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  • 1.

    【2hr】Limitations in physical functioning among older people as a predictor of subsequent disability in instrumental activities of daily living

    包量

    机译 老年人身体机能的局限性可预测随后的日常工具活动中的残疾
    摘要：>Background: physical functioning describes the underlying abilities that make activities necessary for independent living in the community possible.>Objective: to test self-reported and objective measures of physical functioning in predicting subsequent disability in cooking, shopping and housework.>Design: we used data from the first and second waves of the Survey of Health, Ageing and Retirement in Europe. The respondents were asked about physical functioning (climbing, pulling/pushing, stooping/crouching/kneeling, lifting/carrying and reaching/extending were comparable) and they had their grip strength and walking speed measured.>Participants: men and women aged 65 years or over who reported no disability in cooking, shopping and housework at baseline were included in the analysis. There were 6,841 individuals for whom data on disability status at follow-up were available.>Methods: Poisson regression was used to calculate relative risks for the associations between self-reported and objective measures of physical functioning with disability at 2 years, adjusting for age, gender, educational level, cognitive function and chronic conditions.>Results: those with limitations in physical functioning at baseline more frequently reported subsequent disability. Walking ability was most strongly associated with disability; climbing, pulling/pushing, lifting/carrying and reaching/extending were comparable (picking was non-significant). Similar results were obtained with grip strength and walking speed.>Conclusions: both self-reports and objective measures capture information on the functional ability of older people that can be used to predict disability onset. Objective measures offer little to the development of intervention strategies, whereas self-reports provide some insight into the demands of the environment, being more amenable to interventions.
  • 2.

    【2hr】Interventions for addressing low balance confidence in older adults; a systematic review and meta-analysis

    包量

    机译 解决老年人对低平衡信心的干预措施；系统评价和荟萃分析
    摘要：BACKGROUNDLow balance confidence is a major health problem among older adults restricting their participation in daily life.
  • 3.

    【2hr】If Mohammed wont come to the mountain the mountain must go to Mohammed

    包量

    机译 如果穆罕默德不来这座山那座山一定要去穆罕默德
    摘要：
  • 4.

    【2hr】The effect of cognitive impairment on the predictive value of multimorbidity for the increase in disability in the oldest old: the Leiden 85-plus Study

    包量

    机译 认知障碍对多发病率对高龄残疾增加的预测价值的影响：莱顿85岁以上研究
    摘要：>Background: prevention of disability is an important aim of healthcare for older persons. Selection of persons at risk is a first crucial step in this process.>Objectives: this study investigates the predictive value of multimorbidity for the development of disability in the general population of very old people and the role of cognitive impairment in this association.>Design: the Leiden 85-plus Study (1997–2004) is an observational prospective cohort study with 5 years of follow-up.>Setting: general population of the city of Leiden, the Netherlands.>Subjects: population based sample of 594 participants aged 85 years.>Methods: disability in activities of daily living (ADL) was measured annually for 5 years with the Groningen Activity Restriction Scale (range 9–36, 9 = optimal). Multimorbidity is defined as the presence of two or more chronic diseases at age 85 years. Cognitive function was measured at baseline with the mini-mental state examination (MMSE).>Results: at baseline participants with multimorbidity had higher ADL disability scores compared with those without [median 11 inter-quartile range (IQR 9–16) versus 9 (IQR 9–13) ADL points, Mann–Whitney U test P < 0.001]. Stratified into four MMSE groups, ADL disability increased over time in all groups, even in participants without multimorbidity (P trend <0.001). Multimorbidity predicted accelerated increase in ADL disability in participants with MMSE of 28–30 points (n = 205, 0.67 points/year, P < 0.001), but not in participants with lower MMSE scores (all P > 0.100).>Conclusion: the predictive value of multimorbidity for the increase in ADL disability varies with cognitive function in very old people. In very old people with good cognitive function, multimorbidity predicts accelerated increase in ADL disability. This relation is absent in very old people with cognitive impairment.
  • 5.

    【2hr】Ageing and endothelial progenitor cellrelease of proangiogenic cytokines

    包量

    机译 促血管生成细胞因子的衰老和内皮祖细胞释放
    摘要：
  • 6.

    【2hr】Incidence of ischaemic stroke according to income level among older people: the 3C study

    包量

    机译 根据老年人的收入水平缺血性中风的发病率：3C研究
    摘要：BackgroundStroke has been shown to follow a social gradient with incidence rising as socioeconomic status decreases.
  • 7.

    【2hr】Unexpected effects of cognitive-behavioural therapy on self-reported exercise behaviour and functional outcomes in older adults

    包量

    机译 认知行为疗法对老年人自我报告的运动行为和功能结局的意外影响
    摘要：>Background: nearly 61% of older adults do not maintain recommended exercise levels emphasising the need for interventions that promote exercise.>Objectives: to compare self-reported exercise behaviour and functional outcomes over 1 year across three groups of older adults: a cognitive-behavioural therapy group, an attention-control education group and a control group.>Design: randomised intervention.>Setting: community exercise facilities.>Participants: three hundred and thirty-two older adults (mean age = 71.8 ± 5.1 years).>Methods: all three groups received exercise training three times per week for 2 weeks and then one time per week for 8 weeks, during which time the therapy and education groups received their interventions. Blinded data collectors measured follow-up exercise behaviour and functional outcomes at 3-month intervals.>Results: after controlling for previous year exercise behaviour, results showed that relative to the control group, the therapy and education groups increased their strengthening exercises over time (0.05 and 0.06 h/week higher, respectively); only the therapy group's change was significant. Also, relative to the control group, the therapy and education groups significantly reduced their 6-min walking distances over time (−1.6 m, P = 0.030 and −1.5 m, P = 0.026, respectively).>Conclusions: although the therapy group increased their strength training, they reduced their 6-min walking distance.
  • 8.

    【2hr】Lipid-lowering treatment to the end? A review of observational studies and RCTs on cholesterol and mortality in 80+-year olds

    包量

    机译 降脂治疗到底？ 80岁以上人群胆固醇和死亡率的观察性研究和RCT综述
    摘要：People aged 80 or older are the fastest growing population in high-income countries. One of the most common causes of death among the elderly is the cardiovascular disease (CVD). Lipid-lowering treatment is common, e.g. one-third of 75–84-year-old Swedes are treated with statins [ ]. The assumption that hypercholesterolaemia is a risk factor at the highest ages seems to be based on extrapolation from younger adults. A review of observational studies shows a trend where all-cause mortality was highest when total cholesterol (TC) was lowest (‘a reverse J-shaped’ association between TC and all-cause mortality). Low TC (<5.5 mmol/l) is associated with the highest mortality rate in 80+-year olds. No clear optimal level of TC was identified. A review of the few randomised controlled trials including 80+-year olds did not provide evidence of an effect of lipid-lowering treatment on total mortality in 80+-year-old people. There is not sufficient data to recommend anything regarding initiation or continuation of lipid-lowering treatment for the population aged 80+, with known CVD, and it is even possible that statins may increase all-cause mortality in this group of elderly individuals without CVD.
  • 9.

    【2hr】Age-associated differences in the gait pattern changes of older adults during fast-speed and fatigue conditions: results from the Baltimore longitudinal study of ageing

    包量

    机译 在快速和疲劳状态下老年人步态模式变化的年龄相关差异：巴尔的摩纵向衰老研究的结果
    摘要：>Objective: the present study investigated the effects of walking under different challenges and kinematics and kinetics generated during these activities and how these vary with age. We hypothesised that age-associated changes in gait speed and kinetics are more pronounced during fast-speed walking and post-activity walking, compared with usual-speed walking.>Methods: investigated walking under three conditions: (i) usual speed, (ii) fast speed and (iii) post-activity in 183 Baltimore Longitudinal Study of Aging participants (mean 73 ± 9 years) who could walk unassisted.>Results: across all tasks, gait speed decreased with older age and this decline rate was exacerbated in the fast-speed walking task, compared with usual-speed walking (P < 0.001). Medial–lateral (ML) hip-generative mechanical work expenditure declined with age and the rate of decline was steeper for walking at fast speed and post-activity during hip extension (P = 0.032 and 0.027, respectively), compared with usual-speed walking.>Conclusions: these findings indicate that older adults experience exacerbated declines in gait speed and ML control of the hip, which is explicitly evident during challenging walking. Exercise programmes aimed at improving gait speed and ML joint power from hip and ankle may help reverse age-associated changes in gait pattern among older adults.
  • 10.

    【2hr】Health-related quality of life and antihypertensive medication adherence among older adults

    包量

    机译 老年人健康相关的生活质量和抗高血压药物的依从性
    摘要：>Purpose: health-related quality of life (HRQOL) is an important psycho-social characteristic which may impact an individual’s ability to manage their chronic disease. We examined the association between HRQOL and antihypertensive medication adherence in older adults.>Methods: participants were part of a cohort study of older adults enrolled in a managed care organisation and treated for hypertension (n = 2,180). Physical and Mental Component Summary Scores (PCS and MCS) of HRQOL were assessed using the RAND Medical Outcomes Study 36-item tool. Adherence to antihypertensive medication was assessed with the eight-item Morisky Medication Adherence Scale.>Results: the mean age of participants was 75.0 ± 5.6 years, 69.3% were white, 58.5% were women and 14.1% had low antihypertensive medication adherence. Low HRQOL scores were associated with lower levels of antihypertensive medication adherence in older adults. After adjustment for covariates, those with low PCS and MCS scores were 1.33 (95% CI 1.01, 1.74) and 2.26 (95% CI 1.74, 2.97) times more likely, respectively, to have low antihypertensive medication adherence than those with PCS and MCS scores in the top 2 tertiles.>Conclusions: low HRQOL may be an important barrier to achieving high medication adherence.
  • 11.

    【2hr】Sarcopenia: European consensus on definition and diagnosis

    包量

    机译 肌肉减少症：欧洲对定义和诊断的共识
    摘要：The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics—European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document.The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity?For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as ‘presarcopenia’, ‘sarcopenia’ and ‘severe sarcopenia’. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research.Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment.
  • 12.

    【2hr】Muscle strength is associated with adipose tissue gene expression of inflammatory adipokines in postmenopausal women

    包量

    机译 肌肉力量与绝经后女性炎症性脂肪因子的脂肪组织基因表达有关
    摘要：
  • 13.

    【2hr】Identifying frailty in high functioning older adults with normal mobility

    包量

    机译 确定功能正常的高功能老年人的虚弱
    摘要：
  • 14.

    【2hr】Grip strength and cardiovascular drug use in older people: findings from the Hertfordshire Cohort Study

    包量

    机译 老年人的握力和心血管药物使用：赫特福德郡队列研究的发现
    摘要：Backgroundreduced grip strength is associated with adverse health consequences, and there is interest in identifying modifiable influences. Cardiovascular drugs are commonly used by older people, but their effect on muscle strength is unclear.
  • 15.

    【2hr】Risk factors for disability in older persons over 3-year follow-up

    包量

    机译 三年以上随访中老年人残疾的危险因素
    摘要：>Background: the identification of modifiable risk factors for preventing disability in older individuals is essential for planning preventive strategies.>Purpose: to identify cross-sectional correlates of disability and risk factors for the development activities of daily living (ADL) and instrumental ADL (IADL) disability in community-dwelling older adults.>Methods: the study population consisted of 897 subjects aged 65–102 years from the InCHIANTI study, a population-based cohort in Tuscany (Italy). Factors potentially associated with high risk of disability were measured at baseline (1998–2000), and disability in ADLs and IADLs were assessed both at baseline and at the 3-year follow-up (2001–03).>Results: the baseline prevalence of ADL disability and IADL disability were, respectively, 5.5% (49/897) and 22.2% (199/897). Of 848 participants free of ADL disability at baseline, 72 developed ADL disability and 25 of the 49 who were already disabled had a worsening in ADL disability over a 3-year follow-up. Of 698 participants without IADL disability at baseline, 100 developed IADL disability and 104 of the 199 who already had IADL disability had a worsening disability in IADL over 3 years. In a fully adjusted model, high level of physical activity compared to sedentary state was significantly associated with lower incidence rates of both ADL and IADL disability at the 3-year follow-up visit (odds ratio (OR): 0.30; 95% confidence intervals (CI) 0.12–0.76 for ADL disability and OR: 0.18; 95% CI 0.09–0.36 for IADL disability). After adjusting for multiple confounders, higher energy intake (OR for difference in 100 kcal/day: 1.09; 95% CI 1.02–1.15) and hypertension (OR: 1.91; 95% CI 1.06–3.43) were significant risk factors for incident or worsening ADL disability.>Conclusions: higher level of physical activity and lower energy intake may be protective against the development in ADL and IADL disability in older persons.
  • 16.

    【2hr】Coronary heart disease risk factors and regional deprivation in England: does age matter?

    包量

    机译 英格兰冠心病的危险因素和地区匮乏：年龄重要吗？
    摘要：
  • 17.

    【2hr】Cognitive performance in community-dwelling English- and Spanish-speaking seniors

    包量

    机译 在社区居住的英语和西班牙语社区老年人的认知表现
    摘要：>Objectives: to examine the association of language (English vs Spanish), and commonly used measures of memory and word fluency among older adults.>Design: cross-sectional.>Setting: community-based settings in New York City, including senior centres and residential complexes.>Subjects: four hundred and twenty independently living adults aged 60 or older (mean 73.8 years).>Methods: participants completed the Mini-Mental State Exam (MMSE), animal naming test (ANT) and Wechsler Memory Scale III (WMS) Story A immediate and delayed subtests. Scores were examined by strata of language, age or education and for different thresholds of the MMSE. We tested the association of language and cognitive test performance using multivariable linear regression.>Results: twenty-one per cent of subjects were interviewed in Spanish and 16.2% reported poor-fair English proficiency. The mean WMS scores were not statistically different between English and Spanish groups (immediate recall, 9.9 vs 9.5, P = 0.44; delayed recall, 8.0 vs 7.6, P = 0.36, respectively), whereas ANT scores did differ (16.6 vs 14.3, P < 0.0001). These associations were consistent across MMSE thresholds. The association of language and ANT score was not significant after accounting for education.>Conclusions: we found little difference in performance on the Story A subtests from the WMS suggesting that this test may be used for both English- and Spanish-speaking populations. Results suggest that variations in ANT performance may be accounted for by adjusting for the level of education. These results have important implications for the generalisability of test scores among diverse older populations.
  • 18.

    【2hr】SGS: a structured treatment and teaching programme for older patients with diabetes mellitus—a prospective randomised controlled multi-centre trial

    包量

    机译 SGS：针对老年糖尿病患者的结构化治疗和教学计划-前瞻性随机对照多中心试验
    摘要：>Objectives: evaluation of the effectiveness of a new structured diabetes teaching and treatment programme (DTTP) with specific didactical approaches and topics for geriatric patients with diabetes mellitus.>Design: a prospective randomised controlled multi-centre trial.>Setting and participants: a total of 155 geriatric patients were randomly admitted to either the new DTTP SGS (n = 83) or the standard DTTP (n = 72) for insulin-treated patients with type 2 diabetes mellitus (HbA1c 8.0 ± 1.4%, age 76.2 ± 6.3 years).>Measurements: biometrical data, metabolic control, acute complications, diabetes knowledge, self-management.>Results: SGS participants showed improved levels of HbA1c 6 months after the DTTP, and less acute complications than the standard group (P<0.009). Both groups demonstrated a good capacity for diabetes self-management and improvement in diabetes knowledge after the DTTP (P<0.01).>Conclusion: the new SGS diabetes education programme, focusing on the learning capabilities and the particular needs of older persons, is effective in improving metabolic control and in maintaining auto-sufficiency in geriatric patients with diabetes mellitus.
  • 19.

    【2hr】The association between dehydroepiandosterone and frailty in older men and women

    包量

    机译 老年男性和女性中脱氢表雄酮与虚弱的关系
    摘要：>Objectives: to evaluate the association between dehydroepiandosterone (DHEA) and physical frailty in older adults.>Design: cross-sectional analysis of baseline information from three separate studies in healthy older men, women and residents of assisted living.>Setting: academic health centre in greater Hartford, CT, USA.>Participants: eight hundred and ninety-eight adults residing in the community or assisted living facility.>Measurements: participants had measurement of frailty (weight loss, grip strength, sense of exhaustion, walking speed and physical activity) and serum DHEAS levels.>Results: overall, 6% of the individuals in the study were classified as frail, 58% intermediate frail and 35% were not frail. In the bivariate analysis, there were differences between categories of frailty across age, gender and by DHEAS levels. In an ordinal logistic regression model, with frailty as a dependent measure, we found that age, DHEAS and interactions of age and BMI and DHEAS and BMI were predictive of more frailty characteristics.>Conclusion: we found an association between frailty and DHEAS levels. Whether the association is due to similar conditions resulting in lower DHEA levels and more susceptibility to frailty or whether lower DHEA levels have an impact on increasing frailty cannot be addressed by cross-sectional analysis. Gender did not impact the association between DHEAS and frailty, but obesity (BMI > 30 kg/m2) attenuated the association between higher DHEA levels and lower frailty status.
  • 20.

    【2hr】Heart rate variability and its changes over 5 years in older adults

    包量

    机译 老年人5年以上的心率变异性及其变化
    摘要：>Purpose: to characterise the association between age, ageing and heart rate variability (HRV) in older individuals, 585 adults age >65 years with two 24-h Holter recordings in the Cardiovascular Health Study were studied.>Methods: heart rate (HR), ventricular premature contractions (VPCs), atrial premature contractions (APCs), frequency-domain, ratio-based and non-linear HRV and heart rate turbulence (HRT) were examined cross-sectionally by 5-year age groups and prospectively over 5 years. Analyses adjusted for gender, lower versus elevated cardiovascular (CV) risk and for the change in CV risk.>Results: HR declined, and VPCs and APCs increased per 5-year increase in age. Frequency-domain HRV decreased more at 65–69, less at 70–74 and minimally at ≥75 years, independent of CVD risk or change in CVD risk. Ratio and non-linear HRV continued to decline to ≥75 years old. Ratio HRV and HRT slope were more strongly related to CVD risk than frequency-domain HRV.>Conclusions: cardiac autonomic function, assessed by frequency-domain HRV, declines most at 65–70 and levels off at age >75. The decline is independent of CVD risk or change in CVD risk. Ratio-based and non-linear HRV and HRT slope continued to change with increasing age and were more closely related to CVD risk than frequency-domain HRV.
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