Characterizing Deficit Accumulation Among Gulf War Era Veterans.

IF 3.3 Q2 GERIATRICS & GERONTOLOGY
S E Petry, A D Thompson, E R Hauser, S M Lynch, S H Boyle, J Upchurch, A Press, K J Sims, C D Williams, E J Gifford
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引用次数: 0

Abstract

Background: Veterans of the first Gulf War (1990-1991) are reaching middle and older adulthood in differing degrees of health and biological age. Many Gulf War veterans report myriad negative symptoms classified as Gulf War illness (GWI), a chronic multi-symptom illness.

Objectives: To describe and analyze deficit accumulation, among veterans with Severe GWI (SGWI+) and those without Severe GWI (SGWI-), to assess the association between a medically unexplained illness and aging.

Design: This study uses a retrospective cohort design with quasi-longitudinal data.

Setting: The recruitment sample included 10,042 Gulf War era veterans across all four US Census regions.

Participants: The analytic sample included 1,054 participants of the GWECB for whom SGWI case status could be determined and who had valid responses for at least 90% of the deficits included in the deficit accumulation index.

Measurements: Chronic health conditions were retroactively reported, including year of diagnosis, enabling us to create a longitudinal measure of deficit accumulation. This deficit accumulation index (DAI) ranged from 0-1 for each respondent in each year between 1991-2013. We compare veterans with SGWI+ to those with SGWI- using the CDC case definition.

Results: Most veterans in our sample could expect to spend more years with moderate or substantial deficits than without deficits. SGWI+ was associated with spending more years with substantial deficits than those with SGWI-. Veterans in middle age (age 35-65) experienced more years with substantial deficits than younger veterans. Individuals with SGWI+ had 13 times the hazard of accumulating substantial deficits than those without.

Conclusions: This study demonstrated that veterans with SGWI+, even those in midlife, experienced aging as measured by accumulating deficits. Practitioners should consider patients with multi-symptom illnesses as at risk of accelerated aging, tailoring treatments to address patients' holistic needs.

海湾战争时期退伍军人赤字累积的特征。
背景:第一次海湾战争(1990-1991 年)的退伍军人已步入中老年,他们的健康状况和生理年龄各不相同。许多海湾战争退伍军人报告了无数负面症状,这些症状被归类为海湾战争疾病(GWI),这是一种慢性多症状疾病:描述并分析患有严重海湾战争疾病(SGWI+)和未患有严重海湾战争疾病(SGWI-)的退伍军人的赤字积累情况,以评估医学上无法解释的疾病与衰老之间的关联:本研究采用回顾性队列设计和准纵向数据:招募样本包括美国四个人口普查地区的 10,042 名海湾战争时期的退伍军人:分析样本包括 1,054 名 GWECB 参与者,这些参与者的 SGWI 病例状态可以确定,并且对赤字累积指数中至少 90% 的赤字做出了有效回答:我们对慢性健康状况进行了追溯性报告,包括诊断年份,从而建立了赤字累积的纵向衡量标准。1991-2013 年间,每位受访者每年的赤字累积指数(DAI)介于 0-1 之间。我们使用疾病预防控制中心的病例定义,将 SGWI+ 的退伍军人与 SGWI- 的退伍军人进行了比较:在我们的样本中,大多数退伍军人都有中度或严重缺陷,比没有缺陷的退伍军人花费更多的时间。与 SGWI- 的退伍军人相比,SGWI+ 的退伍军人患有严重缺陷的时间更长。与年轻退伍军人相比,中年(35-65 岁)退伍军人出现严重缺陷的年数更多。SGWI+患者累积严重缺陷的风险是非SGWI+患者的13倍:这项研究表明,患有 SGWI+ 的退伍军人,即使是中年退伍军人,也会出现衰老,表现为缺陷不断累积。医生应将患有多种症状疾病的患者视为有加速衰老风险的人群,并根据患者的整体需求调整治疗方法。
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来源期刊
Journal of Frailty & Aging
Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-
CiteScore
5.90
自引率
7.70%
发文量
54
期刊介绍: The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons.          The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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