubbers ", Rubber Age , Vol. 101, No. 9, PP. V7-60, September 1969. 2BergstrQm, E.W,, Ibid. kk ! \\ ir\\ O &#60T\\CO O ir\\ O J CTv oj aj oj r~-co -4...arctic aging has been shown to have the least effect on the aging properties of the vulcanizates tested, no more static exposure tests of rubber

[The nutritional status among children under 60 months year-old after one year of the Earthquake in Wenchuan].

PubMed

Zhao, Xian-feng; Yin, Shi-an; Zhao, Li-yun; Fu, Ping; Zhang, Jian; Ma, Guan-sheng

2010-08-01

To evaluate the effects of Wenchuan Earthquake on the nutritional status, growth, and the prevalence nutritional anemia, vitamin A deficiency (VAD) and vitamin D deficiency among children under 60 months old living in the disaster areas. A nutritional survey was conducted in April 2009. The survey recruited 466 under 60 months old children, including 162 children aged 0 months old and 304 children aged 24 - 59 months old. The children's growth status, prevalence of anemia, and the iron deficiency prevalence, vitamin A, D, B(12), folic acid status were measured. The study findings were compared to the results from 2002 Chinese Nutritional and Health Survey. The exclusive breast milk feeding rate among infants under 6-months was 58.8% (30/51). Among the 0 - 23 months old children, only 10.7% (16/150) got breast feeding within one hour after delivery. Ninety-two per cent (149/162) 0 - 23 months old children never received any nutrient supplements. The average cereals and roots intakes of the 24 - 59 months old children living in the disaster area were (267.2 ± 154.3) g/d, higher than the result of rural children average (178.75 g/d) of 2002 National Nutrition and Health Survey (u = 9.995, P < 0.01). The average intakes of vegetables, aquatic products, meat and poultries were (63.6 ± 56.7), (2.6 ± 7.9), (19.4 ± 24.0) g/d, respectively, significantly lower than 2002 results 135.05, 8.82 and 32.23 g/d (u = 21.971, 13.728 and 9.321, P < 0.01). Fruits, dairy products and legumes intakes were (102.2 ± 110.8), (65.2 ± 123.8) and (20.5 ± 29.0) g/d, respectively, higher than 2002 results (32.81, 2.87 and 6.50 g/d; u = 10.919, 8.778 and 8.417, P < 0.01). The prevalence of vitamin A deficiency and marginal deficiency was 15.4% (29/188) and 30.3% (57/188), respectively. The sum of vitamin D deficiency and insufficiency was 92.0% (183/199). The prevalence of anemia of the 0-months old children and 24 - 59 months old children was 47.5% (77/162) and 21.5% (60

Relationship of intraoperative cerebral oxygen saturation to neurodevelopmental outcome and brain magnetic resonance imaging at 1 year of age in infants undergoing biventricular repair.

PubMed

Kussman, Barry D; Wypij, David; Laussen, Peter C; Soul, Janet S; Bellinger, David C; DiNardo, James A; Robertson, Richard; Pigula, Frank A; Jonas, Richard A; Newburger, Jane W

2010-07-20

Near-infrared spectroscopy monitoring of cerebral oxygen saturation (rSo(2)) has become routine in many centers, but no studies have reported the relationship of intraoperative near-infrared spectroscopy to long-term neurodevelopmental outcomes after cardiac surgery. Of 104 infants undergoing biventricular repair without aortic arch reconstruction, 89 (86%) returned for neurodevelopmental testing at 1 year of age. The primary near-infrared spectroscopy variable was the integrated rSo(2) (area under the curve) for rSo(2) 60-minute period after cardiopulmonary bypass but not with other perfusion phases. Hemosiderin foci on brain magnetic resonance imaging were associated with lower average rSo(2) from postinduction to 60 minutes post cardiopulmonary bypass (71+/-10% versus 78+/-6%, P=0.01) and with lower average rSO(2) during the rewarming phase (72+/-12% versus 83+/-9%, P=.003) and during the 60-minute period following cardiopulmonary bypass (65+/-11% versus 75+/-10%, P=0.009). In regression analyses that adjusted for age 60-minute period following cardiopulmonary bypass. Perioperative periods of diminished cerebral oxygen delivery, as indicated by rSo(2), are associated with 1-year Psychomotor Development Index and brain magnetic resonance imaging abnormalities among infants undergoing reparative heart surgery. Clinical

Prevalence of dementia among population age over 45 years in Chiang Mai, Thailand.

PubMed

Wangtongkum, Suparus; Sucharitkul, Phongsakorn; Silprasert, Nutcharut; Inthrachak, Rudeethawinl

2008-11-01

To determine the prevalence of dementia in Thai people with age 45 years and above. This project used a cross sectional research design to study the prevalence of dementia in Chiang Mai. Door-to-door technique was assigned in condition with multi-stage probability random sampling to obtain subjects representing the population of Chiang Mai between Oct 2004 and Sep 2005. The researchers collected the data from the subjects aged 45 years and above. All subjects were located from every Amphurs of Chiang Mai. They were first screened with Thai Mini Mental State Examination (TMSE) and Thai Beck Depression Inventory (BDI). The subjects whose TMSE was less than 24 were assessed and diagnosed by a neurologist. Subjects who were determined as having dementia might be laboratory analyzed and classified based on DSM-IV and NINDS-AIREN criteria. The authors enrolled 2,311 people and screened them with Batteries test. One thousand four hundred ninety two people qualified with 610 males and 882 females, whose mean age was 59.7 +/- 10.4 years. The authors found that among the 35 people with dementia, the mean age was 67.9 +/- 8.9 years (45-88 years). The prevalence of dementia among the study participants was 2.35%. In the present study, Alzheimer's disease was the most common type of dementia diagnosed (75.0%) and vascular dementia was the second most commonly diagnosed (12.5%). The prevalence of dementia in Chiang Mai was 2.35%, which does not differ from the previous study Alzheimer's disease was the most common type of dementia diagnosed.

Strength and muscle mass loss with aging process. Age and strength loss.

PubMed

Keller, Karsten; Engelhardt, Martin

2013-10-01

aging process is associated with changes in muscle mass and strength with decline of muscle strength after the 30(th) life year. The aim of this study was to investigate these changes in muscle mass and strength. for this analysis 26 participants were subdivided in two groups. Group 1 comprises participants aged <40 years (n=14), group 2 those >40 years (n=12). We assessed anthropometrics, range of motions, leg circumferences and isometric strength values of the knee joints. besides comparable anthropometrics, circumferences and strength were higher in group 1 than in group 2. Circumference of upper leg (20 cm above knee articular space) showed for right leg a trend to a significant (median: 54.45 cm (1(st) quartile: 49.35/3(rd) quartile: 57.78) vs 49.80 cm (49.50/50.75), p=0.0526) and for left leg a significant 54.30 cm (49.28/58.13) vs 49.50 cm (48.00/52.53), p=0.0356) larger circumference in group 1. Isometric strength was in 60° knee flexion significantly higher in group 1 than in group 2 for right (729.88N (561.47/862.13) vs 456.92N (304.67/560.12), p=0.00448) and left leg (702.49N (581.36/983.87) vs 528.49N (332.95/648.58), p=0.0234). aging process leads to distinct muscle mass and strength loss. Muscle strength declines from people aged <40 years to those >40 years between 16.6% and 40.9%.

The effects of age and education on executive functioning and oral naming performance in greek cypriot adults: the neurocognitive study for the aging.

PubMed

Constantinidou, Fofi; Christodoulou, Marianna; Prokopiou, Juliana

2012-01-01

Age, educational experiences, language and culture can affect linguistic-cognitive performance. This is the first systematic study investigating linguistic-cognitive aging in Greek Cypriot adults focusing on executive functioning (EF) and oral naming performance. Three hundred and fifty-nine participants were included, a group of young-old, aged 60-75 years (n = 231), and a group of old-old participants, aged 76 years and older (n = 128). Participants in each age group were divided into three education groups: 0-4 years (n = 50), 5-9 years (n = 198), and 10 years of education and higher (n = 111). Participants were administered 5 measures of EF along with measures of receptive vocabulary and confrontational naming. There was a significant relationship between the EF composite score and all language measures. MANOVA (α = 0.05) indicated significant age and education effects on most measures of EF and language. Performance on receptive vocabulary and cognitive shift remained stable across age groups, but was mediated by education. Education plays a significant role on all measures requiring semantic organization, speed of information processing, cognitive shift, mental flexibility, receptive vocabulary and confrontational naming. Furthermore, strategic thinking has a role in semantic knowledge, word retrieval and semantic access in healthy aging. We conclude with clinical implications and assessment considerations in aphasia. Copyright © 2012 S. Karger AG, Basel.

Review of 125 Children 6 Years of Age and under Who Were Sexually Abused.

ERIC Educational Resources Information Center

Mian, Marcellina; And Others

1986-01-01

The authors present a chart review of 125 children referred in 1981-1983 because of sexual abuse. Among findings were that 60 percent were victims of intrafamilial abuse. Of the preschoolers, 72.5 percent were victims of intrafamilial abuse. At school age there was a reversal with 73 percent of 6-year-olds being abused by extrafamilial offenders.…

Does community deprivation determine longevity after the age of 75? A cross-national analysis.

PubMed

Ribeiro, Ana Isabel; Krainski, Elias Teixeira; Carvalho, Marilia Sá; Launoy, Guy; Pornet, Carole; de Pina, Maria de Fátima

2018-05-01

Analyze the association between socioeconomic deprivation and old-age survival in Europe, and investigate whether it varies by country and gender. Our study incorporated five countries (Portugal, Spain, France, Italy, and England). A 10-year survival rate expressing the proportion of population aged 75-84 years who reached 85-94 years old was calculated at area-level for 2001-11. To estimate associations, we used Bayesian spatial models and a transnational measure of deprivation. Attributable/prevention fractions were calculated. Overall, there was a significant association between deprivation and survival in both genders. In England that association was stronger, following a dose-response relation. Although lesser in magnitude, significant associations were observed in Spain and Italy, whereas in France and Portugal these were even weaker. The elimination of socioeconomic differences between areas would increase survival by 7.1%, and even a small reduction in socioeconomic differences would lead to a 1.6% increase. Socioeconomic deprivation was associated with survival among older adults at ecological-level, although with varying magnitude across countries. Reasons for such cross-country differences should be sought. Our results emphasize the importance of reducing socioeconomic differences between areas.

Prevalence of hepatitis C antibodies in the population aged 16-80 years in the Community of Madrid 2008-2009.

PubMed

García Comas, Luis; Ordobás Gavín, María; Sanz Moreno, Juan Carlos; Ramos Blázquez, Belén; Gutiérrez Rodríguez, Angeles; Astray Mochales, Jenaro; Moreno Guillén, Santiago

2015-10-01

Together with AIDS, the burden of hepatitis C virus (HCV) in Spain heads the list of communicable diseases in terms of impact on public health. The aim of this study was to estimate the prevalence of HCV antibodies in the Community of Madrid, assess changes in recent years and analyse associated risk factors. Descriptive cross-sectional study of a target population consisting of Community of Madrid residents aged 16-80 years old. Two-stage cluster sampling was performed, with stratification by socioeconomic status and percentage immigrant population. The sampling frame consisted of public blood extraction centers attached to the Madrid Health Service. Seroprevalence of HCV antibodies, prevalence ratios by age groups in comparison with 1999 survey data and prevalence association with risk factors were assessed using a logistic regression model. Prevalence of HCV antibodies for the age group 16-80 years was 1.8% (95% CI: 1.3-2.5). The age group with the highest prevalence was 41-60 years. In comparison with the 1999 survey, prevalence fell for the age groups 21-30 and 31-40 years and increased for the age group 41-60. Statistically significant associations were found for age, education, history of hepatitis C and consultation regarding liver problems. Seroprevalence of HCV antibodies in the Community of Madrid is similar to that shown in other regions of Spain. It is increasing in older age groups as the population at risk ages. Incidence of hepatitis C may be decreasing considering the decrease in the seroprevalence in the population younger than 40 related to the previous serosurvey. © 2015 Wiley Periodicals, Inc.

Time Trends in Murray's Psychogenic Needs over Three Decades in Swedish 75-Year-Olds.

PubMed

Billstedt, Eva; Waern, Margda; Falk, Hanna; Duberstein, Paul; Östling, Svante; Hällström, Tore; Skoog, Ingmar

2017-01-01

While time trends in personality traits have been suggested in younger cohorts, little is known regarding this issue in older adults. To test for birth cohort changes in psychogenic needs according to Murray's theory of personality in two birth cohorts of 75-year-olds born 1901-1902 and 1930. Two population-based birth cohorts were examined at the age of 75 years in 1976-1977 and in 2005-2006. Psychogenic needs according to Murray were measured with the Cesarec-Marke Personality Schedule (CMPS), a Swedish version of the Edwards Personal Preference Schedule. Scores on the CMPS subscales (achievement, affiliation, aggression, defence of status, guilt feelings, dominance, exhibition, autonomy, nurturance, order, succorance, and acquiescence) were compared between cohorts. Achievement, exhibition, dominance, aggression, affiliation, and succorance scores were higher, and order and acquiescence scores lower, in the more recent birth cohort of 75-year-olds. Women scored lower than men on exhibition and dominance, and higher on defence of status, guilt feelings, affiliation, nurturance, and succorance. Interaction effects between cohort and sex were found for achievement (women scored lower than men in 1976-1977 but not in 2005-2006), order (the lower scores in 2005-2006 were more accentuated among men), and acquiescence (increased in men and decreased in women). The later-born birth cohort scored higher on self-centred traits, such as more dominant, competitive, and exhibitive traits as well as the need to be taken care of and have friends around, but it scored lower on the need for order. The gap between men and women regarding achievement decreased, possibly reflecting women's more prominent role in society. © 2016 S. Karger AG, Basel.

Characteristics of astigmatism as a function of age in a Hong Kong clinical population.

PubMed

Leung, Tsz-Wing; Lam, Andrew Kwok-Cheung; Deng, Li; Kee, Chea-Su

2012-07-01

To characterize astigmatism as a function of age in a Hong Kong clinical population. All records from new clinical patients at a university optometry clinic in the year 2007 were used for the study. Only data from subjects with corrected visual acuity ≥6/9 in both eyes and with completed subjective refraction were analyzed. The subjects were divided into seven age groups by decade (i.e., 3 to 10 years, 11 to 20 years, …, >60 years). Refractive errors were decomposed into spherical-equivalent refractive error (M), J0, and J45 astigmatic components for analyses. Internal astigmatism was calculated by subtracting corneal astigmatism from refractive astigmatism (RA). Of the 2759 cases that fulfilled our selection criteria, 58.9% had myopia (M ≥-0.75 D) and 28.4% had RA (Cyl ≥ 1.00 D). The prevalence of RA increased from 17.8% in the 3 to 10 years age group to 38.1% in the 21 to 30 years age group. It then dipped to 25.8% in 41 to 50 years age group but increased again to 41.8% in the >60 years age group. Among the astigmats, almost all 3- to 10-year-old children (92.6%) had with-the-rule (WTR) astigmatism, but a majority of the elderly (>60 years) had against-the-rule (ATR) astigmatism (79.7%). For a subset of subjects who had both subjective refraction and keratometric readings (n = 883), RA was more strongly correlated with corneal (r = 0.35 to 0.74) than with internal astigmatism (r = 0.01 to 0.35). More importantly, the magnitudes of both refractive and corneal J0 were consistent with synchronized decrements (-0.15 and -0.14 D per 10 years, respectively) after the age of 30 years, indicating that the shift toward more ATR astigmatism was related to corneal change. In this Hong Kong Chinese clinical population, the prevalence rates of both myopia and astigmatism increased during the first three decades and shared a similar trend before the age of 50 years. The manifest astigmatism was mainly corneal in nature, bilaterally mirror symmetric in axis, and

Quality Improvement Initiative to Improve HPV Vaccine Initiation at Nine Years of Age,.

PubMed

Goleman, Martha J; Dolce, Millie; Morack, Jennifer

2018-05-26

Adolescent human papillomavirus (HPV) vaccine rates remain low. Early vaccination may improve the efficacy of the vaccine and immunization rates. However, clinicians have not routinely made a strong recommendation to younger adolescents. This study assessed the feasibility of routine vaccination at nine years of age. Three sequential quality improvement (QI) interventions were implemented to shift the initiation of the HPV vaccine to nine years of age in a primary care network in low-income neighborhoods in Columbus, Ohio. The first intervention changed the electronic medical record (EMR) alert for the HPV vaccine from eleven to nine years of age and focused on cancer prevention when discussing the vaccine with families. The second intervention was formation of an HPV QI team. The third intervention was a clinic incentive for HPV captured opportunity rates. Immunization rates were monitored using statistical process control charts to compare the HPV immunization rate in a sample of nine and ten-year-old children with a sample of 11 and 12-year-old children. The percentage of patients receiving an HPV vaccine before 11 years increased from 4.6% to 35.7% during the six months after the QI initiative began and to 60.8% 18 months after the project began. In comparison, the HPV vaccination rate in the sample of 11 and 12 year-olds increased from 78.7% to 82.8% 18 months later. This QI project used multiple interventions to increase HPV vaccination at nine years of age in a large primary care network serving a diverse low-income population. Copyright © 2018. Published by Elsevier Inc.

Differences on Six Horn Abilities for 14 Age Groups between 15-16 and 75-94 Years.

ERIC Educational Resources Information Center

Kaufman, Alan S.; And Others

1996-01-01

Six abilities derived from the fluid and crystallized intelligence theory of J. L. Horn were studied with 1,193 individuals in age groups between 15 and 94 years. Results supported Horn's classification of crystallized and quantitative as maintained abilities and of fluid and broad visualization as vulnerable abilities. (SLD)

Early stages of Alzheimer's disease are alarming signs in injury deaths caused by traffic accidents in elderly people (≥60 years of age): A neuropathological study

PubMed Central

Wijesinghe, Printha; Gorrie, Catherine; Shankar, S. K.; Chickabasaviah, Yasha T.; Amaratunga, Dhammika; Hulathduwa, Sanjayah; Kumara, K. Sunil; Samarasinghe, Kamani; Suh, Yoo-Hun; Steinbusch, H. W. M.; De Silva, K. Ranil D.

2017-01-01

Background: There is little information available in the literature concerning the contribution of dementia in injury deaths in elderly people (≥60 years). Aim: This study was intended to investigate the extent of dementia-related pathologies in the brains of elderly people who died in traffic accidents or by suicide and to compare our findings with age- and sex-matched natural deaths in an elderly population. Materials and Methods: Autopsy-derived human brain samples from nine injury death victims (5 suicide and 4 traffic accidents) and nine age- and sex-matched natural death victims were screened for neurodegenerative and cerebrovascular pathologies using histopathological and immunohistochemical techniques. For the analysis, Statistical Package for the Social Sciences (SPSS) version 16.0 was used. Results: There was a greater likelihood for Alzheimer's disease (AD)-related changes in the elders who succumbed to traffic accidents (1 out of 4) compared to age- and sex-matched suicides (0 out of 5) or natural deaths (0 out of 9) as assessed by the National Institute on Aging – Alzheimer's Association guidelines. Actual burden of both neurofibrillary tangles (NFTs) and (SPs) was comparatively higher in the brains of traffic accidents, and the mean NFT counts were significantly higher in the region of entorhinal cortex (P < 0.05). However, associations obtained for other dementia-related pathologies were not statistically important. Conclusion: Our findings suggest that early Alzheimer stages may be a contributing factor to injury deaths caused by traffic accidents in elderly people whereas suicidal brain neuropathologies resembled natural deaths. PMID:29497190

Low prevalence of depression and anxiety is linked to statutory retirement ages rather than personal work exit: a national survey.

PubMed

Villamil, Elena; Huppert, Felicia A; Melzer, David

2006-07-01

Common mental disorder prevalence decreases substantially around the conventional retirement age for men in the UK, but trends for older women are more continuous. Prevalence changes in depression and anxiety around retirement are less clear, as is the role of risk factors. The aim of this study was to establish whether work status, age or other known risk factors account for the reduced prevalence of depressive episode and anxiety disorder around retirement ages for men and for women. The British Psychiatric Morbidity Survey (BPMS) 2000 was analysed, including 1875 men and 2253 women aged 45-75 years. Diagnoses were from the Revised Clinical Interview Schedule (CIS-R). Logistic models were adjusted for sociodemographic factors, social network, work status, life events, physical illness and disability. There are marked reductions in the prevalence of depressive episode after 60 years for women [60% lower prevalence, 95% confidence interval (CI) 40-80] and 65 years for men (90% lower prevalence, 95% CI 70-100), compared to the youngest age groups. For anxiety disorder, the reduction in prevalence was 80% (95% CI 60-90) for men and 40% (95% CI 20-60) for women. In fully adjusted multivariate models, the strong association between diagnoses and age groups remained, for both genders. Work status was a significant factor for men but not for women. There is a discontinuity in the prevalence of depressive episode for both men and women, coinciding with statutory retirement ages. No studied risk factor reduced the associations between age group and disorders. This population scale recovery may provide a model for understanding non-genetic factors.

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.

Argentine references for the assessment of body proportions from birth to 17 years of age.

PubMed

Del Pino, Mariana; Orden, Alicia B; Arenas, María A; Fano, Virginia

2017-06-01

Abnormal body proportions may indicate skeletal disorders; therefore, their detection has great clinical significance. To estimate centiles for head circumference/height (HC/H) and sitting height/height (SH/H) ratios, and assess their diagnostic usefulness among a group of children with skeletal dysplasia. Centiles 3, 10, 25, 50, 75, 90 and 97 for HC/H and SH/H ratios were estimated with the LMS method using Box-Cox transformation to normalize data distribution for each age. Q-Q plot tests were applied to evaluate normality of residuals and the Q test to calculate goodness-of-fit. The sample included 4818 girls and4803 boys, all healthy, between 0-17 years old. The median of the SH/H ratio for each age decreased from 0.67 at birth to 0.57 at age 4. At 12 years of age, values reached 0.52 and 0.53 for males and females, respectively, remaining unchanged until age 17. The median of the HC/H ratio decreased from 0.45 at 6 years old to 0.34 at 17 years old for both sexes. Z-scores for SH/H among 20 children diagnosed with hypochondroplasia were better at showing abnormal proportions than the SH/H ratio not adjusted by age. Estimated centiles for HC/H and SH/H ratios show that the most dramatic changes in body proportions occur in the prepubertal period. These references allow an earlier detection of abnormal body proportions in children with skeletal dysplasia.

50 Years of Cognitive Aging Theory.

PubMed

Anderson, Nicole D; Craik, Fergus I M

2017-01-01

The objectives of this Introduction to the Journal of Gerontology: Psychological Sciences special issue on "50 Years of Cognitive Aging Theory" are to provide a brief overview of cognitive aging research prior to 1965 and to highlight significant developments in cognitive aging theory over the last 50 years. Historical and recent theories of cognitive aging were reviewed, with a particular focus on those not directly covered by the articles included in this special issue. Prior to 1965, cognitive aging research was predominantly descriptive, identifying what aspects of intellectual functioning are affected in older compared with younger adults. Since the mid-1960s, there has been an increasing interest in how and why specific components of cognitive domains are differentially affected in aging and a growing focus on cognitive aging neuroscience. Significant advances have taken place in our theoretical understanding of how and why certain components of cognitive functioning are or are not affected by aging. We also know much more now than we did 50 years ago about the underlying neural mechanisms of these changes. The next 50 years undoubtedly will bring new theories, as well as new tools (e.g., neuroimaging advances, neuromodulation, and technology), that will further our understanding of cognitive aging. © The Author 2016. 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.

Education in ophthalmology over the past 60 years.

PubMed

Spivey, Bruce E

This paper summarizes the personal experience of an ophthalmologist who has been involved in medical education for over 60 years. With clinical experience and leadership positions within ophthalmology and in broad medical organizations, this paper chronicles the evolution of educational practice and approaches for over a half century. Copyright © 2016 Elsevier Inc. All rights reserved.

Dapsone 7.5% Gel: A Review in Acne Vulgaris.

PubMed

Al-Salama, Zaina T; Deeks, Emma D

2017-02-01

Dapsone 7.5% gel (Aczone ® ) is indicated for the once-daily topical treatment of acne vulgaris in patients aged ≥12 years. Dapsone is a sulfone antibacterial with anti-inflammatory actions, which are thought to be largely responsible for its efficacy in treating acne vulgaris. In two phase III trials of 12 weeks' duration in patients aged ≥12 years with moderate acne vulgaris, once-daily dapsone 7.5% gel reduced acne severity (as per the Global Acne Assessment Score) and lesion counts versus vehicle. The benefits of dapsone 7.5% gel over vehicle were seen as early as week 2 for inflammatory lesion counts, and from week 4 or 8 for other outcomes. Dapsone 7.5% gel was well tolerated, with a low incidence of treatment-related adverse events, with the majority of adverse events being administration-site related and mild or moderate in severity. Thus, dapsone 7.5% gel is an effective and well tolerated option for the topical treatment of acne vulgaris in patients aged ≥12 years, with the convenience of once-daily application.

Oxidative Stress Function in Women over 40 Years of Age, Considering Their Lifestyle.

PubMed

Gonçalves Mota, Maria Paula; Santos, Zirlene; Soares, Jorge; Pereira, Ana; Fonseca, Sandra; Peixoto, Francisco; Gaivão, Isabel; Oliveira, Maria

2017-01-01

Aging is dependent on biological processes that determine the aging of the organism at the cellular level. The Oxidative Stress Theory of Aging might explain some of the age-related changes in cell macromolecules. Moreover, exposome and lifestyle may also induce changes in cell damage induced by oxidative stress. The aim of the present study was to analyze the related redox changes in lymphocyte function of healthy women over 40 years old. Three groups: younger (YG: 40-49 years), middle aged (MAG: 50-59 years), and older (OG: ≥60 years) were evaluated on anthropometric variables, blood pressure, cardiovascular fitness, lifestyle habits, perceived stress, DNA damage, malondialdehyde, catalase activity, and total antioxidant capacity. Physical activity and cardiovascular fitness were significantly higher in YG and MAG as compared to the OG. Systolic blood pressure increased significantly with group age. Frequency and total amount of alcohol intake were lower in the OG and higher in the MAG. No significant differences were observed between the three groups in oxidative stress parameters. Only alcohol consumption was associated with the higher DNA FPG-sensitive sites, and only in the YG ( p  < 0.05). Healthy lifestyle is critical to avoiding major ailments associated with aging. This may be inferred from the lack of significant differences in the various oxidative stress parameters measured in the healthy women over the age of 40 who took part in the study. Conscious lifestyle behaviors (decrease in alcohol and smoking habits) could have impaired the expected age-related oxidative stress increase.

Tumor mismatch repair immunohistochemistry and DNA MLH1 methylation testing of patients with endometrial cancer diagnosed at age younger than 60 years optimizes triage for population-level germline mismatch repair gene mutation testing.

PubMed