Background
We consider the relationships between a clinical and radiological diagnosis of knee or hip OA and activities of daily-living (ADL) in older adults.
Methods
Data were available for 222 men ...and 221 women from the Hertfordshire Cohort Study (HCS) who also participated in the UK component of the European Project on Osteoarthritis (EPOSA). Participants completed the EuroQoL survey where they reported if they had difficulties with mobility, self-care, usual activities and movement around their house. Hip and knee radiographs were graded for overall Kellgren and Lawrence score (positive definition defined as a 2 or above). Clinical OA was defined using American College of Rheumatology criteria.
Results
In men, a clinical diagnosis of hip or knee OA were both associated with reported difficulties in mobility, ability to self-care and performing usual-activities (hip OA: OR 17.6, 95% CI 2.07, 149,
p
= 0.009; OR 12.5, 95% CI 2.51, 62.3,
p
= 0.002; OR 4.92, 95% CI 1.06, 22.8,
p
= 0.042 respectively. Knee OA: OR 8.18, 95% CI 3.32, 20.2,
p
< 0.001; OR 4.29, 95% CI 1.34, 13.7,
p
= 0.014; OR 5.32, 95% CI 2.26, 12.5,
p
< 0.001 respectively). Similar relationships were seen in women, where in addition, a radiological diagnosis of knee OA was associated with difficulties performing usual activities (OR 3.25, 95% CI 1.61, 6.54,
p
= 0.001). In general, men with OA reported stronger associations between moving around the house, specifically around the kitchen (clinical hip OA: OR 13.7, 95% CI 2.20, 85.6,
p
= 0.005; clinical knee OA OR 8.45, 95% CI 1.97, 36.2,
p
= 0.004) than women.
Discussion and conclusion
Clinical OA is strongly related to the ability to undertake ADL in older adults and should be considered in clinic consultations when seeing patients with OA.
poor diet quality is common among older people, but little is known about influences on food choice, including the role of psychosocial factors at this age.
to identify psychosocial correlates of ...diet quality in a community-dwelling population of men and women aged 59-73 years; to describe relationships with change in diet quality over 10 years.
Longitudinal cohort, Hertfordshire Cohort Study (HCS).
HCS participants assessed at baseline (1998-2003: 1,048 men, 862 women); 183 men and 189 women re-assessed in 2011.
diet was assessed by administered food frequency questionnaire; diet scores were calculated to describe diet quality at baseline and follow-up. A range of psychosocial factors (social support, social network, participation in leisure activities, depression and anxiety, sense of control) were assessed by questionnaire.
at baseline, better diet quality was related to a range of social factors, including increased confiding/emotional social support (men and women), practical support (men) and a larger social network (women) (all P < 0.05). For both men and women, greater participation in social and cognitive leisure activities was related to better diet quality (P < 0.005). There were few associations between measured psychosocial factors at baseline and change in diet score over 10 years, in the follow-up sub-group. However, greater participation in leisure activities, especially cognitive activities, at baseline was associated with smaller declines in diet quality over the 10-year follow-up period for both men (P = 0.017) and women (P = 0.014).
in community-dwelling older adults, a range of social factors, that includes greater participation in leisure activities, were associated with diets of better quality.
Mild traumatic injuries to the brain (e.g., concussion) are common and have been recognized since antiquity, although definitions have varied historically. Nonetheless, studying the epidemiology of ...concussion helps clarify the overall importance, risk factors, and at-risk populations for this injury. The present review will focus on recent findings related to the epidemiology of concussion including definition controversies, incidence, and patterns in the population overall and in the military and athlete populations specifically. Finally, as this is an area of active research, we will discuss how future epidemiologic observations hold promise for gaining greater clarity about concussion and mild traumatic brain injury.
Purpose
Social isolation has been associated with both physical and psychological adverse outcomes and is prevalent in older adults. We investigated the impact of social isolation on bone mineral ...density (BMD) and physical capability in community-dwelling older adults.
Methods
Data were collected in 2011 and 2017 from the Hertfordshire Cohort Study. In 2011, we assessed social isolation using the six-item Lubben Social Network Scale (LSNS-6) and the Maastricht Social Participation Profile (MSSP) and depressive and anxiety symptoms using the Hospital Anxiety and Depression Scale (HADS). Physical capability was assessed by performing tests of gait speed, chair stands, timed up and go and balance at both time points. BMD was assessed using dual X-ray absorptiometry (DXA) at both time points.
Results
Data were available from 369 participants in 2011 and 184 in 2017. Forty percent of men and 42.4% of women were socially isolated. Isolated participants had higher odds of depressive disorder (OR 3.01, 95% CI 1.27–7.11,
p
< 0.02). Social isolation at baseline was associated with poor physical capability scores at follow-up (OR 5.53, 95% CI 1.09–27.99,
p
< 0.04). No associations were found between social isolation and BMD at either time point.
Conclusions
Social isolation was associated with higher odds of having depressive symptoms and predicted the development of poor physical capability 6 years later. Further longitudinal studies that include loneliness as a covariate are warranted.
High-resolution peripheral quantitative computed tomography (HR-pQCT) captures novel aspects of bone geometry, volumetric bone mineral density and offers the ability to measure bone ...microarchitecture, but data relating measures obtained from this technique to diabetic status are inconsistent in women and lacking in men. Here, we report an analysis from the Hertfordshire Cohort Study, where we were able to study associations between bone microarchitecture from HR-pQCT of distal radius and distal tibia in 332 participants (177 men and 155 women) aged 72.1–81.4 years with or without diabetes mellitus (DM);
n
= 29 (18 men and 11 women) and
n
= 303, respectively. Statistical analyses were performed separately for women and men. The mean (SD) age of participants was 76.4 (2.6) and 76.1 (2.5) years in women and men, respectively. Participants with DM differed significantly in terms of weight in both women (70.4 ± 12.3 vs. 80.3 ± 18.3 kg;
p
= 0.015) and men (81.7 ± 11.4 vs. 92.8 ± 16.3 kg;
p
< 0.001) but no differences were found in height, smoking status, alcohol intake, social class and physical activity among women or men. Analyses in women revealed that cortical pore volume (Ct.Po.V) was higher in participants with DM and close to statistical significance for cortical porosity (Ct.Po) (
β
= 0.76 0.12, 1.41
z
-score,
p
= 0.020 and
β
= 0.62 −0.02, 1.27
z
-score,
p
= 0.059, respectively) at the distal radius. Adjustment for weight did not materially affect the relationship described for Ct.Po.V (
β
= 0.74 0.09, 1.39,
p
= 0.027) and Ct.Po (
β
= 0.65 −0.01, 1.30,
p
= 0.053) at the distal radius. After adjustment for weight, analyses in men revealed that Ct.Po and Ct.Po.V were higher in participants with DM (
β
= 0.57 0.09, 1.06
z
-score,
p
= 0.021 and
β
= 0.48 0.01, 0.95
z
-score,
p
= 0.044, respectively) at the distal tibia. Analyses of distal radial and tibial trabecular bone parameters according to diabetic status revealed no significant differences among men or women after adjustment for weight. We found higher cortical porosity and cortical pore volume at the distal tibia in men with DM and higher cortical pore volume at the distal radius in women with a non-significant tendency for higher cortical porosity. The results of our study suggest that deficits in cortical bone exist both in older men and women with DM.
Sleep duration may be associated with risk of osteoporosis, with suggestions that too little or indeed too much sleep may be detrimental to bone health. In this study, we considered whether perceived ...sleep quality is also associated with bone health in older adults. We explored this association in a cohort of 443 older community-dwelling UK adults. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as > 5 on this score system. Bone density, shape and microarchitecture were assessed using dual energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and high-resolution pQCT (HRpQCT). Thirty-seven percent of men and 43% of women had a PSQI score greater than 5, indicative of poor perceived sleep. We found that quality of sleep was associated with altered bone microarchitecture. In men, poor sleep quality was associated with lower radial trabecular (4% slice,
p
< 0.04) and cortical (66% slice,
p
= 0.02) bone mineral density, as well as decreased tibial cortical density (
p
< 0.02) and increased porosity (
p
< 0.04), but increased size of the tibia (
p
< 0.04). In women, poor perceived sleep quality was associated with thinner (
p
< 0.03) and less dense (
p
< 0.04) cortices of the radius, but greater tibial trabecular number (
p
< 0.02) and lower separation (
p
< 0.04). Relationships with DXA parameters were non-significant after adjustment for confounders. Taking sleep medications was associated with decreased tibial size (38% and 66% slices) and strength in women (all
p
< 0.05), but not in men. Perceived sleep quality was associated with altered bone density and microarchitecture in older adults, and these differences varied according to biological sex and site. Further work is indicated to investigate possible mechanisms underlying these observations.
OBJECTIVES: To examine relationships between diet and grip strength in older men and women and to determine whether prenatal growth modifies these relationships.
DESIGN: Cross‐sectional and ...retrospective cohort study.
SETTING: Hertfordshire, United Kingdom.
PARTICIPANTS: Two thousand nine hundred eighty‐three men and women aged 59 to 73 who were born and still living in Hertfordshire, United Kingdom.
MEASUREMENTS: Weight at birth recorded in Health Visitor ledgers; current food and nutrient intake assessed using an administered food frequency questionnaire; and grip strength measured using a handheld dynamometer.
RESULTS: Grip strength was positively associated with height and weight at birth and inversely related to age (all P<.001). Of the dietary factors considered in relation to grip strength, the most important was fatty fish consumption. An increase in grip strength of 0.43 kg (95% confidence interval (CI)=0.13–0.74) in men (P=.005) and 0.48 kg (95% CI=0.24–0.72) in women (P<.001) was observed for each additional portion of fatty fish consumed per week. These relationships were independent of adult height, age, and birth weight, each of which had additive effects on grip strength. There was no evidence of interactive effects of weight at birth and adult diet on grip strength.
CONCLUSION: These data suggest that fatty fish consumption can have an important influence on muscle function in older men and women. This raises the possibility that the antiinflammatory actions of omega‐3 fatty acids may play a role in the prevention of sarcopenia.
This study aimed to examine the association between sleep quality and physical performance among a group of UK community-dwelling older adults, according to sex.
Sleep quality was assessed using the ...Pittsburgh Sleep Quality Index. Physical performance was assessed using a short physical performance battery (SPPB), a timed up-and-go, and a hand-grip strength test.
Of 591 eligible study members, 401 completed the Pittsburgh Sleep Quality Index. In regression analyses, men who reported poor sleep quality were significantly more likely to have a poor SPPB score, even after adjustment for confounding factors (OR = 2.54, 95% CI 1.10-5.89, P= .03). The direction of the relationship was reversed among women, where those who reported poor sleep were less likely to have a low SPPB score (OR = 0.36, 95% CI 0.15-0.85, P = .02). Poor sleep quality was associated with poorer hand-grip strength among women (regression coefficient = -0.34 z score, 95% CI -0.64, -0.04, P = .03), but this relationship was not observed among men (regression coefficient = 0.28 z score, 95% CI -0.01, 0.57, P = .06).
We found evidence of an association between poor sleep quality and poorer physical performance in older adults, though there appear to be important sex differences.
There is considerable interest in the possible role of vitamin D in respiratory disease, but only one population-based study has reported associations with lung function.
The cross-sectional ...relationships of total dietary vitamin D intake, serum 25 hydroxy vitamin D (25(OH)D) concentrations and three vitamin D receptor (VDR) polymorphisms (Apa1, Fok1 and Cdx2) with lung function and spirometrically-defined chronic obstructive pulmonary disease (COPD) were investigated in men and women aged 59-73 years in the Hertfordshire Cohort Study, UK.
After controlling for confounders, total vitamin D intake was positively associated with forced expiratory volume in 1 s (FEV(1); difference in FEV(1) between top and bottom quintiles of intake 0.079 l (95% CI 0.02 to 0.14), p trend=0.007, n=2942), ratio of FEV(1) to forced vital capacity (FEV(1)/FVC; p trend=0.008) and negatively associated with COPD (OR comparing top and bottom quintiles 0.57 (95% CI 0.38 to 0.87), p trend=0.02). In contrast, serum 25(OH)D concentrations were not related to FEV(1) (p trend=0.89, n=1197) but were positively associated with COPD (p trend=0.046). VDR genotypes were unrelated to lung function and did not modify the effects of dietary intake or 25(OH)D concentrations on lung function.
The results of this study did not confirm a positive association between blood 25(OH)D concentrations and adult lung function. The apparent relationships with dietary vitamin D are likely to be explained by other highly correlated nutrients in the diet.
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