scholarly journals Falls and depression in octogenarians - life and living in advanced age: a cohort study in New Zealand

2017 ◽  
Vol 9 (4) ◽  
pp. 311 ◽  
Author(s):  
Astrid Atlas ◽  
Ngaire Kerse ◽  
Anna Rolleston ◽  
Ruth Teh ◽  
Catherine Bacon
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Depression Score ◽  
Study Data ◽  
Self Report ◽  
Advanced Age ◽  
Geriatric Depression ◽  
Old People ◽  
Very Old ◽  
Age And Sex

ABSTRACT INTRODUCTION Falls and injury have the most devastating consequences for very old people. Depression may be a significant cause and consequence of falls. AIM To examine the association between falls and depression in octogenarians. METHODS LiLACS NZ (Life and Living in Advanced Age: A Cohort Study in New Zealand), cohort study data of Māori (aged 80–90 years, 11-year age band) and non-Māori (aged 85 years, 1-year age band) followed for 3 years was used to describe the incidence and prevalence of falls and depression. Falls by self-report were accumulated over 3 years. Geriatric depression score (GDS) was ascertained at baseline. RESULTS Over 3 years, fewer Māori (47%) than non-Māori (57%) fell; 19% of non-Māori and 20% of Māori scored 5+ (depressed) on the GDS. For non-Māori and Māori, people with depression were more likely to fall than Māori not diagnosed with depression (OR 2.72, CI 1.65–4.48 for non-Māori and OR 2.01, CI 1.25–3.25 for Māori). This remained significant, adjusted for age and sex. Depression was a significant predictor of hospitalisations from falls for Māori (OR 5.59, CI 2.4–12.72, adjusted for age and sex) and non-Māori (OR 4.21, 2.3–7.44, adjusted for sex). CONCLUSION Depression and falls are common and co-exist in octogenarians. GPs thinking about falls should also think about depression and vice versa.

scholarly journals What do we know about the nutritional status of the very old? Insights from three cohorts of advanced age from the UK and New Zealand

2016 ◽  
Vol 75 (3) ◽  
pp. 420-430 ◽  
Author(s):  
Tom R. Hill ◽  
Nuno Mendonça ◽  
Antoneta Granic ◽  
Mario Siervo ◽  
Carol Jagger ◽  
...  
Keyword(s):  
New Zealand ◽  
Nutritional Status ◽  
Dietary Habits ◽  
Taste Perception ◽  
Advanced Age ◽  
Old People ◽  
Task Force Report ◽  
Very Old ◽  
North East ◽  
The Uk

Very old people (referred to as those aged 85 years and over) are the fastest growing age segment of many Western societies owing to the steady rise of life expectancy and decrease in later life mortality. In the UK, there are now more than 1·5 million very old people (2·5 % of total population) and the number is projected to rise to 3·3 million or 5 % over the next 20 years. Reduced mobility and independence, financial constraints, higher rates of hospitalisation, chronic diseases and disabilities, changes in body composition, taste perception, digestion and absorption of food all potentially influence either nutrient intake or needs at this stage of life. The nutritional needs of the very old have been identified as a research priority by the British Nutrition Foundation's Task Force report, Healthy Ageing: The Role of Nutrition and Lifestyle. However, very little is known about the dietary habits and nutritional status of the very old. The Newcastle 85+ study, a cohort of more than 1000 85-year olds from the North East of England and the Life and Living in Advanced Age study (New Zealand), a bicultural cohort study of advanced ageing of more than 900 participants from the Bay of Plenty and Rotorua regions of New Zealand are two unique cohort studies of ageing, which aim to assess the spectrum of health in the very old as well as examine the associations of health trajectories and outcomes with biological, clinical and social factors as each cohort ages. The nutrition domain included in both studies will help to fill the evidence gap by identifying eating patterns, and measures of nutritional status associated with better, or worse, health and wellbeing. This review will explore some of this ongoing work.

scholarly journals Quality of prescribing predicts hospitalisation in octogenarians: life and living in advanced age: a cohort study in New Zealand (LiLACS NZ)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cristín Ryan ◽  
Ruth Teh ◽  
Simon Moyes ◽  
Tim Wilkinson ◽  
Martin Connolly ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Inappropriate Prescribing ◽  
Advanced Age ◽  
Medical Conditions ◽  
Potentially Inappropriate Medicines ◽  
Prescribing Omissions ◽  
Potential Prescribing Omissions

Abstract Background Prescribing for older people is complex, and many studies have highlighted that appropriate prescribing in this cohort is not always achieved. However, the long-term effect of inappropriate prescribing on outcomes such as hospitalisation and mortality has not been demonstrated. The aim of this study was to determine the level of potentially inappropriate prescribing (PIP) for participants of the Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ) study at baseline and examine the association between PIP and hospitalisation and mortality at 12-months follow-up. Methods PIP was determined using STOPP/START. STOPP identified potentially inappropriate medicines (PIMs) prescribed, START identified potential prescribing omissions (PPOs). STOPP/START were applied to all LiLACS NZ study participants, a longitudinal study of ageing, which includes 421 Māori aged 80–90 years and 516 non-Māori aged 85 years. Participants’ details (e.g. age, sex, living arrangements, socioeconomic status, physical functioning, medical conditions) were gathered by trained interviewers. Some participants completed a core questionnaire only, which did not include medications details. Medical conditions were established from a combination of self-report, review of hospital discharge and general practitioner records. Binary logistic regression, controlled for multiple potential confounders, was conducted to determine if either PIMs or PPOs were associated with hospital admissions and mortality (p < 0.05 was considered significant). Results Full data were obtained for 267 Māori and 404 non-Māori. The mean age for Māori was 82.3(±2.6) years, and 84.6(±0.53) years for non-Māori. 247 potentially inappropriate medicines were identified, affecting 24.3% Māori and 28.0% non-Māori. PIMs were not associated with 12-month mortality or hospitalisation for either cohort (p > 0.05; adjusted models). 590 potential prescribing omissions were identified, affecting 58.1% Māori and 49.0% non-Māori. PPOs were associated with hospitalisation (p = 0.001 for Māori), but were not associated with risk of mortality (p > 0.05) for either cohort within the 12-month follow-up (adjusted models). Conclusion PPOs were more common than PIMs and were associated with an increased risk of hospitalisation for Māori. This study highlights the importance of carefully considering all indicated medicines when deciding what to prescribe. Further follow-up is necessary to determine the long-term effects of PIP on mortality and hospitalisation.

scholarly journals Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment

2013 ◽  
Vol 17 (5) ◽  
pp. 638-645 ◽  
Author(s):  
Mia Conradsson ◽  
Erik Rosendahl ◽  
Håkan Littbrand ◽  
Yngve Gustafson ◽  
Birgitta Olofsson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Old People ◽  
Very Old

scholarly journals Protein Intake, Distribution and Food Sources in Adults of Advanced Age: Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ)

Proceedings ◽  
2019 ◽  
Vol 37 (1) ◽  
pp. 10
Author(s):  
Ram ◽  
Kerse ◽  
Moyes ◽  
Rolleston ◽  
Wham
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Muscle Mass ◽  
Protein Intake ◽  
Advanced Age ◽  
Food Sources ◽  
Age Related

Protein intake and its food sources is important to prevent age related loss of muscle mass andstrength. [...]

scholarly journals Testosterone in advance age: a New Zealand longitudinal cohort study: Life and Living in Advanced Age (Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu)

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016572
Author(s):  
Martin J Connolly ◽  
Ngaire Kerse ◽  
Tim Wilkinson ◽  
Oliver Menzies ◽  
Anna Rolleston ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Serum Testosterone ◽  
Older Men ◽  
Community Dwelling ◽  
Advanced Age ◽  
Longitudinal Cohort Study ◽  
Coefficient Of Determination ◽  
Total Testosterone ◽  
Longitudinal Cohort

ObjectivesSerum testosterone (T) levels in men decline with age. Low T levels are associated with sarcopenia and frailty in men aged>80 years. T levels have not previously been directly associated with disability in older men. We explored associations between T levels, frailty and disability in a cohort of octogenarian men.SettingData from all men from Life and Living in Advanced Age Cohort Study in New Zealand, a longitudinal cohort study in community-dwelling older adults.ParticipantsCommunity-dwelling (>80 years) adult men excluding those receiving T treatment or with prostatic carcinoma.Outcomes measuresAssociations between baseline total testosterone (TT) and calculated free testosterone (fT), frailty (Fried scale) and disability (Nottingham Extended Activities of Daily Living scale (NEADL)) (baseline and 24 months) were examined using multivariate regression and Wald’s χ2techniques. Subjects with the lowest quartile of baseline TT and fT values were compared with those in the upper three quartiles.ResultsParticipants: 243 men, mean (SD) age 83.7 (2.0) years. Mean (SD) TT=17.6 (6.8) nmol/L and fT=225.3 (85.4) pmol/L. On multivariate analyses, lower TT levels were associated with frailty: β=0.41, p=0.017, coefficient of determination (R2)=0.10 and disability (NEADL) (β=−1.27, p=0.017, R2=0.11), low haemoglobin (β=−7.38, p=0.0016, R2=0.05), high fasting glucose (β=0.38, p=0.038, R2=0.04) and high C reactive protein (CRP) (β=3.57, p=0.01, R2=0.06). Low fT levels were associated with frailty (β=0.39, p=0.024, R2=0.09) but not baseline NEADL (β=−1.29, p=0.09, R2=0.09). Low fT was associated with low haemoglobin (β=−7.83, p=0.0008, R2=0.05) and high CRP (β=2.86, p=0.04, R2=0.05). Relationships between baseline TT and fT, and 24-month outcomes of disability and frailty were not significant.ConclusionsIn men over 80 years, we confirm an association between T levels and baseline frailty scores. The new finding of association between T levels and disability is potentially relevant to debates on T supplementation in older men, though, as associations were not present at 24 months, further work is needed.

scholarly journals Micronutrient intake in advanced age: Te Puāwaitanga o Ngā Tapuwae Kia ora Tonu, Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ)

2016 ◽  
Vol 116 (10) ◽  
pp. 1754-1769 ◽  
Author(s):  
Carol Wham ◽  
Ruth Teh ◽  
Simon A. Moyes ◽  
Anna Rolleston ◽  
Marama Muru-Lanning ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Vitamin A ◽  
Vitamin C ◽  
Physical Function ◽  
Advanced Age ◽  
Food Sources ◽  
Vitamin B ◽  
Men And Women ◽  
Nutrient Density

AbstractA high prevalence of undernutrition has previously been reported in indigenous Māori (49 %) and non-Māori (38 %) octogenarians and may be associated with risk of micronutrient deficiencies. We examined vitamin and mineral intakes and the contributing food sources among 216 Māori and 362 non-Māori participating in Life and Living to Advanced age a Cohort Study in New Zealand, using a repeat 24-h multiple-pass recall. More than half of the Māori and non-Māori participants had intakes below the estimated average requirement from food alone for Ca, Mg and Se. Vitamin B6(Māori women only), folate (women only), vitamin E (Māori women; all men) and Zn (men only) were low in these ethnic and sex subgroups. Women had intakes of higher nutrient density in folate, vitamin C, Ca, Mg, K, vitamin A (non-Māori) andβ-carotene (Māori) compared with men (P<0·05). When controlling for age and physical function,β-carotene, folate, vitamin C, Ca and Mg were no longer significantly different, but vitamins B2, B12, E and D, Fe, Na, Se and Zn became significantly different for Māori between men and women. When controlling for age and physical function, vitamins A and C and Ca were no longer significantly different, but vitamin B2, Fe, Na and Zn became significantly different for non-Māori between men and women. For those who took nutritional supplements, Māori were less likely to be deficient in food alone intake of vitamin A, folate and Mg, whereas non-Maori were less likely to be deficient in intakes of Mg, K and Zn, but more likely to be deficient in vitamin B12intake. A lack of harmonisation in nutrient recommendations hinders the interpretation of nutrient adequacy; nonetheless, Ca, Mg and Se are key micronutrients of concern. Milk and cheese were important contributions to Ca intake, whereas bread was a key source of Mg and Se. Examination of dietary intake related to biochemical status and health outcomes will establish the utility of these observations.

scholarly journals Cell phone and technology use by octogenarians

2020 ◽  
Vol 12 (1) ◽  
pp. 35
Author(s):  
Astrid Atlas ◽  
Marama Muru-Lanning ◽  
Simon Moyes ◽  
Ngaire Kerse ◽  
Santosh Jatrana
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Technology Use ◽  
Cell Phone ◽  
New Technologies ◽  
Cell Phones ◽  
Living Arrangement ◽  
Advanced Age ◽  
The Internet ◽  
Chronic Obstructive

ABSTRACT INTRODUCTIONMany countries, including New Zealand, have an aging population and new technologies such as cell phones may be useful for older people. AIMTo examine cell phone and technology use by octogenarians. METHODSTe Puawaitanga O Nga Tapuwae Kia Ora Tonu- Life and Living in Advanced Age: A Cohort Study In New Zealand (LILACs NZ) cohort study data of Māori (aged 80–90 years, 11-year age band) and non-Māori (aged 85 years, 1-year age band) followed for 3 years was used to describe the prevalence among study participants of the use of the internet, cell phones and watching pay-per-view television. Association of these activities with living arrangement, congestive heart failure, chronic obstructive respiratory disease and participants’ cognition were examined. RESULTSTechnology use was relatively low among study octogenarians. Fewer Māori used cell phones and the internet (16% and 6%) than non-Māori (30% and 19%). Māori participants supported only by a pension were less likely to use cell phones than Māori with more income. More men watched pay-per-view television (e.g. SKY) than women. Living alone and having chronic lung disease were associated with not watching pay-per-view television. Participants who used the internet had higher cognition scores than others. Non-Māori women were less likely to watch pay-per-view television and non-Māori on a pension only were less likely to watch pay-per-view television than people on a higher income. Participants who lived alone were less likely to watch pay-per-view. CONCLUSIONRelatively low use of technology may limit potential for health technology innovation for people of advanced age. Socioeconomic and ethnic disparities will amplify this.

scholarly journals Time protective effect of contact with a general practitioner and its association with diabetes-related hospitalisations: a cohort study using the 45 and Up Study data in Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e032790
Author(s):  
Ninh Thi Ha ◽  
Mark Harris ◽  
David Preen ◽  
Rachael Moorin
Keyword(s):  
Cohort Study ◽  
General Practitioner ◽  
Protective Effect ◽  
Negative Binomial ◽  
Baseline Period ◽  
Study Data ◽  
Self Report ◽  
Study Cohort ◽  
Related Hospitalisation ◽  
Different Levels

ObjectivesTo evaluate the relationship between the proportion of time under the potentially protective effect of a general practitioner (GP) captured using the Cover Index and diabetes-related hospitalisation and length of stay (LOS).DesignAn observational cohort study over two 3-year time periods (2009/2010–2011/2012 as the baseline and 2012/2013–2014/2015 as the follow-up).SettingLinked self-report and administrative health service data at individual level from the 45 and Up Study in New South Wales, Australia.ParticipantsA total of 21 965 individuals aged 45 years and older identified with diabetes before July 2009 were included in this study.Main outcome measuresDiabetes-related hospitalisation, unplanned diabetes-related hospitalisation and LOS of diabetes-related hospitalisation and unplanned diabetes-related hospitalisation.MethodsThe average annual GP cover index over a 3-year period was calculated using information obtained from Australian Medicare and hospitalisation. The effect of exposure to different levels of the cover on the main outcomes was estimated using negative binomial models weighted for inverse probability of treatment weight to control for observed covariate imbalance at the baseline period.ResultsPerfect GP cover was observed among 53% of people with diabetes in the study cohort. Compared with perfect level of GP cover, having lower levels of GP cover including high (incidence rate ratio (IRR) 2.8, 95% CI 2.6 to 3.0), medium (IRR 3.2, 95% CI 2.7 to 3.8) and low (IRR 3.1, 95% CI 2.0 to 4.9) were significantly associated with higher number of diabetes-related hospitalisation. Similar association was observed between the different levels of GP cover and other outcomes including LOS for diabetes-related hospitalisation, unplanned diabetes-related hospitalisation and LOS for unplanned diabetes-related hospitalisation.ConclusionsMeasuring longitudinal continuity in terms of time under cover of GP care may offer opportunities to optimise the performance of primary healthcare and reduce secondary care costs in the management of diabetes.

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