Journals of Gerontology Series A-Biological Sciences and Medical Sciences最新文献

筛选
英文 中文
Efficacy and Safety of Dapagliflozin in Patients With Chronic Kidney Disease Across the Spectrum of Frailty. 达帕格列净对不同虚弱程度的慢性肾病患者的疗效和安全性
IF 4.3 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-02-01 DOI: 10.1093/gerona/glad181
Priya Vart, Jawad H Butt, Niels Jongs, Meir Schechter, Glenn M Chertow, David C Wheeler, Roberto Pecoits-Filho, Anna Maria Langkilde, Ricardo Correa-Rotter, Peter Rossing, John J V McMurray, Hiddo J L Heerspink
{"title":"Efficacy and Safety of Dapagliflozin in Patients With Chronic Kidney Disease Across the Spectrum of Frailty.","authors":"Priya Vart, Jawad H Butt, Niels Jongs, Meir Schechter, Glenn M Chertow, David C Wheeler, Roberto Pecoits-Filho, Anna Maria Langkilde, Ricardo Correa-Rotter, Peter Rossing, John J V McMurray, Hiddo J L Heerspink","doi":"10.1093/gerona/glad181","DOIUrl":"10.1093/gerona/glad181","url":null,"abstract":"<p><strong>Background: </strong>A sizeable proportion of patients with chronic kidney disease (CKD) are reported to be frail. Here we examined the safety and efficacy of dapagliflozin in patients with CKD by frailty level.</p><p><strong>Methods: </strong>Adults with CKD, with/without type 2 diabetes, with an estimated glomerular filtration rate (eGFR) of 25-75 mL/min/1.73 m2, and urinary albumin-to-creatinine ratio 200-5 000 mg/g were randomized to dapagliflozin (10 mg/day) or placebo. The primary endpoint was a composite of sustained ≥50% eGFR decline, end-stage kidney disease (ESKD), or death from kidney or cardiovascular (CV) causes.</p><p><strong>Results: </strong>Frailty index (FI), assessed by Rockwood cumulative deficit approach, was calculable in 4 303/4 304 (99.9%) patients: 1 162 (27.0%) in not-to-mildly frail (FI ≤0.210), 1 642 (38.2%) in moderately frail (FI 0.211-0.310), and 1 499 (34.8%) in severely frail categories (FI >0.311). Dapagliflozin reduced the risk of the primary composite endpoint across all FI categories (hazard ratios [95% confidence interval {CI}]: 0.50 [0.33-0.76], 0.62 [0.45-0.85], and 0.64 [0.49--0.83], respectively; p-interaction = 0.67). Results were similar for secondary outcomes including kidney composite outcome (sustained ≥50% eGFR decline, ESKD or death from kidney cause; p-interaction = 0.44), CV endpoint (heart failure hospitalization or CV death; p-interaction = 0.63), and all-cause mortality (p-interaction p = .42). Results were consistent when using FI as a continuous variable. Occurrence of serious adverse events was numerically lower in patients receiving dapagliflozin versus placebo in all FI categories (16.9% vs 20.1%, 26.3% vs 30.7%, and 42.9% vs 47.8%, in not-to-mildly, moderately, and severely frail categories, respectively).</p><p><strong>Conclusions: </strong>The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associated safety.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10809037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9917175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vision and Hearing Difficulties and Life Expectancy Without ADL/IADL Limitations: Evidence From the English Longitudinal Study of Ageing and the Health and Retirement Study. 视力和听力障碍与无 ADL/IADL 限制的预期寿命:来自英国老龄化纵向研究和健康与退休研究的证据。
IF 5.1 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-02-01 DOI: 10.1093/gerona/glad136
Paola Zaninotto, Asri Maharani, Giorgio Di Gessa
{"title":"Vision and Hearing Difficulties and Life Expectancy Without ADL/IADL Limitations: Evidence From the English Longitudinal Study of Ageing and the Health and Retirement Study.","authors":"Paola Zaninotto, Asri Maharani, Giorgio Di Gessa","doi":"10.1093/gerona/glad136","DOIUrl":"10.1093/gerona/glad136","url":null,"abstract":"<p><strong>Background: </strong>Hearing and vision difficulties are some of the most common deficits experienced by older adults. Having either visual or hearing difficulties increases the risk of comorbidity, disability, and poor quality of life. So far, however, few studies have examined the association between vision and hearing difficulties on life expectancy without activities of daily living (ADL) or instrumental ADL (IADL) limitations (LEWL).</p><p><strong>Methods: </strong>Data came from the English Longitudinal Study of Ageing and the Health and Retirement Study in the United States from 2002 to 2013. The outcome was defined as reporting 2+ limitations with ADL/IADL. Life expectancy was estimated by discrete-time multistate life table models for hearing and vision difficulties separately as well as for combined vision and hearing difficulties by sex and age.</p><p><strong>Results: </strong>Thirteen percent of men in England and the United States had ADL/IADL limitations, whereas, for women, it was 16% and 19% in England and the United States. At all ages, either vision or hearing difficulty was associated with shorter LEWL compared to no difficulties. Dual sensory difficulty (vision and hearing) reduced LEWL by up to 12 years in both countries. At the ages of 50 and 60 in England, hearing difficulty was associated with fewer years lived without ADL/IADL limitations than vision difficulty. In contrast, in the United States, vision difficulty led to fewer years lived without ADL/IADL limitations than hearing difficulty.</p><p><strong>Conclusions: </strong>The implementation of strategies to reduce the prevalence and incidence of vision and hearing difficulties has the potential to increase the number of years spent without ADL/IADL limitations.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9893323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Depressive Symptoms, Glial Fibrillary Acid Protein Concentrations, and Cognitive Decline in a Cohort Study. 队列研究中的抑郁症状、胶质纤维酸蛋白浓度与认知能力下降
IF 5.1 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-02-01 DOI: 10.1093/gerona/glad129
Pankaja Desai, Kristin R Krueger, Carlos Mendes de Leon, Robert S Wilson, Denis A Evans, Kumar B Rajan
{"title":"Depressive Symptoms, Glial Fibrillary Acid Protein Concentrations, and Cognitive Decline in a Cohort Study.","authors":"Pankaja Desai, Kristin R Krueger, Carlos Mendes de Leon, Robert S Wilson, Denis A Evans, Kumar B Rajan","doi":"10.1093/gerona/glad129","DOIUrl":"10.1093/gerona/glad129","url":null,"abstract":"<p><strong>Background: </strong>Little is known about how depressive symptoms and glial fibrillary acid protein (GFAP) concentrations taken together may influence cognitive functioning. Understanding this relationship may inform strategies for screening and early intervention to decrease the rate of cognitive decline.</p><p><strong>Methods: </strong>This study sample includes 1 169 participants from the Chicago Health and Aging Project (CHAP), consisting of 60% Black participants and 40% White participants, and 63% female participants and 37% male participants. CHAP is a population-based cohort study of older adults with a mean age of 77 years. Linear mixed-effects regression models tested the main effects of depressive symptoms and GFAP concentrations and their interactions on baseline cognitive function and cognitive decline over time. Models included adjustments for age, race, sex, education, chronic medical conditions, body mass index, smoking status, alcohol use, and their interactions with time.</p><p><strong>Results: </strong>The interaction of depressive symptomology and GFAP (β = -0.105 [standard error = 0.038], p = .006) on global cognitive function was statistically significant. Participants with depressive symptoms including and above the cutoff and high log of GFAP concentrations had more cognitive decline over time, followed by participants with depressive symptoms below the cutoff and high log of GFAP concentrations, depressive symptom scores including and above the cutoff and low log of GFAP concentrations, and depressive symptom scores below the cutoff and low log of GFAP concentrations.</p><p><strong>Conclusions: </strong>Depressive symptoms have an additive effect on the association between the log of GFAP and baseline global cognitive function.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9846186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dynapenic Abdominal Obesity Increases Risk for Falls Among Adults Aged ≥50 Years: A Prospective Analysis of the Irish Longitudinal Study on Ageing. 动态腹部肥胖会增加年龄≥50 岁的成年人跌倒的风险:爱尔兰老龄化纵向研究前瞻性分析》。
IF 5.1 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-01-01 DOI: 10.1093/gerona/glad104
Lee Smith, Guillermo F López Sánchez, Nicola Veronese, Pinar Soysal, Masoud Rahmati, Louis Jacob, Karel Kostev, Josep Maria Haro, Abdullah Ahmed Alghamdi, Laurie Butler, Yvonne Barnett, Helen Keyes, Mark A Tully, Jae Il Shin, Ai Koyanagi
{"title":"Dynapenic Abdominal Obesity Increases Risk for Falls Among Adults Aged ≥50 Years: A Prospective Analysis of the Irish Longitudinal Study on Ageing.","authors":"Lee Smith, Guillermo F López Sánchez, Nicola Veronese, Pinar Soysal, Masoud Rahmati, Louis Jacob, Karel Kostev, Josep Maria Haro, Abdullah Ahmed Alghamdi, Laurie Butler, Yvonne Barnett, Helen Keyes, Mark A Tully, Jae Il Shin, Ai Koyanagi","doi":"10.1093/gerona/glad104","DOIUrl":"10.1093/gerona/glad104","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of studies examining the longitudinal relationship between dynapenic abdominal obesity (DAO; ie, impairment in muscle strength and high waist circumference) and future fall risk. Therefore, we aimed to investigate the prospective association between DAO at baseline and falls occurring during 2 years of follow-up in a nationally representative sample of middle-aged and older individuals from Ireland.</p><p><strong>Methods: </strong>Data from 2 consecutive waves of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of <26 kg for men and <16 kg for women. Abdominal obesity was defined as a waist circumference of >88 cm for women and >102 cm for men. DAO was assessed at Wave 1 (2009-2011) and was defined as having both dynapenia and abdominal obesity. Falls occurring between Wave 1 and Wave 2 (2012-2013) were self-reported. Multivariable logistic regression analysis was conducted.</p><p><strong>Results: </strong>Data on 5 275 individuals aged ≥50 years were analyzed (mean [standard deviation {SD}] age 63.2 [8.9] years; 48.8% males). After adjustment for potential confounders, compared to no dynapenia and no abdominal obesity at baseline, DAO was significantly associated with 1.47 (95% confidence interval [CI]: 1.14-1.89) times higher odds for falls at 2-year follow-up. Dynapenia alone (odds ratio [OR] = 1.08; 95% CI: 0.84-1.40) and abdominal obesity alone (OR = 1.09; 95% CI: 0.91-1.29) were not significantly associated with falls at follow-up.</p><p><strong>Conclusions: </strong>DAO increased the risk for falls among middle-aged and older adults in Ireland. Interventions to prevent or reverse DAO may be beneficial for fall reduction.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9673711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantifying Healthy Aging in Older Veterans Using Computational Audio Analysis. 利用计算音频分析量化老年退伍军人的健康老龄化。
IF 4.3 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-01-01 DOI: 10.1093/gerona/glad154
Yunting Yin, Douglas William Hanes, Steven Skiena, Sean A P Clouston
{"title":"Quantifying Healthy Aging in Older Veterans Using Computational Audio Analysis.","authors":"Yunting Yin, Douglas William Hanes, Steven Skiena, Sean A P Clouston","doi":"10.1093/gerona/glad154","DOIUrl":"10.1093/gerona/glad154","url":null,"abstract":"<p><strong>Background: </strong>Researchers are increasingly interested in better methods for assessing the pace of aging in older adults, including vocal analysis. The present study sought to determine whether paralinguistic vocal attributes improve estimates of the age and risk of mortality in older adults.</p><p><strong>Methods: </strong>To measure vocal age, we curated interviews provided by male U.S. World War II Veterans in the Library of Congress collection. We used diarization to identify speakers and measure vocal features and matched recording data to mortality information. Veterans (N = 2 447) were randomly split into testing (n = 1 467) and validation (n = 980) subsets to generate estimations of vocal age and years of life remaining. Results were replicated to examine out-of-sample utility using Korean War Veterans (N = 352).</p><p><strong>Results: </strong>World War II Veterans' average age was 86.08 at the time of recording and 91.28 at the time of death. Overall, 7.4% were prisoners of war, 43.3% were Army Veterans, and 29.3% were drafted. Vocal age estimates (mean absolute error = 3.255) were within 5 years of chronological age, 78.5% of the time. With chronological age held constant, older vocal age estimation was correlated with shorter life expectancy (aHR = 1.10; 95% confidence interval: 1.06-1.15; p < .001), even when adjusting for age at vocal assessment.</p><p><strong>Conclusions: </strong>Computational analyses reduced estimation error by 71.94% (approximately 8 years) and produced vocal age estimates that were correlated with both age and predicted time until death when age was held constant. Paralinguistic analyses augment other assessments for individuals when oral patient histories are recorded.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Childhood Disadvantage Moderates Late Midlife Default Mode Network Cortical Microstructure and Visual Memory Association. 童年劣势对中年后期默认模式网络皮质微结构和视觉记忆关联的调节作用
IF 5.1 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-01-01 DOI: 10.1093/gerona/glad114
Rongxiang Tang, Jeremy A Elman, Anders M Dale, Stephen M Dorros, Lisa T Eyler, Christine Fennema-Notestine, Daniel E Gustavson, Donald J Hagler, Michael J Lyons, Matthew S Panizzon, Olivia K Puckett, Chandra A Reynolds, Carol E Franz, William S Kremen
{"title":"Childhood Disadvantage Moderates Late Midlife Default Mode Network Cortical Microstructure and Visual Memory Association.","authors":"Rongxiang Tang, Jeremy A Elman, Anders M Dale, Stephen M Dorros, Lisa T Eyler, Christine Fennema-Notestine, Daniel E Gustavson, Donald J Hagler, Michael J Lyons, Matthew S Panizzon, Olivia K Puckett, Chandra A Reynolds, Carol E Franz, William S Kremen","doi":"10.1093/gerona/glad114","DOIUrl":"10.1093/gerona/glad114","url":null,"abstract":"<p><strong>Background: </strong>Childhood disadvantage is a prominent risk factor for cognitive and brain aging. Childhood disadvantage is associated with poorer episodic memory in late midlife and functional and structural brain abnormalities in the default mode network (DMN). Although age-related changes in DMN are associated with episodic memory declines in older adults, it remains unclear if childhood disadvantage has an enduring impact on this later-life brain-cognition relationship earlier in the aging process. Here, within the DMN, we examined whether its cortical microstructural integrity-an early marker of structural vulnerability that increases the risk for future cognitive decline and neurodegeneration-is associated with episodic memory in adults at ages 56-66, and whether childhood disadvantage moderates this association.</p><p><strong>Methods: </strong>Cortical mean diffusivity (MD) obtained from diffusion magnetic resonance imaging was used to measure microstructural integrity in 350 community-dwelling men. We examined both visual and verbal episodic memory in relation to DMN MD and divided participants into disadvantaged and nondisadvantaged groups based on parental education and occupation.</p><p><strong>Results: </strong>Higher DMN MD was associated with poorer visual memory but not verbal memory (β = -0.11, p = .040 vs β = -0.04, p = .535). This association was moderated by childhood disadvantage and was significant only in the disadvantaged group (β = -0.26, p = .002 vs β = -0.00, p = .957).</p><p><strong>Conclusions: </strong>Lower DMN cortical microstructural integrity may reflect visual memory vulnerability in cognitively normal adults earlier in the aging process. Individuals who experienced childhood disadvantage manifested greater vulnerability to cortical microstructure-related visual memory dysfunction than their nondisadvantaged counterparts who exhibited resilience in the face of low cortical microstructural integrity.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9395766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hearing Loss and Physical Activity Among Older Adults in the United States. 美国老年人的听力损失和体育活动。
IF 4.3 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-01-01 DOI: 10.1093/gerona/glad186
Sahar Assi, Erica Twardzik, Jennifer A Deal, Kathleen Martin Ginis, Priya Palta, Jennifer A Schrack, Nicholas S Reed, Pablo Martinez-Amezcua
{"title":"Hearing Loss and Physical Activity Among Older Adults in the United States.","authors":"Sahar Assi, Erica Twardzik, Jennifer A Deal, Kathleen Martin Ginis, Priya Palta, Jennifer A Schrack, Nicholas S Reed, Pablo Martinez-Amezcua","doi":"10.1093/gerona/glad186","DOIUrl":"10.1093/gerona/glad186","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss is associated with adverse health outcomes among older adults. Lower physical activity levels may partly explain these observations, yet the association between hearing loss, hearing aid use, and physical activity among older adults is understudied.</p><p><strong>Methods: </strong>Cross-sectional analysis of National Health and Aging Trends Study (2021) participants. The better-hearing ear pure-tone average (BPTA) at speech frequencies (0.5-4 kHz) was modeled continuously (10-dB increments) and categorically (no: ≤25 dB, mild: 26-40 dB, moderate or greater: >40 dB hearing loss). Activity measures were wrist accelerometry-derived (Actigraph) total activity counts, daily active minutes, activity fragmentation (using active-to-sedentary transition probability), and self-reported participation in vigorous activities and walking for exercise in the last month. We used multivariable regression adjusted for sociodemographic and health covariates.</p><p><strong>Results: </strong>Among 504 participants excluding hearing aid users (mean age = 79 years, 57% female, 9% Black), 338 (67%) had hearing loss. Worse hearing (continuously and categorically) was associated with fewer counts and active minutes, more fragmented activity, and greater odds of not reporting recent vigorous activities. Among 472 participants with hearing loss including hearing aid users, nonusers (n = 338) had more fragmented activity and greater odds of not reporting walking for exercise compared to users.</p><p><strong>Conclusions: </strong>Older adults with hearing loss are less physically active. This may mediate the association between hearing loss and other adverse outcomes. Recognition of this potential association is essential for providers to better support older adults in maintaining an active lifestyle. Future research is warranted to understand the impact of hearing interventions.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9917169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Terminal Decline in Physical Function in Older Adults. 老年人身体功能的终末衰退。
IF 5.1 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-01-01 DOI: 10.1093/gerona/glad119
Erwin Stolz, Hannes Mayerl, Graciela Muniz-Terrera, Thomas M Gill
{"title":"Terminal Decline in Physical Function in Older Adults.","authors":"Erwin Stolz, Hannes Mayerl, Graciela Muniz-Terrera, Thomas M Gill","doi":"10.1093/gerona/glad119","DOIUrl":"10.1093/gerona/glad119","url":null,"abstract":"<p><strong>Background: </strong>It is currently unclear whether (and when) physical function exhibits a terminal decline phase, that is, a substantial acceleration of decline in the very last years before death.</p><p><strong>Methods: </strong>702 deceased adults aged 70 years and older from the Yale PEP Study provided 4 133 measurements of physical function (Short Physical Performance Battery, SPPB) up to 20 years before death. In addition, continuous gait and chair rise subtest scores (in seconds) were assessed. Generalized mixed regression models with random change points were used to estimate the onset and the steepness of terminal decline in physical function.</p><p><strong>Results: </strong>Decline accelerated in the last years of life in all 3 measures of physical function. The onset of terminal decline occurred 1 year before death for the SPPB, and at 2.5 and 2.6 years before death for chair rise and gait speed test scores, respectively. Terminal declines in physical function were 6-8 times steeper than pre-terminal declines. Relative to those whose condition leading to death was frailty, participants who died from dementia and cancer had an up to 6 months earlier and 3 months later onset of terminal decline in SPPB, respectively.</p><p><strong>Conclusions: </strong>Terminal decline in physical function among older adults is comparable to the more established terminal decline phenomenon in cognition. Our results provide additional evidence of late-life rapid decline in physical function due to impending death.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9767851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Mild Behavioral Impairment on Longitudinal Changes in Cognition. 轻度行为障碍对认知纵向变化的影响。
IF 4.3 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-01-01 DOI: 10.1093/gerona/glad098
Hillary J Rouse, Zahinoor Ismail, Ross Andel, Victor A Molinari, John A Schinka, Brent J Small
{"title":"Impact of Mild Behavioral Impairment on Longitudinal Changes in Cognition.","authors":"Hillary J Rouse, Zahinoor Ismail, Ross Andel, Victor A Molinari, John A Schinka, Brent J Small","doi":"10.1093/gerona/glad098","DOIUrl":"10.1093/gerona/glad098","url":null,"abstract":"<p><strong>Background: </strong>To examine cross-sectional differences and longitudinal changes in cognitive performance based on the presence of mild behavioral impairment (MBI) among older adults who are cognitively healthy or have mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>Secondary data analysis of participants (n = 17 291) who were cognitively healthy (n = 11 771) or diagnosed with MCI (n = 5 520) from the National Alzheimer's Coordinating Center database. Overall, 24.7% of the sample met the criteria for MBI. Cognition was examined through a neuropsychological battery that assessed attention, episodic memory, executive function, language, visuospatial ability, and processing speed.</p><p><strong>Results: </strong>Older adults with MBI, regardless of whether they were cognitively healthy or diagnosed with MCI, performed significantly worse at baseline on tasks for attention, episodic memory, executive function, language, and processing speed and exhibited greater longitudinal declines on tasks of attention, episodic memory, language, and processing speed. Cognitively healthy older adults with MBI performed significantly worse than those who were cognitively healthy without MBI on tasks of visuospatial ability at baseline and on tasks of processing speed across time. Older adults with MCI and MBI performed significantly worse than those with only MCI on executive function at baseline and visuospatial ability and processing speed tasks across time.</p><p><strong>Conclusions: </strong>This study found evidence that MBI is related to poorer cognitive performance cross-sectionally and longitudinally. Additionally, those with MBI and MCI performed worse across multiple tasks of cognition both cross-sectionally and across time. These results provide support for MBI being uniquely associated with different aspects of cognition.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9289499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Protective Effect of Familial Longevity Persists After Age 100: Findings From the Danish National Registers. 家庭长寿的保护作用在100岁之后仍然存在:来自丹麦国家登记册的研究结果。
IF 4.3 2区 医学
Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-01-01 DOI: 10.1093/gerona/glad164
Angéline Galvin, Jacob Krabbe Pedersen, Mary K Wojczynski, Svetlana Ukraintseva, Konstantin Arbeev, Mary Feitosa, Michael A Province, Kaare Christensen
{"title":"The Protective Effect of Familial Longevity Persists After Age 100: Findings From the Danish National Registers.","authors":"Angéline Galvin, Jacob Krabbe Pedersen, Mary K Wojczynski, Svetlana Ukraintseva, Konstantin Arbeev, Mary Feitosa, Michael A Province, Kaare Christensen","doi":"10.1093/gerona/glad164","DOIUrl":"10.1093/gerona/glad164","url":null,"abstract":"<p><strong>Background: </strong>A recent study suggested that the protective effect of familial longevity becomes negligible for centenarians. However, the authors assessed the dependence on familial longevity in centenarians by comparing centenarians with 1 parent surviving to age 80+ to centenarians whose same-sexed parent did not survive to age 80. Here we test whether the protective effect of familial longevity persists after age 100 using more restrictive definitions of long-lived families.</p><p><strong>Methods: </strong>Long-lived sibships were identified through 3 nationwide, consecutive studies in Denmark, including families with either at least 2 siblings aged 90+ or a Family Longevity Selection Score (FLoSS) above 7. Long-lived siblings enrolled in these studies and who reached age 100 were included. For each sibling, 5 controls matched on sex and year of birth were randomly selected among centenarians in the Danish population. Survival time from age 100 was described with Kaplan-Meier curves for siblings and controls separately. Survival analyses were performed using stratified Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 340 individuals from long-lived sibships who survived to age 100 and 1 700 controls were included. Among the long-lived siblings and controls, 1 650 (81%) were women. The results showed that long-lived siblings presented better overall survival after age 100 than sporadic long-livers (hazard ratio [HR]  = 0.80, 95% confidence interval [CI]  = 0.71-0.91), with even lower estimate (HR = 0.65, 95% CI = 0.50-0.85) if familial longevity was defined by FLoSS.</p><p><strong>Conclusions: </strong>The present study, with virtually no loss to follow-up, demonstrated a persistence of protective effect of familial longevity after age 100.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9778190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信