Browsing by Subject "26-YEAR FOLLOW-UP"

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  • Urtamo, Annele; Huohvanainen, Emmi; Pitkälä, Kaisu H.; Strandberg, Timo E. (2019)
    BackgroundActive and healthy aging (AHA) is an important phenomenon in aging societies.AimsOur aim was to investigate midlife predictors of AHA in a socioeconomically homogenous male cohort.MethodsIn 2010, AHA was defined in the Helsinki Businessmen Study (men born in 1919-1934) with six criteria: (1) being alive, (2) responding to the mailed survey, (3) no reported cognitive problems, (4) feeling of happiness, (5) no difficulties in activities of daily living (ADL), and (6) no significant chronic diseases. Midlife factors were assessed in 1974 (n=1759, mean age 47years). Of the survivors in 2010 (n=839), 10.0% (n=84) fulfilled all AHA criteria, whilst 13.7% (n=115) had chronic diseases but fulfilled other five criteria. Midlife predictors of AHA were analyzed with logistic models.ResultsOf the midlife factors, smoking [Odds ratio (OR) 0.44, 95% confidence interval (CI) 0.25-0.77], higher body mass index (BMI) (OR 0.75, 0.59-0.96), andhigher total cholesterol (OR 0.76, 0.60-0.97)prevented significantly full AHA criteria, whereas higher self-rated health (SRH) (OR 1.73, 1.07-2.80) predicted significantly offulfilling all AHA criteria. Midlife smoking (OR 0.87, 0.84-0.91), higher BMI (OR 0.73, 0.61-0.86), andhigher alcohol consumption (OR 0.73, 0.60-0.90)prevented significantly of fulfilling the five AHA criteria with chronic diseases, and higher SRH (OR 1.90, 1.37-2.63) predictedsignificantly thefive AHA criteria (chronic diseases present).DiscussionOur study suggests that midlife factors, especially good SRH and low levels of cardiovascular risk factors, are associated with AHA.ConclusionsThe study emphasizes the importance of life-course predictors of healthy aging.
  • Dent, E.; Morley, J. E.; Cruz-Jentoft, A. J.; Woodhouse, L.; Rodriguez-Manas, L.; Fried, L. P.; Woo, J.; Aprahamian; Sanford, A.; Lundy, J.; Landi, F.; Beilby, J.; Martin, F. C.; Bauer, J. M.; Ferrucci, L.; Merchant, R. A.; Dong, B.; Arai, H.; Hoogendijk, E. O.; Won, C. W.; Abbatecola, A.; Cederholm, T.; Strandberg, T.; Gutierrez Robledo, L. M.; Flicker, L.; Bhasin, S.; Aubertin-Leheudre, M.; Bischoff-Ferrari, H. A.; Guralnik, J. M.; Muscedere, J.; Pahor, M.; Ruiz, J.; Negm, A. M.; Reginster, J. Y.; Waters, D. L.; Vellas, B. (2019)
    Objective The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. Methods These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.