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Nut consumption and disability-free survival in community-dwelling older adults: a prospective cohort study. 社区老年人的坚果摄入量和无残疾存活率:一项前瞻性队列研究。
IF 6 2区 医学
Age and ageing Pub Date : 2024-11-01 DOI: 10.1093/ageing/afae239
Holly Wild, Madina Nurgozhina, Danijela Gasevic, Alison M Coates, Robyn L Woods, Joanne Ryan, Lawrence Beilin, Thara Govindaraju, John J McNeil, Alice J Owen
{"title":"Nut consumption and disability-free survival in community-dwelling older adults: a prospective cohort study.","authors":"Holly Wild, Madina Nurgozhina, Danijela Gasevic, Alison M Coates, Robyn L Woods, Joanne Ryan, Lawrence Beilin, Thara Govindaraju, John J McNeil, Alice J Owen","doi":"10.1093/ageing/afae239","DOIUrl":"10.1093/ageing/afae239","url":null,"abstract":"<p><strong>Objectives: </strong>The relationship between nut intake and disability-free survival (healthy lifespan) in later life is unclear. The objective was to evaluate the association between nut intake and disability-free survival in a cohort of adults aged ≥70 years, and whether this varied according to overall diet quality.</p><p><strong>Methods: </strong>This prospective cohort study involved 9916 participants from the ASPREE Longitudinal Study of Older Persons. Participants completed a 49-item Food Frequency questionnaire from which frequency of nut intake was obtained and were asked to categories usual intake as no/infrequent [never/rarely, 1-2 times/month], weekly [1-2 times/week, often 3-6 times/week] or daily [every day or several times a day]. The outcome measured was a composite of first-event mortality, onset of dementia, or persistent physical disability. Cox proportional hazards regression models, adjusted for socio-demographic factors, health-related and clinical covariates and overall dietary quality were conducted to examine the association between varying levels of nut intake and disability-free survival.</p><p><strong>Results: </strong>Over a mean of 3.9 years of follow-up, the risk of reaching the DFS endpoint were 23% lower (HR 0.77 [0.61-0.98]) for those who consumed nuts daily, when compared to those with no/infrequent nut consumption. Subgroup analysis demonstrated a significant association between daily nut consumption and healthy lifespan among individuals in the second dietary quality tertile (HR 0.71[0.51-0.98]).</p><p><strong>Conclusion: </strong>For community-dwelling adults aged 70 years and over with sub-optimal diets, daily nut consumption is associated with the promotion of healthy lifespan (disability-free survival).</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"53 11","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646711","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
New horizons in hospital-associated deconditioning: a global condition of body and mind. 医院相关失调症的新视野:一种全球性的身心状况。
IF 6 2区 医学
Age and ageing Pub Date : 2024-11-01 DOI: 10.1093/ageing/afae241
Carly Welch, Yaohua Chen, Peter Hartley, Corina Naughton, Nicolas Martinez-Velilla, Dan Stein, Roman Romero-Ortuno
{"title":"New horizons in hospital-associated deconditioning: a global condition of body and mind.","authors":"Carly Welch, Yaohua Chen, Peter Hartley, Corina Naughton, Nicolas Martinez-Velilla, Dan Stein, Roman Romero-Ortuno","doi":"10.1093/ageing/afae241","DOIUrl":"10.1093/ageing/afae241","url":null,"abstract":"<p><p>Hospital-associated deconditioning is a broad term, which refers non-specifically to declines in any function of the body secondary to hospitalisation. Older people, particularly those living with frailty, are known to be at greatest risk. It has historically been most commonly used as a term to describe declines in muscle mass and function (i.e. acute sarcopenia). However, declines in physical function do not occur in isolation, and it is recognised that cognitive deconditioning (defined by delayed mental processing as part of a spectrum with fulminant delirium at one end) is commonly encountered by patients in hospital. Whilst the term 'deconditioning' is descriptive, it perhaps leads to under-emphasis on the inherent organ dysfunction that is associated, and also implies some ease of reversibility. Whilst deconditioning may be reversible with early intervention strategies, the long-term effects can be devastating. In this article, we summarise the most recent research on this topic including new promising interventions and describe our recommendations for implementation of tools such as the Frailty Care Bundle.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"53 11","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575172","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
Clinical biomarker-based biological ageing and the risk of adverse outcomes in patients with chronic kidney disease. 基于临床生物标志物的生物老化与慢性肾病患者不良预后的风险。
IF 6 2区 医学
Age and ageing Pub Date : 2024-11-01 DOI: 10.1093/ageing/afae245
Hao Xiang, Yu Huang, Yuanyuan Zhang, Panpan He, Ziliang Ye, Sisi Yang, Yanjun Zhang, Xiaoqin Gan, Fan Fan Hou, Xianhui Qin
{"title":"Clinical biomarker-based biological ageing and the risk of adverse outcomes in patients with chronic kidney disease.","authors":"Hao Xiang, Yu Huang, Yuanyuan Zhang, Panpan He, Ziliang Ye, Sisi Yang, Yanjun Zhang, Xiaoqin Gan, Fan Fan Hou, Xianhui Qin","doi":"10.1093/ageing/afae245","DOIUrl":"10.1093/ageing/afae245","url":null,"abstract":"<p><strong>Objective: </strong>Patients with chronic kidney disease (CKD) show features of premature ageing. We aimed to evaluate the association between biological ageing and adverse outcomes, including end-stage kidney disease (ESKD), cardiovascular diseases (CVD) and all-cause mortality, in patients with CKD.</p><p><strong>Methods: </strong>23 435 participants with CKD and free of related adverse outcomes at baseline from the UK Biobank were included. Leukocyte telomere length (LTL) was measured by quantitative polymerase chain reaction assay. Clinical biomarker-based biological ages were quantified using Klemera-Doubal method biological age (KDM-BA) and PhenoAge algorithms.</p><p><strong>Results: </strong>During a median follow-up of 12 years, 3417 incident CVD, 383 incident ESKD and 3195 all-cause mortality were recorded. Per SD increment of KDM-BA acceleration was associated with a 56% [95% confidence interval (CI): 41%-73%], 26% (95% CI: 21%-31%) and 39% (95% CI: 34%-44%) increase in the risk of incident ESKD, incident CVD and all-cause mortality, respectively. Similar results were found for PhenoAge acceleration. LTL (per SD increment) was inversely associated with the risk of incident CVD [hazard ratio (HR): 0.96, 95% CI: 0.92-0.99] and all-cause mortality (HR: 0.94, 95% CI: 0.91-0.98) and was not significantly associated with the risk of incident ESKD (HR: 0.96, 95% CI: 0.86-1.06). Adding KDM-BA acceleration or PhenoAge acceleration, but not LTL, to the traditional validated clinical prediction models significantly improved the predictive performance for incident ESKD, all-cause mortality and CVD.</p><p><strong>Conclusion: </strong>In patients with CKD, both KDM-BA acceleration and PhenoAge acceleration were associated with an increased risk of ESKD, CVD and all-cause mortality, and KDM-BA or PhenoAge may be a better predictor on adverse outcomes than LTL.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"53 11","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612399","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
Reimagining and rebranding advance care planning 重新构想和打造预先护理规划
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-10-24 DOI: 10.1093/ageing/afae233
Chetna Malhotra
{"title":"Reimagining and rebranding advance care planning","authors":"Chetna Malhotra","doi":"10.1093/ageing/afae233","DOIUrl":"https://doi.org/10.1093/ageing/afae233","url":null,"abstract":"Advance care planning (ACP) has traditionally aimed at ensuring that patients’ end-of-life (EOL) wishes are understood and respected. However, recent literature raises concerns about its effectiveness, with many trials indicating that ACP does not significantly improve goal-concordant care, enhance quality of life or reduce healthcare costs. This is because patients’ future decisions are influenced by their transient preferences due to projection bias. To remain relevant, ACP requires a radical shift in perspective, implementation and branding. First, ACP’s mission must be redefined with a focus on: Educate, Share and Prepare. This perspective emphasises ongoing conversations about patient health and illness, sharing of patients’ current values and goals of care and preparation for the future, rather than making definitive future decisions. Second, ACP should be integrated into routine care, normalising these discussions. Simplifying ACP processes and shifting incentives to support shared responsibility among stakeholders can enhance integration. Last, rebranding ACP as ‘Advance Care Preparation’ can clarify its purpose, distinguishing it from EOL planning and increasing its uptake. This rebranding ensures that ACP meets the evolving needs of patients and their families, ultimately enhancing the quality of care and patient satisfaction. These changes in perspective, implementation and branding can transform ACP into a valuable tool for delivering compassionate, patient-centred healthcare, making it relevant to all individuals.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"47 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489743","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
“Research happens a lot in other settings—so why not here?” A qualitative interview study of stakeholders’ views about advance planning for care home residents’ research participation "研究在其他环境中经常发生,为什么这里没有?一项定性访谈研究,探讨利益相关者对养老院居民参与研究的预先规划的看法
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-10-24 DOI: 10.1093/ageing/afae235
Brittany Nocivelli, Fiona Wood, Kerenza Hood, Carolyn Wallace, Victoria Shepherd
{"title":"“Research happens a lot in other settings—so why not here?” A qualitative interview study of stakeholders’ views about advance planning for care home residents’ research participation","authors":"Brittany Nocivelli, Fiona Wood, Kerenza Hood, Carolyn Wallace, Victoria Shepherd","doi":"10.1093/ageing/afae235","DOIUrl":"https://doi.org/10.1093/ageing/afae235","url":null,"abstract":"Background Underrepresentation of care home residents in research has resulted in a poorer evidence base for health care in care homes. Fewer opportunities to take part in research, as well as assumptions made by others about their interest or wishes, creates challenges for residents’ inclusion in research. Early discussions about research preferences and wishes may be beneficial. This qualitative study aimed to explore stakeholders’ views about how care home residents can be supported to communicate their wishes about research participation. Method Semi-structured interviews were conducted with 25 stakeholders: care home residents (n = 5), relatives (n = 5), care home staff (n = 5), other health and social care professionals who work with care homes (n = 6), and care home researchers (n = 4). Interviews were conducted virtually or face-to-face and data were analysed using thematic analysis. Results Views about resident research participation, the barriers and facilitators to their inclusion, and the role of advance research planning were iteratively organized into three themes: (i) We’re of no value to research; (ii) Research is difficult; and (iii) Advance research planning: good in theory, challenging in practice. Subthemes were also identified, and findings were discussed with a Patient and Public Involvement group for additional reflections. Conclusions Stakeholders identified a number of barriers to including care home residents in research, including knowing their preferences about research. The development of interventions to facilitate communication that can be adapted to individuals’ requirements are needed to support discussions and decision-making with care home residents about wishes and preferences for future research participation.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"97 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489744","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
Retrospective evaluation of the world falls guidelines-algorithm in older adults 对世界老年人跌倒指南算法的回顾性评估
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-10-18 DOI: 10.1093/ageing/afae229
Bob van de Loo, Martijn W Heymans, Stephanie Medlock, Ameen Abu-Hanna, Nathalie van der Velde, Natasja M van Schoor
{"title":"Retrospective evaluation of the world falls guidelines-algorithm in older adults","authors":"Bob van de Loo, Martijn W Heymans, Stephanie Medlock, Ameen Abu-Hanna, Nathalie van der Velde, Natasja M van Schoor","doi":"10.1093/ageing/afae229","DOIUrl":"https://doi.org/10.1093/ageing/afae229","url":null,"abstract":"Background The World Falls Guidelines (WFG) propose an algorithm that classifies patients as low-, intermediate-, and high-risk. We evaluated different operationalizations of the WFG algorithm and compared its predictive performance to other screening tools for falls, namely: the American Geriatrics Society and British Geriatrics Society (AGS/BGS) algorithm, the 3KQ on their own and fall history on its own. Methods We included data from 1509 adults aged ≥65 years from the population-based Longitudinal Aging Study Amsterdam. The outcome was ≥1 fall during 1-year follow-up, which was ascertained using fall calendars. The screening tools’ items were retrospectively operationalized using baseline measures, using proxies where necessary. Results Sensitivity ranged between 30.9–48.0% and specificity ranged between 77.0–88.2%. Operationalizing the algorithm with the 3KQ instead of fall history yielded a higher sensitivity but lower specificity, whereas operationalization with the Clinical Frailty Scale (CFS) classification tree instead of Fried’s frailty criteria did not affect predictive performance. Compared to the WFG algorithm, the AGS/BGS algorithm and fall history on its own yielded similar predictive performance, whereas the 3KQ on their own yielded a higher sensitivity but lower specificity. Conclusion The WFG algorithm can identify patients at risk of a fall, especially when the 3KQ are included in its operationalization. The CFS and Fried’s frailty criteria may be used interchangeably in the algorithm’s operationalization. The algorithm performed similarly compared to other screening tools, except for the 3KQ on their own, which have higher sensitivity but lower specificity and lack clinical recommendations per risk category.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"233 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142449495","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
Realising the right to rehabilitation—commentary on ‘reablement, rehabilitation, recovery: everyone’s business’ 实现康复权--关于 "重新适应、康复、恢复:人人有责 "的评论
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-10-14 DOI: 10.1093/ageing/afae228
Hendry Anne
{"title":"Realising the right to rehabilitation—commentary on ‘reablement, rehabilitation, recovery: everyone’s business’","authors":"Hendry Anne","doi":"10.1093/ageing/afae228","DOIUrl":"https://doi.org/10.1093/ageing/afae228","url":null,"abstract":"Rehabilitation is a core component of comprehensive geriatric assessment and should be central to integrated care and support across the whole system. Yet access barriers and ageist practices still prevail within many rehabilitation services. This commentary reflects on a report and recommendations published by the British Geriatrics Society in May 2024. As lead author for the report, I share my personal reflection on the key messages and take this opportunity to thank the multidisciplinary contributors. Reablement, Rehabilitation, Recovery: everyone’s business describes why rehabilitation matters to older people and their caregivers. It provides evidence and examples of practice at different care touchpoints and makes the case that rehabilitation is everyone’s business and knows no boundaries, whether by condition, profession, care setting or taxonomy. The report sets out 12 key actions for health and care systems to deliver effective and integrated rehabilitation as a right for all older people, wherever and whenever they need it. To realise that right, health and care professionals must work together, and with their local community partners, to build capacity and capability for reablement, rehabilitation and recovery across the whole workforce. With population ageing and many more people living with frailty or multimorbidity, there is an urgent need for greater investment in rehabilitation to prevent, delay or reduce disability, caregiver burden and demand for long-term care. This timely BGS report should be essential reading for all who plan, commission, provide or assure health and care services for older people.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"88 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431374","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
Effects of controlled supramaximal high-intensity interval training on muscle capacities and physical functions for older adults: analysis of secondary outcomes from the Umeå HIT study—a randomised controlled trial 受控超大强度高强度间歇训练对老年人肌肉能力和身体机能的影响:乌默奥 HIT 研究--随机对照试验的次要结果分析
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-10-14 DOI: 10.1093/ageing/afae226
Erik Frykholm, Mattias Hedlund, Clemens Becker, Henrik Holmberg, Bengt Johansson, Jochen Klenk, Nina Lindelöf, Ulrich Lindemann, Emma Simonsson, Carl-Johan Boraxbekk, Erikx Rosendahl
{"title":"Effects of controlled supramaximal high-intensity interval training on muscle capacities and physical functions for older adults: analysis of secondary outcomes from the Umeå HIT study—a randomised controlled trial","authors":"Erik Frykholm, Mattias Hedlund, Clemens Becker, Henrik Holmberg, Bengt Johansson, Jochen Klenk, Nina Lindelöf, Ulrich Lindemann, Emma Simonsson, Carl-Johan Boraxbekk, Erikx Rosendahl","doi":"10.1093/ageing/afae226","DOIUrl":"https://doi.org/10.1093/ageing/afae226","url":null,"abstract":"Objective This study investigated the effectiveness of supramaximal high-intensity interval training (supramaximal HIT) on muscle capacities and physical function compared to moderate-intensity training (MIT) for older adults. Methods Sixty-eight older adults (66–79 years, 56% women), not engaged in regular exercise, were randomised to 3 months of twice-weekly supramaximal HIT (20 minutes including 10 × 6-second intervals) or MIT (40 minutes including 3 × 8-minute intervals). Both groups performed the training on stationary bicycles in a group setting. Target intensity was watt-controlled, with standardised cadence and individualised resistance. Outcomes analysed with linear-mixed models included leg power (Nottingham Power Rig), hand grip strength (Jamar dynamometer), static and dynamic balance (One leg stance, 30-second step test), chair stand (30-second chair stand), and anaerobic cycling performance (modified Borg Cycle Strength Test). Results Baseline values were (supramaximal HIT/MIT, mean ± SD) leg power 198 ± 60/189 ± 53 W, hand grip strength 4.2 ± 1.0/4.3 ± 1.1 N/kg, static balance 64 ± 41/62 ± 41 s, dynamic balance 39 ± 7/38 ± 5 steps, chair stands 22 ± 6/22 ± 6 and anaerobic cycling performance 224 ± 60/217 ± 55 W. At 3-month follow-up, a between-group difference in favour of supramaximal HIT [95% CI] was observed in anaerobic cycling performance of 19[3;35] W. Within-group mean changes for supramaximal HIT/MIT were for leg power 8.4[0.9;15.8]/6.0[−1.3;13.3] W, hand grip strength 0.14[0.00;0.27]/0.13[−0.01;0.26] N/kg, static balance 11[3;20]/10[1;18] s, dynamic balance 1.6[0.3;2.8]/2.3[1.1;3.6] steps, 2.1[1.1;3.1]/1.4[0.4;2.3] chair stands and anaerobic cycling performance 31.3[19.6;43.0]/12.0[0.4;23.5] W. Conclusion Supramaximal HIT showed superior effect on anaerobic cycling performance when compared to MIT. Additionally, the results indicate that supramaximal HIT is comparably beneficial as MIT in terms of effects on muscle capacity and physical function for older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"62 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431373","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
Predicting frailty domain impairments and mortality with the Hospital Frailty Risk Score among older adults with cancer: the ELCAPA-EDS cohort study 用医院虚弱风险评分预测癌症老年人的虚弱领域损伤和死亡率:ELCAPA-EDS 队列研究
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-10-14 DOI: 10.1093/ageing/afae222
Charline Jean, Elena Paillaud, Pascaline Boudou-Rouquette, Claudia Martinez-Tapia, Frédéric Pamoukdjian, Meoïn Hagège, Stéphane Bréant, Claire Hassen-Khodja, Pierre-André Natella, Tristan Cudennec, Marie Laurent, Philippe Caillet, Florence Canouï-Poitrine, Etienne Audureau
{"title":"Predicting frailty domain impairments and mortality with the Hospital Frailty Risk Score among older adults with cancer: the ELCAPA-EDS cohort study","authors":"Charline Jean, Elena Paillaud, Pascaline Boudou-Rouquette, Claudia Martinez-Tapia, Frédéric Pamoukdjian, Meoïn Hagège, Stéphane Bréant, Claire Hassen-Khodja, Pierre-André Natella, Tristan Cudennec, Marie Laurent, Philippe Caillet, Florence Canouï-Poitrine, Etienne Audureau","doi":"10.1093/ageing/afae222","DOIUrl":"https://doi.org/10.1093/ageing/afae222","url":null,"abstract":"Background Automated frailty screening tools like the Hospital Frailty Risk Score (HFRS) are primarily validated for care consumption outcomes. We assessed the predictive ability of the HFRS regarding care consumption outcomes, frailty domain impairments and mortality among older adults with cancer, using the Geriatric 8 (G8) screening tool as a clinical benchmark. Methods This retrospective, linkage-based study included patients aged ≥70 years with solid tumor, enrolled in the Elderly Cancer Patients (ELCAPA) multicentre cohort study (2016–2020) and hospitalized in acute care within the Greater Paris University Hospitals. HFRS scores, which encompass hospital-acquired problems and frailty-related syndromes, were calculated using data from the index admission and the preceding 6 months. A multidomain geriatric assessment (GA), including cognition, nutrition, mood, functional status, mobility, comorbidities, polypharmacy, incontinence, and social environment, was conducted at ELCAPA inclusion, with computation of the G8 score. Logistic and Cox regressions measured associations between the G8, HFRS, altered GA domains, length of stay exceeding 10 days, 30-day readmission, and mortality. Results Among 587 patients included (median age 82 years, metastatic cancer 47.0%), 237 (40.4%) were at increased frailty risk by the HFRS (HFRS&amp;gt;5) and 261 (47.5%) by the G8 (G8≤10). Both HFRS and G8 were significantly associated with cognitive and functional impairments, incontinence, comorbidities, prolonged length of stay, and 30-day mortality. The G8 was associated with polypharmacy, nutritional and mood impairment. Discussion Although showing significant associations with short-term care consumption, the HFRS could not identify polypharmacy, nutritional, mood and social environment impairments and showed low discriminatory ability across all GA domains.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"16 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431638","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
Influence of intergenerational social mobility on brain structure and global cognition: findings from the Whitehall II study across 20 years 代际社会流动对大脑结构和全球认知能力的影响:白厅 II 研究 20 年来的发现
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-10-12 DOI: 10.1093/ageing/afae221
Yingxu Liu, Benjamin Thyreau, Yuehua Cui, Ye Zhang, Yasuko Tatewaki, Yasuyuki Taki
{"title":"Influence of intergenerational social mobility on brain structure and global cognition: findings from the Whitehall II study across 20 years","authors":"Yingxu Liu, Benjamin Thyreau, Yuehua Cui, Ye Zhang, Yasuko Tatewaki, Yasuyuki Taki","doi":"10.1093/ageing/afae221","DOIUrl":"https://doi.org/10.1093/ageing/afae221","url":null,"abstract":"Background Whether changes in socioeconomic position (SEP) across generations, i.e. intergenerational social mobility, influence brain degeneration and cognition in later life is unclear. Objective To examine the association of social mobility, brain grey matter structure and global cognition. Methods We analysed T1 brain MRI data of 771 old adults (69.8 ± 5.2 years) from the Whitehall II MRI substudy, with MRI data collected between 2012 and 2016. Social mobility was defined by SEP changes from their fathers’ generation to mid-life status. Brain structural outcomes include grey matter (GM) volume and cortical thickness (CT) covering whole brain. Global cognition was measured by the Mini Mental State Examination. We firstly conducted analysis of covariance to identify regional difference of GM volume and cortical thickness across stable high/low and upward/downward mobility groups, followed with diagonal reference models studying the relationship between mobility and brain cognitive outcomes, apart from SEP origin and destination. We additionally conducted linear mixed models to check mobility interaction over time, where global cognition was derived from three phases across 2002 to 2017. Results Social mobility related to 48 out of the 136 GM volume regions and 4 out of the 68 CT regions. Declined volume was particularly seen in response to downward mobility, whereas no independent association of mobility with global cognition was observed. Conclusion Despite no strong evidence supporting direct influence of mobility on global cognition in later life, imaging findings warranted a severe level of neurodegeneration due to downward mobility from their father’s generation.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"20 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142430426","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}
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