The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremity physical performance status. Its predictive ability for all-cause mortality has been sparsely ...reported, but with conflicting results in different subsets of participants. The aim of this study was to perform a meta-analysis investigating the relationship between SPPB score and all-cause mortality.
Articles were searched in MEDLINE, the Cochrane Library, Google Scholar, and BioMed Central between July and September 2015 and updated in January 2016. Inclusion criteria were observational studies; >50 participants; stratification of population according to SPPB value; data on all-cause mortality; English language publications. Twenty-four articles were selected from available evidence. Data of interest (i.e., clinical characteristics, information after stratification of the sample into four SPPB groups 0-3, 4-6, 7-9, 10-12) were retrieved from the articles and/or obtained by the study authors. The odds ratio (OR) and/or hazard ratio (HR) was obtained for all-cause mortality according to SPPB category (with SPPB scores 10-12 considered as reference) with adjustment for age, sex, and body mass index.
Standardized data were obtained for 17 studies (n = 16,534, mean age 76 ± 3 years). As compared to SPPB scores 10-12, values of 0-3 (OR 3.25, 95%CI 2.86-3.79), 4-6 (OR 2.14, 95%CI 1.92-2.39), and 7-9 (OR 1.50, 95%CI 1.32-1.71) were each associated with an increased risk of all-cause mortality. The association between poor performance on SPPB and all-cause mortality remained highly consistent independent of follow-up length, subsets of participants, geographic area, and age of the population. Random effects meta-regression showed that OR for all-cause mortality with SPPB values 7-9 was higher in the younger population, diabetics, and men.
An SPPB score lower than 10 is predictive of all-cause mortality. The systematic implementation of the SPPB in clinical practice settings may provide useful prognostic information about the risk of all-cause mortality. Moreover, the SPPB could be used as a surrogate endpoint of all-cause mortality in trials needing to quantify benefit and health improvements of specific treatments or rehabilitation programs. The study protocol was published on PROSPERO (CRD42015024916).
Background
The classical phenotype, accumulated deficit model and self-report approach of frailty were found not useful in older adults in northwest Russia. More research is needed to identify ...predictors of adverse outcomes in this population.
Aim
The aim of this study is to identify predictors of mortality, autonomy and cognitive decline in a population that is characterized by a high cardiovascular morbidity and mortality rate.
Methods
A population-based prospective cohort study of 611 community-dwelling individuals 65+. Anthropometry, medical history nutritional status were recorded. An evaluation of cognitive, physical and autonomy function, spirometry, and laboratory tests were performed. The total follow-up was 5 years. Multiple imputation, backward stepwise Cox regression analysis,
C
-statistic, risk reclassification analysis and the bootstrapping techniques were used to analyze the data.
Results
We found that the combination of increasing age, male sex, low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s and anemia was associated with mortality for people 65+. The substitution of anemia with anemia + high level of C-reactive protein (hCRP) and the addition of high brain natriuretic peptide (hBNP) levels improved the classification of older persons at risk for mortality.
Discussion/conclusion
The combination of low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s, anemia with hCRP levels and hBNP identified older persons at a higher risk for mortality. These predictors may be used for the development of a prediction model to detect older people who are at risk for adverse health outcomes in northwest Russia.
BACKGROUND: Malnutrition is associated with decreased levels of physical function, cognitive decline, and an increased risk of all-cause mortality, making it important to identify risk factors for ...malnutrition, especially in old age.
AIM: To identify factors associated with an increase and decrease in the risk of developing malnutrition, as well as to assess the impact of malnutrition and its correction on mortality in older adults.
MATERIALS AND METHODS: A prospective cohort study of a random sample of 611 people aged 65 years and older. Mini Nutritional Assessment, Geriatric Depression Scale, Mini-Mental State Examination, dynamometry, Barthel Index, chronic noncommunicable diseases, clinical blood count, C-reactive protein. 2 examinations, 9 years of total follow-up.
RESULTS: Risk factors for deterioration in nutritional status are decrease in emotional status (odds ratio 5.439; 95% confidence interval 2.79410.588), progression of autonomy decline (odds ratio 2.428; 95% confidence interval 1.3424.393), low physical function (odds ratio 2.877; 95% confidence interval 1.5775.250). A high level of physical function reduces the risk of malnutrition by 64.1%. Malnutrition increases the risk of five-year mortality by 2.7 times. A normal nutritional status reduces the risk of nine-year mortality by 50.2%. Improve nutrition status leads to a lower risk of mortality.
CONCLUSIONS: The main factors in the deterioration of nutritional status are a decrease in emotional status, loss of autonomy and a low level of physical function. Early detection of older adults with malnutrition and its correction can reduce the risk of mortality.
Highlights • The presence of two or more of the following components: poor physical performance, low muscle mass, poor lung function, and anemia (model 1) is associated with a higher risk of ...all-causes mortality in older adults • Adding B-type natriuretic peptide and replacing anemia with a combination of anemia with high C- reactive protein in model 1 allows to better identify persons with a higher risk of cardiovascular mortality compared with model 1 • Both models were externally validated in another cohort of adults 80+
BACKGROUND: Urinary incontinence worsens the psychological state of older adults, increases the risk of developing anxiety, depression, falls-related injuries, leads to a decrease in the quality of ...life, and a decrease in the level of physical activity in old age.
AIM: To assess the prevalence of urinary incontinence according to the data of the Crystal and Eucalyptus studies, to identify factors associated with the development of urinary incontinence, as well as factors that reduce the risk of urinary incontinence in old age.
MATERIALS AND METHODS: A random sample of 1007 people aged 65 and older. The main parameters: urinary incontinence, frailty, nutritional status, anemia, CRP, functional status, depression, dementia, chronic diseases, grip strength, level of physical functioning, falls. The observation time is 2.5 years.
RESULTS: According to the Eucalyptus study, urinary incontinence syndrome was detected in 48.0%, in the Crystal study in 41.2%. In 62.4% cases urinary incontinence was diagnosed for the first time. Urinary incontinence was associated with a higher prevalence of COPD, history of stroke, sensory deficits, frailty and other geriatric syndromes. Improved nutrition and increased protein intake led to the disappearance of urinary incontinence complaints in 47.7% of cases. The disappearance of complaints of urinary incontinence was associated with an improvement in the emotional status. A decline in cognitive function has been associated with an increased risk of urinary incontinence in old age.
CONCLUSIONS: Despite the high prevalence of urinary incontinence, it often remains undiagnosed. The correct wording of the question in the conversation with the patient allows to identify 30% more cases of urinary incontinence. Given the high prevalence of urinary incontinence among patients with COPD, stroke, sensory deficits, frailty and other geriatric syndromes, all patients in these groups should be purposefully asked about the presence of symptoms of urinary incontinence. Improved nutrition and increased protein intake are associated with the disappearance of urinary incontinence complaints.
In this review, we discuss about nutritional status and the role of diet and lifestyle in patients with SARS-COV-2 infection. This review speculates the importance of nutrition as a mitigation ...strategy to support immune function amid the coronavirus pandemic, identifying food groups and key nutrients of importance that may affect the outcomes of respiratory infections.
BACKGROUND: Due to the fact that the number of elderly people with cognitive disorders is steadily increasing worldwide, there is an increased interest in studying the effects of drugs of different ...pharmacological groups on cognitive function.
For many years, beta-blockers have been one of the main groups in the therapy of cardiovascular diseases. The effect of beta-blockers on cognitive function has been studied for a long time, and there is different, sometimes contradictory data on this issue.
AIM: To evaluate the incidence of cognitive impairment in elderly and to determine the associations between cognitive impairment and the beta-blockers use.
MATERIALS AND METHODS: Cross-sectional study included all patients aged 60 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 at the polyclinic No. 78 in Saint Petersburg.
Measurements: the Montreal cognitive assessment (MoCA) test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, a medication review and questionnaire.
RESULTS: The prevalence of cognitive impairment among the study participants was 71.1% (n = 138). Сognitive impairment was associated with high blood pressure and a history of stroke (p 0.05). Beta-blockers use was associated with decreased in total MoCA score, fluency (p = 0.0115), thinking (p = 0.0012), and memory (p = 0.0040). The identified association remained statistically significant after adjusting for gender, age, high blood pressure, a history of stroke, level of education, and decreased emotional background with odds ratio 2.245 (95% confidence interval 1.1564.358) for the fluency test and coefficient of regression 0.781 (95% confidence interval 1,2330,328) for delayed memory.
CONCLUSIONS: Memory impairment (coefficient of regression 0.781, 95% confidence interval 1.233 to 0.328) and decreased fluency (odds ratio 2.245; 95% confidence interval 1.1564.358) were observed in the study in the outpatient elderly patient population taking beta-blockers. The beta-blockers may lead to memory impairment. When choosing hypotensive therapy, all possible effects of beta-blockers should be considered, including the effect on cognitive status.
Thyroid paradox in older age Turusheva, Anna V.; Popova, Ksenia S.; Kinder, Daria S.
Rossijskij semejnyj vrač,
03/2024, Letnik:
28, Številka:
1
Journal Article
Recenzirano
Odprti dostop
BACKGROUND: The thyroid gland plays an important role in our body, influencing almost all metabolic processes in the body throughout life. However, literature data on the effect of decreased thyroid ...function on mortality in older people is contradictory.
AIM: To evaluate the impact of thyroid-stimulating hormone levels on 5-year survival in older adults.
MATERIALS AND METHODS: This work was carried out on the basis of the second screening of the Crystal study of community-dwelling individuals 65+ (n = 383). Main study parameters: thyroid-stimulating hormone level, blood test, lipid profile, albumin, total protein, comprehensive geriatric assessment, 5 years of follow-up.
RESULTS: A thyroid-stimulating hormone level of 3.3–10.0 mIU/L was associated with a 44.6% reduced risk of all-cause mortality (hazard ratio 0.554; 95% confidence interval 0.307–0.999) at 5 years of follow-up, regardless of the presence of non-communicable diseases and geriatric status. A thyroid-stimulating hormone level more 10.0 mIU/L is not associated with an increased risk of mortality. The lower risk of mortality in patients with high thyroid-stimulating hormone levels may be due to a larger thigh muscle circumference. After adjustment for all covariates used and thyroid-stimulating hormone level, a 1 cm increase in thigh muscle circumference was associated with a 4.5% reduction in the risk of all-cause mortality (hazard ratio 0.955; 95% confidence interval 0.932–0.979).
CONCLUSIONS: The lowest risk of all cause-mortality mortality in persons aged 65 years and older is observed with a thyroid-stimulating hormone level of 3.3–10.0 mIU/L. Thyroid-stimulating hormone level more 10.0 mIU/L is not associated with an increased risk of all cause-mortality.
In memory of Professor E.V. Frolova Kuznetsova, Olga Y.; Turusheva, Anna V.; Moiseeva, Irina E.
Rossijskij semejnyj vrač,
01/2024, Letnik:
27, Številka:
4
Journal Article
Recenzirano
Odprti dostop
This obituary is dedicated to Professor E.V. Frolova of the Department of Family Medicine, a member of the editorial board of the Russian Family Doctor Journal.
The study presented in the article was performed at the Department of Family Medicine of North-Western State Medical University named after I.I. Mechnikov. The aim of study was to assess the attitude ...of general practitioners, residents, and students towards vaccination.
Materials and methods. The study involved 22 students, 14 residents and 21 general practitioners. Participants completed a questionnaire that included questions about self-assessment of the level of knowledge in the field of vaccination, attitude towards vaccination, opinion about its effectiveness, etc. Statistical analysis was performed using the software SPSS 20.0 (SPSS Inc., Chicago, IL, USA) and MedCalc 11.5.00 (Medcalc Software, Oostende). The Chi-square test was used to assess intergroup differences.
Results and discussion. 61% of the participants rated their own level of knowledge in the field of vaccine prevention as good, 21% as satisfactory and 5% as excellent. The most confident in their level of knowledge were students, in the second place residents and in the third place doctors (p 0.05). 90% of respondents identified their attitude to vaccination as positive. 95.5% of students, 85.7% of residents and 76.2% of doctors noted that vaccination is necessary (mandatory). The effectiveness of vaccination is considered high by 86% of participants. When asked whether the respondents do preventive vaccinations for themselves and their children, the majority chose the options Yes, within the national calendar plus additional and all within the national calendar (51% and 39%, respectively).
Conclusion. The attitude of the surveyed doctors, residents and students to vaccination is mostly positive, the majority of respondents assess the effectiveness of vaccination as high. Most respondents are vaccinated in accordance with the national vaccination schedule, a large proportion of respondents also do vaccinations that are not included in the national schedule. Almost all respondents recommend preventive vaccinations to patients.
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