Major cardiovascular disease (CVD) risk factors in midlife and extreme longevity

Background The studies on the association of various midlife risk factors with reaching 90 years or more are scarce. We studied this association in a socioeconomically homogenous cohort of businessmen. Methods The study consists of men (n = 970) from the Helsinki Businessmen Study cohort (born 1919–1928). Five major cardiovascular disease (CVD) risk factors (smoking, BMI, blood pressure, serum lipids, fasting glucose), consumption of alcohol and coffee, self-rated health and self-rated fitness, were assessed in 1974, at an average age of 50 years. The number of major risk factors was tested as a risk burden. The Charlson Comorbidity Index and the RAND-36 (SF-36) Physical and Mental health summary scores were calculated from surveys in year 2000, at age of 73 years. Mortality dates were retrieved through 31 March 2018 from the Population Information System of Finland. Results 244 men survived to the age of 90 representing 25.2% of the study cohort. The survivors had less risk factor burden in midlife, and less morbidity and higher physical health summary score in 2000. Of those with five major risk factors only 7% survived up to 90 years, whereas 51% of those without any risk factors reached that age. Single risk factors reducing odds of reaching 90 years were smoking (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.34–0.67), glucose (0.66, 0.49–0.88), BMI (0.63, 0.46–0.86), and cholesterol (0.71, 0.53–0.96). Conclusion Lack of five major CVD risk factors in midlife strongly increased odds of reaching 90 years of age and also predicted factors related to successful ageing in late life.

Associations Between Health-related Quality of Life, Eating Behavior and Gastrointestinal Tolerance Among Exclusively Breastfed Infant-Mother Dyads in the Philippines (P11-107-19)

Objectives Breastmilk offers the most optimal nutrition for infants in first year of life, and breastfeeding may offer additional benefits promoting psychological well-being of infants and mothers. Relationships between infant and maternal quality of life (QoL), baby eating behaviors and gastrointestinal (GI) tolerance have not been widely studied. Methods Healthy term infants whose mothers had decided to exclusively breastfeed from birth until 6 months (m) of age, were enrolled at 21–26 days (d) of age from a single center in the Philippines. Parents completed the Infant Toddler Quality of Life Questionnaire (ITQoL), Short Form Health Survey (SF-36v2) (assessing maternal QoL), Baby Eating Behavior Questionnaire (BEBQ) (assessing appetite), and Infant Gastrointestinal Symptoms Questionnaire (assessing GI burden) at enrollment and when infants were 2.5 m, 4 m, and 6 m of age. Results Among 75 enrolled infants, 70 completed the study at age 6 m. At enrollment, only 1 statistically significant moderate correlation (ρ = 0.46, P < 0.01, Table 1) was seen between maternal Physical Health Summary with infant QoL Impact on Parents-Time. However, most infant QoL concepts became moderately associated with maternal Mental Health Summary scores at 6 m. Statistically significant moderate and positive correlations were detected between maternal Mental Health Summary with Satisfaction with Child's Overall Growth and Development, Temperament and Moods, Overall Health, and with 3 Child's Impacts on Parents concepts. At 6 m, statistically significant moderate and positive correlations were seen between BEBQ concepts (Enjoyment of Food and General Appetite) with Temperament and Moods (ρ = 0.47 and 0.40, respectively, P < 0.01). No moderate correlations between BEBQ concepts and maternal QoL were found. Surprisingly, no correlations between GI tolerance measures and maternal/infant QoL concepts was detected except 1 weak correlation between flatulence and infant QoL Impact on Parents-Emotional at enrollment. Conclusions In this cohort, relationships between infant and maternal health-related quality of life evolved as infants grew older. Infant temperament and moods positively correlated with both maternal mental and physical health and with infant eating behaviors, suggesting that infant temperament and mood may be an important factor affecting maternal and child health. Funding Sources Nestec Ltd. Supporting Tables, Images and/or Graphs

Long-term Functional Outcome after Stapled and Excisional Haemorrhoidectomy

Background: Stapled haemorrhoidectomy (SH) described by Longo has been a recently added option for hemorrhoid surgery. Interest in SH has been principally driven by the fact that conventional excision haemorrhoidectomy (EH) has been an extremely painful procedure as it involves excision of haemorrhoidal tissue along the extremely sensitive anoderm. SH on the other hand has been shown to be associated with decreased postoperative pain, as it does not involve the sensate anal mucosa below the dentate line. To date there have been many randomized controlled studies comparing circular stapled haemorrhoidectomy with traditional excision techniques. Despite proven early postoperative advantages for SH the long-term benefits and effect on patients quality of life (QOL) compared to EH still remains to be debated. Methods: To evaluate long-term patient outcomes via a validated health related QOL survey. Results: QOL measures were satisfactory in both groups across all subscales of physical health summary measures and mental health summary measures. This coincided with Wexner continence scores, which were also satisfactory with median of 0 in both groups. Conclusion: QOL, continence scores and long term symptom follow-up is similar in patients that undergo SH or EH.

Quality of Life and Self-Reported Lower Extremity Function in Adults With HIV-Related Distal Sensory Polyneuropathy

Background Distal sensory polyneuropathy (DSP) is a common complication of HIV disease. Its effects on quality of life (QOL) and function have not been well described. Objective The study objectives were: (1) to compare QOL and lower extremity function in people with HIV-related DSP and people with HIV disease who do not have DSP, (2) to determine the extent to which function predicts QOL, (3) to evaluate the agreement of 2 function scales, and (4) to describe the use of pain management resources. Design This was a cross-sectional survey study with predictive modeling and measurement tool concordant validation. Methods A demographic questionnaire, the Medical Outcomes Study HIV Health Survey, the Lower Extremity Functional Scale (LEFS), the Lower Limb Functional Index (LLFI), and a review of medical records were used. General linear modeling was used to assess group differences in QOL and the relationship between function and QOL. Bland-Altman procedures were used to assess the agreement of the LEFS and the LLFI. Results Usable data for analyses were available for 82 of the 94 participants enrolled. The 67% of participants who reported DSP symptoms tended to be older, had HIV disease longer, and were more likely to receive disability benefits. Participants without DSP had better LLFI, LEFS, and physical health summary scores. In multivariate models, lower limb function predicted physical and mental health summary scores. The LLFI identified participants with a lower level of function more often than the LEFS. Participants with DSP were more likely to use medical treatment, physical therapy, and complementary or alternative treatments. Limitations A sample of convenience was used; the sample size resulted in a low power for the mental health summary score of the Medical Outcomes Study HIV Health Survey. Conclusions Quality of life and function were more impaired in participants with HIV disease and DSP. The LLFI was more likely to capture limitations in function than the LEFS. Participants with DSP reported more frequent use of pain management resources.