Handgrip strength, functional capacity and cognitive status of centenarians / Força de preensão manual, capacidade functional e estado cognitivo em centenários

Objective: To compare and correlate handgrip strength (HGS) with functional capacity and cognitive status in centenarians. Method: This is a cross-sectional study. The study population consisted of 127 centenarians, of which 78 met the inclusion criteria, with a mean age of 101.7 ± 2.52 years. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) and functional capacity using the Katz Scale. To investigate HGS, we used a manual dynamometer. The level of significance was 5%. Results: Centenarian men have higher right (p= 0.005) and left (p<0.001) HGS compared to women. About functional capacity, centenarians more functional present higher right and left HGS (p<0.001) when compared to intermediate and less functional. Furthermore, when analyzing cognition, centenarians with preserved cognitive status have higher right and left HGS (p<0.001) than cognitively impaired elderly. In the relationship analysis, it was possible to verify that the lower the MMSE score, the higher the right (rho= 0.59; p<0.001) and left (rho= 0.57; p<0.001) HGS. Furthermore, the lower the Katz Scale score, the higher the right (rho= -0.53; p<0.001) and left (rho= -0.57; p<0.001) HGS. Conclusion: Our results show that male centenarians, more functional and with preserved cognitive status have higher HGS in both hands. Moreover, we found a moderate negative relationship between HGS and functional capacity and a moderate positive relationship between HGS and cognitive status of centenarians.

Objetivo: Comparar e correlacionar a força de preensão manual (HGS) com a capacidade funcional e o estado cognitivo em centenários. Método: Este é um estudo de corte transversal. A população do estudo consistiu em 127 centenários, dos quais 78 preenchiam os critérios de inclusão, com uma idade média de 101,7 ± 2,52 anos. O estado cognitivo foi avaliado utilizando o Mini-Mental State Examination (MMSE) e a capacidade funcional utilizando a Escala Katz. Para investigar o HGS, utilizamos um dinamômetro manual. O nível de significância foi de 5%. Resultados: Os homens centenários têm o HGS mais alto à direita (p= 0,005) e à esquerda (p<0,001) em comparação com as mulheres. Quanto à capacidade funcional, os centenários mais funcionais apresentam HGS mais altos à direita e à esquerda (p<0,001) quando comparados com os intermediários e menos funcionais. Além disso, ao analisar a cognição, os centenários com estado cognitivo preservado têm HGS direito e esquerdo mais elevados (p<0,001) do que os idosos com deficiência cognitiva. Na análise da relação, foi possível verificar que quanto mais baixa a pontuação MMSE, mais alta a direita (rho= 0,59; p<0,001) e esquerda (rho= 0,57; p<0,001) HGS. Além disso, quanto mais baixa a pontuação da Escala Katz, mais alta a direita (rho= -0,53; p<0,001) e esquerda (rho= -0,57; p<0,001) HGS. Conclusão: Os nossos resultados mostram que os centenários masculinos, mais funcionais e com estatuto cognitivo preservado, têm HGS mais elevado em ambas as mãos. Além disso, encontramos uma relação negativa moderada entre HGS e capacidade funcional e uma relação positiva moderada entre HGS e estado cognitivo dos centenários.

Comparação entre os domínios da função cognitiva e a capacidade funcional de centenários / Relationship between the domains of cognitive function and functional capacity in centenarians

Objetivo: Comparar os domínios da função cognitiva com a capacidade funcional para as atividades básicas de vida diária de centenários. Métodos: Trata-se de um estudo descritivo com 66 idosos com 100 anos ou mais de idade, 45 do sexo feminino e 21 do masculino, com média de idade 102,14 ± 2,71 anos, residentes na Grande Florianópolis/SC. Foram avaliados os domínios da função cognitiva (Mini Exame do Estado Mental- MEEM) e a capacidade funcional (escala de Katz) dos centenários. Os dados foram tratados por meio do Kruskal-Wallis e o post hoc de Bonferroni, com nível de significância de 5%. Também analisou-se com o modelo de regressão multinominal, com intervalo de confiança de 95%. Resultados: Houve diferença significativa entre os centenários MF (Mais Funcional) e Mf (Menos Funcional) em todos os domínios do MEEM: orientação temporal (p<0,001), orientação espacial (p<0,002), memória imediata (p<0,001), atenção e cálculo (p<0,013), memória e evocação (p<0,012) e linguagem (p<0,001) e, os Mf e com FI nos domínios do MEEM memória imediata (p<0,004) e linguagem (p<0,004). Conclusão: Os domínios da função cognitiva estão relacionados à capacidade funcional, ou seja, centenários que apresentam uma boa funcionalidade nas atividades da vida diária básica, possuem uma boa função cognitiva, no que diz respeito a orientação temporal e espacial, memória, cálculo, evocação e linguagem.

Objective: To verify the relationship between the domains of cognitive function and functional capacity for basic activities of daily living in centenarians. Methods: This is a descriptive study with 66 elderly aged 100 years or more, 45 females and 21 males, mean age 102.14 ± 2.71 years, residents in Greater Florianópolis/SC. The domains of cognitive function (Mini Mental State Examination - MMSE) and functional capacity (Katz scale) of the centenarians were evaluated. The data were treated by Kruskal-Wallis and Bonferroni post hoc, with a 5% significance level. Results: There was significant difference between MF and Mf centenarians in all domains of MMSE: temporal orientation (p<0.001), spatial orientation (p<0.002), immediate memory (p<0.001), attention and calculation (p<0.013), memory and recall (p<0.012) and language (p<0.001) and, Mf (More Functional) and with FI (Less Functional) in the domains of MMSE immediate memory (p<0.004) and language (p<0.004). Conclusion: the domains of cognitive function are related to functional capacity, that is, centenarians who have good functionality have good cognitive function, with respect to temporal and spatial orientation, memory, calculation, evocation and language.

Frailty and physical activity in centenarians: a systematic review

There is a lack of studies evaluating frailty and physical activity in people aged 100 years or older. This review aimed to synthesize the evidence on frailty and physical activity in centenarians. A systematic review was conducted according to the PRISMA guidelines. We searched the PubMed, CINAHL, SCOPUS, Web of Science, and Lilacs databases for articles published until 18 June 2020. This review was registered with PROSPERO (CRD42020162913). Five studies were included in this review according to the eligibility and exclusion criteria. In summary, the reviewed studies show that centenarians are fragile and that frailty increases with age; however, women are frailer than men. The most common frailty criteria were low physical activity level (78% to 72.5%), muscle weakness (84.2% to 66%), and slow walking speed (77.6% to 48.4%). Most centenarians perform less exercise than younger older adults, have a low physical activity level, live in nursing homes, and exhibit functional disability. Regarding the methodological quality of the studies, one article was classified as regular and the other four as poor. Frailty and a low physical activity level are common in centenarians. Experimental studies with better methodological quality are necessary to better understand the causal relationship between variables.

Factores asociados a la salud y el bienestar en adultos mayores centenarios / Factors associated with health and well-being in centenarian older adults

Introducción: Con el aumento del nivel de vida y la mejora de los sistemas de salud no es raro alcanzar edades extremas de la vida. A inicios del año 2019, en la provincia Pinar del Río, se declararon 109 centenarios; de ellos, 9 correspondían al municipio Los Palacios, donde se mostró un incremento de 3 individuos en comparación con el año precedente. Objetivo: Caracterizar clínica y funcionalmente a los adultos mayores centenarios del territorio. Métodos: Se realizó un estudio observacional descriptivo de corte transversal en el municipio Los Palacios en el período enero-marzo de 2019. Población objeto de estudio: 9 centenarios, a quienes se les aplicó una encuesta estructurada, el índice de Katz y el test de calidad de vida MGH. Se respetaron los criterios de inclusión y los principios de la ética médica. Resultados: Predominó la edad entre 100 y 104 años, el sexo masculino, el color de la piel blanca, la viudez, la convivencia con los hijos, el consumo de café y el déficit sensorial. Todos realizaron actividad física y sus hábitos alimenticios fueron saludables a lo largo de la vida. La mayoría no tuvo criterio de polifarmacia. En la evaluación funcional se analizó la calidad de vida y las alteraciones en las actividades básicas de la vida diaria. Conclusiones: El envejecimiento exitoso en las personas centenarias se caracterizó por tener buena salud percibida y cognitiva, mantener una actitud optimista ante la vida, buena red de apoyo social familiar, antecedentes de familiares longevos y estilos de vida saludables(AU)

Introduction: With the increase in living standards and the improvement of health systems, it is not unusual to reach extreme ages of life. At the beginning of 2019, in Pinar del Río Province, 109 centenarians were reported; of them, 9 belonged to Los Palacios Municipality, where there was an increase of 3 individuals compared to the previous year. Objective: To characterize clinically and functionally the centenarian adults from the territory. Methods: A cross-sectional, descriptive and observational study was carried out in Los Palacios Municipality, in the period from January to March 2019. The study population consisted of 9 centenarians, to whom a structured survey was applied: Katz index and MGH quality of life test. The inclusion criteria and the principles of medical ethics were respected. Results: There was a predominance of ages 100-104 years, the male sex, white skin color, widowhood, the condition of sharing house with children, coffee consumption and sensory deficit. All the patients did physical activity and their eating habits were healthy throughout life. Most of them did not have polypharmacy criteria. Regarding their functional assessment, quality of life and alterations in basic activities of daily life were analyzed. Conclusions: Successful aging in centenarians showed that they have good health, both cognitive and perceived, maintain an optimistic attitude towards life, have a good family social support network, a history of long-lived family members, and healthy lifestyles(AU)

Sintomas depressivos e perspectivas de vida, mediante o nível de atividade física de centenários / Depressive symptoms and perspectives of life, according to the level of physical activity of centennials

Este estudo tem como objetivo descrever as características dos centenários quanto aos sintomas depressivos e as perspectivas futuras de vida, mediante ao nível de atividade física. É de cunho descritivo qualitativo, constituído por 20 centenários com cognição preservada, residentes em Santa Catarina. Foi aplicado aos idosos a Escala de Depressão Geriátrica (GDS-15) para verificar os sintomas depressivos, com perguntas abertas quanto as perspectivas futuras de vida e o pedômetro para verificar o nível de AF. Os dados foram analisados por meio de estatística descritiva. Percebe-se que a heterogeneidade no número de passos e média geral de sintomas depressivos é baixa (4,3 ± 3,02). A maioria atribuiu sua perspectiva de quantos anos quer viver a Deus, alguns querem viver somente com saúde e outros não querem mais viver. Conclui-se que a AF não influencia os idosos na percepção de quantos anos querem viver, porém faz diferença na suspeita de depressão.

This study aims to describe the characteristics of centenarians in terms of depressive symptoms and future life prospects, according to the level of physical activity. It is of a qualitative descriptive nature, consisting of 20 centenarians with preserved cognition, residing in Santa Catarina. The Geriatric Depression Scale (GDS-15) was applied to the elderly to check depressive symptoms, with open questions about future life prospects and the pedometer to check the level of PA. The data were analyzed using descriptive statistics. It is noticed that the heterogeneity in the number of steps and the general average of depressive symptoms is low (4.3 ± 3.02). Most attributed their perspective of how old they want to live to God, some want to live only in health and others do not want to live anymore. It is concluded that PA does not influence the elderly in the perception of how many years they want to live, but it does make a difference in the suspicion of depression.

Cross-sectional analysis of gonadal hormone expression and relevant factors in female centenarians in Hainan, China / 中南大学学报(医学版)

OBJECTIVES@#Gonadal hormone is essential for the health of postmenopausal women, however, few studies have focused on the epidemiological distribution of gonadal hormones in postmenopausal women in very late postmenopausal women. This study aims to investigate and analyze the differences of serum gonadal hormone content and its influential factors among female centenarians in Hainan, China.@*METHODS@#The questionnaire and physical examination data of 741 female centenarians and 401 elderly females in Hainan Province were collected, and venous blood samples were taken to detect the indexes of lipid metabolism, bone metabolism, and gonadal hormone. The differences of gonadal hormones and relavant factors in female centenarians were analyzed and compared.@*RESULTS@#The serum levels of estradiol and progesterone of female centenarians were significantly higher than those of the elderly females (both P<0.001). The serum levels of estradiol and testosterone of ethnic minority centenarians were higher than those in Han nationality (P<0.001), and the serum estradiol and testosterone concentrations were relatively higher when the daily activities were more than 10 min (both P<0.05). Serum estradiol concentration was negatively correlated with apolipoprotein A-I, high density lipoprotein, triglyceride and bone formation markers such as calcium, inorganic phosphorus and vitamin D3, and was positively correlated with the special sequence of β-collagen (markers of bone resorption) (all P<0.01).@*CONCLUSIONS@#For the extremely late postmenopausal women (such as centenarians), there may be characteristic expressions of gonadal hormones, especially estradiol. There is an unprotective correlation of serum estradiol with lipid metabolism index and bone metabolism index in female centenarians, so it is necessary to evaluate the estrogen content and the use of estrogen therapy in postmenopausal women.

Força de preensão manual e velocidade máxima da caminhada de acordo com o nível de atividade física e o sexo de centenários / Handgrip strenght and maximum walking speed according to the physical activity and sex of centenarians

Objetivo: comparar a força de preensão manual (FPM) e a velocidade máxima da caminhada de acordo com o nível de atividade física (NAF) e o sexo em idosos centenários. Método: participaram do estudo 48 centenários (101,73±2,52 anos), sendo 29 mulheres e19 homens. Dados sociodemográficos, de saúde e hábitos de vida foram analisados por meio do Protocolo de Avaliação Multidimensional do Idoso Centenário ­ PAMIC. A FPM foi mensurada por meio de dinamômetro, o NAF por meio de pedômetro e a velocidade máxima da caminhada por meio de teste físico. Foram classificados como centenários ativos os que atingiram no mínimo 1.000 passos/semana e como insuficientemente ativos aqueles abaixo deste valor. O nível de significância adotado foi de 5%. Resultados: centenários do sexo masculino apresentaram maior FPM direita (17,47±6,94kgf) e esquerda (16,63±6,28kgf) quando comparados ao sexo feminino (11,90±4,84kgf; 10,48±5,00kgf) (p<0,05). Quando analisados de acordo com o NAF, centenários ativos apresentaram maior FPM direita (22,86±8,01 kgf) e esquerda (22,14±5,55kgf) em comparação aos insuficientemente ativos (14,33±3,82kgf; 13,42±4,14kgf) (p<0,05). Para o sexo feminino, a FPM direita foi maior nas centenárias ativas (15,75±4,68kgf) quando comparadas às insuficientemente ativas (10,43±4,12kgf) (p=0,006). Na FPM esquerda, o grupo ativo apresentou maior valor médio (14,00±4,63 kgf) em comparação ao grupo insuficientemente ativo (9,14±4,55kgf) (p=0,017). A velocidade máxima da caminhada não apresentou diferença significativa de acordo com o NAF ou o sexo dos idosos. Conclusão: o estudo evidencia que a atividade física está intimamente relacionada a melhores valores de FPM, indicando que idosos centenários ativos possuem melhor força corporal global.(AU)

Aim: to compare the handgrip strength (HGS) and the maximum walking speed according to the level of physical activity (PA) and sex in elderly centenarians. Method: 48 centenarians (101.73 ± 2.52 years old) participated in the study, 29 women and 19 men. Sociodemographic, health, and lifestyle data were analyzed using the Multidimensional Assessment Protocol for the Elderly Centenary ­ PAMIC. HGS was measured using a dynamometer, PA utilizing a pedometer, and the maximum gait speed through a physical test. Those who reached at least 1,000 steps/week were classified as active centenarians and those below this value as insufficiently active. The level of significance adopted was 5%. Results: centenarians of the male sex had higher HGS on the right (17.47 ± 6.94kgf) and left (16.63 ± 6.28kgf) when compared to the female sex (11.90 ± 4.84kgf; 10.48 ± 5, 00kgf) (p<0.05). When analyzed according to PA, active centenarians had a higher right (22.86 ± 8.01 kgf) and left (22.14 ± 5.55kgf) HGS compared to insufficiently active (14.33 ± 3.82kgf; 13, 42 ± 4.14 kgf) (p <0.05). For females, the right HGS was higher in active centenarians (15.75 ± 4.68kgf) when compared to insufficiently active women (10.43 ± 4.12kgf) (p = 0.006). In the left HGS, the active group had a higher mean value (14.00 ± 4.63 kgf) compared to the insufficiently active group (9.14 ± 4.55kgf) (p = 0.017). The maximum gait speed did not show any significant difference according to PA or the gender of the elderly. Conclusion: the study shows that physical activity is closely related to better values of HGS, indicating that active elderly centenarians have better overall body strength.(AU)

Handgrip strength accuracy as discriminator of functional independence in centenarian women / Acurácia da força de preensão manual como discriminador da independência funcional em centenárias

Abstract The aim of this study was to verify and compare handgrip strength (HS) with activities of the daily living (ADL) and to identify the cutoff point of HGS in the prediction of independence in ADL of centenarians. Twenty-four centenarians with mean age of 101.67 ± 2.80 years participated in the study. Subjects were asked about marital status, schooling (years), diseases, hearing difficulties and activities of the daily living (Katz scale), to classify functional independence. Handgrip strength of the right hand (HSR) and left hand (HSL) (mean of the three measures of each hand) was evaluated by means of manual dynamometer. The U Mann Whitney test was applied to compare HSR and HSL with functions of ADL. To identify the cutoff point (sensitivity and specificity) of the right and left HGS of centenarians in the prediction of independence in functions of ADL, the Received Operating Characteristic (ROC) Curves were used. The following cutoff points were used: 11 Kgf for HSR (sensitivity = 66.7%, specificity = 100%, ROC curve = 0.778) and 9 Kgf for HSL (sensitivity = 66.7%, specificity = 77.8%, curve ROC = 0.730) to predict independence in performing the "bathing" function; 11 Kgf for HSR for the "continence" function (sensitivity = 83.3%, specificity = 66.7%, ROC curve = 0.712); and 9 Kgf for HSL for "transfer" function (sensitivity = 80%, specificity = 71.4%, ROC curve = 0.786). For these functions, sensitivity and specificity presented values ​​greater than 66%. On all these functions, sensitivity showed values higher than 46% and specificity 77%. Minimum HSR is required to perform functions of ADL independently. The best HSR cutoff point to predict independence of subjects differs according to functions of activities of the daily living and hand evaluated.

Resumo Objetivou-se verificar e comparar a força de preensão manual (FPM) com as funções das atividades de vida diária (AVD's) e identificar o ponto de corte dessa força na predição da independência nas AVD's em centenárias. Participaram do estudo 24 centenárias, com média de idade de 101,67±2,80 anos. Foram aplicadas nas idosas, em forma de entrevista, questões sobre o estado civil, escolaridade (anos), doenças, dificuldade auditiva e as atividades de vida diária (escala de Katz), para classificar a independência funcional. Foi avaliada a força da preensão manual direita (FPMD) e esquerda (FPME) (média entre as três medidas de cada mão) das centenárias por meio do dinamômetro manual. Foi aplicado o teste U Mann Whitney para comparar a FPMD e FPME com as funções das AVD's. Para identificar o ponto de corte (sensibilidade e especificidade) da FPM direita e esquerda das centenárias na predição da independência nas funções das AVD's, foi utilizado as Curvas ROC (Received Operating Characteristic). O ponto de corte de 11 Kgf para a FPMD (sensibilidade=66,7%; especificidade=100%; curva ROC=0,778) e 9 Kgf para a FPME (sensibilidade=66,7%; especificidade=77,8%; curva ROC=0,730) para predizem independência na realização da função "tomar banho"; de 11 Kgf para a FPMD para a função "continência" (sensibilidade=83,3%; especificidade=66,7%; curva ROC=0,712); e de 9 Kgf para a FPME para a "transferência" (sensibilidade=80%; especificidade=71,4%; curva ROC=0,786). Para estas funções a sensibilidade e a especificidade apresentaram valores maiores de 66%. É necessário um nível mínimo de FPM para executar as funções da AVD com independência. O melhor ponto de corte da FPM para predizer a independência de centenárias, difere de acordo com as funções de vida diária e a mão avaliada.

Meta-analysis of genomic variants and gene expression data in schizophrenia suggests the potential need for adjunctive therapeutic interventions for neuropsychiatric disorders

Schizophrenia (SZ) is a debilitating mental illness with a multigenic aetiology and significant heritability. Despite extensive genetic studies, the molecular aetiology has remained enigmatic. A recent systems biology study suggested a protein–protein interaction network for SZ with 504 novel interactions. The onset of psychiatric disorders is predominant during adolescence, often accompanied by subtle structural abnormalities in multiple regions of the brain. The availability of BrainSpan Atlas data allowed us to re-examine the genes present in the SZ interactome as a function of space and time. The availability of genomes of healthy centenarians and nonpsychiatric Exome Aggregation Consortium database allowed us to identify the variants of criticality. The expression of the SZ candidate genes responsible for cognition and disease onset was studied in different brain regions during particular developmental stages. A subset of novel interactors detected in the network was further validated using gene expression data of post-mortem brains of patients with psychiatric illness. We have narrowed down the list of drug targets proposed by theprevious interactome study to 10 proteins. These proteins belonging to 81 biological pathways are targeted by 34 known Food and Drug Administration-approved drugs that have distinct potential for the treatment of neuropsychiatric disorders. We also report the possibility of targeting key genes belonging to celecoxib pharmacodynamics, Gα signalling and cGMP-PKG signalling pathwaysthat are not known to be specific to SZ aetiology.

A study of health status in Hainan centenarians / 中华老年医学杂志

Objective@#To evaluate the health status of Hainan centenarians and compare the gender disparity, and to determine whether the'male-female health-survival paradox’is present among them.@*Methods@#A cross-sectional study was conducted on the health status and gender disparity of individuals aged 100 and over in Hainan province from June 2014 to December 2016.Data of sociodemographics, lifestyles as well as health-related parameters were collected.The multi-dimensional health assessment of centenarians was conducted based on the recognition of standard on Chinese healthy elderly in 2013.@*Results@#A total of 940 centenarians(men 18.6%, women 81.4%)were included.The prevalences of hypertension, diabetes and dyslipidemia were 66.1%, 9.8%, and 21.2%, respectively, while no significant gender difference was found.Male centenarians were more independent in activity of daily living than did female centenarians(41.1% vs.25.9%, P<0.001). The prevalences of dementia(7.7% vs.4.0%)and depression(33.6% vs.18.9%)were more dominant in females than in males.Multivariate logistic regression showed that the proportions of functional disability, depression and sleep disorders were higher in female centenarians than in male centenarians(P<0.05)after adjusting for general demographic characteristics, lifestyle and other health indicators.@*Conclusions@#Although the female proportion dominates the centenarian population, female general health states are worse than male centenarians.More attentions on physical and mental health should be paid to the female centenarians.

A study of health status in Hainan centenarians / 中华老年医学杂志

Objective To evaluate the health status of Hainan centenarians and compare the gender disparity,and to determine whether the‘ male-female health-survival paradox’is present among them.Methods A cross-sectional study was conducted on the health status and gender disparity of individuals aged 100 and over in Hainan province from June 2014 to December 2016.Data of sociodemographics,lifestyles as well as health-related parameters were collected.The multi dimensional health assessment of centenarians was conducted based on the recognition of standard on Chinese healthy elderly in 2013.Results A total of 940 centenarians(men 18.6％,women 81.4％)were included.The prevalences of hypertension,diabetes and dyslipidemia were 66.1％,9.8％,and 21.2％,respectively,while no significant gender difference was found.Male centenarians were more independent in activity of daily living than did female centenarians(41.1％ vs.25.9 ％,P ＜0.001).The prevalences of dementia(7.7％ vs.4.0％)and depression(33.6％ vs.18.9％)were more dominant in females than in males.Multivariate logistic regression showed that the proportions of functional disability,depression and sleep disorders were higher in female centenarians than in male centenarians (P＜0.05)after adjusting for general demographic characteristics,lifestyle and other health indicators.Conclusions Although the female proportion dominates the centenarian population,female general health states are worse than male centenarians.More attentions on physical and mental health should be paid to the female centenarians.

Analysis of related factors for clinical characteristics and the outcome in centenarian hospitalized patients / 中华老年医学杂志

Objective To investigate the health status of centenarian hospitalized patients and analyze the risk factors for in-hospital death in Nanjing district.Methods All centenarians hospitalized patients who were discharged from wards of 10 upper first-class general hospitals in Nanjing district during the past five years were retrieved from their hospital information systems.Then,a retrospective study was performed on centenarians' data of general information,laboratory test results,Charlson comorbidity index (CCI),neutrophil to lymphocyte ratio (NLR) and shock index(SI),etc.were calculated and collected.Relevant risk factors for in-hospital death were analyzed by multivariate logistic regression analysis.Results A total of 156 patients aged 100 years and over,with an average age of (101.0±2.1)years,were enrolled during the past 5 years.The top 3 admitting diagnosis for the patients were pulmonary infection(30.1％,47/156 cases),coronary heart disease(10.9％,17/156 cases)and cerebrovascular disease(7.1％,11/156 cases).Fifty patients died during hospitalization,with a mortality of 32.1％ (50/156).Pneumonia was the most common admitting diagnosis(40.0％,20/50 case).Among causes of death,the combined admitting diagnosis with dementia,chronic renal insufficiency,one or more basic disease were significantly associated with death.There were statistically significant differences between bad vs.good vs.indifferent prognosis in heart rate,shock index,leukocyte count,neutrophil count,NLR,hemoglobin,albumin,albumin/globulin,fasting blood glucose,blood urea nitrogen,serum creatinine,C-reactive protein(CRP)and CCI levels.Multivariate logistic regression analysis suggested that NLR≥13.18,fasting blood glucose ≥7.56 mmol/L,blood urea nitrogen ≥20.74 mmol/L,CRP≥65 mg/L and CCI≥3 might be predictors for in-hospital death in the cohort(OR =48.91、3.43、1.22、6.55、1.55,all P＜0.05).Conclusions Pulmonary infection is the most common reason for admission and the cause of death in centenarian inpatients.Comorbidities increase the risk of death.To lower in-hospital mortality,CCI and other assessment indicators should be used to strengthen the comprehensive assessment and chronic disease management of hospitalized centenarians.Infectious diseases should be prevented beforehand.

Characteristics of serum lipid levels in 899 centenarians of Hainan / 中华老年医学杂志

Objective To investigate the characteristics of serum lipid levels in centenarians in Hainan province.Methods A total of 899 centenarians were enrolled.Fasting venous blood samples were collected,and serum levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A-1 (Apo A1),apolipoprotein B(Apo B) and lipoprotein (a) [Lp (a)] were determined.Characteristics of serum lipid levels in centenarians with different age and gender were analyzed.Results The ratio of male to female in this study was 1 ∶ 4,101 years of age comprised the largest proportion(20.4 ％,183 cases),and the highest age was 109 years old for men and 116 years old for women.People aged 102 years had the highest levels of TC,TG,LDL-C and Apo B,and also had the lowest levels of HDL-C and Apo A1.Serum levels of TC and LDL-C reached the peak at the age of 102 years and showed downward trends year by year.Serum levels of TC,TG,LDL-C,Apo A1 and Apo B were lower in males than in females(P＜0.01),and HDL-C had no significant difference between males and females(P ＞0.05).The detection rates for abnormal serum lipid levels were higher in females than in males(P＜0.01).Serum Lp(a) level was higher in females than in males.Conclusions Serum lipid levels show a peak expression at a certain age in centenarians of Hainan,and the types and ratio of abnormal blood lipids are higher in female centenarians than in male centenarians.

Relationship between thyroid nodules and lifestyle characteristics in Chinese centenarians / 中华超声影像学杂志

Objective@#To study the correlation of lifestyle characteristics with thyroid nodules in a population-based sample of centenarians in Hainan.@*Methods@#The study was based on China Hainan Centenarian Cohort Study (CHCCS) conducted in 18 cities and counties in Hainan province from 2014 to 2016. A group of multidisciplinary team interviewed and examined local centenarians with structured questionnaires and ultrasonography procedures. A total of 918 centenarians were analyzed after excluding those who refused ultrasonographic examinations or had relevant missing data. Thyroids of centenarians were examined by 3-year experienced sonographer, details on lifestyle characteristics and dietary habits were collected by standard procedure.@*Results@#Of the 918 centenarians, 683 (74.4%) had thyroid nodules under the ultrasonography procedures. The prevalence of thyroid nodules in different group of areca nut consumption varied significantly (P<0.05). In multivariate logistic regression model, the results showed female and areca nut intake were independently associated with thyroid nodules in centenarians (P<0.05).@*Conclusions@#The modifiable variables including areca nut intake as well as non-modifiable such as gender are independent determinants of thyroid nodules in centenarians. Further studies are warranted to explore and verify these associations in populations with different ranges of age.

A survey on the cognitive function and its correlative factors in 49 centenarians / 中华老年医学杂志

Objective To evaluate the cognitive function and its correlative factors in centenarians.Methods Forty-nine subjects in Zhongxiang city were included in this mass screening.Questionnaire was utilized to collect basic data,including age,gender,ability of daily life,depression,life habits,body mass index,and history of chronic diseases on all the subjects.And the mini-mental state examination(MMSE)was adopted to evaluate cognitive function of old people.T test and chi-square test were used to compare the difference in effectiveness of multiple different factors on cognitive function,while binary logistic regression analysis was used to assess the effects of multiple different factors on cognitive function.Results The mean score of the ability of different dimensions of cognitive function was (7.10 ± 2.71) in direction,(1.94 ±± 0.80) in memory,(0.61 ± 1.07) in attention and computation,(1.92 ± 0.86) in recall,and (4.73 ± 2.14) in speech,respectively,with total score of cognitive function of(16.30±6.02) in forty-nine centenarians.Normal cognitive function was found in 25 cases,and decreased cognitive function was found in 24 cases.Single factor logistic analysis indicated that body mass index(t=-3.399,P=0.001)and self-rating depression scale(t=-5.731,P＜0.001) were lower in patients with normal cognitive function than in patients with declined cognitive function.And smoking patients were associated with higher rates of normal cognitive function than the non-smoking patients(87.5％ vs.43.9％,x2 =5.091,P=0.028),and patients with normal hearing were associated with higher rate of normal cognitive function than patients with hearing loss(70.3 ％ vs.27.3 ％,x2 =9.01,P=0.030).Multivariate logistic analysis indicated that depression index(β=-14.40,P=0.001) and body mass index(β=-0.424,P=0.015) were independent effective factors for cognitive function.Conclusions Improvement of the condition of depression and controlling the body mass index are hopeful for recovering or postponing their cognitive impairment in centenarians.

Study on sleep quality and related determinants among centenarians in Hainan province / 中华流行病学杂志

Objective To investigate the sleep quality and related determinants among centenarians in Hainan.Methods A cross-sectional study of centenarians from 16 cities/counties was carried out in Hainan province between June 2014 and June 2016.Data related to demography,chronic diseases and lifestyles of the centenarians were collected.Pittsburg sleep quality index (PSQI) was used to assess the quality of sleep while multivariable logistic Regression model was used to determine the risk factors on the quality of sleep.Results Of the 730 centenarians in this study,225 suffered from sleep disorders (30.8％).The average score of PSQI was (6.44 ± 3.05),with the top three problems related to sleep as sleep inefficiency (48.5％),sleep latency (35.5％),and daytime dysfuntion (20.6％) among the centenarians.Results from the multivariate logistic analysis showed that incontinence,cardiovascular disease and chronic pain were risk factors,while habitual afternoon nap,and regular diet appeared as protective factors (P＜0.05),related to sleep disorder.Conclusions Quality of sleep had been a problem to the centenarians in Hainan.Intervention on risk factors of sleep disorder should be helpful on these centenarians.

Study on self-rated health and related factors in centenarians in Hainan province / 中华流行病学杂志

Objective To investigate the self-rated health and related factors in centenarians in Hainan province.Methods A cross-sectional study in centenarians from 18 cities and counties was carried out in Hainan between June 2014 and December 2016.They data about their demographics,chronic diseases,ability of daily life,mental health and sleep quality were collected in a household interview.Self-rated health status was classified into 5 degrees according to the subjective assessment by centenarians.Results Of 991 centenarians in this study,157 (15.8％) were in good self-rated health and 228 (23.0％) were in poor self-rated health.Multivariate logistic regression analysis showed that chronic pain,visual impairment,depression,limited ability of daily life and poor sleep quality were the factors associated with poor self-rated health in centenarians in Hainan (P＜0.05).Conclusion The proportion of centenarians in good self-rated health was low in Hainan,the influencing factors included chronic pain,visual impairment,depression,poor sleep quality and limited ability of daily life.It is necessary to conduct targeted intervention in centenarians in Hainan.

Study on sleep quality and related determinants among centenarians in Hainan province / 中华流行病学杂志

Objective To investigate the sleep quality and related determinants among centenarians in Hainan.Methods A cross-sectional study of centenarians from 16 cities/counties was carried out in Hainan province between June 2014 and June 2016.Data related to demography,chronic diseases and lifestyles of the centenarians were collected.Pittsburg sleep quality index (PSQI) was used to assess the quality of sleep while multivariable logistic Regression model was used to determine the risk factors on the quality of sleep.Results Of the 730 centenarians in this study,225 suffered from sleep disorders (30.8％).The average score of PSQI was (6.44 ± 3.05),with the top three problems related to sleep as sleep inefficiency (48.5％),sleep latency (35.5％),and daytime dysfuntion (20.6％) among the centenarians.Results from the multivariate logistic analysis showed that incontinence,cardiovascular disease and chronic pain were risk factors,while habitual afternoon nap,and regular diet appeared as protective factors (P＜0.05),related to sleep disorder.Conclusions Quality of sleep had been a problem to the centenarians in Hainan.Intervention on risk factors of sleep disorder should be helpful on these centenarians.

Study on self-rated health and related factors in centenarians in Hainan province / 中华流行病学杂志

Objective To investigate the self-rated health and related factors in centenarians in Hainan province.Methods A cross-sectional study in centenarians from 18 cities and counties was carried out in Hainan between June 2014 and December 2016.They data about their demographics,chronic diseases,ability of daily life,mental health and sleep quality were collected in a household interview.Self-rated health status was classified into 5 degrees according to the subjective assessment by centenarians.Results Of 991 centenarians in this study,157 (15.8％) were in good self-rated health and 228 (23.0％) were in poor self-rated health.Multivariate logistic regression analysis showed that chronic pain,visual impairment,depression,limited ability of daily life and poor sleep quality were the factors associated with poor self-rated health in centenarians in Hainan (P＜0.05).Conclusion The proportion of centenarians in good self-rated health was low in Hainan,the influencing factors included chronic pain,visual impairment,depression,poor sleep quality and limited ability of daily life.It is necessary to conduct targeted intervention in centenarians in Hainan.

Prevalence of thyroid nodules among centenarians and its correlation with chronic diseases / 中华超声影像学杂志

Objective To investigate the prevalence of thyroid nodules(TN)among centenarians in Hainan province and explore the association between thyroid nodules and major chronic diseases.Methods A mixed cross-sectional study of questionnaire survey,medical examination including ultrasonography and laboratory examination were conducted in elderly who resided in Hainan province and aged 100 and over,the subjects who have signed consent and complete data in both basic information and medical examination were included in this study.Eight hundred and four centenarians were finally enrolled and data of them was analyzed to investigate the prevalence of thyroid nodules and to explore its association with common chronic diseases by comparing the prevalence of chronic conditions between groups with and without thyroid nodules.Results The overall prevalence of TN was 73.5%(591、804)and the prevalence of TN was significantly higher in female when comparing with male[75.1%(505、672)vs 65.2%(86、132)](P <0.001).No significant correlation was found between the prevalence of TN and major chronic diseases (P>0.05),however,the factors associated with dyslipidemia and anemia such as TC[(4.6±1.2)mmol、L vs(4.3±1.5)mmol、L],LDL-C[(2.8±0.8)mmol、L vs(2.7±0.8)mmol、L],and Hb[(110.6±22.5)g、L vs(105.5±31.7)g、L]were significant higher in TN group than those in Non-TN group(P <0.05). Conclusions The thyroid nodule is common in centenarian population and its prevalence was higher in female than male.The associations between TN and biomarkers of dyslipidemia and anemia are found in the present study.