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1.
Biomed Environ Sci ; 34(7): 509-519, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34353414

RESUMO

Objective: Evidence regarding alcohol consumption and cognitive impairment is controversial. Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown. This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment. Methods: This study included 15,758 participants age 65 years or older, selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that covered 23 provinces in China. Current alcohol use status, duration of alcohol cessation, and alcohol consumption before abstinence were self-reported by participants; cognitive function was evaluated using Mini-mental State Examination (MMSE). Cause-specific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment. Results: Among the 15,758 participants, mean (± SD) age was 82.8 years (± 11.9 years), and 7,199 (45.7%) were males. During a mean of 3.9 years of follow-up, 3,404 cases were identified as cognitive impairment. Compared with current drinkers, alcohol cessation of five to nine years [adjusted HR, 0.79 (95% CI: 0.66-0.96)] and more than nine years [adjusted HR, 0.82 (95% CI: 0.69-0.98)] were associated with lower risk of cognitive impairment. Conclusion: A longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE. Alcohol cessation is never late for older adults to prevent cognitive impairment.


Assuntos
Abstinência de Álcool , Disfunção Cognitiva/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas , China , Cognição , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Estudos Longitudinais , Masculino , Testes de Estado Mental e Demência , Risco
2.
Clin Nutr ; 40(5): 2620-2629, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33933728

RESUMO

BACKGROUND & AIMS: The association between dietary diversity (DD) changes and mortality remains unclear. We aimed to investigate the association between DD changes and all-cause mortality among older people. METHODS: A total of 17,959 participants with a mean age of 84.8 years old were enrolled at baseline. Food groups were collected at baseline and follow-up using simplified food frequency questionnaire (FFQ), and then overall, plant-based and animal-based dietary diversity score (DDS) were calculated. DDS changes were calculated using DDS at baseline and the first follow-up. The association between three DDS changes (overall, plant-based and animal-based DDS) and subsequent all-cause mortality were evaluated. Nonparametrically restricted cubic splines and a multivariable-adjusted Cox proportional hazards model were used to estimate HRs and 95% CIs. RESULTS: We documented 12,974 deaths over a 129,590 person-years of follow up. Compared with high-to-high DDS pattern, participants with lower overall DDS patterns had increased mortality risk with HRs (95%CI) of 1.39 (1.29-1.49), 1.53 (1.37-1.70), 1.38 (1.18-1.60) and 1.55 (1.31-1.83) for medium-to-medium, low-to-low, low-to-high and high-to-low patterns, respectively. And compared with high-to-high DDS pattern, the estimates were 1.34 (1.23-1.46), 1.49 (1.35-1.65), 1.43 (1.23-1.67) and 1.62 (1.40-1.88) for plant-based DDS, and 1.23 (1.15-1.31), 1.29 (1.20-1.40), 1.24 (1.12-1.37) and 1.28 (1.15-1.44) for animal-based DDS for medium-to-medium, low-to-low, low-to-high and high-to-low patterns, respectively. There was a U-shaped association between DDS change scores and mortality, and compared with participants with whose DDS remained stable, those with extreme declines and extreme improvements had higher risks of mortality with HRs (95% CI) of 1.15 (1.09-1.22) and 1.11 (1.04-1.17). CONCLUSIONS: Maintaining a lower DDS, extreme declines and extreme improvements in DDS were all associated with an increased risk of all-cause mortality.


Assuntos
Dieta/classificação , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Estudos de Coortes , Inquéritos sobre Dietas , Comportamento Alimentar , Feminino , Humanos , Masculino , Estado Nutricional , Estudos Prospectivos
3.
Biomed Environ Sci ; 34(2): 163-169, 2021 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-33685575

RESUMO

Objective: This study aims to investigate the correlation of an ultrasonic scoring system with intraoperative blood loss (IBL) in placenta accreta spectrum (PAS) disorders. Methods: A retrospective cohort study was conducted between January 2015 and November 2019. Clinical data for patients with PAS have been obtained from medical records. Generalized additive models were used to explore the nonlinear relationships between ultrasonic scores and IBL. Logistic regressions were used to determine the differences in the risk of IBL ≥ 1,500 mL among groups with different ultrasonic scores. Results: A total of 332 patients participated in the analysis. Generalized additive models showed a significant positive correlation between score and blood loss. The amount of IBL was increased due to the rise in the ultrasonic score. All cases were divided into three groups according to the scores (low score group: ≤ 6 points, n = 147; median score group: 7-9 points, n = 126; and high score group: ≥ 10 points, n = 59). Compared with the low score group, the high score group showed a higher risk of IBL ≥ 1,500 mL [odds ratio, 15.09; 95% confidence interval (3.85, 59.19); P ≤ 0.001] after a multivariable adjustment. Conclusions: The risk of blood loss equal to or greater than 1,500 mL increases further when ultrasonic score greater than or equal to 10 points, the preparation for transfusion and referral mechanism should be considered.


Assuntos
Perda Sanguínea Cirúrgica/estatística & dados numéricos , Placenta Acreta/diagnóstico por imagem , Ultrassonografia Pré-Natal/estatística & dados numéricos , Adulto , Perda Sanguínea Cirúrgica/prevenção & controle , Feminino , Idade Gestacional , Humanos , Modelos Logísticos , Placenta Acreta/cirurgia , Valor Preditivo dos Testes , Gravidez , Estudos Retrospectivos , Risco
4.
J Cachexia Sarcopenia Muscle ; 12(2): 350-357, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33527771

RESUMO

BACKGROUND: Candidate genes of neuromuscular junction (NMJ) pathway increased risk of frailty, but the extent and whether can be offset by exercises was unclear. The aim of this study was to investigate the association between aerobic exercises and incident frailty regardless of NMJ pathway-related genetic risk. METHODS: A cohort study on participants from Chinese Longitudinal Healthy Longevity Survey was conducted from 2008 to 2011. A total of 7006 participants (mean age of 80.6 ± 10.3 years) without frailty at baseline were interviewed to record aerobic exercise status, and 4053 individuals among them submitted saliva samples. NMJ pathway-related genes were genotyped and weighted genetic risk scores were constructed. RESULTS: During a median follow-up of 3.1 years (19 634 person-years), there were 1345 cases (19.2%) of incident frailty. Persistent aerobic exercises were associated with a 26% lesser frailty risk [adjusted hazard ratio (HR) = 0.74, 95% confidence interval (CI) = 0.64-0.85]. This association was stronger in a subgroup of 1552 longevous participants (age between 90 and 111 years, adjusted HR = 0.72, 95% CI = 0.60-0.87). High genetic risk was associated with a 35% increased risk of frailty (adjusted HR = 1.35, 95% CI = 1.16-1.58). Of the participants with high genetic risk and no persistent aerobic exercises, there was a 59% increased risk of frailty (adjusted HR = 1.59, 95% CI = 1.20-2.09). HRs for the risk of frailty increased from the low genetic risk with persistent aerobic exercise to high genetic risk without persistent aerobic exercise (P trend <0.001). CONCLUSIONS: Both aerobic exercises and NMJ pathway-related genetic risk were significantly associated with frailty. Persistent aerobic exercises can partly offset NMJ pathway-related genetic risk to frailty in elderly people.


Assuntos
Exercício Físico , Fragilidade , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Idoso Fragilizado , Fragilidade/epidemiologia , Fragilidade/genética , Humanos , Incidência , Junção Neuromuscular
5.
Minerva Endocrinol ; 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33435649

RESUMO

INTRODUCTION: This study aimed to determine the relationship between the expression of epidermal growth factor receptor (EGFR) and pathological indicators in papillary thyroid carcinoma (PTC). EVIDENCE ACQUISITION: PubMed, Embase, Web of Science, MEDLINE, and Cochrane Library databases were searched for relevant clinical trials. The odds ratio (OR) and 95% confidence interval (CI) showed the effect magnitude of the expression of EGFR, age, gender, tumor size, lymph node metastasis (LNM), extrathyroid extension(ETE), and TNM(Tumor, Lymph node, Metastasis) stage. Stata 12.0 was used for statistical analysis of data. EVIDENCE SYNTHESIS: A total of 845 cases of PTC were included through the retrieval of 8 studies performed abroad. EGFR significantly correlated with extrathyroid extension (OR = 3.25; 95% CI: 1.25-8.43; Z = 2.42; P = 0.015), LNM (OR = 8.40; 95% CI: 5.44-12.97; Z = 9.61; P = 0.000), and TNM stage (OR = 2.30, 95% CI: 1.51-3.51; Z = 3.87; P= 0.000). EGFR had no correlation with age (OR =1.13; 95% CI: 0.83-1.53; Z = 0.77; P = 0.44], gender (OR = 0.93; 95% CI: 0.66-1.33; Z = 0.38; P = 0.70), and tumor size (OR = 1.68; 95% CI: 1.06-2.68; Z = 2.19; P = 0.03). Sensitivity analysis demonstrated that the studies by Cui Tang and Alfred King Yin Lam in LNM impacted the pooled OR. After removing these two studies, relatively stable results between the expression of EGFR and LNM were obtained. CONCLUSIONS: The results in the expression of EGFR is frequent and cancer-specific event in PTC. Besides, the expression of EGFR was involved in the progression and metastasis of PTC.

6.
J Am Med Dir Assoc ; 22(9): 1946-1952.e3, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33249058

RESUMO

OBJECTIVES: A few studies of Western populations have found inconsistent results regarding the associations between vitamin D status and physical function. We explored the association between circulating vitamin D status [plasma 25-hydroxyvitamin D, 25(OH)D] and incident activities of daily living (ADL) disability among Chinese older adults. DESIGN: Community-based longitudinal cohort study. SETTING AND PARTICIPANTS: A total of 2453 men and women (median age 84.0 years) in 7 Chinese longevity areas were included. MEASURES: Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident ADL, with adjustments for potential sociodemographic, and lifestyle confounders and biomarkers. Because there was a statistically significant interaction between plasma 25(OH)D and sex in relation to incident ADL, men and women were analyzed separately. RESULTS: The median concentrations of plasma 25(OH)D were 46.6 nmol/L and 36.4 nmol/L for men and women, respectively. Compared with the lowest quartile in the fully adjusted model, the HR for incident ADL disability for the highest quartile was 0.55 (95% CI 0.36-0.85) for women; for men, a null association was indicated (HRhighest vs lowest 0.61, 95% CI 0.37-1.00). However, when using the recommended circulating 25(OH)D thresholds by the US Institute of Medicine, those with vitamin D sufficiency (≥50 nmol/L) had better ADL disability prognoses than those with vitamin D deficiency (<30 nmol/L) in both sexes (men HR 0.45, 95% CI 0.28-0.72; women HR 0.58, 95% CI 0.37-0.90). CONCLUSIONS AND IMPLICATIONS: The relationship between plasma 25(OH)D concentration and incident ADL disability was sex-specific among Chinese older adults. However, participants with recommended vitamin D sufficiency may have better disability prognoses in both sexes, suggesting that the recommended 25(OH)D concentration for bone health may extend to functional outcomes such as ADL disability in Chinese older adults.

8.
Aging (Albany NY) ; 12(11): 10687-10703, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32532929

RESUMO

INTRODUCTION: To investigate the independent and joint effects of leisure activities on disability in activities of daily living (ADL) among the oldest-old Chinese population (aged ≥ 80 years). RESULTS: A total of 3696 participants with ADL disability were identified during the median follow-up period of 3.1 years. Compared to the participants who "never" watched TV or listened to the radio and who "never" kept domestic animals or pets, those who engaged in these activities "almost every day" had a significantly lower ADL disability risk (adjusted hazard ratios were 0.74 and 0.66, respectively; both P < 0.001). Furthermore, participants engaging in multiple leisure activities showed a reduced risk of ADL disability (P for trend < 0.001). CONCLUSIONS: Frequently watching TV or listening to the radio and keeping domestic animals or pets was associated with a lower risk of ADL disability among the oldest-old Chinese population. METHODS: We included 12,331 participants (aged ≥ 80 years) (mean [SD] age: 89.5 [7.0] years) who managed to perform ADL independently at baseline in the Chinese Longitudinal Healthy Longevity Survey 1998-2014 waves. Cox proportional hazards models were used to examine whether leisure activities were associated with ADL disability.


Assuntos
Atividades Cotidianas , Pessoas com Deficiência/estatística & dados numéricos , Atividades de Lazer , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Feminino , Inquéritos Epidemiológicos , Envelhecimento Saudável , Humanos , Estudos Longitudinais , Masculino , Modelos de Riscos Proporcionais , Fatores de Risco
9.
Ann Rheum Dis ; 79(6): 829-836, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32253185

RESUMO

OBJECTIVES: To evaluate the associations of regular glucosamine use with all-cause and cause-specific mortality in a large prospective cohort. METHODS: This population-based prospective cohort study included 495 077 women and men (mean (SD) age, 56.6 (8.1) years) from the UK Biobank study. Participants were recruited from 2006 to 2010 and were followed up through 2018. We evaluated all-cause mortality and mortality due to cardiovascular disease (CVD), cancer, respiratory and digestive disease. HRs and 95% CIs for all-cause and cause-specific mortality were calculated using Cox proportional hazards models with adjustment for potential confounding variables. RESULTS: At baseline, 19.1% of the participants reported regular use of glucosamine supplements. During a median follow-up of 8.9 years (IQR 8.3-9.7 years), 19 882 all-cause deaths were recorded, including 3802 CVD deaths, 8090 cancer deaths, 3380 respiratory disease deaths and 1061 digestive disease deaths. In multivariable adjusted analyses, the HRs associated with glucosamine use were 0.85 (95% CI 0.82 to 0.89) for all-cause mortality, 0.82 (95% CI 0.74 to 0.90) for CVD mortality, 0.94 (95% CI 0.88 to 0.99) for cancer mortality, 0.73 (95% CI 0.66 to 0.81) for respiratory mortality and 0.74 (95% CI 0.62 to 0.90) for digestive mortality. The inverse associations of glucosamine use with all-cause mortality seemed to be somewhat stronger among current than non-current smokers (p for interaction=0.00080). CONCLUSIONS: Regular glucosamine supplementation was associated with lower mortality due to all causes, cancer, CVD, respiratory and digestive diseases.


Assuntos
Doenças Cardiovasculares/mortalidade , Doenças do Sistema Digestório/mortalidade , Glucosamina/uso terapêutico , Neoplasias/mortalidade , Doenças Respiratórias/mortalidade , Suplementos Nutricionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Reino Unido/epidemiologia
10.
BMC Oral Health ; 20(1): 100, 2020 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-32276615

RESUMO

BACKGROUND: The associations between the number of natural teeth/denture use and all-cause mortality remain unclear due to lake of investigation for the potential interaction between tooth loss and denture use and for the potential changes in these exposures over time in older adults. We undertake this study to evaluate the associations of the number of natural teeth and/or denture use with mortality in Chinese elderly. METHODS: This is a prospective cohort study of 36,283 older adults (median age: 90). The number of natural teeth and denture use were collected with structured questionnaire. We evaluated hazard ratios (HRs) and confidence intervals (CIs) using a Cox proportional hazards model adjusting for demographic factors, education, income, lifestyle factors, and comorbidities. RESULTS: We documented 25,857 deaths during 145,947 person-years of observation. Compared to those with 20+ teeth, tooth loss was associated with a gradual increase in mortality, with an adjusted HR of 1.14 (95% CI, 1.06 to 1.23) for those with 10-19 teeth, 1.23 (95% CI, 1.15 to 1.31) for those with 1-9 teeth, and 1.35 (95% CI, 1.26 to 1.44) for those without natural teeth. Denture use was associated with lower risk of mortality (adjusted HR 0.81; 95% CI, 0.77 to 0.84). Subgroup analyses indicated that the benefit of denture use was greater in men than in women (P = 0.02) and tended to decrease with age (P < 0.001). The effects of denture use did not differ among various degrees of tooth loss (P = 0.17). CONCLUSIONS: Tooth loss was associated with an increased risk of mortality in older adults. Denture use provided a protective effect against death for all degrees of tooth loss however, this effect appeared to be modified by sex and age.


Assuntos
Dentaduras/estatística & dados numéricos , Mortalidade , Boca Edêntula , Vigilância da População/métodos , Perda de Dente/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco
11.
BMJ ; 368: m456, 2020 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-32131999

RESUMO

OBJECTIVES: To evaluate the associations of habitual fish oil supplementation with cardiovascular disease (CVD) and mortality in a large prospective cohort. DESIGN: Population based, prospective cohort study. SETTING: UK Biobank. PARTICIPANTS: A total of 427 678 men and women aged between 40 and 69 who had no CVD or cancer at baseline were enrolled between 2006 and 2010 and followed up to the end of 2018. MAIN EXPOSURE: All participants answered questions on the habitual use of supplements, including fish oil. MAIN OUTCOME MEASURES: All cause mortality, CVD mortality, and CVD events. RESULTS: At baseline, 133 438 (31.2%) of the 427 678 participants reported habitual use of fish oil supplements. The multivariable adjusted hazard ratios for habitual users of fish oil versus non-users were 0.87 (95% confidence interval 0.83 to 0.90) for all cause mortality, 0.84 (0.78 to 0.91) for CVD mortality, and 0.93 (0.90 to 0.96) for incident CVD events. For CVD events, the association seemed to be stronger among those with prevalent hypertension (P for interaction=0.005). CONCLUSIONS: Habitual use of fish oil seems to be associated with a lower risk of all cause and CVD mortality and to provide a marginal benefit against CVD events among the general population.


Assuntos
Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais/estatística & dados numéricos , Óleos de Peixe/administração & dosagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Reino Unido/epidemiologia
12.
BMC Geriatr ; 20(1): 29, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992221

RESUMO

BACKGROUND: Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluated by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the differences in associations of cognitive impairment, taking the stratification by educational levels into account, with all-cause mortality and further explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China. METHODS: A total of 13,906 and 13,873 Chinese elderly aged 65 years and older were included in the 2002-2008 and 2008-2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality. RESULTS: For the 2002-2008 and 2008-2014 cohorts, 55,277 and 53,267 person-years were followed up, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.32 (95% confidence interval [CI], 1.25-1.39) in 2002-2008 cohort and 1.26 (95% CI, 1.19-1.32) in 2008-2014 cohort, stratified by educational levels. The trend of cognitive impairment with all-cause mortality risk decreased from 2002 to 2008 to 2008-2014 cohort, while no significant interaction of cognitive impairment with cohort for all-cause mortality was observed. The associations of cognitive impairment and mortality were decreased with age in the two cohorts. CONCLUSIONS: Cognitive impairment evaluated by different cut-offs were associated with increased risk of mortality, especially among those aged 65-79 years in the two cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted.


Assuntos
Disfunção Cognitiva/mortalidade , Disfunção Cognitiva/psicologia , Testes de Estado Mental e Demência , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Cognição/fisiologia , Disfunção Cognitiva/diagnóstico , Estudos de Coortes , Feminino , Seguimentos , Humanos , Longevidade/fisiologia , Estudos Longitudinais , Masculino , Mortalidade/tendências , Estudos Prospectivos , Fatores de Tempo
13.
J Gerontol A Biol Sci Med Sci ; 75(4): 739-746, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-30946444

RESUMO

BACKGROUND: Little is known about the role of specific leisure activities in affecting cognitive functions. We aim to examine the associations of specific leisure activities with the risk of cognitive impairment among oldest-old people in China. METHODS: This community-based prospective cohort study included 10,741 cognitively normal Chinese individuals aged 80 years or older (median age 88 years) from the Chinese Longitudinal Healthy Longevity Survey. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Cox proportional hazards models were utilized to estimate the effects of specific leisure activities on cognitive impairment outcome. RESULTS: During a median follow-up time of 3.4 years (41,760 person-years), 2,894 participants developed cognitive impairment. Compared to those who "never" engaged in watching TV or listening to radio, reading books or newspapers, and playing cards or mah-jong, those who engaged in such activities "almost every day" reduced their risk of cognitive impairment, the fully-adjusted hazard ratios were 0.56 (0.51-0.61), 0.64 (0.53-0.78), and 0.70 (0.56-0.86), respectively. The association between the risk of cognitive impairment and watching TV and listening to the radio, playing cards or mah-jong, and reading books or newspapers were stronger among those who had two or more years of education. Moreover, the association between risk of cognitive impairment and watching TV and listening to radio was stronger in men than in women. CONCLUSIONS: In conclusion, a greater frequency of TV watching or radio listening, reading books or newspapers, and playing cards or mah-jong may decrease the risk of cognitive impairment among the oldest-old.


Assuntos
Cognição/fisiologia , Envelhecimento Saudável/psicologia , Atividades de Lazer/psicologia , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/psicologia , China/epidemiologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/prevenção & controle , Estudos de Coortes , Feminino , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Fatores de Risco
14.
J Gerontol A Biol Sci Med Sci ; 75(11): 2113-2118, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31603986

RESUMO

BACKGROUND: Evidence of the trend of the incidence of activities of daily living (ADL) disability among Chinese older people is limited. We aimed to investigate the time trends and potential risk factors for the incidence of ADL disability among Chinese older people (≥65 years). METHODS: We established two consecutive and nonoverlapping cohorts (6,857 participants in the 2002 cohort and 5,589 participants in the 2008 cohort) from the Chinese Longitudinal Healthy Longevity Survey. ADL disability was defined as the need for assistance with at least one essential activity (dressing, bathing, toileting, eating, indoor activities, and continence). Cox proportional hazards models were used to identify factors associated with the trend in the incidence of ADL disability from 2002 to 2014. RESULTS: The incidence (per 1,000 person-years) of ADL disability decreased significantly from 64.2 in the 2002 cohort to 46.6 in the 2008 cohort (p < .001), and decreasing trends in the incidence of ADL disability were observed for all sex, age, and residence subgroups (all p < .001), even after adjusting for multiple potential confounding factors. Moreover, we found that adjustment for sociodemographic, lifestyle information, and cardiovascular risk factors (hypertension, diabetes, heart disease, and stroke) explained less of the decline in ADL disability during the period from 2002 to 2014. CONCLUSION: The incidence of ADL disability among the older adults in China appears to have decreased during the study period, and this finding cannot be explained by existing sociodemographic and lifestyle information and cardiovascular risk factors.


Assuntos
Atividades Cotidianas , Avaliação da Deficiência , Avaliação Geriátrica , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Fatores de Risco
15.
J Am Med Dir Assoc ; 21(6): 713-719.e2, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31588027

RESUMO

OBJECTIVE: To investigate associations between leisure activities, examining each activity separately and in combination, and all-cause mortality among the Chinese oldest-old (≥80 years) population. DESIGN: Prospective cohort study. SETTING: Community-living, the oldest-old from 22 provinces in China. PARTICIPANTS: We included 30,070 Chinese individuals aged ≥80 years (mean age: 92.7 years) from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014. MEASUREMENTS: Cox proportional hazards models were used to estimate relationships between leisure activities and all-cause mortality, adjusting for covariates including sociodemographic and lifestyle factors, self-reported medical history, and other potential confounders. RESULTS: During 110,278 person-years of follow-up, 23,661 deaths were documented. Participants who engaged in watching TV or listening to the radio, playing cards or mah-jong, reading books or newspapers, gardening, keeping domestic animals or pets, or attending religious activities "almost every day" had a significantly lower mortality risk (adjusted hazard ratios ranged from 0.82 to 0.89; P < .01 for all) than did participants who "never" engaged in those activities. Furthermore, engagement in multiple leisure activities was associated with a reduced risk of all-cause mortality (P for the trend < .001). CONCLUSIONS AND IMPLICATIONS: Frequent participation in leisure activities might help decrease the risk of death in the Chinese oldest-old population. This finding has important implications for public health policy and encourages the incorporation of a broad range of leisure activities into the daily lives of oldest-old individuals.


Assuntos
Atividades de Lazer , Mortalidade , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Humanos , Estudos Longitudinais , Modelos de Riscos Proporcionais , Estudos Prospectivos
16.
J Cell Biochem ; 121(1): 713-722, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31385350

RESUMO

Small for gestational age (SGA) has a high risk of mortality and morbidity and is common in obstetrics. To date, no effective prediction and treatment tools are available. Acting as microRNA (miRNA) sponges and disease biomarkers are clear functions of circular RNAs (circRNAs). However, it is still unknown what role circRNAs act in SGA. To explore the role of circRNAs in SGA, circRNA expression patterns of the umbilical cord and maternal plasma in SGA was assessed. We first evaluated circRNAs in umbilical cord blood of the SGA and appropriate for gestational age (AGA) groups by microarray sequencing. In total, 170 340 circRNAs were sequenced, and 144 circRNAs were significantly upregulated while 977 were markedly downregulated. Has_circRNA15994-13, has_circ_0001359, and has_circ_0001360 were abundant and differentially expressed between the SGA and AGA groups, and confirmed in the umbilical cord and maternal blood specimens by reverse transcription polymerase chain reaction. By combining miRNA microarray data of the SGA placenta tissue in NCBI, it was found that two miRNAs were both hsa_circRNA15994-13 targets and differentially expressed, including hsa-miR-3619-5p and hsa-miR-4741. Further KEEG analysis revealed that the most significant pathway enriched by hsa-miR-3619-5p was Wnt signaling that is closely related to SGA; meanwhile, previous reports demonstrated that hsa-miR-3619-5p directly binds to ß-catenin to accommodate the Wnt/ß-catenin pathway, whereby the suggestive hsa_circRNA15994-13 → hsa-miR-3619-5p → ß-catenin signaling pathway may play an important part in SGA.


Assuntos
Recém-Nascido Pequeno para a Idade Gestacional/sangue , Plasma/metabolismo , RNA Circular/sangue , RNA Circular/genética , Cordão Umbilical/metabolismo , Feminino , Idade Gestacional , Humanos , Recém-Nascido , MicroRNAs/sangue , MicroRNAs/genética , Gravidez , beta Catenina/sangue , beta Catenina/genética
17.
J Gerontol A Biol Sci Med Sci ; 75(6): 1214-1221, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-31435643

RESUMO

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.


Assuntos
Atividades Cotidianas , Idoso de 80 Anos ou mais/estatística & dados numéricos , Disfunção Cognitiva/epidemiologia , Aptidão Física , Atividades Cotidianas/psicologia , Fatores Etários , Idoso de 80 Anos ou mais/fisiologia , Idoso de 80 Anos ou mais/psicologia , China/epidemiologia , Disfunção Cognitiva/etiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes de Estado Mental e Demência , Aptidão Física/psicologia , Fatores de Risco
18.
Immun Ageing ; 16: 28, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31708993

RESUMO

Background: The association of high-sensitivity C-reactive protein (hsCRP) with mortality is controversial. We aimed to investigate the associations of hsCRP concentrations with the risks of all-cause and cause-specific mortality and identify potential modifying factors affecting these associations among middle-aged and elderly individuals. Methods: This community-based prospective cohort study included 14,220 participants aged 50+ years (mean age: 64.9 years) from the Health and Retirement Study. Cox proportional hazard models were employed to estimate the associations between the hsCRP concentrations and the risk of all-cause and cause-specific mortality with adjustment for sociodemographic and lifestyle factors, self-reported medical history, and other potential confounders. Results: In total, 1730 all-cause deaths were recorded, including 725 cardiovascular- and 417 cancer-related deaths, after an 80,572 person-year follow-up (median: 6.4 years; range: 3.6-8.1 years). The comparisons of the groups with the highest (quartile 4) and lowest (quartile 1) hsCRP concentrations revealed that the adjusted hazard ratios and 95% confidence intervals were 1.50 (1.31-1.72) for all-cause mortality, 1.44 (1.13-1.82) for cardiovascular mortality, and 1.67 (1.23-2.26) for cancer mortality. The associations between high hsCRP concentrations and the risks of all-cause, cardiovascular, and cancer mortality were similar in the men and women (P for interaction > 0.05). Conclusions: Among middle-aged and older individuals, elevated hsCRP concentration could increase the risk of all-cause, cardiovascular, and cancer mortality in men and women.

19.
J Nutr ; 149(6): 1056-1064, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30949685

RESUMO

BACKGROUND: High concentrations of plasma 25-hydroxyvitamin D [25(OH)D], a marker of circulating vitamin D, have been associated with a lower risk of mortality in epidemiologic studies of multiple populations, but the association for Chinese adults aged ≥80 y (oldest old) remains unclear. OBJECTIVE: We investigated the association between plasma [25(OH)D] concentration and all-cause mortality among Chinese adults aged ≥80 y. DESIGN: The present study is a prospective cohort study of 2185 Chinese older adults (median age: 93 y). Prospective all-cause mortality data were analyzed for survival in relation to plasma 25(OH)D using Cox proportional hazards regression models, with adjustments for potential sociodemographic and lifestyle confounders and biomarkers. The associations were measured with HR and 95% CIs. RESULTS: The median plasma 25(OH)D concentration was 34.4 nmol/L at baseline. Over the 5466 person-year follow-up period, 1100 deaths were identified. Men and women were analyzed together as no effect modification by sex was found. After adjusting for multiple potential confounders, the risk of all-cause mortality decreased as the plasma 25(OH)D concentration increased (P-trend <0.01). Compared with the lowest age-specific quartile of plasma 25(OH)D, the adjusted HRs for mortality for the second, third, and fourth age-specific quartiles were 0.72 (95% CI: 0.57, 0.90), 0.73 (95% CI: 0.58, 0.93), and 0.61 (95% CI: 0.47, 0.81), respectively. The observed associations were broadly consistent across age and other subgroups. Sensitivity analyses generated similar results after excluding participants who died within 2 y of follow-up or after further adjustment for ethnicity and chronic diseases. CONCLUSIONS: A higher plasma 25-hydroxyvitamin D concentration was associated with a reduced risk of all-cause mortality among Chinese adults aged ≥80 y. This observed inverse association warrants further investigation in randomized controlled trials testing vitamin D supplementation in this age group.


Assuntos
Mortalidade , Vitamina D/análogos & derivados , Fatores Etários , Idoso de 80 Anos ou mais , Envelhecimento/sangue , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Biomarcadores/sangue , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Longevidade/fisiologia , Estudos Longitudinais , Masculino , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Vitamina D/sangue
20.
BMC Geriatr ; 19(1): 104, 2019 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-30987591

RESUMO

BACKGROUND: Oxidative stress is an important theory of aging but population-based evidence has been lacking. This study aimed to evaluate the associations between biomarkers of oxidative stress, including plasma superoxide dismutase (SOD) activity and malondialdehyde (MDA), with all-cause mortality in older adults. METHODS: This is a community-based cohort study of 2224 participants (women:1227, median age: 86 years). We included individuals aged 65 or above and with plasma SOD activity and/or MDA tests at baseline. We evaluated the hazard ratios (HRs) and 95% confidence intervals (CIs) by multivariable Cox models. RESULTS: We documented 858 deaths during six years of follow-up. There was a significant interaction effect of sex with the association between SOD activity and mortality (P < 0.001). Compared with the lowest quintile, the risk of all-cause mortality was inversely associated with increasing quintiles of plasma SOD activity in women(P-trend< 0.001), with adjusted HRs for the second through fifth quintiles of 0.73 (95% CI 0.53-1.02), 0.52(95% CI 0.38-0.72), 0.53(95% CI 0.39-0.73), and 0.48(95% CI 0.35-0.66). There were no significant associations between SOD activity and mortality in men (P-trend = 0.64), and between MDA and mortality in all participants (P-trend = 0.79). CONCLUSIONS: Increased activity of SOD was independently associated with lower all-cause mortality in older women but not in men. This epidemiological study lent support for the free radical/oxidative stress theory of aging.


Assuntos
Vida Independente/tendências , Malondialdeído/sangue , Mortalidade/tendências , Superóxido Dismutase/sangue , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Estresse Oxidativo/fisiologia , Estudos Prospectivos , Fatores Sexuais
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