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OBJECTIVES: Heat vulnerability is increasing owing to climate change, aging and urbanization. This vulnerability may vary geographically. Our study examined the prevalence and distribution of risk and protective factors of heat-related outcomes among older adults across three health regions of Southern Quebec (Canada). METHOD: This secondary cross-sectional study used data from the 1st follow-up of the NuAge longitudinal study, a cohort of community-dwelling older adults, aged 68-82 years at baseline, of three health regions: Eastern Townships, Montreal and Laval. Prevalence of factors, identified in Health Canada guidelines, was measured. An Older Adult Heat Vulnerability Index (OAHVI) simultaneously considering medical, social and environmental factors was constructed. The distribution of each factor and OAHVI was examined across the three regions. Results were weighted forage, sex (overall and region-specific analyses) and region (overall analyses). RESULTS: Ninety percent of participants had [greater than or equal to]1 risk factor, the most prevalent being: cardiovascular medication (50.8%), hypertension (46.7%), living alone (39.2%), cardiovascular disease (36.9%), living in an urban heat island (34.7%) and needing help in activities of daily living (26.5%). Two thirds of participants had [greater than or equal to]1 protective factor, the most prevalent being talking on the phone daily (70.9%). Heat vulnerability varied greatly by region and this variation was mainly attributable to social and environmental rather than medical factors. According to the OAHVI, 87.2% of participants cumulated >2 factors (median = 3.0 factors/participant). CONCLUSION: Our results support the need for small-scale assessment of heat vulnerability. This study could help stakeholders tackle heat-related illness and develop regionally tailored prevention programs. KEY WORDS: Extreme heat; risk factors; protective factors; aged OBJECTIFS: La vulnerabilite a la chaleur est en augmentation en raison des changements climatiques, du vieillissement de la population et de l'urbanisation. Cette vulnerabilite peut varier geographiquement. Notre etude examine la prevalence globale et la distribution des facteurs de risque et de protection des problemes de sante lies a la chaleur chez les personnes agees dans trois regions sociosanitaires du sud du Quebec (Canada). METHODES: Il s'agit d'une etude transversale des donnees du 1er suivi de l'etude longitudinale NuAge, une cohorte de personnes agees de 68-82 ans a l'inclusion et vivant dans la communaute, dans trois regions sociosanitaires: Estrie, Montreal et Laval. La prevalence des facteurs, identifies dans les lignes directrices de Sante Canada, a ete mesuree. Un indice de vulnerabilite a la chaleur des arnes (IVCA) considerant simultanement plusieurs facteurs medicaux, sociaux et environnementaux a ete construit. La distribution de chaque facteur et de l'IVCA a ete examinee dans chacune des trois regions. Les resultats ont ete ponderes selon l'age, le sexe (analyses globales et regionales) et les regions (analyses globales). RESULTATS: Quatre-vingt-dix pour cent des participants presentaient ≥1 facteur de risque, les plus frequents etant la medication cardiovasculaire (50,8%), l'hypertension (46,7 %), vivre seul (39,2 %f), les maladies cardiovasculaires (36,9 %), vivre dans un ilot de chaleur urbain (34,7 %) et le besoin d'aide dans les activites de la vie quotidienne (26,5 %). Les deux tiers des participants presentaient ≥1 facteur de protection, le plus frequent etant de parler au telephone tous les jours (70,9 %). La vulnerabilite a la chaleur variait grandement selon la region et cette variation etait principalement attribuable a des facteurs sociaux et environnementaux plutot qu'a des facteurs medicaux. Selon l'IVCA, 87,2 % des participants cumulaient ≥2 facteurs (mediane = 3,0 facteurs/participant). CONCLUSION: Nos resultats appuient la necessite d'evaluer la vulnerabilite a la chaleur a une echelle regionale. Cette etude pourrait aider les parties prenantes a lutter contre les maladies liees a la chaleur et a developper des programmes de prevention adaptes aux differentes regions. MOTS CLES: chaleur extreme; facteurs de risque; facteurs de protection; vieillissement doi: 10.17269/CJPH.106.5029, Extreme heat can cause a range of heat-related illnesses and exacerbate certain pre-existing chronic conditions. (1) In Quebec, extreme heat is defined as a temperature ≥30°C and a humidex value [...]

Objectives. Weight change in older adults affects physical function (PF). However, data suggest that, conversely, PF may be a determinant of weight change. Our objective was to assess the role of baseline PF as a predictor of 2-year weight loss (WL) and weight gain (WG) [greater than or equal to] 5% among healthy well-functioning community-dwelling older adults. Methods. The NuAge cohort (67-84 years) was classified into three groups according to the percent weight change over a 2-year follow-up: weight stable (weight change [less than or equal to] 2%: n = 629), WL [greater than or equal to] 5% (n = 189), and WG [greater than or equal to] 5% (n = 111). A summary measure of baseline PF was computed (sum of biceps, quadriceps, and grip strength, timed up and go, chair stand, normal and maximal gait speed, and balance performance scores [individual test score range = 0-4]; PF score range = 0-32). Multivariable logistic regression models separately assessed the relationships between baseline PF and 2-year WL and WG [greater than or equal to] 5%. Results. Baseline PF was worse in both the WL (p < .001) and the WG (p = .001) groups compared with the weight stable group. In models adjusting for sex, age, body mass index, energy intake, depressive symptoms, and other significantly associated covariates, each 1-unit increase in standard deviation of PF was associated with decreased risk of either 2-year WL (odds ratio = 0.79, 95% CI = 0.63-0.99, p = .043) or WG (odds ratio = 0.74, 95% CI = 0.55 0.99, p = .041). Conclusions. Low baseline PF was an independent common predictor of 2-year WL and WG [greater than or equal to] 5% in the healthy well-functioning community-dwelling elderly population. Whether PF is an early cause or marker of weight change in this population remains to be determined. Key Words: Elderly--Physical function--Weight loss--Weight gain--Longitudinal study. doi: 10.1093/geroa/glq150

Population level data on how older individuals living at high latitudes achieve optimal vitamin D status are not fully explored. Our objective was to examine the intake of vitamin D among healthy older individuals with 25-hydroxyvitamin D [25(OH)D] concentrations [greater than or equal to] 75 nmol/L and to describe current sources of dietary vitamin D. We conducted a population-based, cross-sectional study of 404 healthy men and women aged 69 to 83 y randomly selected from the NuAge longitudinal study in Quebec, Canada. Dietary intakes were assessed by 6 24-h recalls. We examined the contribution of foods and vitamin/ mineral supplements to vitamin D intake. Serum 25(OH)D was assessed by RIA. We assessed smoking status, season of 25(OH)D measurement, physical activity, and anthropometric and sociodemographic variables. Vitamin D status was distributed as follows: 7% (75 nmol/L had mean intakes of 14.1 [micro]g/d from food and supplements. Supplement use is an important contributor to achieve a minimal target of 25(OH)D concentration [greate than or equal to] 75 nmol/L. doi: 10.3945/jn.109.115626.

Many 'functional foods' (FF), common foods with health benefits beyond their nutritive value, have antioxidant properties with the potential to mediate the degenerative changes of aging. A pilot study was conducted among 51 healthy, home-dwelling elderly people aged 70-86 y (51% male) to develop a method for evaluating relationships between lifelong diet and health. A population-based semiquantitative food frequency questionnaire (FFQ) was used to assess the usual diet. A nonquantitative questionnaire (FF-FFQ) was developed to examine current intake patterns of 33 FF, and at ages 65, 45, 25 and 10 y. Visual and memory cues were employed to help respondents remember past intakes, and their reporting confidence was queried. The instrument was self-administered (among 35%), or administered by a dietitian-interviewer in face-to-face (39%) or telephone (25%) interviews. The FFQ was validated by four dietary recalls statistically adjusted for intraindividual and seasonal variability. The FF-FFQ reliability was assessed in a subsample (n = 20). Mean usual FFQ-derived energy intakes were 7941 [+ or -] 2071 kJ (men) and 7033 [+ or -] 1916 kJ (women). Reported current, regular (several times/mo) FF numbered 18 [+ or -] 4 (men) and 20 [+ or -] 4 (women). These means decreased almost linearly with time; at age 10 y, FF reported were 12 [+ or -] 7 (men) and 15 [+ or -] 4 (women). Men differed from women in their memory of food consumption, food choices and FF intakes. Instrument reliability was good, with 73% identical responses. Food-related memory appears to be linked to dietary knowledge, food preparation experience and availability of foods in the past. The FF-FFQ provides novel data on lifetime FF consumption that may help clarify relationships between diet and health, and the role of diet in aging. KEY WORDS: * dietary assessment * elderly * functional foods * past diet * questionnaires

Background. Numerous studies of the elderly population have indicated that body weight and weight changes are related to mortality, but the one group at particularly high risk of nutritional inadequaciesfrail elders receiving home help serviceshas not been studied. Methods. A prospective cohort of 288 frail elders (81 men; 207 women; mean age: 78.2 +/-7.6 yrs) receiving home support services was followed for 3-5 years. Nutritional variables included baseline body mass index (BMI), weight loss prior to baseline, and energy and protein intake. Covariates included age, gender, smoking, and health and functional status. Cox's multivariate survival analysis was used to identify independent predictors of mortality. Results. There were 102 deaths (35.4%) over the follow-up period. Univariate predictors included age, sex, BMI, weight loss, and functional status. In multivariate analysis, weight loss at baseline was a significant predictor of mortality, RR=1.76(95%CI: 1.15-2.71), as was male gender, RR=2.71(95%CI: 1.73-4.24), and age at baseline, RR=1.40(95%CI: 1.06-1.86). Conclusion. Among free-living frail elders, weight loss is a predictor of early mortality after controlling for smoking, and functional and health status indicators. From our observations, however, we cannot conclude that prevention of weight loss would lead to increased survival. This needs to be explored in an intervention study.

Research indicates that nutritional status could have an impact on the response of elderly subjects to influenza vaccination. Nutritional parameters such as levels of vitamin E, iron, total protein and hemoglobin were substantially lower among those who did not respond to the vaccination than those who did, with the cellular immune response and DHEA level also much lower in the nonresponsive group. Twelve out of twenty-three elderly patients did not respond to the vaccination.

Nutritional deficiencies, frequently observed among the frail elderly, have been associated with increased morbidity and dependency. A randomized clinical trial was conducted to assess the impact of nutritional supplementation on the functional status of frail elderly living at home. Subjects (n = 50) over age 60 (mean 78 y) requiring community services and at elevated risk of undernutrition (excessive weight loss or body mass index INDEXING KEY WORDS: nutritional supplementation; functional status; body weight; elderly; humans