The State of aging and health in America 2004

The State of Aging and Health in America 2004 is the third annual volume in a series that presents a snapshot of the entire health and aging landscape in the United States or another area of the world. The reports are produced by the Merck Institute of Aging & Health (MIAH) and various partnership organizations that are recognized leaders in the aging field. Previous partners include the Gerontological Society of America and the Pan American Health Organization.The Merck Institute of Aging & Health (MIAH), the Centers for Disease Control and Prevention (CDC) and the Gerontological Society of America (GSA) are releasing this report to assess the health status of the growing number of older Americans and to make recommendations to improve the mental and physical health of all Americans in their later years.An Introduction to the Health of Older Americans -- The National Report Card on Healthy Aging -- The State-by-State Report Card on Healthy Aging -- Spotlight: Physical Activity and Older Americans -- Our Nation's Health Care Workforce: Is it Ready for the Graying of America? -- State Examples -- Appendix: Major Data Sources and Technical Information.200

Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study.

OBJECTIVE: To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC. METHODS: This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. RESULTS: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B=0.032, 95% confidence interval 0.015-0.049; p=0.0003) and between the duration of HIV-1 infection and NARC (B=0.039, 95% confidence interval 0.017-0.059; p=0.0005). CONCLUSIONS: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.info:eu-repo/semantics/publishedVersio

Life expectancy in Australian senior with or without cognitive impairment: the Australia Diabetes, Obesity and Lifestyle Study Wave 3

Objective: To determine prevalence of cognitive impairment (CI) and to estimate life expectancy with and without cognitive impairment in the Australian population over age 60. Method: Adults aged 60 and older participating in the 12 year follow-up of the Australia Diabetes Obesity and Lifestyle Study (AusDiab) were included in the sample (n=1666). The mean age was 69.5 years, and 46.3% of the sample was male. The Mini-Mental State Examination was used to assess cognitive impairment. Logistic regression analysis was used to determine the effect of predictor variables (age, gender, education), measured at baseline, on cognitive impairment status. The Sullivan Method was used to estimate Total Life Expectancy (TLE), Cognitively Impaired (CILE) and Cognitive Impairment-free life expectancies (CIFLE). Results: Odds of CI were greater for males than females (OR 2.1, 95% confidence interval: 1.2-3.7) and among Australians with low education levels compared with Australians with high education levels (OR 2.1, 95% confidence interval: 1.2-3.7). The odds of CI also increased each year with age (OR 1.1, (95% confidence interval: 1.0-1.1). It was found that in all age groups females have greater TLE and CIFLE when compared to their male counterparts.This research was supported by the Australian Research Council Centre of Excellence in Population Aging Research (project number CE110001029). KJA is funded by NHMRC Fellowship #1002560. We acknowledge support from the NHMRC Dementia Collaborative Research Centres. The AusDiab study co-coordinated by the Baker IDI Heart and Diabetes Institute, gratefully acknowledges the support and assistance given by: K Anstey, B Atkins, B Balkau, E Barr, A Cameron, S Chadban, M de Courten, D Dunstan, A Kavanagh, D Magliano, S Murray, N Owen, K Polkinghorne, J Shaw, T Welborn, P Zimmet and all the study participants. Also, for funding or logistical support, we are grateful to: National Health and Medical Research Council (NHMRC grants 233200 and 1007544), Australian Government Department of Health and Aging, Abbott Australasia Pty Ltd, Alphapharm Pty Ltd, Amgen Australia, AstraZeneca, Bristol-Myers Squibb, City Health Centre-Diabetes Service-Canberra, Department of Health and Community Services- Northern Territory, Department of Health and Human Services– Tasmania, Department of Health–New South Wales, Department of Health–Western Australia, Department of Health–South Australia, Department of Human Services–Victoria, Diabetes Australia, Diabetes Australia Northern Territory, Eli Lilly Australia, Estate of the Late Edward Wilson, GlaxoSmithKline, Jack Brockhoff Foundation, Janssen-Cilag, Kidney Health Australia, Marian & FH Flack Trust, Menzies Research Institute, Merck Sharp & Dohme, Novartis Pharmaceuticals, Novo Nordisk Pharmaceuticals, Pfizer Pty Ltd, Pratt Foundation, Queensland Health, Roche Diagnostics Australia, Royal Prince Alfred Hospital, Sydney, Sanofi Aventis, sanofi-synthelabo, and the Victorian Government’s OIS Program

Mendelian randomization shows a causal effect of low vitamin D on multiple sclerosis risk.

ObjectiveWe sought to estimate the causal effect of low serum 25(OH)D on multiple sclerosis (MS) susceptibility that is not confounded by environmental or lifestyle factors or subject to reverse causality.MethodsWe conducted mendelian randomization (MR) analyses using an instrumental variable (IV) comprising 3 single nucleotide polymorphisms found to be associated with serum 25(OH)D levels at genome-wide significance. We analyzed the effect of the IV on MS risk and both age at onset and disease severity in 2 separate populations using logistic regression models that controlled for sex, year of birth, smoking, education, genetic ancestry, body mass index at age 18-20 years or in 20s, a weighted genetic risk score for 110 known MS-associated variants, and the presence of one or more HLA-DRB1*15:01 alleles.ResultsFindings from MR analyses using the IV showed increasing levels of 25(OH)D are associated with a decreased risk of MS in both populations. In white, non-Hispanic members of Kaiser Permanente Northern California (1,056 MS cases and 9,015 controls), the odds ratio (OR) was 0.79 (p = 0.04, 95% confidence interval (CI): 0.64-0.99). In members of a Swedish population from the Epidemiological Investigation of Multiple Sclerosis and Genes and Environment in Multiple Sclerosis MS case-control studies (6,335 cases and 5,762 controls), the OR was 0.86 (p = 0.03, 95% CI: 0.76-0.98). A meta-analysis of the 2 populations gave a combined OR of 0.85 (p = 0.003, 95% CI: 0.76-0.94). No association was observed for age at onset or disease severity.ConclusionsThese results provide strong evidence that low serum 25(OH)D concentration is a cause of MS, independent of established risk factors

Meaningful Self-Reporting Of Quality Of Life In People Living With Dementia

The aim of this research study is to investigate the hypothesis that people living with dementia can comment meaningfully on their quality of life. A careful literature review revealed that “while it is generally agreed that any appraisal of quality of life should as far as possible rely on the individual’s own perspective, having people with dementia evaluate their own quality of life remains a much-debated issue” although the findings of many recent studies support the theory that people with dementia can evaluate their own quality of life (Cahill et al., 2004, p. 313). A 32-question questionnaire adapted from the Dementia Quality of Life scale (Brod, Stewart, Sands, & Walton, 1999) was administered to nine elder participants with dementia. A family caregiver and a professional caregiver also completed the Quality of Life Scale to reflect how they thought the elder with dementia experienced quality of life. Analysis indicated high inter-item consistency across all items and respondents on the Quality of Life Scale (α = 0.957). Correlations between respondents (participants and informal and formal caregivers) on most subscales were high (τ = .040 to .717) (although correlations often did not reach statistical significance with N = 9), further affirming that the ratings of Quality of Life by participants with dementia were as valid as the ratings of those who knew them and their lives best. The findings provide evidence that comments about quality of life made by people living with dementia can be regarded as meaningful, indicating that this population deserves greater respect regarding their ability to be included in decisions regarding their well-being and quality of life

Common BACE2 Polymorphisms are Associated with Altered Risk for Alzheimer's Disease and CSF Amyloid Biomarkers in APOE ε4 Non-Carriers

It was recently suggested that beta-site amyloid precursor protein (APP)-cleaving enzyme 2 (BACE2) functions as an amyloid beta (A beta)-degrading enzyme; in addition to its better understood role as an APP secretase. Due to this finding we sought to understand the possible genetic risk contributed by the BACE2 locus to the development of late-onset Alzheimer's disease (AD). In this study, we report that common single nucleotide polymorphism (SNP) variation in BACE2 is associated with altered AD risk in apolipoprotein E gene (APOE) epsilon 4 variant (e4) non-carriers. In addition, in e4 non-carriers diagnosed with AD or mild cognitive impairment (MCI), SNPs within the BACE2 locus are associated with cerebrospinal fluid (CSF) levels of A beta 1-42. Further, SNP variants in BACE2 are also associated with BACE2 RNA expression levels suggesting a potential mechanism for the CSF A beta 1-42 findings. Lastly, overexpression of BACE2 in vitro resulted in decreased A beta 1-40 and A beta 1-42 fragments in a cell line model of A beta production. These findings suggest that genetic variation at the BACE2 locus modifies AD risk for those individuals who don't carry the e4 variant of APOE. Further, our data indicate that the biological mechanism associated with this altered risk is linked to amyloid generation or clearance possibly through BACE2 expression changes.National Institute on Aging (NIA); National Alzheimer's Coordinating Center (NACC) [U01 AG016976]; National Institute on Aging: Ruth Seemann, John Hopkins Alzheimer's Disease Research Center (NIA) [AG05146, P50 AG16570, AG05128]; NINDS [NS39764]; Glaxo Smith Kline [P50-AG053760, AG05144, P50AG05681, P50 AG05136, P30-AG13846, 211002]; Arizona Biomedical Research Commission [4001, 0011, 05_ 901]; Michael J. Fox Foundation [AG10161, HHSN-271-2013-00030C]; McGowan Endowment; Medical Research Council, local NHS trusts and Newcastle University; Medical Research Council; Safa Al-Sarraj; Netherlands Brain Bank; Stichting MS Research, Brain Net Europe; Hersenstichting Nederland Breinbrekend Werk, International Parkinson Fonds; Internationale Stiching Alzheimer Onderzoek; NIH-NIA [R01-AG041232]; State of Arizona DHS (Arizona Alzheimer's Consortium) - NIH EUREKA [R01-AG034504]; NIH intramural funds; UK Dementia Research Institute; DRI Ltd - UK Medical Research Council; Alzheimer's Society; Alzheimer's Research UK - Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health) [U01 AG024904]; DOD ADNI (Department of Defense) [W81XWH-12-2-0012]; National Institute on Aging; National Institute of Biomedical Imaging and Bioengineering; Alzheimer'sAssociation; Alzheimer's Drug Discovery Foundation; Araclon Biotech; Biogen; Bristol-Myers Squibb Company; CereSpir, Inc.; Cogstate; Elan Pharmaceuticals, Inc.; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd; Fujirebio; Johnson & Johnson Pharmaceutical Research & Development LLC.; Merck Co., Inc.; Meso Scale Diagnostics; NeuroRx Research; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Takeda Pharmaceutical Company; Canadian Institutes of Health Research isproviding funds; ADNI clinical sites in Canada; Foundation for the National Institutes of Health; Northern California Institute for Research and Education; Laboratory for Neuro Imaging at the University of Southern CaliforniaOpen access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

A common language to assess allergic rhinitis control : results from a survey conducted during EAACI 2013 Congress

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