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A 10-Year Follow-Up of Adiposity and Dementia in Swedish Adults Aged 70 Years and Older.

https://arctichealth.org/en/permalink/ahliterature300956
Source
J Alzheimers Dis. 2018; 63(4):1325-1335
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
2018
Author
Ilse A C Arnoldussen
Valter Sundh
Kristoffer Bäckman
Silke Kern
Svante Östling
Kaj Blennow
Henrik Zetterberg
Ingmar Skoog
Amanda J Kiliaan
Deborah R Gustafson
Author Affiliation
Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands.
Source
J Alzheimers Dis. 2018; 63(4):1325-1335
Date
2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adiponectin - blood
Adiposity
Aged
Aged, 80 and over
Anthropometry
Body mass index
Dementia - blood - epidemiology - pathology
Fasting
Female
Humans
Independent living
Leptin - blood
Longitudinal Studies
Male
Psychiatric Status Rating Scales
Sex Factors
Sweden - epidemiology
Waist-Hip Ratio
Abstract
Adiposity measured in mid- or late-life and estimated using anthropometric measures such as body mass index (BMI) and waist-to-hip ratio (WHR), or metabolic markers such as blood leptin and adiponectin levels, is associated with late-onset dementia risk. However, during later life, this association may reverse and aging- and dementia-related processes may differentially affect adiposity measures.
We explored associations of concurrent BMI, WHR, and blood leptin and high molecular weight adiponectin levels with dementia occurrence.
924 Swedish community-dwelling elderly without dementia, aged 70 years and older, systematically-sampled by birth day and birth year population-based in the Gothenburg city region of Sweden. The Gothenburg Birth Cohort Studies are designed for evaluating risk and protective factors for dementia. All dementias diagnosed after age 70 for 10 years were identified. Multivariable logistic regression models were used to predict dementia occurrence between 2000-2005, 2005-2010, and 2000-2010 after excluding prevalent baseline (year 2000) dementias. Baseline levels of BMI, WHR, leptin, and adiponectin were used.
Within 5 years of baseline, low BMI (
PubMed ID
29758945 View in PubMed
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The AGES-Reykjavik Study suggests that change in kidney measures is associated with subclinical brain pathology in older community-dwelling persons.

https://arctichealth.org/en/permalink/ahliterature300494
Source
Kidney Int. 2018 09; 94(3):608-615
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Date
09-2018
Author
Sanaz Sedaghat
Jie Ding
Gudny Eiriksdottir
Mark A van Buchem
Sigurdur Sigurdsson
M Arfan Ikram
Osorio Meirelles
Vilmundur Gudnason
Andrew S Levey
Lenore J Launer
Author Affiliation
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Source
Kidney Int. 2018 09; 94(3):608-615
Date
09-2018
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Keywords
Aged
Albuminuria - physiopathology - urine
Cerebral Small Vessel Diseases - diagnosis - epidemiology
Creatinine - urine
Disease Progression
Female
Follow-Up Studies
Glomerular Filtration Rate - physiology
Humans
Incidence
Independent living
Kidney - physiopathology
Magnetic Resonance Imaging
Male
Prospective Studies
Renal Insufficiency, Chronic - physiopathology - urine
Risk factors
Serum Albumin
White Matter - diagnostic imaging - pathology
Abstract
Decreased glomerular filtration rate (GFR) and albuminuria may be accompanied by brain pathology. Here we investigated whether changes in these kidney measures are linked to development of new MRI-detected infarcts and microbleeds, and progression of white matter hyperintensity volume. The study included 2671 participants from the population-based AGES-Reykjavik Study (mean age 75, 58.7% women). GFR was estimated from serum creatinine, and albuminuria was assessed by urinary albumin-to-creatinine ratio. Brain MRI was acquired at baseline (2002-2006) and 5 years later (2007-2011). New MRI-detected infarcts and microbleeds were counted on the follow-up scans. White matter hyperintensity progression was estimated as percent change in white matter hyperintensity volumes between the two exams. Participants with a large eGFR decline (over 3 ml/min/1.73m2 per year) had more incident subcortical infarcts (odds ratio 1.53; 95% confidence interval 1.05, 2.22), and more marked progression of white matter hyperintensity volume (difference: 8%; 95% confidence interval: 4%, 12%), compared to participants without a large decline. Participants with incident albuminuria (over 30 mg/g) had 21% more white matter hyperintensity volume progression (95% confidence interval: 14%, 29%) and 1.86 higher odds of developing new deep microbleeds (95% confidence interval 1.16, 2.98), compared to participants without incident albuminuria. The findings were independent of cardiovascular risk factors. Changes in kidney measures were not associated with occurrence of cortical infarcts. Thus, larger changes in eGFR and albuminuria are associated with increased risk for developing manifestations of cerebral small vessel disease. Individuals with larger changes in these kidney measures should be considered as a high risk population for accelerated brain pathology.
PubMed ID
29960746 View in PubMed
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Anticholinergic burden and dry mouth among Finnish, community-dwelling older adults.

https://arctichealth.org/en/permalink/ahliterature294919
Source
Gerodontology. 2018 Mar; 35(1):3-10
Publication Type
Journal Article
Date
Mar-2018
Author
Antti Tiisanoja
Anna-Maija Syrjälä
Kaija Komulainen
Pasi Lampela
Sirpa Hartikainen
Heidi Taipale
Matti Knuuttila
Pekka Ylöstalo
Author Affiliation
Unit of Oral Health Sciences Research, University of Oulu, Oulu, Finland.
Source
Gerodontology. 2018 Mar; 35(1):3-10
Date
Mar-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cholinergic Antagonists - adverse effects - therapeutic use
Finland - epidemiology
Humans
Independent living
Male
Poisson Distribution
Saliva - secretion
Xerostomia - chemically induced - epidemiology
Abstract
The aim was to study whether the anticholinergic burden of drugs is related to xerostomia and salivary secretion among community-dwelling elderly people.
Anticholinergic drugs have been shown to be a risk factor for dry mouth, but little is known about the effects of cumulative exposure to anticholinergic drugs measured by anticholinergic burden on salivary secretion or xerostomia.
The study population consisted of 152 community-dwelling, dentate, non-smoking, older people from the Oral Health GeMS study. The data were collected by interviews and clinical examinations. Anticholinergic burden was determined using the Anticholinergic Drug Scale (ADS). A Poisson regression model with robust error variance was used to estimate relative risks (RR) with 95% confidence intervals (CI 95%).
Participants with a high-anticholinergic burden (ADS = 3) were more likely to have xerostomia (RR: 3.17; CI: 1.44-6.96), low-unstimulated salivary flow (
PubMed ID
28940566 View in PubMed
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Anticholinergic drug use and its association with self-reported symptoms among older persons with and without diabetes.

https://arctichealth.org/en/permalink/ahliterature298928
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Publication Type
Journal Article
Date
Apr-2019
Author
Niina-Mari Inkeri
Merja Karjalainen
Maija Haanpää
Hannu Kautiainen
Juha Saltevo
Pekka Mäntyselkä
Miia Tiihonen
Author Affiliation
School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Date
Apr-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cholinergic Antagonists - adverse effects - therapeutic use
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus - epidemiology
Female
Finland
Humans
Independent living
Male
Practice Patterns, Physicians' - statistics & numerical data
Primary Health Care
Self Report
Surveys and Questionnaires
Abstract
Anticholinergic drug use has been associated with a risk of central and peripheral adverse effects. There is a lack of information on anticholinergic drug use in persons with diabetes. The aim of this study is to investigate anticholinergic drug use and the association between anticholinergic drug use and self-reported symptoms in older community-dwelling persons with and without diabetes.
The basic population was comprised of Finnish community-dwelling primary care patients aged 65 and older. Persons with diabetes were identified according to the ICD-10 diagnostic codes from electronic patient records. Two controls adjusted by age and gender were selected for each person with diabetes. This cross-sectional study was based on electronic primary care patient records and a structured health questionnaire. The health questionnaire was returned by 430 (81.6%) persons with diabetes and 654 (73.5%) persons without diabetes. Data on prescribed drugs were obtained from the electronic patient records. Anticholinergic drug use was measured according to the Anticholinergic Risk Scale. The presence and strength of anticholinergic symptoms were asked in the health questionnaire.
The prevalence of anticholinergic drug use was 8.9% in the total study cohort. There were no significant differences in anticholinergic drug use between persons with and without diabetes. There was no consistent association between anticholinergic drug use and self-reported symptoms.
There is no difference in anticholinergic drug use in older community-dwelling persons with and without diabetes. Anticholinergic drug use should be considered individually and monitored carefully.
PubMed ID
30315583 View in PubMed
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The association between anemia and falls in community-living women and men aged 65 years and older from the fifth Tromsø Study 2001-02: a replication study.

https://arctichealth.org/en/permalink/ahliterature293028
Source
BMC Geriatr. 2017 12 27; 17(1):292
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-27-2017
Author
Laila Arnesdatter Hopstock
Elisabeth Bøe Utne
Alexander Horsch
Tove Skjelbakken
Author Affiliation
Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037, Tromsø, Norway. laila.hopstock@uit.no.
Source
BMC Geriatr. 2017 12 27; 17(1):292
Date
12-27-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Accidental Falls - prevention & control - statistics & numerical data
Aged
Aged, 80 and over
Anemia - complications - diagnosis - epidemiology - physiopathology
Cohort Studies
Female
Frailty - diagnosis - epidemiology - physiopathology
Geriatric Assessment - methods
Hemoglobins - analysis
Humans
Independent Living - statistics & numerical data
Male
Norway - epidemiology
Risk Assessment - methods
Risk factors
Self Report
Statistics as Topic
Abstract
Falls are common among elderly people, and the risk increase with age. Falls are associated with both health and social consequences for the patient, and major societal costs. Identification of risk factors should be investigated to prevent falls. Previous studies have shown anemia to be associated with increased risk of falling, but the results are inconsistent. The aim of this study was to investigate the association between anemia and self-reported falls among community-living elderly people. The study is a replication of the study by Thaler-Kall and colleagues from 2014, who studied the association between anemia and self-reported falls among 967 women and men 65 years and older in the KORA-Age study from 2009.
We included 2441 participants (54% women) 65 years and older from the population-based Tromsø 5 Study 2001-2002. Logistic regression models were used to investigate the association between anemia (hemoglobin
Notes
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PubMed ID
29282000 View in PubMed
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Associations between gait speed and well-known fall risk factors among community-dwelling older adults.

https://arctichealth.org/en/permalink/ahliterature301605
Source
Physiother Res Int. 2019 Jan; 24(1):e1743
Publication Type
Journal Article
Date
Jan-2019
Author
Ingebjørg Lavrantsdatter Kyrdalen
Pernille Thingstad
Leiv Sandvik
Heidi Ormstad
Author Affiliation
Service of Physiotherapy and Occupational Therapy, Sande Community, Vestfold, Norway.
Source
Physiother Res Int. 2019 Jan; 24(1):e1743
Date
Jan-2019
Language
English
Publication Type
Journal Article
Keywords
Accidental Falls - prevention & control
Aged
Aged, 80 and over
Cohort Studies
Cross-Sectional Studies
Fear
Female
Gait
Humans
Independent living
Male
Norway
Risk factors
Walking
Walking Speed
Abstract
Exercise interventions are effective at preventing falls in community-dwelling older adults, especially before disability is present. Gait speed below 1.0 m/s is a strong predictor for falls in the elderly. However, evidence is sparse for gait speed alone being sufficient to identify individuals at a high risk of falling. This study aimed to describe the prevalence of fall risk factors among community-dwelling older adults in their late 70s and to investigate the associations between these risk factors and low gait speed in this population.
This cross-sectional cohort study comprised 108 elderly living in a small Norwegian municipality, born between 1936 and 1938. Exclusion criteria were living in residential care, inability to walk 4 m, and severe cognitive impairment. Measurements included gait speed, depressive symptoms, executive functions, fear of falling, vision function, fall history, body mass index, medications, and comorbidity. Gait speed was dichotomized using a cut-off of 1 m/s, and associations between different risk factors and low gait speed was explored using logistic regression analysis.
Mean gait speed was 1.0 ± 0.3 m/s. In 44.4% of the participants, gait speed was below 1.0 m/s, indicating increased fall risk. Low gait speed was significantly associated with a history of multiple falls (odds ratio [OR] = 3.70, 95% CI [1.18, 11.65]), low educational level (OR = 3.58, 95% CI [1.10, 11.66]), higher number of medications (OR = 4.28, 95% CI [1.63, 11.2]), and higher number of depressive symptoms (OR = 1.31, 95% CI [1.09, 1.58]). We found no significant associations between gait speed and comorbidity, sex, vision, executive functions, or fear of falling.
Our results indicate that gait speed with cut-off 1.0 m/s could represent a useful tool for identifying individuals who are vulnerable but not yet disabled and could benefit from fall-preventive exercise. However, extended assessment is probably needed to personalize interventions.
PubMed ID
30198603 View in PubMed
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Cardiovascular biomarkers predict fragility fractures in older adults.

https://arctichealth.org/en/permalink/ahliterature299736
Source
Heart. 2019 03; 105(6):449-454
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2019
Author
Madeleine Johansson
Fabrizio Ricci
Giuseppe Di Martino
Cecilia Rogmark
Richard Sutton
Viktor Hamrefors
Olle Melander
Artur Fedorowski
Author Affiliation
Department of Clinical Sciences, Faculty of Medicine, Clinical Research Center, Lund University, Malmö, Sweden.
Source
Heart. 2019 03; 105(6):449-454
Date
03-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adrenomedullin - blood
Aged
Atrial Natriuretic Factor - blood
Biomarkers - blood
Body mass index
Cardiovascular System - metabolism
Cohort Studies
Correlation of Data
Endothelin-1 - blood
Female
Fractures, Bone - blood
Humans
Independent Living - statistics & numerical data
Male
Middle Aged
Peptide Fragments - blood
Prospective Studies
Protein Precursors - blood
Reproducibility of Results
Risk assessment
Risk factors
Sweden
Vasopressins - blood
Abstract
To assess the role of four biomarkers of neuroendocrine activation and endothelial dysfunction in the longitudinal prediction of fragility fractures.
We analysed a population-based prospective cohort of 5415 community-dwelling individuals (mean age, 68.9±6.2 years) enrolled in the Malmö Preventive Project followed during 8.1±2.9 years, and investigated the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures.
Overall, 1030 (19.0%) individuals suffered vertebral, pelvic or extremity fracture. They were older (70.7±5.8 vs 68.4±6.3 years), more likely women (46.9% vs 26.3%), had lower body mass index and diastolic blood pressure, were more often on antihypertensive treatment (44.1% vs 38.4%) and had more frequently history of fracture (16.3% vs 8.1%). Higher levels of MR-proADM (adjusted HR (aHR) per 1 SD: 1.51, 95% CI 1.01 to 2.28, p
Notes
CommentIn: Heart. 2019 Mar;105(6):427-428 PMID 30361269
PubMed ID
30322844 View in PubMed
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Characteristics and predictors for hospitalizations of home-dwelling older persons receiving community care: a cohort study from Norway.

https://arctichealth.org/en/permalink/ahliterature299876
Source
BMC Geriatr. 2018 09 03; 18(1):203
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-03-2018
Author
Martha Therese Gjestsen
Kolbjørn Brønnick
Ingelin Testad
Author Affiliation
Centre for age-related medicine (SESAM), Stavanger University Hospital, Stavanger, Norway. martha.therese.gjestsen@sus.no.
Source
BMC Geriatr. 2018 09 03; 18(1):203
Date
09-03-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Delivery of Health Care, Integrated - organization & administration
Female
Frail Elderly
Geriatric Assessment
Home Care Services - organization & administration
Hospitalization - statistics & numerical data
Humans
Independent living
Male
Norway - epidemiology
Retrospective Studies
Abstract
Older persons are substantial consumers of both hospital- and community care, and there are discussions regarding the potential for preventing hospitalizations through high quality community care. The present study report prevalence and factors associated with admissions to hospital for community-dwelling older persons (>?67 years of age), receiving community care in a Norwegian municipality.
This was a cohort study of 1531 home-dwelling persons aged =67 years, receiving community care. We retrospectively scrutinized admissions to hospital for the study cohort over a one-year period in 2013. The frequency of admissions was evaluated with regard to association with age (age groups 67-79 years, 80-89 years and?=?90 year) and gender. The hospital admission incidence was calculated by dividing the number of admissions by the number of individuals included in the study cohort, stratified by age and gender. The association between age and gender as potential predictors and hospitalization (outcome) was first examined in univariate analyses followed by multinomial regression analyses in order to investigate the associations between age and gender with different causes of hospitalization.
We identified a total of 1457 admissions, represented by 739 unique individuals, of which 64% were women, and an estimated mean age of 83 years. Mean admission rate was 2 admissions per person-year (95% confidence interval (CI): 1.89-2.11). The admission rate varied with age, and hospital incidents rates were higher for men in all age groups. The overall median length of stay was 4 days. The most common reason for hospitalization was the need for further medical assessment (23%). We found associations between increasing age and hospitalizations due to physical general decline, and associations between male gender and hospitalizations due to infections (e.g., airways infections, urinary tract infections).
We found the main reasons for hospitalizations to be related to falls, infections and general decline/pain/unspecified dyspnea. Men were especially at risk for hospitalization as they age. Our study have identified some clinically relevant factors that are vital in understanding what health care personnel in community care need to be especially aware of in order to prevent hospitalizations for this population.
PubMed ID
30176794 View in PubMed
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Community-level factors that contribute to First Nations and Inuit older adults feeling supported to age well in a Canadian city.

https://arctichealth.org/en/permalink/ahliterature300274
Source
J Aging Stud. 2019 Mar; 48:50-59
Publication Type
Journal Article
Date
Mar-2019
Author
Lauren A Brooks-Cleator
Audrey R Giles
Martha Flaherty
Author Affiliation
School of Human Kinetics, University of Ottawa, 420B Montpetit Hall, Ottawa, ON K1N 6N5, Canada. Electronic address: Lbroo049@uottawa.ca.
Source
J Aging Stud. 2019 Mar; 48:50-59
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Cities
Female
Health Services for the Aged
Humans
Independent living
Interviews as Topic
Inuits
Male
Quebec
Social Environment
Social Support
Socioeconomic Factors
Abstract
Despite the proliferation of age-friendly cities in Canada that are intended to support older adults to age well, there are still many inequalities between groups of older adults, particularly, and of concern for this paper, between Indigenous older adults, who experience colonialism's ongoing impacts, and non-Indigenous older adults. A better understanding of factors that inform these inequalities will help in the development of policies and programs that better support Indigenous older adults to age well and, thus, will contribute to ameliorating the inequalities that they face. Using a community-based participatory research approach, informed by a postcolonial theoretical lens, in this paper we addressed the question, "what community-level factors contribute to Indigenous older adults (aged 55 years and over) feeling supported to age well in the city of Ottawa?" We specifically examined this question in relation to the age-friendly communities framework, which guides the City of Ottawa's Older Adult Plan. Thematic analysis of semi-structured interviews, focus groups, and photovoice with 32 First Nations and Inuit older adults revealed that the participants felt both supported and unsupported to age well. More specifically, there were two main areas in which they felt they could be better supported to age well: the social environment and physical environment. There were three subthemes within the social environment theme: responsive health and community support services, respect and recognition, and communication and information. Within the physical environment theme there were four subthemes: transportation, housing, accessibility, and gathering space. The results demonstrate that despite there being similarities in the areas that the participants felt they needed support and the areas on which the Older Adult Plan focuses, if the domains of aging well initiatives do not better account for the impacts of colonialism, it is unlikely that they will be effective in supporting Indigenous older adults' health and well-being.
PubMed ID
30832930 View in PubMed
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Comparison of Summer and Winter Objectively Measured Physical Activity and Sedentary Behavior in Older Adults: Age, Gene/Environment Susceptibility Reykjavik Study.

https://arctichealth.org/en/permalink/ahliterature290965
Source
Int J Environ Res Public Health. 2017 10 21; 14(10):
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, Non-P.H.S.
Date
10-21-2017
Author
Nanna Yr Arnardottir
Nina Dora Oskarsdottir
Robert J Brychta
Annemarie Koster
Dane R van Domelen
Paolo Caserotti
Gudny Eiriksdottir
Johanna E Sverrisdottir
Erlingur Johannsson
Lenore J Launer
Vilmundur Gudnason
Tamara B Harris
Kong Y Chen
Thorarinn Sveinsson
Author Affiliation
Faculty of Education, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland. nanna@unak.is.
Source
Int J Environ Res Public Health. 2017 10 21; 14(10):
Date
10-21-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, Non-P.H.S.
Keywords
Accelerometry
Aged
Aged, 80 and over
Exercise
Female
Humans
Iceland
Independent Living - statistics & numerical data
Male
Seasons
Sedentary lifestyle
Abstract
In Iceland, there is a large variation in daylight between summer and winter. The aim of the study was to identify how this large variation influences physical activity (PA) and sedentary behavior (SB). Free living PA was measured by a waist-worn accelerometer for one week during waking hours in 138 community-dwelling older adults (61.1% women, 80.3 ± 4.9 years) during summer and winter months. In general, SB occupied about 75% of the registered wear-time and was highly correlated with age (ß = 0.36). Although the differences were small, more time was spent during the summer in all PA categories, except for the moderate-to-vigorous PA (MVPA), and SB was reduced. More lifestyle PA (LSPA) was accumulated in =5-min bouts during summer than winter, especially among highly active participants. This information could be important for policy makers and health professionals working with older adults. Accounting for seasonal difference is necessary in analyzing SB and PA data.
Notes
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