Nasrin Rezaee, Mohammad Abbasi, Sally Pezaro
et al.
Abstract Background The dual vulnerability inherent in advanced age and mental illness makes the provision of dignified care critical. However, current literature has given limited attention to identifying the specific threats and compromises to dignity experienced by older adults living with mental health conditions. The aim of this study was to investigate nurses’ perceptions of threats to dignified care for older people with mental illness. Methods A qualitative interview study was conducted. Semi-structured and individual interviews with nurses (n = 27) were undertaken. Content analysis was used to make sense of the data collected. Results Threats to dignified care for older people included unavoidable personal context, inadequate organizational infrastructure, and sociocultural traumatic wounds. The first category included the traumatic nature of the illness and being a victim of ageism. The second category included lack of necessary physical space and absence of integrated end-of-life care. The third category included the dominance of culturally rooted explanatory models of illness, lack of family support, and living in an ignorant society. The reports of, and threats of, violence and abuse directed towards older people are particularly concerning. Conclusions Sociocultural dynamics pose a direct challenge to the dignity of older individuals, often culminating in the threat of undignified care. At the heart of this issue are several core influences: the effects of culturally rooted explanatory models of illness, the presence of insufficient family support, and the pervasive consequences of inhabiting a society marked by traumatic historical and cultural wounds. These components are critical determinants of the quality of dignified care received by older adults. Consequently, a focused combination of educational and sociocultural interventions is urgently needed to dismantle the cultural stigma and prejudice evident within this care context.
ObjectiveDespite high recanalization rates with mechanical thrombectomy (MT) for acute ischemic stroke (AIS), functional outcomes remain variable. Systemic inflammation is a key driver of secondary brain injury post-reperfusion. The systemic immune-inflammation index (SII), calculated as (platelet count × neutrophil count)/lymphocyte count, integrates multiple inflammatory pathways and has shown prognostic value in cardiovascular diseases and stroke treated with intravenous thrombolysis. However, its role in predicting outcomes specifically for AIS patients undergoing MT remains underexplored. This study aimed to develop and validate an SII-based model for predicting 90-day functional outcomes after MT and to compare its performance with traditional inflammatory biomarkers, namely neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR).MethodsWe retrospectively analyzed data from 387 AIS patients treated with MT. The cohort had a median age of 68 years [interquartile range (IQR): 59–75], 67.2% were male, and the median time from stroke onset to thrombectomy was 340 min (IQR: 242.5–465.5). Inflammatory markers were measured at admission, such as SII, platelet lymphocyte ratio (PLR), neutrophil lymphocyte ratio (NLR) and 90-day modified Rankin Scale (mRS) scores. Patients were divided into good (90-day mRS ≤ 2; n = 151) and poor (mRS > 2; n = 236) outcome groups. We constructed and compared four logistic regression models: clinical baseline, baseline + SII, baseline + PLR, and baseline + NLR. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration, and decision curve analysis (DCA).ResultsSII alone showed higher predictive accuracy (AUC: 0.834) than PLR or NLR. The optimal model (baseline + SII) achieved an AUC of 0.863, significantly improving outcome prediction over the baseline model (AUC: 0.655). Shapley Additive exPlanations (SHAP) analysis confirmed SII as the most influential variable (74.2% contribution). The model demonstrated good calibration and clinical utility across a range of probability thresholds.ConclusionA model incorporating the SII provides superior accuracy for predicting 90-day functional outcome after MT compared to models using NLR or PLR. As an easily obtainable composite biomarker, SII enhances risk stratification and could aid early clinical decision-making for AIS patients undergoing endovascular therapy.
Geriatrics rely on their medications to keep them healthy, but complex medication schedules can lead to mistakes like missing doses, taking incorrect amounts, or taking medicines at the wrong times. These mistakes could lead to unnecessary doctor or hospital visits, illness and even death. Hence there is a need to design a Medication Dispensing Device that can help Geriatrics to take medication on schedule. This would prevent unplanned hospital or doctor visits related to incorrect medication use. This paper proposes a design of a smart device which dispenses the medications on the prescribed schedule.
Abstract Background The ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) (NHHR) served as a novel comprehensive lipid indicator. This study aimed to explore the association between NHHR and the incidence of cardiometabolic multimorbidity (CMM). Methods This study included 8191 individuals from the China Health and Retirement Longitudinal Study (CHARLS) database. We used multivariable cox proportional hazards regression, logistic regression, and restricted cubic splines (RCS) analysis to evaluate the association between NHHR and CMM. Subgroup analyses and interaction tests were also performed. Results The incidences of CMM among participants in quartiles (Q) 1–4 of NHHR were 7.03%, 8.3%, 10.06%, and 16.55%, respectively. The NHHR was significantly higher in individuals with CMM compared to those without CMM (P < 0.001). When assessed as a continuous variable, NHHR was independently associated with the risk of CMM, as demonstrated by both multivariable cox proportional hazards regression analysis (HR = 1.05, 95% CI = 1.02–1.07, P < 0.001) and logistic regression analysis (OR = 1.09, 95% CI = 1.04–1.15, P < 0.001). Compared to individuals in the lowest quartiles of the NHHR (Q1), the risk of CMM in the highest quartiles (Q4) was increased by 1.25-fold according to multivariable cox proportional hazards regression analysis (HR = 2.25, 95% CI = 1.73–2.93, P < 0.001) and by 1.48-fold according to logistic regression analysis (OR = 2.48, 95% CI = 1.86–3.31, P < 0.001). This association was consistent across nearly all subgroups. RCS analysis revealed a significant nonlinear association between NHHR and CMM. Additionally, the predictive ability of NHHR for CMM was 0.613, which was superior to that of both HDL-C and non-HDL-C (P < 0.05). Furthermore, the composite variable comprising NHHR and other traditional risk factors exhibited the highest predictive value (C statistic = 0.679). Conclusion A higher NHHR was closely associated with an increased risk of CMM. Further studies on NHHR could be beneficial for preventing and treating CMM.
Mohammad Ismail Hajary Sagor, Qiuran Wang, Junshu Wang
et al.
Abstract Pyroptosis, a programmed form of cell death, typically increases during the atherosclerosis development. Cyclodextrins are oligosaccharides with anti-atherosclerotic properties. Therefore, the present study aims to explore the role of methyl-ß-cyclodextrin (Mß-CD), a representative of cyclodextrin, in suppressing the development of atherosclerosis. Atherosclerosis animal and cell models were established by feeding ApoE −/− mice a high-fat diet for 12 weeks and by inducing oxidized low-density lipoprotein (ox-LDL) (75 µg/mL for 24 h) in rat vascular smooth muscle cells (VSMCs), respectively. Meanwhile, Mß-CD (2.0 g/kg, twice a week in vivo and 5mM in vitro) was used to manipulate GSDMD-mediated pyroptosis.The present study revealed a reduction in atherosclerotic plaques in the aorta (19.46 ± 2.38% vs. 8.10 ± 1.28%,P < 0.01), accompanied by a decrease in the number of CD68+ cells in the aortic sinus of atherosclerotic mice following Mß-CD intervention. Additionally, there were reduced levels of lipids and cholesterol, as well as lower levels of IL-1ß and IL-18 cytokines, alongside decreased activation of the TLR4/NF-κB/NLRP3 pathway. This resulted in decreased pyroptosis proteins in both in vivo (GSDMD-NT: 1.06 ± 0.24 vs. 0.26 ± 0.03, P < 0.01) and in vitro (GSDMD-NT: 1.37 ± 0.15 vs. 0.62 ± 0.14, P < 0.01) models after Mß-CD treatment. Moreover, the number of PI-positive cells was reduced in the atherosclerotic cell model after treatment with Mß-CD. This study provides evidence that Mß-CD may reduce atherosclerosis by inhibiting the TLR4/NF-κB/NLRP3 pathway and GSDMD-mediated pyroptosis, highlighting the need for further investigation of Mß-CD as a potential treatment option for atherosclerosis.
Selman Bolukbasi, Nilufer Demiral Yilmaz, Fisun Senuzun Aykar
et al.
Abstract Background This study aims to assess social workers’ educational needs in geriatric competencies and their attitudes toward older adults, providing insights for the development of a targeted training program. Methods This cross-sectional study was conducted with 1,619 social workers. Data were collected using the Geriatric Social Work Competency Scale and the UCLA Geriatric Attitudes Scale and analyzed using IBM SPSS Statistics 26.0. The study received ethics committee approval from the Medical Research Ethics Committee of Ege University (Decision No. 21–5.1T/63, dated May 27, 2021). Results The study included 1,619 social workers, of whom 53.8% were women, with a median age of 32 years. The findings from the Geriatric Social Work Competency Scale revealed that social workers’ geriatric competencies were relatively low. A negative correlation was found between age and competency, whereas professional experience, as well as the subscales of values, assessment, and intervention, showed a positive correlation with competency. Additionally, the number of older adults with whom the social workers lived positively influenced their competency. The UCLA Geriatric Attitudes Scale indicated that social workers’ age was negatively correlated with their attitudes toward older adults, while professional experience and participation in in-service training on aging had a positive effect on their attitudes. Conclusion This study emphasizes the importance of developing a specialized training program to enhance social workers’ geriatric competencies and attitudes toward older adults. Key factors such as age, professional experience, in-service training, and personal interactions with older adults significantly influence social workers’ effectiveness. Tailored training initiatives that focus on geriatric knowledge, positive attitudes, and practical skills will better equip social workers to meet the demands of an aging society.
Anna M. Imiela, Elżbieta Kozak-Szkopek, Katarzyna Kurnicka
et al.
Abstract Introduction Post-pulmonary embolism syndrome (PPES) is an emerging phenomenon and a major complication of acute pulmonary embolism (APE). The pathogenesis of PPES is complex and multifactorial, and involves clinical, laboratory, and echocardiographic findings. A major component of PPES is persistent dyspnea, along with other symptoms such as fatigue, chest pain, lightheadedness, and/or syncope, persisting for more than 3-months after APE. Despite extensive research on PPES, there is a limited understanding of its course and management in the elderly population. The Vulnerable Elders Survey (VES-13), a tool used to identify health impairment risks, is specifically employed for patients aged≥ 60 years. Aim This study aimed to identify elderly survivors of APE who are at a higher risk of developing PPES, thereby guiding more targeted interventions. Patients and methods This study included 241 patients aged ≥60 years who were diagnosed with APE. All patients with APE were diagnosed and managed according to the European Society of Cardiology (ESC) guidelines, presented with dyspnea at admission, and were followed up for at least 3-months after discharge. Clinical evaluation, biochemical tests, the VES-13 score, and transthoracic echocardiography (TTE) were evaluated at baseline. After 3-months period, the routine evaluation of persistent dyspnea was assessed during the follow-up visit in the outpatient clinic. The primary endpoint was dyspnea 3-months after the acute episode. Results A total of 179 patients were included. Persistent dyspnea was observed in 42 subjects (23,4%). There were no significant differences in age, sex and BMI between the groups. Patients with persistent dyspnea after 3-months, as compared to patients without dyspnea, were significantly characterized as follows: -Higher VES-13 score [median 5.5 (2;10) vs. 1 (0;4) score] -Longer length of stay [median 9 (6;16) vs. 6 (5;9) days] -Higher sPESI scores [median 2 (1;2.5) vs. 1 (0;2) points] -Lower TAPSE/PASP [median 0.44 (0.25;0.7) vs. 28 (25.4;30.9) mm/mmHg]. -Higher urea concentrations [median 42.4 (35.3;67.8) vs 0.56 (0.38;0.76) mg/dl] -Higher neutrophil-to-lymphocyte ratio (NLR) [median 5.5 (3;8.2) vs. 3.7 (2.6;6.3] ) Logistic regression analysis identified the VES-13 score and NLR as significant independent risk factors for 3-month mortality (the regression model included. sPESI, VES-13 score (points), length of stay (days), urea level (mg/dl), NLR, TAPSE/PASP, Norton scale (points), Barthel scale (points), Activities of Daily Living (ADL, points), and coronary artery disease. Conclusions The VES-13 score could be particularly valuable in predicting dyspnea 3-months after APE. Elderly survivors of APE with higher baseline VES-13 scores should be closely monitored after discharge. This proactive approach can help identify patients at a greater risk of developing persistent dyspnea, enabling timely intervention and potentially improving outcomes.
Yıldız ERDOĞANOĞLU, Birgül Elmas OKTAR, Sinem SEL
et al.
Objective: This study was conducted to investigate the effects of reaction time (RT) exercises on functional independence, static balance, fall risk, upper and lower extremity RT, and quality of life in older adults. Methods: Forty participants aged 65-77 years were included in the study. Participants’ functional independence was evaluated using the Functional Independence Scale, static balance using the Single-Leg-Squat Test, fall risks using the Morse Fall Scale, lower- and upper-extremity RT’s using the Light Trainer Flash Light Exercise System (Model LTV2, Turkey, 2017), and their quality of life using the Short Form-36. RT exercises were performed using the Light Trainer Flash Light Exercise System for six weeks, three days a week. Measurements were repeated after the treatment. Results: In the older adults examined, there was a significant difference between before and after the 6-week exercise protocol in functional independence, static balance, fall risk, upper- and lower-extremity RT, and quality of life (p<0.05). Conclusion: The study showed that a 6-week RT exercise program had positive effects on functional independence, static balance, fall risk, upper- and lower-extremity RT, and quality of life in older adults. The results showed that reaction-time exercises can be added to rehabilitation protocols for older adults and can be used in clinical settings.
Delphine Bourmorck, Marie de Saint-Hubert, Marianne Desmedt
et al.
Abstract Background Older patients are increasingly showing multi-comorbidities, including advanced chronic diseases. When admitted to the emergency department (ED), the decision to pursue life-prolonging treatments or to initiate a palliative care approach is a challenge for clinicians. We test for the first time the diagnostic accuracy of the Supportive and Palliative Care Indicators Tool (SPICT) in the ED to identify older patients at risk of deteriorating and dying, and timely address palliative care needs. Methods We conducted a prospective bicentric cohort study on 352 older patients (≥ 75 years) admitted to two EDs in Belgium between December 2019 and March 2020 and between August and November 2020. SPICT (French version, 2019) variables were collected during the patients’ admission to the ED, along with socio-demographic, medical and functional data. The palliative profile was defined as a positive SPICT assessment. Survival, symptoms and health degradation (≥ 1 point in ADL Katz score or institutionalisation and death) were followed at 12 months by phone. Main accuracy measures were sensitivity, specificity and likelihood ratios (LR) as well as cox regression, survival analysis using the Kaplan Meier method, and ordinal regression. Results Out of 352 patients included in the study (mean age 83 ± 5.5 years, 43% male), 167 patients (47%) had a positive SPICT profile. At one year follow up, SPICT positive patients presented significantly more health degradation (72%) compared with SPICT negative patients (35%, p < 0.001). SPICT positivity was correlated with 1-year health degradation (OR 4.9; p < 0.001). The sensitivity and specificity of SPICT to predict health degradation were 0.65 (95%CI, 0.57–0.73) and 0.72 (95%CI, 0.64–0.80) respectively, with a negative LR of 0.48 (95%CI, 0.38–0.60) and a positive LR of 2.37 (1.78–3.16). The survival time was shorter in SPICT positive patients than in SPICT negative ones (p < 0.001), the former having a higher 1-year mortality rate (HR = 4.21; p < 0.001). Conclusions SPICT successfully identifies older patients at high risk of health degradation and death. It can support emergency clinicians to identify older patients with a palliative profile and subsequently initiate a palliative care approach with a discussion on goals of care.
Thi Phuong Thao Tran, Ngoc Minh Luu, Thi Tra Bui
et al.
Abstract Background Physical activity (PA) changes throughout an individual’s life, but the association between such changes and cancer risk seems to be overlooked in the literature. Thus, this study aimed to examine the association between the trajectories of PA frequency and cancer incidence among middle-aged Korean adults. Methods A total of 1,476,335 eligible participants (992,151 men and 484,184 women) aged ≥40 years from the National Health Insurance Service cohort (2002–2018) were included. Assessment of PA frequency was a self-reported measure, based on the question: “How many times per week do you perform exercise that makes you sweat?”. PA frequency trajectories (i.e., trajectory classes of change in PA frequency) from 2002 to 2008 were identified using group-based trajectory modeling. Cox proportional hazards regression was used to assess the associations between the PA trajectories and cancer incidence. Results Five PA frequency trajectories over 7 years were identified: persistently low (men:73.5%; women:74.7%), persistently moderate (men:16.2%; women:14.6%), high-to-low (men:3.9%; women:3.7%), low-to-high (men:3.5%; women:3.8%), and persistently high (men:2.9%; women:3.3%). Compared with persistently low frequency, maintaining a high PA frequency was associated with a lower risk of all cancers (Hazard ratio (HR) = 0.92, 95%CI = 0.87–0.98) and breast cancer (HR = 0.82, 95%CI = 0.70–0.96) among women. There was a lower risk for thyroid cancer among men in the high-to-low (HR = 0.83, 95%CI = 0.71–0.98), low-to-high (HR = 0.80, 95%CI = 0.67–0.96), and high PA trajectories (HR = 0.82, 95%CI = 0.68–0.99). There was a significant association between moderate trajectory and lung cancer in men (HR = 0.88, 95%CI = 0.80–0.95), in both smoking and non-smoking men. Conclusion Long-term persistent high frequency of PA as part of the daily routine should be widely promoted and encouraged to reduce the risk for all cancer development in women.
Karin Erwander, Kjell Ivarsson, Mona Landin Olsson
et al.
Introduction: The Emergency Department (ED) is a common route to hospitalization for critically ill and older adults. Older patients are admitted to hospital at a higher rate and have longer length of stay (LOS) when hospitalized. To be able to confront an increasing aging population, meet their medical needs and influence rising costs of health care, there is a need to focus on the older population. In Scandinavia, few studies are made that focus on the geriatric population at the ED. It is essential to early identify risk factors for hospitalization at the ED to improve the medical care for older adults and the influence of prehospital comorbidities. Methods: This is a retrospective observational study of older adults visiting the ED in southwest Sweden. The aim of this study was to examine if routinely collected patient demographics and prehospital comorbidities were associated with ED disposition and in-patient process outcomes. The data collection was generated from the Regional Healthcare Information Platform. The variables extracted were age, gender, ED-visits, LOS at ED, admission rate, in-hospital LOS and comorbidities before visiting the ED. Results: A total of 15 528 patients aged ≥ 65 years visited the ED during 2016, 8 098 (52%) were female and 7 430 (48%) were male, 6 631 (41%) were 65–74 years of age, 5 585 (36%) were 75–84 years of age and 3 612 (23%) were 85 years or older. LOS at the ED were over 4 hours for 45% of the population. Patients aged 85 or older had a Hazard ratio of 2.56 (CI 2.33–2.82) for admission and patients with HF had a Hazard ratio of 1.75 (CI 1.46–2.09). Conclusion: Patients with old age, HF and comorbidities as prehospital conditions have a significant higher risk for admission to the hospital and a longer in-hospital stay regardless reason for the ED visit. The awareness of this could help physicians identify older patients with high risk for admission and early initiate an admission plan to be able to reduce LOS at the ED.
Geriatrics, Medical emergencies. Critical care. Intensive care. First aid
Abstract Background To establish a system for assessing pre-chronic disease status (PCDS) whereby changes in biomolecule levels occur before the appearance of physical damage to body organs. We based our study on the common biomarkers of aging, disease and end-of-life processes. Methods The red blood cell count as well as levels of albumin, creatinine and aspartate aminotransferase were used as indicators for measurement. The basic premise for determining PCDS was that the measured value was outside the reference range for a healthy individual. A binary outcome was determined according to reference range given by the laboratory undertaking the measurements. The Biological Age Index (BAI) was used to ascertain PCDS. Results The four indictors that we chose were sensitive for end-of-life and aging. The BAI score for each age group increased significantly with increasing age. The BAI score of patients with cardiac disease, cerebrovascular disease, cancer or chronic obstructive pulmonary disease were mostly higher than those in healthy age-matched people. Conclusion A system for assessing PCDS centered on biomolecular detection and independent of the pathologic diagnosis could be effective.
Abstract Background There is a evidence of negative association between loneliness and sleep quality in older adults. However, little is known regarding the relationship between loneliness and sleep quality among Chinese rural older adults. This study examined the associations of loneliness and sleep quality in a cross-sectional study of older adults. Methods A face-to-face questionnaire survey was conducted among 1658 rural older adults in Shandong Province, China. Loneliness was assessed using the University of California at Los Angeles Loneliness Scale. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Ordinal logistic regression was conducted to examine the association of loneliness and sleep quality after adjustment for multiple confounding variables. Results After variables such as age, marriage, education, occupation, economic income, family relationships, living arrangement, smoking behavior, alcohol consumption, chronic disease experience, and quality of life were controlled in a multivariable analysis, poor sleep quality was still associated with loneliness in the rural older population. Conclusion This finding implied an adverse effect of sleep quality on the loneliness of older adults. Poor sleep quality was associated with increased odds of loneliness in Chinese rural older adults. Sleep-based interventions should be developed to prevent loneliness in rural older adults in China.
Hope E.M. Schwartz, Camden P. Bay, Brittany M. McFeeley
et al.
Abstract Introduction Converging evidence suggests that increasing healthy behaviors may slow or prevent cognitive decline. Methods We piloted a six‐month, randomized, controlled investigation of 40 patients with mild dementia, mild cognitive impairment, or subjective cognitive decline. The intervention consisted of weekly motivational interviewing phone calls and three visits with a “Brain Health Champion” health coach, who guided participants to achieve personalized goals. Changes in behavior were measured using validated questionnaires. Results Compared with the standard‐of‐care control group, Brain Health Champion participants had statistically significant and clinically meaningful increases in physical activity (Cohen's d = 1.37, P < .001), adherence to the Mediterranean diet (Cohen's d = 0.87, P = .016), cognitive/social activity (Cohen's d = 1.09, P = .003), and quality of life (Cohen's d = 1.23, P < .001). The magnitude of behavior change strongly predicted improvement in quality of life. Discussion Our results demonstrate the feasibility and potential efficacy of a health coaching approach in changing health behaviors in cognitively impaired and at‐risk patients.
Neurology. Diseases of the nervous system, Geriatrics
Clare M. McNally, MPhil(Dent), Renuka Visvanathan, MBBS, PhD, Sharon Liberali, DClinDent(SND)
et al.
Background: Antibiotic prophylaxis before dental treatment is routinely recommended by orthopaedic surgeons to prevent prosthetic joint infection (PJI). This recommendation is at odds with current guidelines.
Methods: A postal survey of 9 checkbox or short-answer questions was completed by 633 orthopaedic surgeons.
Results: The majority of respondents (n = 186 of 260, 72%) believe that antibiotic prophylaxis is required indefinitely for dental treatment. A small number (n = 43, 15%) seek a dentist's opinion before elective joint replacement. The surgeons reported low numbers of PJIs, although 24% (n = 68 of 280) believed that they were associated with dental treatment.
Conclusions: Australian orthopaedic surgeons continue to recommend antibiotic prophylaxis for dental treatment. The recording of PJI in relation to dental procedures into clinical registries would enable the development of consistent guidelines between professional groups responsible for the care of this patient group.
Janusz Śmigielski, Joanna Ruszkowska, Walerian Piotrowski
et al.
Objectives: The role of leisure-time physical activity in reducing all-cause and cardiovascular mortality is well explored. The knowledge on occupational and commuting physical activity continues to be ambiguous and misleading. The aim of the study is to assess the influence of different kinds of physical activity on cardiovascular mortality risk in men. Material and Methods: Data analysis on physical activity level and other selected cardiovascular risk factors acquired from 3577 men in the age between 50–80 years who participated in the National Multicenter Health Survey WOBASZ (Wieloośrodkowe Ogólnopolskie Badanie Stanu Zdrowia), Poland (2003–2005) was linked with male mortality in 2004–2009. Data about causes of deaths were obtained from the Central Statistical Office and the Population Electronic Register. Results: Among males aged 50–59 years, the strongest risk factor was living in large settlements and provincial capitals as a place of residence and the most protective factor was occupational physical activity. In the age group 60–69 years and 70–80 years, the strongest protective effect was observed for leisure-time physical activity. In men aged between 70–80 years (unlike in the 50–59 years age group), the protective effect of large settlements and provincial capitals as a place of residence was noted. Conclusions: Occupational physical activity significantly reduced cardiovascular mortality in men aged 50–69 years, while for leisure-time activity the positive effect was observed in age group 60–69 years and 70–80 years. On the other hand, for the inhabitants of large settlements and provincial capitals, significantly higher risk of cardiovascular mortality in the age group 50–69 years and lower risk in the age group ≥ 70 years was noted, both in comparison with smaller places of residence.
Sheng-Ying Yang, Pei-Hsuan Weng, Jen-Hau Chen
et al.
Leisure activities have been associated with a decreased risk of dementia. However, to date, no study has explored how apolipoprotein E (ApoE) e4 status or vascular risk factors modified the association between leisure activities and dementia risks.
Methods: This case–control study recruited patients (age ≥ 60 years) with Alzheimer's disease (AD; n = 292) and vascular dementia (VaD; n = 144) and healthy controls (n = 506) from three teaching hospitals in Taiwan between 2007 and 2010. Information on patient's leisure activities were obtained through a questionnaire. Conditional logistic regression models were used to assess the association of leisure activities and ApoE e4 status with the risk of dementia.
Results: High-frequency physical activity was associated with a decreased risk of AD [adjusted odds ratio (AOR) = 0.45], and the results become more evident among ApoE e4 carriers with AD (AOR = 0.30) and VaD (AOR = 0.26). Similar findings were observed for cognitive (AOR = 0.42) and social activities (AOR = 0.55) for AD. High-frequency physical, cognitive, and social activities were associated with a decreased risk of VaD (AOR = 0.29–0.60). Physical and social activities significantly interacted with each other on the risk of VaD (pinteraction = 0.04).
Conclusion: Physical activity consistently protects against AD and VaD. Significant interactions were identified across different types of leisure activities in lowering dementia risk.