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.
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.
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
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Cites: J Am Geriatr Soc. 2000 Jun;48(6):618-2410855596
Cites: Int J Geriatr Psychiatry. 2001 Apr;16(4):415-2111333430
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.
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
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.