This meta-analysis aimed to estimate the shape of the dose-response association between objectively-assessed daily sedentary time (ST) and all-cause mortality, and to explore whether there is a ...threshold of ST above which there is an increase in mortality risk in older adults.
Searches for prospective cohort studies providing effect estimates of daily ST (exposure) on all-cause mortality (outcome) were undertaken in five databases up to 31 March 2019. A random-effects meta-regression model was conducted to quantify the dose-response relationship between daily ST and all-cause mortality. Sensitivity analyses were also performed to test the stability of the results.
Our analysis of pooled data from 11 eligible studies did not reveal a consistent shape of association between ST and mortality. After excluding three studies with potential confounding bias, there was a log-linear dose-response relationship between daily ST and all-cause mortality. Overall, higher amounts of time spent in sedentary behaviors were associated with elevated mortality risks in older adults. Visual assessments of dose-response relationships based on meta-regression analyses indicated that increased mortality risks became significant when total ST exceeded approximately 9 h/day.
Based on a limited number of studies, this meta-analysis provides a starting point for considering a cut-off of daily sedentary time, suggesting older adults spend less time in daily sitting.
Geriatric depression is a common but preventable psychiatric disorder; however, its association with specific sleep patterns remains unclear. Therefore, we examined the association of self-reported ...sleep duration and sleep timing with depressive symptoms in the older population.
A total of 1068 older Taiwanese adults (52.7% women; 72.2 ± 5.7 y) responded to a telephone survey during 2019–2020. Self-reported data on sociodemographic characteristics, sleep duration, bedtime, wake-up time (adapted items from Pittsburgh Sleep Quality Index), and depressive symptoms (five-item Center for Epidemiological Studies–Depression scale) were included. Generalized additive models were used to examine the nonlinear associations of sleep duration and midpoint sleep time (ie, the midpoint of bedtime and wake-up time) with depressive symptoms.
The means of sleep duration and midpoint sleep time in the participants were 6 h per night and 02:13 h, respectively. The results showed marked nonlinear associations of sleep patterns with depressive symptoms. Sleep duration shorter than 4 h per night was associated with a relatively higher level of depressive symptoms, with the highest risk (coefficient = 3.41; 95% confidence interval CI = 2.12, 4.70) while sleeping 2.06 h per night. The midpoint sleep time was positively associated with depressive symptom scores after 01:00 h.
The results showed that sleep duration and fitting sleep timing were nonlinearly associated with the risks of depressive symptoms in the general older adult population. These findings have implications for targeting nonpharmacological approaches by tackling modifiable behaviors, such as adequate sleep duration and timing, with decreased risks of depressive symptoms in the older adult population.
•Nonlinear associations between sleep patterns and depressive symptoms in older adults.•Sleep duration less than 4 h/night was associated with higher depressive risks.•The midpoint sleep time after 01:00 h was associated with higher depressive risks.•Sleep-related approach to reduce the depressive risks includes adequate duration and fitting timing.
A multicenter collection of bacteremic isolates of
(
= 423),
(
= 372),
(
= 300), and
complex (
= 199) was analyzed for susceptibility. Xpert Carba-R assay and sequencing for
genes were performed for ...carbapenem- or colistin-resistant isolates. Nineteen (67.8%) carbapenem-resistant
(
= 28) and one (20%) carbapenem-resistant
(
= 5) isolate harbored
(
= 17),
(
= 2), and
(
= 1) genes.
Surgical resection is a curative therapy for early-stage hepatocellular carcinoma (HCC); however, HCC recurrence is not uncommon. Identifying outcome predictors helps to manage the disease. ...Gamma-glutamyl transferase (GGT) may predict the development of HCC, but its role to predict the outcomes after surgical resection of HCC was unclear. This study aimed to investigate pre-operative GGT levels for outcome prediction in patients with hepatitis B virus (HBV)-related HCC.
We conducted a retrospective cohort study to include patients with HBV-related HCC receiving surgical resection. Clinical information, HCC characteristics and usage of antiviral therapy were collected. A time-dependent Cox proportional hazard regression analysis were used to predict HCC recurrence and survival.
A total of 699 consecutive patients with HBV-related HCC who received surgical resection with curative intent between 2004 and 2013 were included. After a median of 4.4 years, 266 (38%) patients had HCC recurrence. Pre-operative GGT positively correlated with cirrhosis, tumor burden and significantly increased in patients to develop HCC recurrence. Multivariable analysis demonstrated that pre-operative GGT ≥38 U/L increased 57% risk (hazard ratio HR: 1.57, 95% confidence interval CI: 1.20–2.06) of recurrent HCC after adjustment for confounding factors. Specifically, pre-operative GGT ≥38 U/L predicted early (<2 years) HCC recurrence (HR: 1.94, 95% CI: 1.30–2.89). Moreover, pre-operative GGT ≥38 U/L predicted all-cause mortality (HR: 1.73, 95% CI: 1.06–2.84) after surgery.
Pre-operative GGT levels ≥38 U/L independently predict high risks of HCC recurrence and all-cause mortality in HBV-related HCC patients receiving surgical resection.
Symptoms of essential tremor (ET) are similar to those of Parkinson's disease (PD) during their initial stages. Presently, there are few stable biomarkers available on a neuroanatomical level for ...distinguishing between these two diseases. However, few investigations have directly compared the changes in brain volume and assessed the compensatory effects of a change in the parts of the brain associated with PD and with ET. To determine the compensatory and/or degenerative anatomical changes in the brains of PD and ET patients, the present study tested, via two voxel-based morphometry (VBM) approaches (Basic vs. DARTEL VBM processing), the anatomical brain images of 10 PD and 10 ET patients, as well as of 13 age-matched normal controls, obtained through a 3T magnetic resonance scanner. These findings indicate that PD and ET caused specific patterns of brain volume alterations in the brains examined. In addition, our observations also revealed compensatory effects, or self-reorganization, occurring in the thalamus and the middle temporal gyrus in the PD and ET patients, due perhaps in part to the enhanced thalamocortical sensorimotor interaction and the head-eye position readjustment, respectively, in these PD and ET patients. Such a distinction may lend itself to use as a biomarker for differentiating between these two diseases.
Evidence of the harmful health effects of sedentary behavior is emerging; however, little is known about domain-specific sedentary behavior correlates. Thus, in this study, the personal and ...behavioral correlates of total and domain-specific sedentary behavior in older Taiwanese adults were identified.
The sample comprised 1046 older adults (aged ≥65 years). Cross-sectional data on self-administered personal behavioral variables and time spent engaging in domain-specific sedentary behavior were obtained using computer-assisted telephone-based interviews. Binary logistic regression analyses were performed.
Those aged older than 75 years were less likely to have longer total sedentary, computer use, and transportation times. Compared to women, older men were more likely to have longer total sedentary and transportation times. Older adults with low educational levels were less likely to have longer total sedentary and computer use times but were more likely to have an excessive television (TV) viewing time (≥2 h/day). Older adults who lived alone and were overweight had a longer TV viewing time. Furthermore, unemployment was associated with an excessive TV viewing time and shorter transportation time. Older adults residing in nonmetropolitan areas had lower total sedentary, TV viewing, and computer use times. Older adults who engaged in insufficient leisure time physical activity were more likely to have longer total sedentary and transportation times.
Both common and distinct personal and behavioral factors were associated with total and domain-specific sedentary behavior. Interventions for reducing total and domain-specific sedentary behavior should focus on both common and distinct subgroups of the Taiwanese older population.
Lifestyle behaviors are modifiable factors that can provide information for designing intervention strategies for sarcopenia. The present study aimed to identify the relationships between a range of ...daily lifestyle behaviors and sarcopenia risks among older adults.
A nationwide telephone-based survey targeting older adults (≥65 years) was performed in Taiwan. Data based on self-reported daily lifestyle behaviors (food selection, physical activity, sitting time, and sleep duration), the presence or absence of sarcopenia (measured by SARC-F), and personal characteristics were obtained. Binary logistic regression models were applied.
A total of 1068 older adults participated in this survey. In the adjusted model, older adults who selected unbalanced foods (odds ratio OR = 1.93, 95% confidence interval CI = 1.12-3.34), engaged in insufficient physical activity (OR = 5.14, 95% CI = 3.04-8.70), and sat for longer periods of time (OR = 1.98, 95% CI = 1.09-3.59) were more likely to have higher risks of sarcopenia. No significant association was observed for sleep duration.
The results of this study highlight that, among health behaviors, an unbalanced food selection (six nutrients), not meeting physical activity recommendations (150 min/week), and a higher sitting time (≥7 h/day) were risk factors for sarcopenia among older adults. Intervention programs for sarcopenia prevention in older adults should focus on promoting balanced food selection, sufficient physical activity, and reduced sitting time.
Given the inconsistent findings of the association between frailty and sedentary behavior in older adults, this cross-sectional study investigated the aforementioned association using four different ...frailty criteria and two sedentary behavior indices in older adults.
Data from older adults (age ≥ 65 y) who participated in health examinations or attended outpatient integrated clinics at a medical center in Taipei, Taiwan, were collected. Frailty was measured using the modified Fried Frailty Phenotype (mFFP), Clinical Frailty Scale in Chinese Translation (CFS-C), Study of Osteoporotic Fractures (SOF) index, and Clinical Frailty-Deficit Count (CF-DC) index; sedentary behavior was assessed with a waist-worn accelerometer. Adjusted linear regression ascertained the association between frailty and both sedentary behavior outcomes.
Among the 214 participants (mean age 80.82 ± 7.14 y), 116 were women. The average total sedentary time and number of sedentary bouts were 609.74 ± 79.29 min and 5.51 ± 2.09 times per day, respectively. Frail participants had a longer total sedentary time (odds ratio OR: 30.13, P = .01 and 39.43, P < .001) and more sedentary bouts (OR: 3.50 and 5.86, both P < .001) on mFFP and CFS-C assessments, respectively. The SOF index revealed more sedentary bouts among frail than in robust participants (OR: 2.06, P = .009), without a significant difference in the total sedentary time. Frail participants defined by the CF-DC index were more likely to have frequent sedentary bouts (OR: 2.03, P = .016), but did not have a longer total sedentary time.
Regardless of the frailty criteria adopted, frailty was positively associated with the number of sedentary bouts per day in older adults. A significant correlation between frailty and total sedentary time was detected only with mFFP and CFS-C indices. Further research may target decreasing the sedentary bouts in older adults as a strategy to improve frailty.
This study examined the associations of overall and domain-specific (i.e., occupational, transport, and leisure-time) sedentary behaviors with cardiovascular disease (CVD) risk factors among ...high-tech company employees in Taiwan. A total of 363 participants employed at high-tech companies (mean age ± standard deviation: 37.4 ± 7.2 years) completed a questionnaire administered by email regarding their overall, occupational, transport, and leisure-time sedentary behaviors. Self-reported data of height and weight, blood pressure, blood sugar, and total cholesterol levels were also collected in 2018. An adjusted binary logistic regression model was employed in the analysis. After adjusting for sociodemographic variables, high-tech company employees who used a computer (or Internet) for more than 2 h per day during their leisure time were more likely to have CVD risk factors (odds ratio: 1.80; 95% confidence interval: 1.08-3.00). No significant associations with CVD risk factors were detected for total sedentary time, occupational sitting, television viewing time, and transport-related sitting. Despite the nature of cross-sectional design in this study, our findings may have considerable implications for intervention designers and policymakers of Taiwan. Developing effective strategies for limiting leisure-time computer use should be considered for the prevention of CVD among high-tech company employees.
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