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Effect of parental age at birth on the accumulation of deficits, frailty and survival in older adults.

https://arctichealth.org/en/permalink/ahliterature151908
Source
Age Ageing. 2009 Jul;38(4):380-5
Publication Type
Article
Date
Jul-2009
Author
Ruth E Hubbard
Melissa K Andrew
Kenneth Rockwood
Author Affiliation
Dalhousie University and QEII Health Sciences Centre, Halifax, Nova Scotia, Canada. Ruth.Hubbard@cdha.nshealth.ca
Source
Age Ageing. 2009 Jul;38(4):380-5
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging - physiology
Canada
Female
Frail Elderly
Humans
Kaplan-Meier Estimate
Longevity - physiology
Male
Maternal Age
Paternal Age
Physical Fitness
Proportional Hazards Models
Self-Assessment
Survival
Abstract
parental age at conception may affect life expectancy. Adult daughters of older fathers seem to live shorter lives and, in one study, being born to a mother aged or=65 using a Self-Assessed Risk Factor Questionnaire and screening interview. In this secondary analysis, 5112 participants had complete data for parental age, frailty status and 10-year survival. Parental age was divided into three groups, with cut-offs at 25 and 45 for fathers and at 25 and 40 for mothers. Frailty was defined by an index of deficits. Survival was analysed using Kaplan-Meier curves and Cox regression with analyses adjusted for subject's age, sex and age of the other parent.
mean maternal age at subject's birth was 29.2y (SD 6.8) and mean paternal age 33.3y (SD 7.8). There was no effect of maternal or paternal age on survival for either sons or daughters. Similarly, there was no association between parental age and subject frailty in old age.
we did not identify an association between parental age and frailty or longevity in older adult participants in the CSHA.
PubMed ID
19307228 View in PubMed
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The impact of social vulnerability on the survival of the fittest older adults.

https://arctichealth.org/en/permalink/ahliterature127519
Source
Age Ageing. 2012 Mar;41(2):161-5
Publication Type
Article
Date
Mar-2012
Author
Melissa K Andrew
Arnold Mitnitski
Susan A Kirkland
Kenneth Rockwood
Author Affiliation
Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. mandrew@dal.ca
Source
Age Ageing. 2012 Mar;41(2):161-5
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging
Canada - epidemiology
Female
Frail Elderly
Geriatric Assessment - statistics & numerical data
Health Surveys
Humans
Independent living
Kaplan-Meier Estimate
Male
Physical Fitness
Proportional Hazards Models
Risk assessment
Risk factors
Socioeconomic Factors
Survival Rate
Time Factors
Vulnerable Populations - statistics & numerical data
Abstract
even older adults who are fit experience adverse health outcomes; understanding their risks for adverse outcomes may offer insight into ambient population health. Here, we evaluated mortality risk in relation to social vulnerability among the fittest older adults in a representative community-dwelling sample of older Canadians.
in this secondary analysis of the Canadian Study of Health and Aging, participants (n = 5,703) were aged 70+ years at baseline. A frailty index was used to grade relative levels of fitness/frailty, using 31 self-reported health deficits. The analysis was limited to the fittest people (those reporting 0-1 health deficit). Social vulnerability was trichotomised from a social vulnerability scale, which consisted of 40 self-reported social deficits.
five hundred and eighty-four individuals had 0-1 health deficit. Among them, absolute mortality risk rose with increasing social vulnerability. In those with the lowest level of social vulnerability, 5-year mortality was 10.8%, compared with 32.5% for those with the highest social vulnerability (adjusted hazard ratio 2.5, 95% CI: 1.5-4.3, P = 0.001).
a 22% absolute mortality difference in the fittest older adults is of considerable clinical and public health importance. Routine assessment of social vulnerability by clinicians could have value in predicting the risk of adverse health outcomes in older adults.
PubMed ID
22287038 View in PubMed
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Prevalence and outcomes of delirium in community and non-acute care settings in people without dementia: a report from the Canadian Study of Health and Aging.

https://arctichealth.org/en/permalink/ahliterature168675
Source
BMC Med. 2006;4:15
Publication Type
Article
Date
2006
Author
Melissa K Andrew
Susan H Freter
Kenneth Rockwood
Author Affiliation
Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada. mandrew@dal.ca
Source
BMC Med. 2006;4:15
Date
2006
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cognition Disorders - epidemiology
Community Health Services - statistics & numerical data
Delirium - epidemiology - mortality - therapy
Frail Elderly
Humans
Long-Term Care
Survival Analysis
Treatment Outcome
Abstract
While delirium is common among older adults in acute care hospitals, its prevalence in other settings has been less well studied. We examined delirium prevalence and outcomes in a large cohort of older Canadians living outside of acute care.
In this secondary analysis of the Canadian Study of Health and Aging, the prevalence of clinically diagnosed delirium was estimated and five-year survival was compared with that of individuals with dementia of graded severity.
Delirium was very uncommon (prevalence
Notes
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Cites: CMAJ. 1994 Feb 15;150(4):489-958313261
PubMed ID
16796755 View in PubMed
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Psychiatric illness in relation to frailty in community-dwelling elderly people without dementia: a report from the Canadian Study of Health and Aging.

https://arctichealth.org/en/permalink/ahliterature164179
Source
Can J Aging. 2007;26(1):33-8
Publication Type
Article
Date
2007
Author
Melissa K Andrew
Kenneth Rockwood
Author Affiliation
Division of Geriatric Medicine, Dalhousie University.
Source
Can J Aging. 2007;26(1):33-8
Date
2007
Language
English
Publication Type
Article
Keywords
Aged
Aging
Canada - epidemiology
Cluster analysis
Cohort Studies
Dementia - epidemiology
Educational Status
Female
Frail Elderly - statistics & numerical data
Geriatric Assessment
Humans
Male
Mental Disorders - epidemiology
Odds Ratio
Prevalence
Questionnaires
Residence Characteristics
Sex Factors
Abstract
We investigated whether frailty, defined as the accumulation of multiple, interacting illnesses, impairments and disabilities, is associated with psychiatric illness in older adults. Five-thousand-six-hundred-and-seventy-six community dwellers without dementia were identified within the Canadian Study of Health and Aging, and self-reported psychiatric illness was compared by levels of frailty (defined by an index of deficits that excluded mental illnesses). People with psychiatric illness (12.6% of those surveyed, who chiefly reported depression) had a higher mean frailty index value than those who did not. Older age was not associated with higher odds of psychiatric illness. Taking sex, frailty, and education into account, the odds of psychiatric illness decreased with each increasing year of age (OR 0.95; 95% CI, 0.94-0.97). Frailty was associated with psychiatric illness; for each additional deficit-defining frailty, odds of psychiatric illness increased (OR 1.23; 95% CI, 1.19-1.26). Similarly, psychiatric illness was associated with much higher odds of being among the most frail. These findings lend support to a multidimensional conceptualization of frailty. Our data also suggest that health care professionals who work with older adults with psychiatric illness should expect frailty to be common, and that those working with frail seniors should consider the possible co-existence of depression and psychiatric illness.
PubMed ID
17430802 View in PubMed
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Psychological well-being in relation to frailty: a frailty identity crisis?

https://arctichealth.org/en/permalink/ahliterature125966
Source
Int Psychogeriatr. 2012 Aug;24(8):1347-53
Publication Type
Article
Date
Aug-2012
Author
Melissa K Andrew
John D Fisk
Kenneth Rockwood
Author Affiliation
Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. mandrew@dal.ca
Source
Int Psychogeriatr. 2012 Aug;24(8):1347-53
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Depressive Disorder - diagnosis - mortality - psychology
Educational Status
Female
Frail Elderly - psychology - statistics & numerical data
Geriatric Assessment
Humans
Identity Crisis
Male
Quality of Life - psychology
Questionnaires
Self Concept
Sex Factors
Survival Analysis
Abstract
Frailty can be defined as the presence of multiple, interacting medical and functional problems. Frailty is associated with psychiatric conditions but its relation to psychological well-being is unclear. A "frailty identity crisis" has been proposed as a maladaptive response to the sense of self as health deficits accumulate. We evaluated this so-called identity crisis by investigating associations between well-being, frailty, and mortality in community-dwelling older Canadians.
In this secondary analysis of the Canadian Study of Health and Aging (N = 5,703; age 70+), frailty was defined by an index of 33 health deficits. Psychological well-being was measured using Ryff's 18-item scale, with six domains (autonomy, personal growth, environmental mastery, positive relations, purpose in life, and self-acceptance). Cognition was measured using the Modified Mini-Mental State Examination. Associations between well-being, frailty, and mortality were measured using linear regression, adjusting for age, sex, education, cognition, and mental health.
For each additional frailty-defining deficit, the psychological well-being score worsened by 0.3 points (0.29, 95% CI: 0.22-0.36, p
PubMed ID
22436131 View in PubMed
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Social vulnerability predicts cognitive decline in a prospective cohort of older Canadians.

https://arctichealth.org/en/permalink/ahliterature142163
Source
Alzheimers Dement. 2010 Jul;6(4):319-325.e1
Publication Type
Article
Date
Jul-2010
Author
Melissa K Andrew
Kenneth Rockwood
Author Affiliation
Division of Geriatric Medicine and Geriatric Medicine Research Unit, Dalhousie University, Halifax, NS, Canada.
Source
Alzheimers Dement. 2010 Jul;6(4):319-325.e1
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Canada - epidemiology
Cognition Disorders - psychology
Disease Progression
Female
Frail Elderly - psychology
Health status
Humans
Leisure Activities
Logistic Models
Male
Neuropsychological Tests
Odds Ratio
Predictive value of tests
Prospective Studies
Social Behavior
Social Support
Socioeconomic Factors
Abstract
Although numerous social factors have been associated with cognition in older adults, these findings have been limited by the consideration of individual factors in isolation. We investigated whether social vulnerability, defined as an index comprising many social factors, is associated with cognitive decline.
In this secondary analysis of the Canadian Study of Health and Aging, 2468 community-dwellers aged 70 and older were followed up for 5 years. The social vulnerability index incorporated 40 social variables. Each response was scored as 0 if the "deficit" was absent and 1 if it was present; the 40 deficit scores were then summed. For some analyses, index scores were split into tertiles of high, intermediate, and low social vulnerability. Cognitive decline was defined as a >or=5-point decline in the Modified Mini-Mental State Examination (3MS). Associations of social vulnerability with 5-year cognitive decline (adjusting for age, sex, frailty, and baseline cognition) were analyzed by using logistic regression.
Mean social vulnerability was 0.25 (standard deviation, 0.09) or 9.9 deficits of the list of 40. The median cognitive change of -1.0 (interquartile range, -6 to 2) points on the 3MS was noted at 5 years. About 743 individuals (30% of the sample) experienced a decline of >or=5 points on the 3MS. Each additional social deficit was associated with increased odds of cognitive decline (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.06; P = .02). Compared with those with low social vulnerability, individuals with high social vulnerability had a 36% increased odds of experiencing cognitive decline (odds ratio, 1.36; 95% confidence interval, 1.06 to 1.74; P = .015).
Increasing social vulnerability, defined by using a social vulnerability index incorporating many social factors, was associated with increased odds of cognitive decline during a period of 5 years in this study of older Canadians. Further study of social vulnerability in relation to cognition is warranted, with particular attention to potential interventions to alleviate its burden.
PubMed ID
20630414 View in PubMed
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6 records – page 1 of 1.