1,721,062 research outputs found
Is there a bidirectional relationship between depressive symptoms and cognitive ability in older people?
No full textBackground: cross-sectional surveys of older people commonly find associations between higher levels of depressive symptoms and poorer cognitive performance, but the direction of effect is unclear. We examined whether there was a bidirectional relationship between depressive symptoms and general cognitive ability in non-demented older people, and explored the role of physical health, smoking, exercise, social class and education as potential confounders of this association and as possible determinants of the rate of change of cognitive decline and depressive symptoms.Method: the English Longitudinal Study of Ageing consists of people aged 50 years and over. Cognitive function and self-reported depressive symptoms were measured in 2002–2003, 2004–2005, 2006–2007 and 2008–2009. We fitted linear piecewise models with fixed knot positions to allow different slopes for different age groups. Analyses are based on 8611 people.Results: mean cognitive function declined with age; there was no trend in the trajectory of depressive symptoms. Better cognitive function was associated with less depression up to the age of 80 years. Greater depression was associated with a slightly faster rate of cognitive decline but only in people aged 60–80 years. There were no consistent associations across age groups between sex, smoking, education, social class, exercise or number of chronic physical illnesses and the rate of change of cognitive decline or depressive symptoms.Conclusions: in this longitudinal study of older people, there was no consistent evidence that being more depressed led to an acceleration in cognitive decline and no support for the hypothesis that there might be reciprocal dynamic influences between cognitive ability and depressive symptom
Cognitive abilities in later life and the onset of physical frailty: the Lothian Birth Cohort 1936
No full textOBJECTIVES: To investigate whether poorer cognitive ability is a risk factor for the development of physical frailty, and whether this risk varies by cognitive domain. DESIGN: Prospective longitudinal study with six-year follow-up.SETTING: Edinburgh, Scotland.PARTICIPANTS: 594 members of the Lothian Birth Cohort 1936.MEASUREMENTS: Frailty was assessed at ages 70 and 76 using the Fried criteria. Cognitive functions were assessed at ages 70, 73, and 76. Factor score estimates were derived for baseline level of and change in four cognitive domains: visuospatial ability, memory, processing speed, and crystallized cognitive ability. RESULTS: Higher baseline levels of processing speed, memory, visuospatial ability and crystallized ability derived from ages 70, 73 and 76, and less decline in speed, memory and crystallized ability were associated with a reduced risk of becoming physically frail by age 76. When all cognitive domains were modelled together, processing speed was only domain associated with frailty risk: for a standard deviation increment in initial level of processing speed, the relative risk for frailty (RR) (95% confidence interval (CI)) was 0.53 (0.33, 0.85), after adjustment for age, sex, baseline frailty status, social class, depressive symptoms, number of chronic physical diseases, levels of inflammatory biomarkers, and other cognitive factor score estimates; for a SD increment in processing speed change (i.e. less decline) the RR (95% CI) was 0.26 (0.16, 0.42). When we conducted additional analyses using a single test of processing speed that did not require fast motor responses—Inspection Time—results were similar.CONCLUSIONS: The speed with which older people process information and the rate at which this declines over time may be an important indicator of the risk of physical frailty. <br/
Mental ability across childhood in relation to risk factors for premature mortality in adult life: the 1970 British Cohort Study
No full textObjectives To examine the relation of scores on tests of mental ability across childhood with established risk factors for premature mortality at the age of 30 years. Methods: A prospective cohort study based on members of the British Cohort Study born in Great Britain in 1970 who had complete data on IQ scores at five (N = 8203) or 10 (N = 8171) years of age and risk factors at age 30 years. Results: In sex-adjusted analyses, higher IQ score at age 10 years was associated with a reduced prevalence of current smoking (OR(per 1 SD advantage in IQ) 0.84; 95% CI 0.80, 0.88), overweight (0.88; 0.84, 0.92), obesity (0.84; 0.79, 0.92), and hypertension (0.90; 0.83, 0.98), and an increased likelihood of having given up smoking by the age of 30 years (1.25; 1.18, 1.24). These gradients were attenuated after adjustment for markers of socioeconomic circumstances across the life course, particularly education. There was no apparent relationship between IQ and diabetes. Essentially the same pattern of association was evident when the predictive value of IQ scores at five years of age was examined. Conclusions: The mental ability-risk factor gradients reported in the present study may offer some insights into the apparent link between low pre-adult mental ability and premature mortalit
Patterns of prescribing of nutritional supplements in the United Kingdom
No full textBackground and Aims: A large number of prescriptions are issued for nutritional supplements under British National Formulary classifications 9.4.1 (foods for special diets) and 9.4.2 (enteral feeds), but little is known about the characteristics of the patients who receive them. We used the General Practice Research Database to examine patterns of prescribing of these supplements.Methods: We selected patients who had been prescribed supplements under classifications 9.4.1 and 9.4.2 during 1996–1997. Descriptive statistics were used to examine how prescribing varied. Results: 28644 patients received prescriptions during 1996–1997. Among the 27413 (96%) patients prescribed supplements for oral use, 14750 received supplements for enteral nutrition alone, 8122 received supplements for special diets alone and 4541 had both types of supplement. 51% of patients receiving supplements for special diets were <18 years. The commonest diagnoses among such children were milk intolerance (24%) and malnutrition (17%). 94% of patients receiving supplements for enteral nutrition were adult, 52% of whom had cancer or cardiovascular disease. Only 4% of patients had weight and height recorded prior to first prescription.Conclusions: The GPRD provides valuable information on the characteristics of patients prescribed nutritional supplements. But because only limited data are available on their nutritional status prior to supplementation, it is hard to assess whether general practitioners are prescribing these supplements appropriately
Prevalence of frailty and disability: findings from the English Longitudinal Study of Ageing
Full text linkOBJECTIVE: to examine the prevalence of frailty and disability in people aged 60 and over and the proportion of those with disabilities who receive help or use assistive devices.METHODS: participants were 5,450 people aged 60 and over from the English Longitudinal Study of Ageing. Frailty was defined according to the Fried criteria. Participants were asked about difficulties with mobility or other everyday activities. Those with difficulties were asked whether they received help or used assistive devices.RESULTS: the overall weighted prevalence of frailty was 14%. Prevalence rose with increasing age, from 6.5% in those aged 60-69 years to 65% in those aged 90 or over. Frailty occurred more frequently in women than in men (16 versus 12%). Mobility difficulties were very common: 93% of frail individuals had such difficulties versus 58% of the non-frail individuals. Among frail individuals, difficulties in performing activities or instrumental activities of daily living were reported by 57 or 64%, respectively, versus 13 or 15%, respectively, among the non-frail individuals. Among those with difficulties with mobility or other daily activities, 71% of frail individuals and 31% of non-frail individuals said that they received help. Of those with difficulties, 63% of frail individuals and 20% of non-frail individuals used a walking stick, but the use of other assistive devices was uncommon.CONCLUSIONS: frailty becomes increasingly common in older age groups and is associated with a sizeable burden as regards difficulties with mobility and other everyday activities.<br/
Early life IQ, risk factors, and later cardiovascular disease: new data from the 1958 British Birth Cohort and a systematic review. [Quociente de inteligência na infância, fatores de risco e doença cardiovascular na vida adulta: revisão sistemática e dados recentes do Estudo de Coorte Inglês de 1958]
No full textA 6-month exercise intervention among inactive and overweight favela-residing women in Brazil: the Cranguejo exercise trial
No full textObjectives. We examined the viability and efficacy of a known quantity of exercise in facilitating weight loss among previously sedentary or irregularly active overweight and obese adult women residing in a slum (favela) in Brazil.Methods. In this randomized controlled trial, 156 women were randomized to a control or intervention group (78 in each group). Exercise was supervised, consisting of three 50-minute aerobic sessions each week for 6 months.Results. Ninety-one percent (71) of the participants in the intervention group completed 6 months of the exercise program. At 6 months, women in the treatment group showed significant reduction in weight (mean = –1.69 kg; 95% confidence interval [CI] = –2.36,–1.03) and body mass index (mean = –0.63 kg/m2; 95% CI = –0.97, –0.30) compared with controls (P for both < .001).Conclusions. A moderately intense, structured exercise program resulted in modest weight loss in women when sustained for 6 months
Glucocorticoid metabolism and the Metabolic Syndrome: associations in an elderly cohort
No full textObjective: The phenotype of the Metabolic Syndrome (hypertension, insulin resistance and hyperlipidaemia) bears similarities to Cushing's Syndrome, in which the cause of these features is elevated cortisol production. We have investigated relationships between glucocorticoid production and features of the Metabolic Syndrome in a cohort of elderly subjects.Design: A cross-sectional analysis was carried out of a subset of a birthweight cohort from Sheffield.Methods: 92 men and 40 women (aged 69-75 y) representative of the original cohort were investigated. Features of the Metabolic Syndrome (blood pressure, BMI, waist hip ratio, fasting glucose, insulin and triglycerides) were recorded and urinary glucocorticoid metabolites were measured by gas chromatography mass spectrometry.Results: Total glucocorticoid metabolites were correlated with the overall phenotype of the Metabolic Syndrome (P = 0.002), whereas specific pathways of metabolism (activity of 11?-hydroxysteroid dehydrogenases and A-ring reductases) did not show significant associations. Specifically total glucocorticoid production increased with increasing systolic blood pressure (r = 0.21, P = 0.013), fasting glucose (r = 0.19, P = 0.02) and insulin (r = 0.23, P = 0.025). Glucocorticoid production was greater with increasing abdominal girth (r = 0.19, P = 0.033), but there was no association with enhanced metabolism via a specific pathway. Within this cohort, birthweight was not associated with total glucocorticoid metabolites. However, decreasing birthweight (P = 0.022), increasing obesity (P = 0.026) and increasing total glucocorticoid production (P = 0.009) were all independent predictors of fasting glucose.Conclusions: These data support the concept that cortisol production is enhanced in the Metabolic Syndrome, although they did not confirm the recent evidence that increased cortisol secretion is predicted by low birthweight.<br/
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