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OBJECTIVE: Chronic subdural hematoma is frequently seen within the elderly population and neurosurgeons are confronted with patients older than 80 years presenting with symptomatic chronic subdural hematoma. However, data on surgical outcome are scarce. The aim of this study is to analyze the mortality and outcome after burr-hole drainage in patients older than 80 years. METHODS: This is a single-center retrospective study including patients who underwent burr-hole drainage of chronic subdural hematoma between the years 2016 and 2019. The cohort was divided into 3 age groups (80-84 years; 85-89 years; >90 years). Primary outcome was 30-day and overall mortality, whereas secondary outcome measures were recurrence rates, postoperative bleeding rates, and outcome measured by the modified ranking scale. Uni- and multivariate analysis was conducted to assess for potential risk factors for mortality, recurrence and postoperative bleeding rates. RESULTS: In total, 107 patients with a mean age of 85.5 ± 3.9 years were included. Mortality rate was less than 10% in each group, showing no significant difference between them (P = 0.455). No significant difference in recurrence and postoperative bleeding rates was seen (P = 0.491 and P = 0.532). Modified Ranking scale score differed significantly at release, whereas at follow-up no difference was seen. After uni- and multivariate analysis, age was not correlated with higher recurrence, postoperative bleeding, or mortality rates. Preoperative midline shift was found to be an independent risk factor for recurrence. CONCLUSIONS: In patients older than 80 years undergoing burr-hole drainage for chronic subdural hematoma, age was not directly correlated with higher recurrence, postoperative bleeding, or mortality rates.
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Anciano de 80 o más Años/estadística & datos numéricos , Drenaje/métodos , Hematoma Subdural Crónico/mortalidad , Hematoma Subdural Crónico/cirugía , Procedimientos Neuroquirúrgicos/métodos , Factores de Edad , Femenino , Escala de Coma de Glasgow , Humanos , Masculino , Hemorragia Posoperatoria/epidemiología , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , TrepanaciónRESUMEN
This study intends to assess the relationship between resilience in extremely long-lived individuals and sociodemographic, cognitive and health status variables, and significant life events. A selected sample of 48 centenarians (mean age = 100.8 years, SD = 1.2; 83.3% female) from two centenarian studies was considered. A resilience score covering five items (aging and usefulness, hopefulness, worryness, loneliness, and control) was considered. Multivariable linear regression analyses were conducted in order to identify predictors of resilience. No significant differences in the resilience score regarding sociodemographic variables or typology of significant life events were found. Our findings underscore that health perception (better) and pain (less frequent) were associated with higher levels of resilience. In being present in extremely long-lived individuals, resilience should be object of interest in further research.
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Anciano de 80 o más Años/psicología , Resiliencia Psicológica , Factores de Edad , Anciano de 80 o más Años/estadística & datos numéricos , Envejecimiento/psicología , Ansiedad/epidemiología , Ansiedad/psicología , Femenino , Estado de Salud , Esperanza , Humanos , Modelos Lineales , Soledad/psicología , Masculino , Autonomía Personal , Portugal/epidemiologíaRESUMEN
The purpose of this study was a cross-cultural examination of centenarians' personality through a person-centered approach to examine if there is a "resilient" personality profile consistent across cultures. Proxy reports information was obtained from family and close friends of 239 U.S. centenarians from the Georgia Centenarians Study and 272 Japanese centenarians from the Tokyo Centenarian Study. Latent profile analyses were conducted to identify personality profiles in centenarians from the United States and Japan. Two personality profiles were identified in both samples: a "resilient" personality profile and "nonresilient" personality profile. The "resilient" group had higher levels of positive personality traits with higher scores on agreeableness and extraversion and lower scores on neuroticism, conscientiousness, and openness. The "nonresilient" group had higher scores on neuroticism and lower scores on extraversion, openness, agreeableness, and conscientiousness. Fifty percent of U.S. centenarians and 65% of Japanese centenarians were in the "resilient" group.
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Anciano de 80 o más Años/psicología , Comparación Transcultural , Personalidad , Anciano de 80 o más Años/estadística & datos numéricos , Extraversión Psicológica , Femenino , Humanos , Japón , Masculino , Neuroticismo , Optimismo , Resiliencia Psicológica , Estados UnidosRESUMEN
INTRODUCTION: Advances in healthcare have resulted in an increasing UK population, with the proportion of elderly individuals expanding significantly, including centenarians. Hospitals can expect to see growing numbers of so-called 'super-elderly' patients with trauma, a majority of whom will have hip fractures. We performed a multicentre review of hip fracture outcomes in centenarians to assess whether being an outlier in age correlates with poorer prognosis. METHODS: Centenarians admitted to Basingstoke, Southampton, Dorset, and Salisbury district hospitals with hip fractures between January 2014 and June 2019 were included. Electronic records were searched to obtain demographics, functional status, and admission details. RESULTS: A total of 60 centenarians were included, with a median age of 101 years (range 100-108 years), 85% of whom were female; 29 were admitted from their own home or sheltered housing and 31 from nursing or residential care; 33 had some outdoor mobility, 26 only mobilised indoors, and 1 had no mobility. Common comorbidities were renal and heart disease and dementia. Of the total, 56 underwent surgery, 51 within 36 hours. In terms of accommodation, 63.4% returned to their pre-injury level of independence. At 30 days, three months, and one year, mortality rates were 27% (n = 16), 40% (n = 24) and 55% (n = 33), respectively. CONCLUSION: Trauma in the elderly population is an area of growing interest, yet few studies address centenarians with hip fractures. This work demonstrates that mortality rates within one year of injury were high, but almost half survived beyond a year. Two-thirds of patients regained their pre-injury level of independence, suggesting that functional recovery may not be as poor as previously reported.
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Fijación de Fractura/estadística & datos numéricos , Fracturas de Cadera/mortalidad , Factores de Edad , Anciano , Anciano de 80 o más Años/estadística & datos numéricos , Comorbilidad , Demencia/epidemiología , Femenino , Cardiopatías/epidemiología , Fracturas de Cadera/etiología , Fracturas de Cadera/cirugía , Humanos , Enfermedades Renales/epidemiología , Masculino , Pronóstico , Factores de Riesgo , Tiempo de Tratamiento/estadística & datos numéricos , Reino Unido/epidemiologíaRESUMEN
Factors affecting independence in basic and instrumental activities of daily living have been established in older adults, but not centenarians. The purpose of this study was to examine the state and factors affecting activities of daily living independence in centenarians who resided in Guangxi Province, China. A cross-sectional design was used. Activities of daily living, physical activity, mobility, and physical performance were measured by the Population Study of ChINese Elderly study instruments, and demographics and cognition were assessed. Of the 228 participants, 57% were independent in basic activities of daily living and 5.7% in instrumental activities of daily living. Stepwise regression showed physical activity, cognition, calf circumference, and self-reported health were associated with basic activities of daily living. Physical activity, mobility, cognition, and physical performance were correlated with instrumental activities of daily living. In conclusion, the Chinese centenarians showed impaired instrumental activities of daily living but mostly maintained basic functioning. Physical activity and cognition were associated with activities of daily living independence.
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Actividades Cotidianas , Anciano de 80 o más Años/psicología , Estado Funcional , Anciano de 80 o más Años/estadística & datos numéricos , China , Estudios Transversales , Femenino , Humanos , Masculino , AutoinformeRESUMEN
OBJECTIVES: Previous literature has consistently shown a positive association between negative self-perception of aging and mortality in middle-aged and older adults. However, two questions remain unsolved: (a) whether such association holds among very old people (i.e., the fourth age) and (b) the potential mediators that could contribute to the positive association. This study sought to fill in the research gap by examining the association between self-perception of aging and mortality in a group of very old Chinese participants (i.e., aged over 78 years). METHODS: Four waves of data across a span of 8 years (2000-2008) were obtained from the Chinese Longitudinal Healthy Longevity Survey, which measured a total of 9,683 participants' negative self-perception of aging, survival status, cognitive functioning, diet, as well as other demographic information. RESULTS: Latent growth models with survival analysis were conducted, and the results replicated previous findings indicating an association between negative self-perceptions of aging and reduced survival. Moreover and more importantly, a potential mediator-healthy lifestyle (e.g., eating fresh vegetables and fruits, exercising regularly, and no smoking)-was identified, such that older adults with more negative self-perception of aging tended to engage in less healthy lifestyle, which could lead to increased risk of mortality. DISCUSSION: The findings provided support for a longitudinal behavioral pathway of health, linking negative perceptions of aging to mortality, and also yielded important practical implications for older adults to reach longevity.
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Anciano de 80 o más Años/psicología , Envejecimiento/psicología , Actitud Frente a la Muerte , Estilo de Vida Saludable , Autoimagen , Anciano de 80 o más Años/estadística & datos numéricos , China , Cognición , Femenino , Humanos , Estudios Longitudinales , MasculinoRESUMEN
BACKGROUND: The aim of this study was to examine the trends in impairment regarding activities of daily living (ADL), physical performance, and cognitive function among the oldest-old (those aged 80 and older) in China between 1998 and 2014. METHODS: We used data on 34,297 oldest-old individuals from the seven waves of the Chinese Longitudinal Healthy Longevity Study. We estimated age, period, and cohort effects on the prevalence of self-reported ADL impairment, tested physical performance and cognitive function impairment using the age-period-cohort model. RESULTS: Regarding age, the prevalence of ADL, physical performance, and cognitive function impairment were highest in the centenarians, but they did not increase with age in this population. Among the literate subgroup, the prevalence of cognitive impairment increased more rapidly with age than that in the illiterate subgroup. Regarding period, the prevalence of self-reported and tested physical impairment slowly increased between 1998 and 2014, but cognitive impairment remained stable. Regarding cohort, ADL impairment continuously decreased. However, physical and cognitive impairment remained stable after a brief decline in the early birth cohorts. CONCLUSIONS: The results suggest that the age effect is still the most obvious effect regarding several types of functional impairment. The likelihood of a younger person experiencing functional impairment may not change significantly, but ADL is likely to be amenable to improvement resulting from improved medical and social care. Therefore, increased care for the oldest-old may considerably improve their quality of life, particularly regarding their basic ADL.
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Actividades Cotidianas , Anciano de 80 o más Años/estadística & datos numéricos , Disfunción Cognitiva/epidemiología , Aptitud Física , Actividades Cotidianas/psicología , Factores de Edad , Anciano de 80 o más Años/fisiología , Anciano de 80 o más Años/psicología , China/epidemiología , Disfunción Cognitiva/etiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Pruebas de Estado Mental y Demencia , Aptitud Física/psicología , Factores de RiesgoRESUMEN
Traumatic brain injury (TBI) in older adults is an increasing issue in modern medicine. Nevertheless, it remains unclear which patients presenting with TBI and 80 years of age or older benefit from an operative treatment. The aim of this study was to explore the effect of an operative treatment in isolated TBI patients ≥ 80 years of age. Data were derived from the TraumaRegister DGU® from 2002 to 2016. Inclusion criteria were ≥ 80 years of age, an Abbreviated Injury ScaleHead (AIS) ≥ 3, and an AISNon-Head ≤ 1. The cohort was split in operatively and non-operatively treated patients, and outcome was assessed at discharge using the Glasgow Outcome Scale (GOS). A favorable outcome was defined as a GOS of 4 or 5. A total of 1.693 patients (431 operatively and 1.262 non-operatively treated patients) were analyzed. Mortality rate was 54.4% (687 patients) in the non-operative group and 49.4% in the operative group. Simultaneously, there were more patients discharged with a GOS 2 (persistent vegetative state) in the operative group (7.9%, 34 patients) than in the non-operative group (1.0%, 13 patients). An analysis of the operatively treated patients showed an association between a higher mortality risk and brainstem hemorrhage (p = 0.04), fixed pupils (p = 0.001), initial intubation (p = 0.03), and an AISHead of 5/6 (p = 0.03). Patients 80 years of age or older seem to benefit from an operative treatment regarding mortality rate. However, there has been a higher rate of a poor neurological outcome particularly with regard to persistent vegetative state in the operative treatment group at discharge.
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Anciano de 80 o más Años/estadística & datos numéricos , Lesiones Traumáticas del Encéfalo/cirugía , Lesiones Traumáticas del Encéfalo/terapia , Procedimientos Neuroquirúrgicos/métodos , Lesiones Traumáticas del Encéfalo/mortalidad , Estudios de Cohortes , Femenino , Escala de Consecuencias de Glasgow , Humanos , Hemorragias Intracraneales/etiología , Hemorragias Intracraneales/mortalidad , Masculino , Procedimientos Neuroquirúrgicos/mortalidad , Estado Vegetativo Persistente/etiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/mortalidad , Resultado del TratamientoRESUMEN
OBJECTIVES: We examined the development of disease and disability in a large cohort of older women, the extent to which these conditions exempt them from being classified as successful agers and different trajectories of disease, disability and longevity across women's later life. METHODS: We used survey data from 12,432 participants of the 1921-26 birth cohort of the Australian Longitudinal Study of Women's Health from 1996 (age 70-75) to 2016 (age 90-95). Repeated measures latent class analysis (RMLCA) identified trajectories of the development of disease with or without disability and according to longevity. Bivariate analyses and multivariable multinomial logistic regression models were used to examine the association between participants' baseline characteristics and membership of the latent classes. RESULTS: Over one-third of women could be considered to be successful agers when in their early 70s, few women could still be classified in this category throughout their later life or by the end of the study when they were in their 90s (~1%). RMLCA identified six trajectory groups including managed agers long survivors (9.0%) with disease but little disability, usual agers long survivors (14.9%) with disease and disability, usual agers (26.6%) and early mortality (25.7%). A small group of women having no major disease or disability well into their 80s were identified as successful agers (5.5%). A final group, missing surveys (18.3%), had a high rate of non-death attrition. Groups were differentiated by a number of social and health factors including marital status, education, smoking, body mass index, exercise and social support. CONCLUSIONS: The study shows different trajectories of disease and disability in a cohort of ageing women, over time and through to very old ages. While some women continue into very old age with no disease or disability, many more women live long with disease but little disability, remaining independent beyond their capacity to be classified as successful agers.
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Envejecimiento Saludable , Anciano/estadística & datos numéricos , Anciano de 80 o más Años/estadística & datos numéricos , Australia , Femenino , Humanos , Longevidad , Estudios LongitudinalesRESUMEN
Background Adverse reactions to warfarin may be serious and can lead to hospitalisation or death. Minimising the risk of adverse drug reactions through the intervention of community pharmacists is important for patients receiving warfarin, especially for elderly (≥ 65 years) patients living in rural areas. Objective To evaluate the impact of an intervention by community pharmacists on the risk of adverse drug reactions in elderly rural patients receiving warfarin. Setting: A community pharmacy in a rural area of Croatia. Method We conducted a prospective randomised trial. Eligible patients were recruited at the pharmacy and randomised into one of two groups. The participants were followed up every month for 6 months. Main outcome measure: The incidence and type of adverse drug reactions caused by warfarin and the time-to-event. Results In total, 140 patients were randomized and 131 patients completed the study; 65 patients were in the intervention group. The median age of patients was 73 years of age. The cumulative incidence of adverse drug reactions was significantly lower in the intervention group (6-months rate 29% vs. 85% for intervention and control, respectively; hazard ratio = 0.17, p < 0.001) than in the control group. Factors multivariately associated with the development of adverse drug reactions related to warfarin (p < 0.05) were the absence of pharmaceutical intervention, higher time in therapeutic range, change of warfarin dose, changes in dietary vitamin K intake, and marital status other than married. Conclusion Overall, the pharmacist's intervention significantly prolonged the time to occurrence of adverse drug reactions and reduced their incidence.
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Anciano de 80 o más Años/estadística & datos numéricos , Anciano/estadística & datos numéricos , Anticoagulantes/efectos adversos , Farmacéuticos , Warfarina/efectos adversos , Servicios Comunitarios de Farmacia , Croacia/epidemiología , Femenino , Humanos , Incidencia , Masculino , Educación del Paciente como Asunto , Farmacias , Estudios Prospectivos , Población RuralRESUMEN
INTRODUCTION: The number of centenarians is increasing with the aging of the Spanish population. This age group might present different clinical features from younger groups. This study was carried out to determine the impact hospital admission on centenarians with an acute disease. MATERIALS AND METHODS: A retrospective observational study was conducted that included patients ≥100 years-old admitted from 1995 to 2016 to a third level university hospital and attended by the Geriatrics department in the acute ward, the Orthogeriatric ward, and by request. An analysis was made using the clinical-administrative databases containing information about the demographics, clinical, functional and cognitive features, length of hospital length, as well as discharge destination. RESULTS: The study included 165 patients with a mean age of 101.6 ± 1.7 (range 100-109) years, of whom 140 (85%) were female. The mean hospital stay was 10.3 ± 7.4 days. Respiratory infections (41%) were the most common cause of admission to the Acute Geriatric Unit (AGU). The overall in-hospital mortality was 16%, but mortality in AGU reached up to 31%. There was an increase on moderate-severe functional disability (51% to 96%), and on the inability to walk independently (52% to 99%) from baseline to admission. There was a reduction in people living in their own home from 71% prior to admission to 29% at hospital discharge. CONCLUSIONS: Centenarians who required hospital admission showed a high rate of mortality, a significant deterioration in their functional capacity, and a decrease in their chances of going back to their own home at discharge.
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Enfermedad Aguda/mortalidad , Anciano de 80 o más Años/estadística & datos numéricos , Deterioro Clínico , Mortalidad Hospitalaria , Hospitalización/estadística & datos numéricos , Distribución por Edad , Femenino , Hospitales Universitarios , Humanos , Vida Independiente/estadística & datos numéricos , Vida Independiente/tendencias , Tiempo de Internación , Masculino , Limitación de la Movilidad , Alta del Paciente/estadística & datos numéricos , Rendimiento Físico Funcional , Estudios Retrospectivos , Distribución por Sexo , España/epidemiología , Centros de Atención Terciaria/estadística & datos numéricosRESUMEN
Background Polypharmacy in older patients can lead to potentially inappropriate prescribing. The risk of the latter calls for effective medication review to ensure proper medication usage and safety. Objective Provide insight on the similarities and differences of medication review done in multiple ways that may lead to future possibilities to optimize medication review. Setting This study was conducted in Zuyderland Medical Centre, the second largest teaching hospital in the Netherlands. Method This descriptive study compares the quantity and content of remarks identified by medication review performed by a geriatrician, outpatient pharmacist, and Clinical Decision Support System. The content of remarks is categorized in seven categories of possible pharmacotherapeutic problems: 'indication without medication', 'medication without indication', 'contra-indication/interaction/side-effect', 'dosage problem', 'double medication', 'incorrect medication' and 'therapeutic drug monitoring'. Main outcome measure Number and content of remarks on medication review. Results The Clinical Decision Support System (1.8 ± 0.8 vs. 0.9 ± 0.9, p < 0.001) and outpatient pharmacist (1.8 ± 0.8 vs. 0.9 ± 0.9, p = 0.045) both noted remarks in significantly more categories than the geriatricians. The Clinical Decision Support System provided more remarks on 'double medication', 'dosage problem' and 'contraindication/interaction/side effects' than the geriatrician (p < 0.050), while the geriatrician did on 'medication without indication' (p < 0.001). The Clinical Decision Support System noted significantly more remarks on 'contraindication/interaction/side effects' and 'therapeutic drug monitoring' than the outpatient pharmacist, whereas the outpatient pharmacist reported more on 'indication without medication' and 'medication without indication' than the Clinical Decision Support System (p ≤ 0.007). Conclusion Medication review performed by a geriatrician, outpatient pharmacist, and Clinical Decision Support System provides different insights and should be combined to create a more comprehensive report on medication profiles.
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Anciano de 80 o más Años/estadística & datos numéricos , Anciano/estadística & datos numéricos , Administración del Tratamiento Farmacológico/estadística & datos numéricos , Sistemas de Apoyo a Decisiones Clínicas , Interacciones Farmacológicas , Femenino , Geriatras , Humanos , Prescripción Inadecuada , Masculino , Países Bajos , Farmacéuticos , PolifarmaciaRESUMEN
The effect of hospice care on place of death among centenarians remained unexplored. Using data obtained from National Health Insurance Research Database (2002-2010), we compared the differences in place and cause of death between centenarians and noncentenarians. These data were stratified into centenarian (n = 2495) and noncentenarian (n = 820 563) death. Data in place and cause of death and hospice care interventions were retrieved. Poisson regression models were used to evaluate factors associated with the centenarians' place of death. Time series models were used to predict the number of centenarian deaths until 2025. Most (63.8%) of the centenarians died at their own homes, followed by 30.5% who died in hospital. Hospice home care was involved in only 0.3% of the centenarian deaths but in 1.8% of the noncentenarian deaths. The leading causes of death among centenarians were respiratory diseases (16.6%), circulatory diseases (15.2%), and pneumonia (14.8%). Among the centenarians, those who died of circulatory disease, old age, and respiratory diseases were more likely to die at their own homes. We forecasted the number of annual centenarian deaths to reach 800 in 2025. Therefore, an increase in the provision of advanced care planning and earlier home hospice care intervention may enable centenarians to die at their own residence.
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Anciano de 80 o más Años/estadística & datos numéricos , Muerte , Cuidados Paliativos al Final de la Vida/estadística & datos numéricos , Factores de Edad , Anciano , Causas de Muerte , Femenino , Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Factores Sexuales , TaiwánRESUMEN
The population of France and the world is aging with an increase in the population of people aged over 65 years old. Old people are the second largest population affected by seizures. Hence, neurologists and geriatricians have to be able to identify and treat elderly that suffer from seizures. The current epileptic seizure classification is inappropriate for old people. It is difficult to identify seizures in this group of patients for many reasons and some semiological particularities are required to establish a diagnostic. Within the elderly, first generalized seizures are rare except when epilepsy begins in childhood. The most common type of epilepsy in the elderly is partial seizure but in most cases, the beginning of seizure is difficult to analyze. Seizures clinical description depends on functional areas concerned by the spread of the epileptic discharge. Keep in mind that most of functional areas are interconnected and because of the epileptic discharge speed, clinical expression is polymorph.
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Anciano de 80 o más Años/estadística & datos numéricos , Anciano/estadística & datos numéricos , Convulsiones/terapia , Francia/epidemiología , Humanos , Convulsiones/diagnóstico , Convulsiones/epidemiologíaRESUMEN
OBJECTIVE: To study ED utilisation by people aged 100 years and over with a focus on patient demographics, reasons for presentation and patient flow factors. METHODS: This is a retrospective descriptive analysis of linked ED Data Collection Registry for presentations to New South Wales (NSW) EDs over a 5 year period. Patients were included if they presented to an ED and were aged 100 years and over at the time of presentation. Demographics, triage category, presenting problem, ED length of stay, disposition and ED re-presentation were determined for this age group. RESULTS: A total of 4033 presentations to 115 NSW EDs during 2010-2014 were analysed. We found that 78% of the patients were females and 76% still living at home. This group were the second most common age group to present to ED, after the 90-99 year age group, with 87% arriving via ambulance. Most presentations were triaged as a category 3 or 4, with the most common presenting problem being because of injury (28.5%) followed by respiratory disease (11.4%) and cardiovascular disease (10.0%). Overall, 64% required hospital admission and the average length of stay for all patients was 5.7 h. CONCLUSIONS: Centenarians ED presentations are increasing over time with injuries as the most common reason for presentation. Most patients have prolonged ED length of stay and many require hospital admission. Early streaming of these patients through specialised geriatric assessment units may be more appropriate to reduce the demand on EDs and improve patient care. Models that facilitate rapid access to supported living arrangements and improved advanced care planning may be more realistic for many centenarians and different models of care need to be considered for this age group.
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Anciano de 80 o más Años/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Factores de Edad , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Nueva Gales del Sur , Triaje/estadística & datos numéricosRESUMEN
BACKGROUND: China has transitioned from being one of the fastest-growing populations to among the most rapidly aging countries worldwide. In particular, the population of oldest-old individuals, those aged 80+, is projected to quadruple by 2050. The oldest-old represent a uniquely important group-they have high demand for personal assistance and the highest healthcare costs of any age group. Understanding trends in disability and longevity among the oldest-old-that is, whether successive generations are living longer and with less disability-is of great importance for policy and planning purposes. METHODS: We utilized data from successive birth cohorts (n = 20,520) of the Chinese oldest-old born 10 years apart (the earlier cohort was interviewed in 1998 and the later cohort in 2008). Disability was defined as needing personal assistance in performing one or more of five essential activities (bathing, transferring, dressing, eating, and toileting) or being incontinent. Participants were followed for age-specific disability transitions and mortality (in 2000 and 2002 for the earlier cohort and 2011 and 2014 for the later cohort), which were then used to generate microsimulation-based multistate life tables to estimate partial life expectancy (LE) and disability-free LE (DFLE), stratified by sex and age groups (octogenarians, nonagenarians, and centenarians). We additionally explored sociodemographic heterogeneity in LE and DFLE by urban/rural residence and educational attainment. RESULTS: More recently born Chinese octogenarians (born 1919-1928) had a longer partial LE between ages 80 and 89 than octogenarians born 1909-1918, and octogenarian women experienced an increase in partial DFLE of 0.32 years (P = 0.004) across the two birth cohorts. Although no increases in partial LE were observed among nonagenarians or centenarians, partial DFLE increased across birth cohorts, with a gain of 0.41 years (P < 0.001) among nonagenarians and 0.07 years (P = 0.050) among centenarians. Subgroup analyses revealed that gains in partial LE and DFLE primarily occurred among the urban resident population. CONCLUSIONS: Successive generations of China's oldest-old are living with less disability as a whole, and LE is expanding among octogenarians. However, we found a widening urban-rural disparity in longevity and disability, highlighting the need to improve policies to alleviate health inequality throughout the population.
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Anciano de 80 o más Años/estadística & datos numéricos , Disparidades en el Estado de Salud , Esperanza de Vida/tendencias , Pueblo Asiatico , China , Estudios de Cohortes , Evaluación de la Discapacidad , Personas con Discapacidad , Femenino , Humanos , Longevidad , MasculinoRESUMEN
Time spent out-of-home can increase physical activity (PA) levels. However, the association between the purpose for leaving home and the mode of transport on time out-of-home and PA are not straightforward. In a large sample of community-dwelling older adults (≥65 years), daily walking duration was measured prospectively over 1 week using body-fixed sensors and time-out-of-home questionnaires. Data from 1,277 participants yielded 6,500 full days for analysis. The following statistically significant associations were seen: public transport use increased the time spent out-of-home by 88 min and daily walking duration by 16 min. Social contacts or the use of a car increased the time out-of-home, but decreased PA. Shopping or "going by foot" decreased the time spent out-of-home by 19 and 62 min, respectively, while both increased the daily walking duration by 5 min. The association between time out-of-home and PA (daily walking duration) is strongly dependent on the activity and mode of transport.
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Transportes/estadística & datos numéricos , Caminata/estadística & datos numéricos , Acelerometría , Actividades Cotidianas , Anciano/estadística & datos numéricos , Anciano de 80 o más Años/estadística & datos numéricos , Estudios Transversales , Ejercicio Físico , Femenino , Humanos , Masculino , Factores de TiempoRESUMEN
I present a body of data that, I argue, cumulatively casts serious doubt on the validity of Jeanne Calment's accepted world record of human life span. First, I assess the plausibility of the record based on the life spans of other centenarians in the International Database of Longevity (IDL) and critique some arguments put forward previously in support of that plausibility, including the longevity of Calment's ancestors. Second, I review the literature dedicated to Calment and discuss multiple contradictions in her interviews, biographies, photos, and documents. I argue that the evidence from these sources motivates renewed consideration of the previously rejected hypothesis that Jeanne's daughter Yvonne acquired her mother's identity after her death to avoid financial problems and that Jeanne Calment's death was reported as Yvonne's death in 1934. Finally I discuss the importance of reconsidering the principles of validation, due to the possibility of similar problems regarding other exceptionally long-lived people and the mistaken inferences that researchers may draw from flawed datasets. The phenomenon of Jeanne Calment may prove to be an instructive example of the uncertainty of seemingly well-established facts.
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Anciano de 80 o más Años/estadística & datos numéricos , Muerte , Longevidad , Femenino , Humanos , Factores de TiempoRESUMEN
Incidence rates of cutaneous squamous cell carcinoma (SCC) are increasing in many countries. To estimate detailed trends of SCC incidence rates in the population of Akita Prefecture as the forerunner of super-aged societies, we conducted a retrospective analysis of patients diagnosed with SCC between 2007 and 2016 in Akita University Hospital. The crude SCC incidence rate increased rapidly between 2007 and 2016 from 2.5 to 10.0/100 000 people. Remarkably, the age-specific incidence rate of people aged 80 years or over increased between 2007 and 2016 from 14.7 to 51.6/100 000 people, suggesting that SCC incidence rates increase possibly due to not only the increased number of aged people but also because of unidentified cancer-prone environments. When the findings of the present study are generalized to other regions entering the era of super-aging, it is clear that we need to prepare for the economic disease burden together with careful monitoring to confirm future trends for SCC.