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The Pietà study: epidemiological investigation on successful brain aging in Caeté (MG), Brazil. Methods and baseline cohort characteristics
Caramelli, Paulo;Barbosa, Maira Tonidandel;Sakurai, Emília;Santos, Etelvina Lucas dos;Beato, Rogério Gomes;Machado, Jo?o Carlos Barbosa;Guimar?es, Henrique Cerqueira;Teixeira, Antonio Lucio;
Arquivos de Neuro-Psiquiatria , 2011, DOI: 10.1590/S0004-282X2011000500002
Abstract: objectives: to present the methods and baseline characteristics of the pietà study, a population-based survey investigating successful brain aging in the oldest-old. method: the study was conducted in caeté (mg), brazil. in 2007, 1,251 individuals aged 75+ years were living in the city and were invited to participate. participants responded to a general health questionnaire and were submitted to clinical, neurological, cognitive, psychiatric and functional evaluations. a subgroup was submitted to neuropsychological testing, blood tests and magnetic resonance of the skull. individuals were classified as having cognitive impairment-no dementia, dementia, parkinsonism, psychiatric disorders or successful brain aging. results: we evaluated 639 individuals (51.1% of the target population; 64% women), aged 81.4±5.2 years and with 2.7±2.6 years of schooling. almost 30% of the elderly were illiterates and 82.1% belonged to middle/middle-low socioeconomic levels. almost 50% were widows, but only 14.3% were living alone. conclusion: the pietà cohort is representative of the oldest-old brazilian population. we believe the results of the study may contribute to increase our knowledge about healthy and pathological brain aging in the oldest-old.
Birth cohort differences in physical functioning levels among elderly Brazilians: findings from the Bambuí cohort study of aging (1997-2008)
Oliveira, Cesar Messias de;Lima-Costa, Maria Fernanda;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001500015
Abstract: the aim of this study was to investigate the cohort differences in physical functioning levels among the older (cohort members born in 1916-1926 and in 1927-1937) participants of the bambuí cohort study of aging. the data came from participants aged 71-81 who took part at baseline in 1997 (n = 491) and in the 11th wave in 2008 (n = 620). the physical functioning variables included the following self-reported measures: activities of daily living, the instrumental activities of daily living and mobility. poisson regression analyses were used to investigate the cohort year differences in physical functioning levels. overall, the young cohort (2008) showed better levels of physical functioning compared to the older cohort (1997) across all three measures of physical functioning used.
Birth cohort differences in hypertension control in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)
Firmo, Josélia O. A.;Peixoto, Sérgio Viana;Loyola Filho, Ant?nio Ignácio de;Uch?a, Elizabeth;Lima-Costa, Maria Fernanda;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001500013
Abstract: we examined for cohort differences in hypertension control between participants in the bambuí cohort study of aging of aging born 1916-1926 and 1927-1937. participants included hypertensive elderly aged 71-81 at baseline (n = 313) and at 11th wave follow up (n = 484). prevalence of hypertension awareness (70.9% and 81.2%, respectively), median medical appointments in previous 12 months (2 and 3, respectively) and antihypertensive drug use (74.4% and 90.7% respectively) increased significantly from older to younger cohort. however, prevalence of appropriately controlled hypertension among those treated (< 140/< 90mmhg) was similar in both cohorts (44.6% and 40.1%, p = 0.255). multivariate analysis returned schooling as the only factor independently associated with appropriately controlled hypertension. despite increased medical appointments and drug use in the recent cohort, the prevalence of appropriately controlled hypertension remained as low as in the older cohort.
Trajectories of cognitive decline over 10 years in a Brazilian elderly population: the Bambuí cohort study of aging
Castro-Costa, Erico;Dewey, Michael E.;Uch?a, Elizabeth;Firmo, Josélia O. A.;Lima-Costa, Maria Fernanda;Stewart, Robert;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001500004
Abstract: few population-based studies have examined long term cognitive trajectory, and these studies were conducted in high income countries. we investigated the association of age, gender and education with 10-year cognitive trajectory in a well-defined population of elderly using data from the bambuí cohort study of aging, in brazil. cognition was measured using the mini- mental state examination (mmse). cohort members underwent annual follow-ups. this analysis was based on 12,206 mmse measurements from 1,461 (91%) baseline participants. we used mixed effects models to study mmse as outcome. the key findings from this analysis are that women and people with a higher schooling level at baseline had high scores of mmse, while older participants started off lower. regarding cognitive decline, women, older people and those with a higher schooling level declined faster.
Frailty, HIV Infection, and Mortality in an Aging Cohort of Injection Drug Users  [PDF]
Damani A. Piggott, Abimereki D. Muzaale, Shruti H. Mehta, Todd T. Brown, Kushang V. Patel, Sean X. Leng, Gregory D. Kirk
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0054910
Abstract: Background Frailty is associated with morbidity and premature mortality among elderly HIV-uninfected adults, but the determinants and consequences of frailty in HIV-infected populations remain unclear. We evaluated the correlates of frailty, and the impact of frailty on mortality in a cohort of aging injection drug users (IDUs). Methods Frailty was assessed using standard criteria among HIV-infected and uninfected IDUs in 6-month intervals from 2005 to 2008. Generalized linear mixed-model analyses assessed correlates of frailty. Cox proportional hazards models estimated risk for all-cause mortality. Results Of 1230 participants at baseline, the median age was 48 years and 29% were HIV-infected; the frailty prevalence was 12.3%. In multivariable analysis of 3,365 frailty measures, HIV-infected IDUs had an increased likelihood of frailty (OR, 1.66; 95% CI, 1.24–2.21) compared to HIV-uninfected IDUs; the association was strongest (OR, 2.37; 95% CI, 1.62–3.48) among HIV-infected IDUs with advanced HIV disease (CD4<350 cells/mm3 and detectable HIV RNA). No significant association was seen with less advanced disease. Sociodemographic factors, comorbidity, depressive symptoms, and prescription drug abuse were also independently associated with frailty. Mortality risk was increased with frailty alone (HR 2.63, 95% CI, 1.23–5.66), HIV infection alone (HR 3.29, 95% CI, 1.85–5.88), and being both HIV-infected and frail (HR, 7.06; 95%CI 3.49–14.3). Conclusion Frailty was strongly associated with advanced HIV disease, but IDUs with well-controlled HIV had a similar prevalence to HIV-uninfected IDUs. Frailty was independently associated with mortality, with a marked increase in mortality risk for IDUs with both frailty and HIV infection.
Design and baseline characteristics of a prospective cohort study for determinants of osteoporotic fracture in community-dwelling elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Study
Masayuki Iki, Yuki Fujita, Junko Tamaki, Katsuyasu Kouda, Akiko Yura, Eiko Kadowaki, Yuho Sato, Jong-Seong Moon, Nozomi Okamoto, Norio Kurumatani, Study Group for Functioning Capacity and Quality of Life in Elderly Japanese (Fujiwara-kyo Study Group)
BMC Musculoskeletal Disorders , 2009, DOI: 10.1186/1471-2474-10-165
Abstract: Design: A community-based single-centre prospective cohort study with at least a 5-year follow-upSubjects: All the male participants of the Fujiwara-kyo study who were living in the four cities studied, aged 65 years and older, and able to walk without aid from others.Primary outcome: Incidence of osteoporotic fractures including vertebral and clinical non-vertebral fractures.Additional outcomes: Change in bone mineral density (BMD), change in hip geometry, onset of receiving benefits from Long-term Care Insurance (LCI), health-related quality of life, and mortality.Baseline measurements: BMD at the lumbar spine (LS) and hip (TH), hip geometry, vertebral deformity assessment, bone turnover markers, physical and cognitive performance, various medical and lifestyle factors, and geriatric psychosocial measures confirmed by interviews based on self-administrated questionnaires.Outcome surveillance: Annual mail surveys and a follow-up survey at the fifth year comprising similar items to the baseline study will be used to determine the outcomes. Receipt of benefits from LCI and mortality will be obtained from the city governments.Current status: The baseline study was conducted for 2174 eligible men, and 2012 completed the study and were eligible for follow-up. Prevalence rates of osteoporosis (BMD 2.5 SD or more below the young adult mean (YAM)) and low BMD (BMD 1 SD or more below YAM) in at least one of LS and TH were calculated to be 4.4% and 41.8%, respectively. The proportion of men with low BMD only at TH showed a significant increasing trend with aging (p < 0.0001) while that only at LS showed a decreasing trend (p = 0.0386). The prevalence rate of osteoporosis was underestimated when diagnosed using only BMD at LS. Other baseline measurements were successfully obtained.FORMEN baseline study was performed as designed and the FORMEN cohort study was successfully launched.Osteoporotic fracture is a significant and increasing public health burden, for men as well as w
Social Determinants of Active Aging: Differences in Mortality and the Loss of Healthy Life between Different Income Levels among Older Japanese in the AGES Cohort Study  [PDF]
Hiroshi Hirai,Katsunori Kondo,Ichiro Kawachi
Current Gerontology and Geriatrics Research , 2012, DOI: 10.1155/2012/701583
Abstract: We examined the relationship between income, mortality, and loss of years of healthy life in a sample of older persons in Japan. We analyzed 22,829 persons aged 65 or older who were functionally independent at baseline as a part of the Aichi Gerontological Evaluation Study (AGES). Two outcome measures were adopted, mortality and loss of healthy life. Independent variables were income level and age. The occurrence of mortality and need for care during these 1,461 days were tracked. Cox regressions were used to calculate the hazard ratio for mortality and loss of healthy life by income level. We found that people with lower incomes were more likely than those with higher incomes to report worse health. For the overall sample, using the governmental administrative data, the hazard ratios of mortality and loss of healthy life-years comparing the lowest to the highest income level were 3.50 for men and 2.48 for women for mortality and 3.71 for men and 2.27 for women for loss of healthy life. When only those who responded to questions about income on the mail survey were included in the analysis, the relationships became weaker and lost statistical significance. 1. Introduction There is a well-established inverse relationship between income and health [1–7]. However, many of the studies reporting on this relationship have used mortality as an indicator of health. In evaluating health, the World Health Organization recommends using indicators that reflect quality of life (QOL), such as healthy life expectancy, which measures active aging. Active aging aims to extend healthy life expectancy and quality of life in older persons, and the quality of life is largely determined by its ability to maintain autonomy and independence [8]. Fewer studies use active aging as an endpoint because these measures, unlike measures of mortality, require investigation into the physical and cognitive functioning of surviving participants. As a result, in large-scale cohort studies it is much more difficult and costly to follow functional status over a long period than to simply follow mortality. Measuring income is a difficult issue in studies that investigate the relationship between income and health. Individuals with lower socioeconomic status (SES) tend to be less likely to respond to surveys by mail or similar means. In addition, income data are often unreliable or missing for a large part of the sample [9]. Therefore, lower income groups, which are predicted to be the least healthy, are not well represented. This underrepresentation gives rise to the possibility of
Aging cellular networks: chaperones as major participants  [PDF]
Csaba Soti,Peter Csermely
Quantitative Biology , 2006, DOI: 10.1016/j.exger.2006.05.017
Abstract: We increasingly rely on the network approach to understand the complexity of cellular functions. Chaperones (heat shock proteins) are key "networkers", which have among their functions to sequester and repair damaged protein. In order to link the network approach and chaperones with the aging process, we first summarize the properties of aging networks suggesting a "weak link theory of aging". This theory suggests that age-related random damage primarily affects the overwhelming majority of the low affinity, transient interactions (weak links) in cellular networks leading to increased noise, destabilization and diversity. These processes may be further amplified by age-specific network remodelling and by the sequestration of weakly linked cellular proteins to protein aggregates of aging cells. Chaperones are weakly linked hubs [i.e., network elements with a large number of connections] and inter-modular bridge elements of protein-protein interaction, signalling and mitochondrial networks. As aging proceeds, the increased overload of damaged proteins is an especially important element contributing to cellular disintegration and destabilization. Additionally, chaperone overload may contribute to the increase of "noise" in aging cells, which leads to an increased stochastic resonance resulting in a deficient discrimination between signals and noise. Chaperone- and other multi-target therapies, which restore the missing weak links in aging cellular networks, may emerge as important anti-aging interventions.
Protocol of the baseline assessment for the Environments for Healthy Living (EHL) Wales cohort study
Rebecca A Hill, Sinead Brophy, Huw Brunt, Mel Storey, Non E Thomas, Catherine A Thornton, Stephen Palmer, Frank Dunstan, Shantini Paranjothy, Roderick McClure, Sarah E Rodgers, Ronan A Lyons
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-150
Abstract: EHL is a longitudinal birth cohort study. We aim to recruit 1000 pregnant women in the period April 2010 to March 2013. We will examine the impact of the gestational environment (maternal health) and the postnatal environment (housing and neighbourhood conditions) on subsequent health outcomes for the infants born to these women. Data collection will commence during the participants' pregnancy, from approximately 20 weeks gestation. Participants will complete a questionnaire, undergo anthropometric measurements, wear an accelerometer, compile a food diary, and have environmental measures taken within their home. They will also be asked to consent to having a sample of umbilical cord blood taken following delivery of their baby. These data will be complemented by routinely collected electronic data such as health records from GP surgeries, hospital admissions, and child health and development records. Thereafter, participants will be visited annually for follow-up of subsequent exposures and child health outcomes.The baseline assessment of EHL will provide information concerning the impact of gestational and postnatal environments on birth outcomes and maternal and infant health. The findings can be used to inform the development of complex interventions targeted at structural, environmental factors, intended to reduce ill-health. Long-term follow-up of the cohort will focus on relationships between environmental exposures and the later development of adverse health outcomes, including obesity and diabetes.Health is the result of many interacting factors [1-3]. Foetal life and early infancy are important periods of susceptibility to environmental hazards, and exposures during early development can predispose the individual to disease such as diabetes, allergy, and asthma [4-8]. The foetus is susceptible to both historic and gestational maternal exposures via the placenta [8], such as maternal smoking and alcohol consumption. Adverse gestational environments have been
Birth cohort differences in cardiovascular risk factors in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)
Freitas, Marco Polo Dias;Loyola Filho, Ant?nio Ignácio de;Lima-Costa, Maria Fernanda;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001500011
Abstract: the aim of this study was to investigate whether cohort differences exist in the prevalence of cardiovascular risk factors among older elderly from the bambuí cohort study of aging. participants were those aged 71-81 years at two points in time a decade apart: 457 in 1997 (earlier cohort) and 553 in 2008 (recent cohort). the prevalence of hypertension (pr = 1.27; 95%ci: 1.19-1.36) and of diabetes mellitus (pr = 1.39; 95%ci: 1.06-1.83) was higher in the recent cohort compared to the earlier one, regardless of sex. the recent cohort had a lower prevalence of smoking (pr = 0.58; 95%ci: 0.42-0.80), and lower total cholesterol/hdl cholesterol ratio level (pr = 0.85; 95%ci: 0.80-0.89). there was a 136% increase in the pharmacologic treatment of diabetes and a 56% increase in pharmacologic management of hypertension in 2008 in comparison with 1997. overall, the number of cardiovascular risk factors in the recent cohort remained similar to that of the early cohort.
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