Burden of cardiovascular risk factors and cardiovascular disease in childhood cancer survivors: data from the German CVSS-study.

Aims: The cardiac and vascular late sequelae in long-term survivors of childhood cancer (CVSS)-study aimed to quantify the prevalence of cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) in German childhood cancer survivors (CCS). Methods and results: In the CVSS-study (NCT02181049), 1002 CCS (age range 23-48 years) diagnosed with neoplasia prior to 15 years of age between 1980 and 1990 prospectively underwent a systematic, standardized clinical and laboratory cardiovascular screening, identical to the population-based Gutenberg Health Study (GHS) cohort. For 951 individuals, prevalences of CVRF and CVD were primarily compared to the GHS sample and to two further German population-based cohorts. Using log-binomial regression models, an increased risk for occurrence of arterial hypertension [relative risk (RR) 1.38, 95% confidence interval (95% CI 1.21-1.57)] and dyslipidaemia [RR 1.26 (95% CI 1.12-1.42)] was found. This indicates a premature occurrence compared to the general population of approximately 6 and 8 years, respectively [rate advancement period estimator, RAPhypertension 5.75 (95% CI 3.5-8.0) and RAPdyslipidaemia 8.16 (95% CI 4.4-11.9)]. Overall, no differences were observed for obesity and diabetes. Overt CVD was present in 4.5% (95% CI 3.0-6.6%) of CCS [RR 1.89 (95% CI 1.34-2.66), RAPCVD 7.9 (95% CI 4.1-11.7)], of which the most frequent entities were congestive heart failure and venous thromboembolism. Prevalences of CVRF and CVD increased with age without reaching a plateau over time. Conclusion: This large CCS screening examination revealed consistently in comparison to three population samples a considerably increased risk for premature CVD. The findings in these young adult CCS indicate a high burden of cardiovascular morbidity and mortality in the long term. Clinicaltrials. gov-Nr: NCT02181049.

Association of serum vitamin D with change in weight and total body fat in a German cohort of older adults.

We examined the association of baseline serum 25-hydroxyvitamin D (25(OH)D) with change in weight and total body fat in a cohort of community-dwelling older adults from Southern Germany. A total of 735 participants of the population-based KORA-Age Study (2009-2012), aged 65-90 years, were followed for 2.9±0.1 years. Body fat was assessed with bioelectrical impedance analysis. Linear and multinomial logistic models, adjusted for baseline covariables, were used to examine the association of 25(OH)D with percentage weight and body fat change during follow-up. 25(OH)D levels were not associated with overall weight change or body fat loss. Higher 25(OH)D levels were associated with a lower likelihood of having gained >3% of body fat in women but not in men. As we cannot exclude residual confounding by outdoor physical activity and diet, our results are not sufficient to support a causal role of 25(OH)D in the etiology of obesity in Caucasian older adults.

Mind over hormones: sex differences in associations of well-being with IGF-I, IGFBP-3 and physical activity in the KORA-Age study.

OBJECTIVES: A ssociations between well-being, serum levels of insulin-like growth factor 1 (IGF-I), and its primary binding protein IGFBP-3, were examined in an epidemiologic study. The influence of physical activity on the effect of hormones on well-being was considered. METHODS: Cross-sectional data from participants of the KORA-Age study (n=985, age 64-93) was analyzed in sex-specific multivariable regressions of well-being (World Health Organization (WHO) -5) or ill-being (geriatric depression scale (GDS) -15). Models were adjusted for age, physical activity, sleep, BMI, smoking, and cognition. Adjusted WHO-5 means demonstrated the interaction between hormone quintiles with physical activity. RESULTS: Full models indicated that increased IGFBP-3 positively associated with well-being in women (ß estimate=0.14, standard error (SE)=0.06) and less so in men (ß=0.11, SE=0.07). IGF-I associated positively with depression (ß=0.11, SE=0.06) and negatively with well-being (ß=-0.11, SE=0.06) in women. Similar but not statistically discernable effects were observed in men. Adjusted mean WHO-5 scores illustrated the positive effect of physical activity and IGFBP-3 on well-being in women only. CONCLUSIONS: Opposite and independent associations of IGF-I and IGFBP-3 on well-being observed in women suggests neuroprotective effects of IGFBP-3 in age.

[Data for epidemiological research on ageing in Germany. Opportunities and limitations of existing datasets: results of the second workshop of the working group Epidemiology of Ageing within the German Society for Epidemiology (DGEpi)]. / Daten für die epidemiologische Altersforschung. Möglichkeiten und Grenzen vorhandener Datensätze. Ergebnisse des 2. Workshops der Arbeitsgruppe Epidemiologie des Alterns der Deutschen Gesellschaft für Epidemiologie (DGEpi).

Due to the increasing proportion of older people in the general population epidemiologists are interested in identifying which factors determine healthy ageing. For this reason within the German Society for Epidemiology we founded the working group 'Epidemiology of Ageing' in 2011. The working group organised a workshop to present useful datasets on ageing in Germany for epidemiological research. Those presented included: Study of Health in Pomerania (SHIP) The German Ageing Survey (DEAS) Surveys from the Robert Koch Institute: German Health Interview and Examination Survey for Adults (DEGS) and the German Health Update (GEDA) The German Socio-Economic Panel Study (SOEP) Cooperative Health Research in the Region of Augsburg (KORA-Age) Survey of Health, Ageing and Retirement in Europe (SHARE) Germany Claims data from statutory health insurance agencies Presentations contained a brief description of the datasets, methodologies, age-related themes, their strengths and limitations as well as their availability for secondary analysis. All presented datasets can be used for longitudinal analyses and are available to the scientific community.

Feasibility, internal consistency and covariates of TICS-m (telephone interview for cognitive status-modified) in a population-based sample: findings from the KORA-Age study.

OBJECTIVE: Test the feasibility of the modified telephone interview for cognitive status (TICS-m) as a screening tool to detect cognitive impairment in a population-based sample of older subjects. METHODS: Data were collected from 3,578 participants, age 65-94 years, of the KORA-Age study. We used analysis of covariance to test for significant sex, age and educational differences in raw TICS-m scores. Internal consistency was analysed by assessing Cronbach's alpha. Correction for education years was undertaken, and participants were divided in three subgroups following validated cut-offs. Finally, a logistic regression was performed to determine the impact of sex on cognition subgroups. RESULTS: Internal consistency of the TICS-m was 0.78. Study participants needed approximately 5.4 min to complete the interview. Lower raw TICS-m scores were associated with male sex, older age and lower education (all p < 0.0001). After correction for education years, 2,851 (79%) had a non-impaired cognitive status (score >31). Male sex was independently associated with having a score equal to or below 27 and 31 (OR = 1.9, 95% CI 1.4-2.5 and OR = 1.5, 95% CI 1.2-1.7, respectively). CONCLUSIONS: The TICS-m is a feasible questionnaire for community-dwelling older adults with normal cognitive function or moderate cognitive impairment. Lower cognitive performance was associated with being a man, being older, and having fewer years of formal education.

[Multimorbidity and successful aging: the population-based KORA-Age study]. / Multimorbidität und erfolgreiches Altern: Ein Blick auf die Bevölkerung im Rahmen der KORA-Age-Studie.

BACKGROUND: The objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public. PATIENTS AND METHODS: In the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics. RESULTS: A total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%). CONCLUSION: The KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.