RESUMO
The thalamus is a central hub of the autonomic network and thalamic volume has been associated with high-risk phenotypes for sudden cardiac death. Heart rate response to physiological stressors (e.g., standing) and the associated recovery patterns provide reliable indicators of both autonomic function and cardiovascular risk. Here we examine if thalamic volume may be a risk marker for impaired heart rate recovery in response to orthostatic challenge. The Irish Longitudinal Study on Aging involves a nationally representative sample of older individuals aged ≥50 years. Multimodal brain magnetic resonance imaging and orthostatic heart rate recovery were available for a cross-sectional sample of 430 participants. Multivariable regression and linear mixed-effects models were adjusted for head size, age, sex, education, body mass index, blood pressure, history of cardiovascular diseases and events, cardiovascular medication, diabetes mellitus, smoking, alcohol intake, timed up-and-go (a measure of physical frailty), physical exercise and depression. Smaller thalamic volume was associated with slower heart rate recovery (-1.4 bpm per 1 cm3 thalamic volume, 95% CI -2.01 to -0.82; p < .001). In multivariable analysis, participants with smaller thalamic volumes had a mean heart rate recovery -2.7 bpm slower than participants with larger thalamic volumes (95% CI -3.89 to -1.61; p < .001). Covariates associated with smaller thalamic volume included age, history of diabetes, and heavy alcohol consumption. Thalamic volume may be an indicator of the structural integrity of the central autonomic network. It may be a clinical biomarker for stratification of individuals at risk of autonomic dysfunction, cardiovascular events, and sudden cardiac death.
Assuntos
Doenças do Sistema Nervoso Autônomo/patologia , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Frequência Cardíaca/fisiologia , Rede Nervosa/fisiologia , Rede Nervosa/fisiopatologia , Tálamo/patologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/patologia , Envelhecimento/fisiologia , Doenças do Sistema Nervoso Autônomo/diagnóstico por imagem , Feminino , Humanos , Irlanda , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Rede Nervosa/diagnóstico por imagem , Posição Ortostática , Decúbito Dorsal/fisiologia , Tálamo/diagnóstico por imagemRESUMO
OBJECTIVES: We aimed to explore the relationship between religiosity and depressive symptoms longitudinally. METHOD: We used four waves (2009-2016) of the Irish Longitudinal Study on Ageing (TILDA) to create growth curve models (GCM) of depressive symptoms and religious attendance/importance in a sample aged 50+ in Ireland and structural models to assess the longitudinal associations between religious attendance/importance and depressive symptoms. We tested whether this relationship was mediated by social connectedness. RESULTS: GCM showed that higher religious attendance at baseline was associated with lower baseline depressive symptoms, while higher religious importance was associated with higher baseline depressive symptoms. Social connectedness partially mediated the baseline associations between religious attendance and lower depressive symptoms. There were no associations between religious factors and the development of depressive symptoms over time. DISCUSSION: This study found that the relationship between religion and depressive symptoms is complex, and any protective effect was driven by religious attendance.
Assuntos
Depressão/psicologia , Religião , Espiritualidade , Idoso , Idoso de 80 Anos ou mais , Depressão/epidemiologia , Feminino , Humanos , Irlanda/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Apoio SocialRESUMO
Mandatory fortification of staple grains with folic acid and/or vitamin B12 (B12) is under debate in many countries including Ireland, which has a liberal, but voluntary, fortification policy. Older adults can be at risk of both deficiency and high folate status, although little is known on the actual prevalence and the major predictors. Population prevalence estimates from older adults (n 5290 ≥50 years) from the Irish Longitudinal Study on Ageing (TILDA) (Wave 1) are presented here. Measures included plasma total vitamin B12 and folate, whereas predictors included detailed demographic, socio-economic, geographic, seasonal and health/lifestyle data. The prevalence of deficient or low B12 status (45 nmol/l) was observed in 8·9 %, whereas high B12 status was observed in 3·1 % (>601 pmol/l). The largest positive predictor of B12 concentration was self-reported B12 injection and/or supplement use (coefficient 51·5 pmol/; 95 % CI 9·4, 93·6; P=0·016) followed by sex and geographic location. The largest negative predictor was metformin use (-33·6; 95 % CI -51·9, -15·4; P<0·0001). The largest positive predictor of folate concentration was folic acid supplement use (6·0; 95 % CI 3·0, 9·0 nmol/l; P<0·001) followed by being female and statin medications. The largest negative predictor was geographic location (-5·7; 95 % CI -6·7, -4·6; P<0·0001) followed by seasonality and smoking. B-vitamin status in older adults is affected by health and lifestyle, medication, sampling period and geographic location. We observed a high prevalence of low B12 and folate status, indicating that the current policy of voluntary fortification is ineffective for older adults.
Assuntos
Envelhecimento , Suplementos Nutricionais , Deficiência de Ácido Fólico/prevenção & controle , Ácido Fólico/sangue , Deficiência de Vitamina B 12/prevenção & controle , Vitamina B 12/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Análise por Conglomerados , Estudos de Coortes , Feminino , Deficiência de Ácido Fólico/sangue , Alimentos Fortificados , Geografia , Humanos , Irlanda , Estilo de Vida , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Análise de Regressão , Risco , Estações do Ano , Fumar , Deficiência de Vitamina B 12/sangue , VitaminasRESUMO
Background: Few data are available examining the determinants of vitamin D status exclusively in older adults. We aimed to investigate the prevalence and determinants of vitamin D deficiency in a representative sample of the older Irish population (aged 50-98 years). Methods: The concentration of 25-hydroxyvitamin D (25(OH)D) was measured in 5,356 community-dwelling older Irish adults from The Irish Longitudinal Study on Ageing (TILDA). Detailed demographic, geographic, lifestyle, and socioeconomic factors were assessed by questionnaire. Proportions of deficiency prevalence were generated by season sampled. Linear regression was used to investigate the association between 25(OH)D concentration and reported risk factors. Results: The prevalence of deficiency (25(OH)D < 30 nmol/L) was 13.1% (95% CI: 12.1-14.2). Deficiency status was more prevalent in nonsupplement users, in winter, in smokers, in obese adults, the physically inactive, those living alone, and in the oldest old (>80 years). The main predictors (p < .05) of 25(OH)D concentration were supplement use (coefficient nmol/L: 27.2 [95% CI: 15.3-39.2]), smoking (-8.9 [-12.6--5.2]), summer season (5.9 [2.7-9.1]), and obesity (-4.0 [-6.3--1.7]). Conclusion: Vitamin D deficiency is common among older Irish adults. These data indicate the need for targeted strategies within sections of the older population to improve vitamin D status.
Assuntos
Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Idoso , Idoso de 80 Anos ou mais , Demografia , Feminino , Humanos , Irlanda/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Vitamina D/sangueRESUMO
Performing musicians invest thousands of hours becoming experts in a range of perceptual, attentional, and cognitive skills. The duration and intensity of musicians' training - far greater than that of most educational or rehabilitation programs - provides a useful model to test the extent to which skills acquired in one particular context (music) generalize to different domains. Here, we asked whether the instrument-specific and more instrument-general skills acquired during professional violinists' and pianists' training would generalize to superior performance on a wide range of analogous (largely non-musical) skills, when compared to closely matched non-musicians. Violinists and pianists outperformed non-musicians on fine-grained auditory psychophysical measures, but surprisingly did not differ from each other, despite the different demands of their instruments. Musician groups did differ on a tuning system perception task: violinists showed clearest biases towards the tuning system specific to their instrument, suggesting that long-term experience leads to selective perceptual benefits given a training-relevant context. However, we found only weak evidence of group differences in non-musical skills, with musicians differing marginally in one measure of sustained auditory attention, but not significantly on auditory scene analysis or multi-modal sequencing measures. Further, regression analyses showed that this sustained auditory attention metric predicted more variance in one auditory psychophysical measure than did musical expertise. Our findings suggest that specific musical expertise may yield distinct perceptual outcomes within contexts close to the area of training. Generalization of expertise to relevant cognitive domains may be less clear, particularly where the task context is non-musical.