Tooth Loss and Allostatic Load Changes Later in Life: A 12-Year Follow-Up Analysis of the English Longitudinal Study of Ageing (ELSA)

2019 ◽  
Author(s):  
Cesar de Oliveira ◽  
Wael Sabah ◽  
Ione Jayce Ceola Schneider ◽  
Eduardo Bernabe
Author(s):  
Rebecca Bendayan ◽  
Yajing Zhu ◽  
A D Federman ◽  
R J B Dobson

Abstract Background We aimed to examine the multimorbidity patterns within a representative sample of UK older adults and their association with concurrent and subsequent memory. Methods Our sample consisted of 11,449 respondents (mean age at baseline was 65.02) from the English Longitudinal Study of Ageing (ELSA). We used fourteen health conditions and immediate and delayed recall scores (IMRC and DLRC) over 7 waves (14 years of follow up). Latent class analyses were performed to identify the multimorbidity patterns and linear mixed models were estimated to explore their association with their memory trajectories. Models were adjusted by socio-demographics, BMI and health behaviors. Results Results showed 8 classes: Class 1:Heart Disease/Stroke (26%), Class 2:Asthma/Lung Disease (16%), Class 3:Arthritis/Hypertension (13%), Class 4:Depression/Arthritis (12%), Class 5:Hypertension/Cataracts/Diabetes (10%), Class 6:Psychiatric Problems/Depression (10%), Class 7:Cancer (7%) and Class 8:Arthritis/Cataracts (6%). At baseline, Class 4 was found to have lower IMRC and DLRC scores and Class 5 in DLRC, compared to the no multimorbidity group (n=6380, 55.72% of total cohort). For both tasks, in unadjusted models, we found an accelerated decline in Classes 1, 3 and 8; and, for DLRC, also in Classes 2 and 5. However, it was fully attenuated after adjustments. Conclusions These findings suggest that individuals with certain combinations of health conditions are more likely to have lower levels of memory compared those with no multimorbidity and their memory scores tend to differ between combinations. Socio-demographics and health behaviours have a key role to understand who is more likely to be at risk of an accelerated decline.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016358 ◽  
Author(s):  
Nafeesa N Dhalwani ◽  
Radia Fahami ◽  
Harini Sathanapally ◽  
Sam Seidu ◽  
Melanie J Davies ◽  
...  

ObjectivesAssess the longitudinal association between polypharmacy and falls and examine the differences in this association by different thresholds for polypharmacy definitions in a nationally representative sample of adults aged over 60 years from England.DesignLongitudinal cohort study.SettingThe English Longitudinal Study of Ageing waves 6 and 7.Participants5213 adults aged 60 or older.Main outcome measuresRates, incidence rate ratio (IRR) and 95% CI for falls in people with and without polypharmacy.ResultsA total of 5213 participants contributed 10 502 person-years of follow-up, with a median follow-up of 2.02 years (IQR 1.9–2.1 years). Of the 1611 participants with polypharmacy, 569 reported at least one fall within the past 2 years (rate: 175 per 1000 person-years, 95% CI 161 to 190), and of the 3602 participants without polypharmacy 875 reported at least one fall (rate: 121 per 1000 person-years, 95% CI 113 to 129). The rate of falls was 21% higher in people with polypharmacy compared with people without polypharmacy (adjusted IRR 1.21, 95% CI 1.11 to 1.31). Using ≥4 drugs threshold the rate of falls was 18% higher in people with polypharmacy compared with people without (adjusted IRR 1.18, 95% CI 1.08 to 1.28), whereas using ≥10 drugs threshold polypharmacy was associated with a 50% higher rate of falls (adjusted IRR 1.50, 95% CI 1.34 to 1.67).ConclusionsWe found almost one-third of the total population using five or more drugs, which was significantly associated with 21% increased rate of falls over a 2-year period. Further exploration of the effects of these complex drug combinations in the real world with a detailed standardised assessment of polypharmacy is greatly required along with pragmatic studies in primary care, which will help inform whether the threshold for a detailed medication review should be lowered.


BMJ ◽  
2019 ◽  
pp. l6377 ◽  
Author(s):  
Daisy Fancourt ◽  
Andrew Steptoe

AbstractObjectiveTo explore associations between different frequencies of arts engagement and mortality over a 14 year follow-up period.DesignProspective cohort study.ParticipantsEnglish Longitudinal Study of Ageing cohort of 6710 community dwelling adults aged 50 years and older (53.6% women, average age 65.9 years, standard deviation 9.4) who provided baseline data in 2004-05.InterventionSelf reported receptive arts engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera).MeasurementMortality measured through data linkage to the National Health Service central register.ResultsPeople who engaged with receptive arts activities on an infrequent basis (once or twice a year) had a 14% lower risk of dying at any point during the follow-up (809/3042 deaths, hazard ratio 0.86, 95% confidence interval 0.77 to 0.96) compared with those who never engaged (837/1762 deaths). People who engaged with receptive arts activities on a frequent basis (every few months or more) had a 31% lower risk of dying (355/1906 deaths, 0.69, 0.59 to 0.80), independent of demographic, socioeconomic, health related, behavioural, and social factors. Results were robust to a range of sensitivity analyses with no evidence of moderation by sex, socioeconomic status, or social factors. This study was observational and so causality cannot be assumed.ConclusionsReceptive arts engagement could have a protective association with longevity in older adults. This association might be partly explained by differences in cognition, mental health, and physical activity among those who do and do not engage in the arts, but remains even when the model is adjusted for these factors.


2018 ◽  
Vol 73 (1) ◽  
pp. 86-88 ◽  
Author(s):  
Lin Yang ◽  
Lee Smith ◽  
Mark Hamer

BackgroundThe aetiology of age-related sarcopenia is not known.ObjectivesTo investigate if risk of developing sarcopenia differs by gender and to identify gender-specific risk factors of incident sarcopenia in a large population-based cohort of older English adults.MethodsThe sample (n=3404; age 63.4 (SD 7.7) years; 54.1% women) comprised older community-dwelling adults recruited from the English Longitudinal Study of Ageing. Sarcopenia was defined as handgrip <26 kg in men and <16 kg in women. Handgrip strength was assessed at baseline (2004/2005) and repeated at follow-up (2012/2013). Analysed risk factors included baseline anthropometric measures, smoking, vigorous and moderate physical activity, depressive symptoms, chronic illnesses and wealth. After excluding participants with sarcopenia at baseline, multivariable logistic regressions were used to explore baseline risk factors for incident sarcopenia.ResultsDuring 8-year follow-up, 208 and 287 cases of sarcopenia were identified in men (n=1564) and women (n=1840), respectively. Women were at 20% (age adjusted OR=1.20, 95% CI 0.98 to 1.47) higher risk of developing sarcopenia than men. The inverse association between physical activity and sarcopenia risk was observed at moderate (OR=0.44, 95% CI 0.27 to 0.67) and vigorous (0.53, 95% CI 0.31 to 0.82) intensities in men and only vigorous (OR=0.44, 95% CI 0.28 to 0.68) intensity in women. Social factors, such as wealth, and chronic health conditions appeared to be more strongly associated with sarcopenia in men.ConclusionWomen are at higher risk of developing incident sarcopenia than men, and this is likely explained by a range of gender-specific risk factors.


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