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Accelerated decline in quadriceps area and Timed Up and Go test performance are associated with hip fracture risk in older adults with impaired kidney function.

https://arctichealth.org/en/permalink/ahliterature311122
Source
Exp Gerontol. 2021 Mar 16; 149:111314
Publication Type
Journal Article
Date
Mar-16-2021
Author
Elisa A Marques
Martine Elbejjani
João L Viana
Vilmundur Gudnason
Gunnar Sigurdsson
Thomas Lang
Sigurdur Sigurdsson
Thor Aspelund
Kristin Siggeirsdottir
Lenore Launer
Gudny Eiriksdottir
Tamara B Harris
Author Affiliation
Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Portugal. Electronic address: eamarques@me.com.
Source
Exp Gerontol. 2021 Mar 16; 149:111314
Date
Mar-16-2021
Language
English
Publication Type
Journal Article
Abstract
This study aimed to examine whether an accelerated decline in quadriceps cross-sectional area (CSA), attenuation (a surrogate of quality), and strength, as well as lower limb muscular function, are associated with hip fractures in older adults with impaired kidney function.
Prospective population-based study.
Community-dwelling old population in Reykjavik, Iceland.
A total of 875 older adults (mean baseline age 76 years) from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study with impaired kidney function.
Quadriceps CSA and density were determined using computed tomography (CT), knee extension strength was measured with an isometric dynamometer chair, and muscular function was assessed using the Timed Up and Go (TUG) test. All muscle-related measurements were assessed twice over a mean follow-up of 5.2 years. Data on hip fracture incidence was obtained from medical records during a maximum of 8.4 years of follow-up time.
Fully adjusted cox-proportional hazard regression models showed that a faster decline in quadriceps CSA and TUG test performance were significantly associated with increased hip fracture risk (HR = 1.55, 95% CI = 1.02-2.36, and HR = 1.80, 95% CI = 1.19-2.72, respectively). A faster decrease in quadriceps density and isometric knee extension strength were not associated with fracture risk.
Accelerated decline in CT-derived quadriceps CSA and muscular function, as measured by the TUG test's performance, are predictive of hip fracture risk in older adults with impaired kidney function. TUG test is a simple measure and easily included in routine medical examinations, compared to CT scans, which seems to be useful for identifying a subgroup of individuals with high risk of fracture.
PubMed ID
33741458 View in PubMed
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Accidental injuries among older adults: An incidence study.

https://arctichealth.org/en/permalink/ahliterature297612
Source
Int Emerg Nurs. 2018 09; 40:12-17
Publication Type
Journal Article
Date
09-2018
Author
Maria Gudnadottir
Thordis Katrin Thorsteinsdottir
Brynjolfur Mogensen
Thor Aspelund
Edda Bjork Thordardottir
Author Affiliation
Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland. Electronic address: maria.gudnadottir@gmail.com.
Source
Int Emerg Nurs. 2018 09; 40:12-17
Date
09-2018
Language
English
Publication Type
Journal Article
Keywords
Accidents - statistics & numerical data
Aged
Aged, 80 and over
Cohort Studies
Emergency Service, Hospital - organization & administration
Female
Geriatrics - statistics & numerical data
Humans
Iceland
Male
Risk factors
Abstract
To date, the majority of studies assessing accidental injuries among the elderly have focused on fall injuries, while studies of other mechanisms of injuries have been lacking. Therefore, the main objective of this study was to investigate all injury-related visits among older adults to an emergency department and risk factors for injuries.
Data were collected on all registered visits of adults, =67?years old, living in the capital of Iceland, to the emergency department of Landspitali, the National University Hospital, in 2011 and 2012.
The yearly incidence rate for injuries was 106 per 1000 adults, =67?years old. Of all injuries (n?=?4,469), falls were the most common mechanism of injury (78 per 1000), followed by being struck or hit (12 per 1000) and being crushed, cut or pierced (8 per 1000). Other mechanisms of injury, such as acute overexertion, foreign body in natural orifice, injuries caused by thermal and chemical effect and other and unspecified mechanism were less common (8 per 1000). Fractures were the most common consequences of injuries (36 per 1000). The most frequent place of injury was in or around homes (77 per 1000), with men being more likely than women to be injured outside of the home (60 per 1000 vs. 36 per 1000).
Results indicate that falls are the main cause of accidental injuries, followed by being struck and hit injuries but other causes contributed to the rest. Falls constitute a major public health problem and fall-related injuries can have a substantial impact on the lives of older adults. As life expectancy continues to increase, fall risk is expected to increase. Since falls constitute a major impact on the lives of older adults and can lead to not only declines in physical activity and functional status, but to considerable health care costs, the health care system needs to intervene.
PubMed ID
29661594 View in PubMed
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ACE2 levels are altered in comorbidities linked to severe outcome in COVID-19.

https://arctichealth.org/en/permalink/ahliterature305635
Source
medRxiv. 2020 Jun 05; :
Publication Type
Preprint
Date
Jun-05-2020
Author
Valur Emilsson
Elias F Gudmundsson
Thor Aspelund
Brynjolfur G Jonsson
Alexander Gudjonsson
Lenore J Launer
John R Lamb
Valborg Gudmundsdottir
Lori L Jennings
Vilmundur Gudnason
Source
medRxiv. 2020 Jun 05; :
Date
Jun-05-2020
Language
English
Publication Type
Preprint
Abstract
Severity of outcome in COVID-19 is disproportionately higher among the obese, males, smokers, those suffering from hypertension, kidney disease, coronary heart disease (CHD) and/or type 2 diabetes (T2D). We examined if serum levels of ACE2, the cellular entry point for the coronavirus SARS-CoV-2, were altered in these high-risk groups.
Associations of serum ACE2 levels to hypertension, T2D, obesity, CHD, smokers and males in a single center population-based study of 5457 Icelanders from the Age, Gene/Environment Susceptibility Reykjavik Study (AGES-RS) of the elderly (mean age 75+/-6 years).
Smokers, males, and individuals with T2D or obesity have altered serum levels of ACE2 that may influence productive infection of SARS-CoV-2 in these high-risk groups.
ACE2 levels are upregulated in some patient groups with comorbidities linked to COVID-19 and as such may have an emerging role as a circulating biomarker for severity of outcome in COVID-19.
PubMed ID
32511628 View in PubMed
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Airflow obstruction, atherosclerosis and cardiovascular risk factors in the AGES Reykjavik study.

https://arctichealth.org/en/permalink/ahliterature275323
Source
Atherosclerosis. 2016 Jul 28;252:122-127
Publication Type
Article
Date
Jul-28-2016
Author
Gunnar Gudmundsson
Olof Birna Margretardottir
Martin Ingi Sigurdsson
Tamara B Harris
Lenore J Launer
Sigurdur Sigurdsson
Orn Olafsson
Thor Aspelund
Vilmundur Gudnason
Source
Atherosclerosis. 2016 Jul 28;252:122-127
Date
Jul-28-2016
Language
English
Publication Type
Article
Abstract
Airflow limitation, i.e. reduced forced expiratory volume in 1-s (FEV1), is associated with increased prevalence of atherosclerosis, however, causal mechanisms remain elusive. The objective of the study was to determine if the association between airflow obstruction and markers of atherosclerosis is mediated by systemic inflammation.
1154 subjects from the longitudinal AGES Reykjavik study were included. Population characteristics, systemic inflammation markers from blood (white blood cell counts (WBC) and level of C-reactive protein (CRP)) were compared between patients with and without airflow limitation defined by reduced FEV1 on spirometry. Atherosclerosis burden was quantified by measurements of coronary artery calcium, aortic arch and distal aortic calcification in addition to carotid intimal media thickness (CIMT).
Subjects were split into four groups according to smoking status and whether airflow limitation was present. There was a higher overall burden of atherosclerosis in ever-smokers compared to never-smokers, and in individuals with airflow obstruction compared to individuals without airflow obstruction. After adjusting for population characteristics, Framingham cardiovascular risk factors and markers of systemic inflammation (WBC and CRP), there was a significantly increased aortic arch and distal aorta calcification and higher CIMT measurement in individuals with airflow obstruction compared to individuals without airflow obstruction. After adjusting for population characteristics, Framingham cardiovascular risk factors and markers of systemic inflammation (WBC and CRP), there was a significantly increased aortic arch and distal aorta calcification and higher CIMT measurement in individuals with airflow obstruction compared to individuals without airflow obstruction.
Systemic inflammation (WBC and CRP) does not appear to mediate the association between airflow limitation and atherosclerosis. Only airflow limitation and not systemic inflammation (WBC and CRP) appears to be an independent predictor of atherosclerosis.
PubMed ID
27522264 View in PubMed
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The alcohol paradox: light-to-moderate alcohol consumption, cognitive function, and brain volume.

https://arctichealth.org/en/permalink/ahliterature259852
Source
J Gerontol A Biol Sci Med Sci. 2014 Dec;69(12):1528-35
Publication Type
Article
Date
Dec-2014
Author
Benjamin J K Davis
Jean-Sebastian Vidal
Melissa Garcia
Thor Aspelund
Mark A van Buchem
Maria K Jonsdottir
Sigurdur Sigurdsson
Tamara B Harris
Vilmundur Gudnason
Lenore J Launer
Source
J Gerontol A Biol Sci Med Sci. 2014 Dec;69(12):1528-35
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Aged
Aging
Alcohol Drinking - epidemiology - physiopathology - psychology
Brain - pathology
Cognition Disorders - diagnosis - epidemiology - psychology
Disease Progression
Female
Follow-Up Studies
Humans
Iceland - epidemiology
Incidence
Magnetic Resonance Imaging
Male
Neuropsychological Tests
Prevalence
Prognosis
Questionnaires
Retrospective Studies
Risk factors
Abstract
Studies of older persons show consumption of light-to-moderate amounts of alcohol is positively associated with cognitive function and, separately, is negatively associated with total brain volume (TBV). This is paradoxical as generally, cognitive function is positively associated with TBV. We examined the relationships of TBV, global cognitive function (GCF), and alcohol consumption in a population-based cohort of 3,363 men and women (b. 1907-1935) participating in the Age Gene/Environment Susceptibility-Reykjavik Study (2002-2006) and who were free of dementia or mild cognitive impairment
Drinking status (never, former, and current) and current amount of alcohol consumed were assessed by questionnaire. GCF is a composite score derived from a battery of cognitive tests. TBV, standardized to head size, is estimated quantitatively from brain magnetic resonance imaging.
Among women and not men, adjusting for demographic and cardiovascular risk factors, current drinkers had significantly higher GCF scores than abstainers and former drinkers (p
PubMed ID
24994845 View in PubMed
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Analysing the large decline in coronary heart disease mortality in the Icelandic population aged 25-74 between the years 1981 and 2006.

https://arctichealth.org/en/permalink/ahliterature139092
Source
PLoS One. 2010;5(11):e13957
Publication Type
Article
Date
2010
Author
Thor Aspelund
Vilmundur Gudnason
Bergrun Tinna Magnusdottir
Karl Andersen
Gunnar Sigurdsson
Bolli Thorsson
Laufey Steingrimsdottir
Julia Critchley
Kathleen Bennett
Martin O'Flaherty
Simon Capewell
Author Affiliation
Icelandic Heart Association, Kopavogur, Iceland.
Source
PLoS One. 2010;5(11):e13957
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Coronary Disease - mortality - prevention & control
Female
Humans
Iceland - epidemiology
Incidence
Male
Middle Aged
Models, Statistical
Mortality - trends
Myocardial Infarction - mortality - prevention & control
Abstract
Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s. We examined how much of the decrease between 1981 and 2006 could be attributed to medical and surgical treatments and how much to changes in cardiovascular risk factors.
The previously validated IMPACT CHD mortality model was applied to the Icelandic population. The data sources were official statistics, national quality registers, published trials and meta-analyses, clinical audits and a series of national population surveys.
Between 1981 and 2006, CHD mortality rates in Iceland decreased by 80% in men and women aged 25 to 74 years, which resulted in 295 fewer deaths in 2006 than if the 1981 rates had persisted. Incidence of myocardial infarction (MI) decreased by 66% and resulted in some 500 fewer incident MI cases per year, which is a major determinant of possible deaths from MI. Based on the IMPACT model approximately 73% (lower and upper bound estimates: 54%-93%) of the mortality decrease was attributable to risk factor reductions: cholesterol 32%; smoking 22%; systolic blood pressure 22%, and physical inactivity 5% with adverse trends for diabetes (-5%), and obesity (-4%). Approximately 25% (lower and upper bound estimates: 8%-40%) of the mortality decrease was attributable to treatments in individuals: secondary prevention 8%; heart failure treatments 6%; acute coronary syndrome treatments 5%; revascularisation 3%; hypertension treatments 2%, and statins 0.5%.
Almost three quarters of the large CHD mortality decrease in Iceland between 1981 and 2006 was attributable to reductions in major cardiovascular risk factors in the population. These findings emphasize the value of a comprehensive prevention strategy that promotes tobacco control and a healthier diet to reduce incidence of MI and highlights the potential importance of effective, evidence based medical treatments.
Notes
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PubMed ID
21103050 View in PubMed
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Antihypertensive medication uses and serum ACE2 levels: ACEIs/ARBs treatment does not raise serum levels of ACE2.

https://arctichealth.org/en/permalink/ahliterature305650
Source
medRxiv. 2020 May 25; :
Publication Type
Preprint
Date
May-25-2020
Author
Valur Emilsson
Elias F Gudmundsson
Thor Aspelund
Brynjolfur G Jonsson
Alexander Gudjonsson
Lenore J Launer
Lori L Jennings
Valborg Gudmundsdottir
Vilmundur Gudnason
Author Affiliation
Icelandic Heart Association, Holtasmari 1, IS-201 Kopavogur, Iceland.
Source
medRxiv. 2020 May 25; :
Date
May-25-2020
Language
English
Publication Type
Preprint
Abstract
Recent reports have shown that hypertension is the most common comorbidity associated with mortality in the current coronavirus disease 2019 (COVID-19). This has been related to the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) as animal studies indicate that these medications increase levels of ACE2, the cellular entry point for the coronavirus SARS-CoV-2. This has prompted clinicians to recommend discontinuing ACEIs and ARBs.
To examine the effect of ACEIs or ARBs treatment on serum levels of ACE2 and other key enzymes in the renin-angiotensin system (RAS).
A single center population-based study of 5457 Icelanders from the Age, Gene/Environment Susceptibility Reykjavik Study (AGES-RS) of the elderly (mean age 75±6 years) stratified by ACEIs (N = 699) or ARBs (N = 753) treatment.
The AGES-RS study population was stratified by ACEIs and ARBs medication use and compared for age, body mass index (BMI) (kg/m2), hypertension and type 2 diabetes (T2D) as well as serum levels of renin, ACE and ACE2.
While renin and ACE levels were significantly raised in serum of individuals on ACEIs or ARBs treatments, the ACE2 levels remained unaffected.
Treatment with ACEIs or ARBs does not raise ACE2 levels in serum. Therefore, the present study does not support the proposed discontinuation of these medications among patients affected with COVID-19.
PubMed ID
32511473 View in PubMed
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Apolipoprotein E genotype and statins affect CRP levels through independent and different mechanisms: AGES-Reykjavik Study.

https://arctichealth.org/en/permalink/ahliterature53039
Source
Atherosclerosis. 2006 May;186(1):222-4
Publication Type
Article
Date
May-2006
Author
Gudny Eiriksdottir
Thor Aspelund
Kristjana Bjarnadottir
Elin Olafsdottir
Lenore J Launer
Tamara B Harris
Vilmundur Gudnason
Author Affiliation
Icelandic Heart Association, Holtasmara 1, 201 Kopavogur, Iceland.
Source
Atherosclerosis. 2006 May;186(1):222-4
Date
May-2006
Language
English
Publication Type
Article
Abstract
OBJECTIVE: C-reactive protein (CRP), an inflammatory marker, was linked to coronary heart disease (CHD) in the Reykjavik study cohort. Recent genetic studies have shown that the apolipoprotein E (APOE) varepsilon4 allele is associated with lower CRP levels. Statin treatment has also been shown to lower CRP levels. In the Age Gene/Environment Susceptibility (AGES)-Reykjavik Study, we examined the association of APOE genotypes with CRP accounting for the effect of statin treatment, previous CHD and a mid-life measurement of erythrocyte sedimentation rate (ESR), an inflammatory marker associated with risk in this cohort. METHODS AND RESULTS: The first 2296 participants (mean age 76+/-6 years, 42% men) in the AGES-Reykjavik Study were genotyped for APOE CRP concentration was measured with a high sensitivity method. A general linear model was used to evaluate the association of APOE genotype to CRP levels. The frequencies of the APOE alleles are varepsilon2=0.06, varepsilon3=0.78 and varepsilon4=0.16. CRP levels ranged from 0.2 to 56.6mg/L, median 1.9mg/L. Participants carrying one or two varepsilon4 alleles have significantly lower CRP levels than non-carriers and this effect was observed in a dose-dependent manner. This trend is the same in users and non-users of statin treatment. CONCLUSIONS: This study suggests that the contribution of the varepsilon4 allele towards lowering CRP levels is independent and may be by a different mechanism than how statins affect inflammation.
PubMed ID
16445917 View in PubMed
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Arterial stiffness, pressure and flow pulsatility and brain structure and function: the Age, Gene/Environment Susceptibility--Reykjavik study.

https://arctichealth.org/en/permalink/ahliterature129735
Source
Brain. 2011 Nov;134(Pt 11):3398-407
Publication Type
Article
Date
Nov-2011
Author
Gary F Mitchell
Mark A van Buchem
Sigurdur Sigurdsson
John D Gotal
Maria K Jonsdottir
Ólafur Kjartansson
Melissa Garcia
Thor Aspelund
Tamara B Harris
Vilmundur Gudnason
Lenore J Launer
Author Affiliation
Cardiovascular Engineering, Inc., Norwood, MA 02062, USA. garyfmitchell@mindspring.com
Source
Brain. 2011 Nov;134(Pt 11):3398-407
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aorta - physiopathology
Blood Flow Velocity - physiology
Blood Pressure - physiology
Brain - blood supply - pathology - physiopathology
Cardiovascular Diseases - pathology - physiopathology
Carotid Arteries - physiopathology
Female
Gene-Environment Interaction
Humans
Iceland
Male
Prospective Studies
Pulsatile Flow - physiology
Risk factors
Vascular Stiffness - physiology
Abstract
Aortic stiffness increases with age and vascular risk factor exposure and is associated with increased risk for structural and functional abnormalities in the brain. High ambient flow and low impedance are thought to sensitize the cerebral microcirculation to harmful effects of excessive pressure and flow pulsatility. However, haemodynamic mechanisms contributing to structural brain lesions and cognitive impairment in the presence of high aortic stiffness remain unclear. We hypothesized that disproportionate stiffening of the proximal aorta as compared with the carotid arteries reduces wave reflection at this important interface and thereby facilitates transmission of excessive pulsatile energy into the cerebral microcirculation, leading to microvascular damage and impaired function. To assess this hypothesis, we evaluated carotid pressure and flow, carotid-femoral pulse wave velocity, brain magnetic resonance images and cognitive scores in participants in the community-based Age, Gene/Environment Susceptibility--Reykjavik study who had no history of stroke, transient ischaemic attack or dementia (n = 668, 378 females, 69-93 years of age). Aortic characteristic impedance was assessed in a random subset (n = 422) and the reflection coefficient at the aorta-carotid interface was computed. Carotid flow pulsatility index was negatively related to the aorta-carotid reflection coefficient (R = -0.66, P
Notes
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PubMed ID
22075523 View in PubMed
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Assessment of incident spine and hip fractures in women and men using finite element analysis of CT scans.

https://arctichealth.org/en/permalink/ahliterature256993
Source
J Bone Miner Res. 2014 Mar;29(3):570-80
Publication Type
Article
Date
Mar-2014
Author
David L Kopperdahl
Thor Aspelund
Paul F Hoffmann
Sigurdur Sigurdsson
Kristin Siggeirsdottir
Tamara B Harris
Vilmundur Gudnason
Tony M Keaveny
Author Affiliation
O.N. Diagnostics, Berkeley, CA, USA.
Source
J Bone Miner Res. 2014 Mar;29(3):570-80
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Aged
Bone Density
Female
Finite Element Analysis
Hip Fractures - radiography
Humans
Male
Spinal Fractures - radiography
Tomography, X-Ray Computed - methods
Abstract
Finite element analysis of computed tomography (CT) scans provides noninvasive estimates of bone strength at the spine and hip. To further validate such estimates clinically, we performed a 5-year case-control study of 1110 women and men over age 65 years from the AGES-Reykjavik cohort (case?=?incident spine or hip fracture; control?=?no incident spine or hip fracture). From the baseline CT scans, we measured femoral and vertebral strength, as well as bone mineral density (BMD) at the hip (areal BMD only) and lumbar spine (trabecular volumetric BMD only). We found that for incident radiographically confirmed spine fractures (n?=?167), the age-adjusted odds ratio for vertebral strength was significant for women (2.8, 95% confidence interval [CI] 1.8 to 4.3) and men (2.2, 95% CI 1.5 to 3.2) and for men remained significant (p?=?0.01) independent of vertebral trabecular volumetric BMD. For incident hip fractures (n?=?171), the age-adjusted odds ratio for femoral strength was significant for women (4.2, 95% CI 2.6 to 6.9) and men (3.5, 95% CI 2.3 to 5.3) and remained significant after adjusting for femoral neck areal BMD in women and for total hip areal BMD in both sexes; fracture classification improved for women by combining femoral strength with femoral neck areal BMD (p?=?0.002). For both sexes, the probabilities of spine and hip fractures were similarly high at the BMD-based interventional thresholds for osteoporosis and at corresponding preestablished thresholds for "fragile bone strength" (spine: women = 4500?N, men = 6500?N; hip: women = 3000?N, men = 3500?N). Because it is well established that individuals over age 65 years who have osteoporosis at the hip or spine by BMD criteria should be considered at high risk of fracture, these results indicate that individuals who have fragile bone strength at the hip or spine should also be considered at high risk of fracture.
PubMed ID
23956027 View in PubMed
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163 records – page 1 of 17.