Search

Background: Aging changes in different body system are well described, but few studies have considered the relationship between them.Objective: The purpose of this study was, therefore, to investigate the interrelationships between markers of aging in different parts of the body.Methods: A cross-sectional study design was used. Structural and functional markers of aging were measured in a number of different body systems.Results: Conditional independence analysis demonstrated that the aging markers selected clustered into two groups, either related to chronological age or adult height. Visual acuity, lens opacity, hearing threshold, cognitive decline, and the number of teeth were associated with age, while systolic blood pressure and skin thickness were related to height. Grip strength was associated with both.Conclusions: The differential associations of the aging markers with chronological age and adult height suggest that different systems do not age together. This may have relevance for understanding what underlies aging, and these preliminary findings now require replication in other aging cohorts. [ABSTRACT FROM AUTHOR]

Presents a study that evaluated grip strength, a measure of skeletal function but a powerful predictor of disability, morbidity and mortality. Influences of grip strength; Analysis of the insulin-like growth factor II; Factors that exert independent additive effects on adult grip strength in men.

The authors comment on a study on the association between grip strength and mortality and incident disease as a biomarker of ageing. They offer their interpretation of the research findings on grip strength as a predictor of all-cause mortality, its relation to cardiovascular mortality and morbidity, as a predictor of cardiovascular outcomes. They also point out the study limitations and discuss the importance of skeletal muscle function as a component of health, ageing and disease.

Objective Consistent positive relationships have been found between birthweight and grip strength in young, middle-aged and older adults, suggesting that early influences on the growth and development of muscle are important for muscle function later in the lifecourse. However there are limited data in children. We aimed to assess the relationship between birthweight and grip strength in children aged 4 years. Design Prospective general population birth cohort study with data from birth to four years, drawn from the Southampton Women's Survey. Grip strength was measured using a Jamar handgrip dynamometer at age four years. We also measured height and weight and assessed body composition (lean mass) using dual energy x-ray absorptiometry. Multiple regression was used to relate grip strength to birthweight allowing for adjustment for confounding factors. Setting Southampton, UK. Participants 968 children took part in a sub-study assessing body composition and had their grip strength measured at age four years. Their socio-demographic characteristics were similar to the remainder of the cohort. Main outcome measure Grip strength in kilograms. Results Birthweight was positively associated with grip strength, with each kilogram of birthweight being associated with a 0.5 kg increase in grip strength (95% CI 0.30 to 0.70). Grip strength was also strongly related to current body size and adjustment of the birthweight relationship for height and weight attenuated the relationship such that it became non-significant with a 1kg increase in birthweight being associated with 0.15kg (95% CI -0.05 to 0.34kg) increase in grip strength. Adjustment for absolute and percentage lean mass instead of height and weight attenuated the relationship still further such that only a 0.07kg (95% CI −0.16 to 0.30) increase in grip strength was seen in relation to a 1kg increase in birthweight. Conclusion Birthweight is associated with muscle strength in children aged 4 years. Adjustment for current body size or lean mass explains the relationship suggesting that muscle size is on the causal pathway. Early influences on muscle growth and development appear to impact on grip strength in children as well as adults. [ABSTRACT FROM PUBLISHER]

The article presents a research describing the perception of older people about assistive devices and adapted activity for maintaining their independence. The researchers sent a questionnaire to respondents as part of the longitudinal Hertfordshire Ageing Study. Results showed that 93% of polled older people prefer to use a walking stick while 57% want to try a powered scooter. Moreover, women appeared to more likely ask for help with tasks.

Background There is a suggestion that acute dehydration in childhood may lead to elevated blood pressure. We examined if episodes of diarrhoea in childhood, a recognized proxy for acute dehydration, were related to measured blood pressure and coronary heart disease in older adults. Methods Data were pooled from two prospective UK cohort studies (participants born 1920–39) in which episodes of diarrhoea were ascertained from health visitor records from birth until 5 years of age. Blood pressure and coronary heart disease were assessed during medical examination in men and women over 64 years of age. In total, 5203 men and women had data on diarrhoea in early life, adult blood pressure and a range of covariates; 4181 of these also had data on coronary heart disease status. Results The prevalence of diarrhoea in infancy (3.3%) and between 1 and 5 years (1.1%) was low. There was no relation of diarrhoea from either period (age- and sex-adjusted results for diarrhoea in infancy presented here) with measured blood pressure [coefficient for systolic; 95% CI (confidence interval): 0.44; −2.88–3.76] or coronary heart disease (Odds ratio, OR; 95% CI: 0.91; 0.54–1.54) in adulthood. There was a similar lack of association when hypertension was the outcome of interest. These observations were unchanged after adjustment for a range of covariates. Conclusions In the largest study to date to examine the relation, there was no evidence that diarrhoea in early life had an influence on measured blood pressure, hypertension or coronary heart disease in older adults. [ABSTRACT FROM AUTHOR]

Background Several studies in older people have shown that grip strength predicts all-cause mortality. The mechanisms are unclear. Muscle strength declines with age, accompanied by a loss of muscle mass and an increase in fat, but the role that body composition plays in the association between grip strength and mortality has been little explored. We investigated the relation between grip strength, body composition, and cause-specific and total mortality in 800 men and women aged 65 and over. Methods During 197374 the UK Department of Health and Social Security surveyed random samples of men and women aged 65 and over living in eight areas of Britain to assess the nutritional state of the elderly population. The survey included a clinical examination by a geriatrician who assessed grip strength and anthropometry. We used Cox proportional hazards models to examine mortality over 24 years of follow-up. Results Poorer grip strength was associated with increased mortality from all-causes, from cardiovascular disease, and from cancer in men, though not in women. After adjustment for potential confounding factors, including arm muscle area and BMI, the relative risk of death in men was 0.81 (95% CI 0.700.95) from all-causes, 0.73 (95% CI 0.600.89) from cardiovascular disease, and 0.81 (95% CI 0.660.98) from cancer per SD increase in grip strength. These associations remained statistically significant after further adjustment for fat-free mass or % body fat. Conclusion Grip strength is a long-term predictor of mortality from all-causes, cardiovascular disease, and cancer in men. Muscle size and other indicators of body composition did not explain these associations. [ABSTRACT FROM AUTHOR]

Academic geriatric medicine activity lags behind the scale of clinical activity in the specialty. A meeting of UK academic geriatricians was convened in March 2018 to consider causes and solutions to this problem. The meeting highlighted a lack of research-active clinicians, a perception that research is not central to the practice of geriatric medicine and a failure to translate discovery science to clinical studies. Solutions proposed included better support for early-career clinical researchers, schemes to encourage non-University clinicians to be research-active, wider collaboration with organ specialists to broaden the funding envelope, and the need to co-produce research programmes with end-users. Solutions to grow academic geriatric medicine are essential if we are to provide the best care for the growing older population., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: To determine the feasibility and acceptability of using peak power and force, measured by jumping mechanography (JM), to detect early age-related features of sarcopenia in older women., Methods: Community-dwelling women aged 71-87 years were recruited into this cross-sectional study. Physical function tests comprised the short physical performance battery (SPPB), grip strength and, if SPPB score≥6, JM. JM measured peak weight-adjusted power and force from two-footed jumps and one-legged hops respectively. Questionnaires assessed acceptability., Results: 463 women were recruited; 37(8%) with SPPB⟨6 were ineligible for JM. Of 426 remaining, 359(84%) were able to perform ≥1 valid two-footed jump, 300(70%) completed ≥1 valid one-legged hop. No adverse events occurred. Only 14% reported discomfort. Discomfort related to JM performance, with inverse associations with both power and force (p⟨0.01). Peak power and force respectively explained 8% and 10% of variance in SPPB score (13% combined); only peak power explained additional variance in grip strength (17%)., Conclusions: Peak power and force explained a significant, but limited, proportion of variance in SPPB and grip strength. JM represents a safe and acceptable clinical tool for evaluating lower-limb muscle power and force in older women, detecting distinct components of muscle function, and possibly sarcopenia, compared to those evaluated by more established measures.

Background: poor diet quality is common among older people, but little is known about influences on food choice, including the role of psychosocial factors at this age., Objective: to identify psychosocial correlates of diet quality in a community-dwelling population of men and women aged 59-73 years; to describe relationships with change in diet quality over 10 years., Design: Longitudinal cohort, Hertfordshire Cohort Study (HCS)., Subjects: HCS participants assessed at baseline (1998-2003: 1,048 men, 862 women); 183 men and 189 women re-assessed in 2011., Methods: diet was assessed by administered food frequency questionnaire; diet scores were calculated to describe diet quality at baseline and follow-up. A range of psychosocial factors (social support, social network, participation in leisure activities, depression and anxiety, sense of control) were assessed by questionnaire., Results: at baseline, better diet quality was related to a range of social factors, including increased confiding/emotional social support (men and women), practical support (men) and a larger social network (women) (all P < 0.05). For both men and women, greater participation in social and cognitive leisure activities was related to better diet quality (P < 0.005). There were few associations between measured psychosocial factors at baseline and change in diet score over 10 years, in the follow-up sub-group. However, greater participation in leisure activities, especially cognitive activities, at baseline was associated with smaller declines in diet quality over the 10-year follow-up period for both men (P = 0.017) and women (P = 0.014)., Conclusions: in community-dwelling older adults, a range of social factors, that includes greater participation in leisure activities, were associated with diets of better quality., (© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com)

Using data from eight UK cohorts participating in the Healthy Ageing across the Life Course (HALCyon) research programme, with ages at physical capability assessment ranging from 50 to 90+ years, we harmonised data on objective measures of physical capability (i.e. grip strength, chair rising ability, walking speed, timed get up and go, and standing balance performance) and investigated the cross-sectional age and gender differences in these measures. Levels of physical capability were generally lower in study participants of older ages, and men performed better than women (for example, results from meta-analyses (N = 14,213 (5 studies)), found that men had 12.62 kg (11.34, 13.90) higher grip strength than women after adjustment for age and body size), although for walking speed, this gender difference was attenuated after adjustment for body size. There was also evidence that the gender difference in grip strength diminished with increasing age, whereas the gender difference in walking speed widened (p<0.01 for interactions between age and gender in both cases). This study highlights not only the presence of age and gender differences in objective measures of physical capability but provides a demonstration that harmonisation of data from several large cohort studies is possible. These harmonised data are now being used within HALCyon to understand the lifetime social and biological determinants of physical capability and its changes with age.

Unlabelled: We utilised the Hertfordshire cohort study to examine relationships between bone density at baseline and SF-36 status 4 years later. We found deterioration in the mental health domain over follow-up in osteoporotic men (but not women) compared with other groups (relative rate ratio=5.78, 95% confidence interval (CI) 1.78-19.2)., Introduction: Osteoporosis is associated with decreased quality of life, although it has been difficult to evaluate the confounding effects of fracture and co-morbidity. Having previously shown that male osteoporotics have poorer health than counterparts with normal bone mineral density, even after adjustment for co-morbidity and prior fracture, we assessed quality of life in both groups 4 years apart., Methods: Four hundred and ninety-eight men and 468 women completed questionnaires detailing lifestyle factors, co-morbidities and quality of life (SF-36) before undergoing bone density measurements at the lumbar spine and total femur. At follow-up 4 years later, 322 men and 320 women were reassessed., Results: Multinomial logistic regression confirmed deterioration in mental health over follow-up in osteoporotic men compared with other groups (relative rate ratio=5.78, 95% CI 1.78-19.2). These patterns were not apparent among women., Conclusions: Men with lower bone density at baseline had poorer quality of life some 4 years later, even after adjustment for co-morbidity and fracture. This may reflect secondary osteoporosis in men (due to alcohol or hypogonadism).

Previous studies of diet and lung function have focused on associations with individual nutrients and foods, and not dietary patterns. The relationships between dietary patterns and lung function and spirometrically defined chronic obstructive pulmonary disease (COPD) were investigated in 1,551 males and 1,391 females in Hertfordshire, UK. Dietary information was obtained by food frequency questionnaire and dietary patterns were identified using principal components analysis. Using regression analysis, after controlling for confounders, a "prudent" pattern (high consumption of fruit, vegetables, oily fish and wholemeal cereals) was positively associated with forced expiratory volume in 1 s (FEV(1)) (trend p-value <0.001 in males, 0.008 in females) (difference in FEV(1) between top and bottom quintiles of pattern score, 0.18 L (95% CI 0.08-0.28 L) in males, 0.08 L (95% CI 0.00-0.16 L) in females). This pattern was also positively associated with forced vital capacity (FVC) in both sexes. Males with a higher "prudent" pattern score had a higher FEV(1)/FVC (trend p-value 0.002) and a lower prevalence of COPD (odds ratio comparing top versus bottom quintile 0.46, 95% CI 0.26-0.81; trend p-value 0.012). Associations in males were stronger in smokers than nonsmokers (interaction p-value for FEV(1)/FVC 0.002). A "prudent" dietary pattern may protect against impaired lung function and COPD, especially in male smokers.

Background: Mobility disability is a major problem in older people. Numerous scales exist for the measurement of disability but often these do not permit comparisons between study groups. The physical functioning (PF) domain of the established and widely used Short Form-36 (SF-36) questionnaire asks about limitations on ten mobility activities., Objectives: To describe prevalence of mobility disability in an elderly population, investigate the validity of the SF-36 PF score as a measure of mobility disability, and to establish age and sex specific norms for the PF score., Methods: We explored relationships between the SF-36 PF score and objectively measured physical performance variables among 349 men and 280 women, 59-72 years of age, who participated in the Hertfordshire Cohort Study (HCS). Normative data were derived from the Health Survey for England (HSE) 1996., Results: 32% of men and 46% of women had at least some limitation in PF scale items. Poor SF-36 PF scores (lowest fifth of the gender-specific distribution) were related to: lower grip strength; longer timed-up-and-go, 3m walk, and chair rises test times in men and women; and lower quadriceps peak torque in women but not men. HSE normative data showed that median PF scores declined with increasing age in men and women., Conclusion: Our results are consistent with the SF-36 PF score being a valid measure of mobility disability in epidemiological studies. This approach might be a first step towards enabling simple comparisons of prevalence of mobility disability between different studies of older people. The SF-36 PF score could usefully complement existing detailed schemes for classification of disability and it now requires validation against them.

Background: Body mass index (BMI) and bone mineral density (BMD) are positively correlated in several studies, but few data relate bone density, lipid profile and anthropometric measures., Aim: To investigate these relationships in a large, well-characterized cohort of men and women (The Hertfordshire Cohort Study)., Methods: Men (n = 465) and women (n = 448) from Hertfordshire, UK were recruited. Information was available on demographic and lifestyle factors, anthropometric measurements, body fat percentage, fasting triglycerides, cholesterol (total, HDL, LDL), apolipoprotein (a) and apolipoprotein (b); bone mineral density (BMD) was recorded at the lumbar spine and total femur., Results: BMD at the lumbar spine (males r = 0.15, p = 0.001; females r = 0.14, p = 0.003) and total femoral region (males r = 0.18, p = 0.0001; females r = 0.16, p = 0.0008) was related to serum triglyceride level, even after adjustment for waist-hip ratio, age, social class and lifestyle factors, but not if body fat percentage was substituted for waist-hip ratio in the regression model. Fasting HDL cholesterol level was related to lumbar spine BMD in women (r = -0.15, p = 0.001) and total femoral BMD in both sexes (males r = -0.15, p = 0.002; females r = -0.23, p < 0.0001); these relationships were also attenuated by adjustment for body fat percentage but not waist-hip ratio. No relationships were seen between total or LDL cholesterol with BMD., Discussion: In this cohort, relationships between lipid profile and BMD were robust to adjustment for one measure of central obesity (waist-hip ratio), but not total body fat. This broadly supports the idea that adiposity may confound the relationship between lipids and bone mass.

Environmental influences during gestation may have long-term effects on adult muscle strength. It is not known how early in adult life such effects are manifest and whether they are modified by childhood body size. The authors examined the relation between birth weight and hand grip strength in a prospective national birth cohort of 1,371 men and 1,404 women from the Medical Research Council National Survey of Health and Development who were aged 53 years in 1999. A positive relation between birth weight and adult grip strength remained after adjustment first for adult height and weight and then additionally for childhood height and weight (p = 0.006 for men and p = 0.01 for women). The effects of birth weight on grip strength did not vary by childhood or current body size and were not confounded by social class. To the authors' knowledge, this is the first study to show that birth weight has an important influence on muscle strength in midlife independent of later body size and social class. It suggests that birth weight is related to the number of muscle fibers established by birth and that even in middle age compensating hypertrophy may be inadequate. As the inevitable loss of muscle fibers proceeds in old age, a deficit in the number of fibers could threaten quality of life and independence.

Aim: To determine whether fetal and infant growth, as assessed by weight at birth and weight at 1 year, are related to intraocular pressure., Methods: 717 men and women born in Hertfordshire between 1920 and 1930, for whom records of birth weight and weight at 1 year were available, were examined. Visual fields were assessed using the Takagi central 25 degrees 75 point static threshold screening program. Tonometry was performed using the Perkin's tonometer. The disc was assessed by direct ophthalmoscopy through dilated pupils., Results: A significant inverse relation was found between systolic blood pressure and birth weight. However, no association was found between birth weight or weight at 1 year and intraocular pressure, cup/disc ratio, or visual field defects., Conclusions: There was no evidence to support fetal or infant growth as being important factors for the subsequent development of raised intraocular pressure.

Purpose: The aim of this study was to assess the relationship between fetal and infant growth, as measured by birthweight and weight at 1 year and the development of age-related lens opacities., Methods: A total of 1428 men and women who were born in Hertfordshire, United Kingdom, between 1920 and 1930, and for whom records of birthweight and weight at 1 year were available, were traced and invited for examination. Of these, 717 (50%) attended for ophthalmic examination. After dilation with tropicamide 1%, lens opacities were graded using the Lens Opacities Classification System (LOCS) III., Results: In this population of English men and women aged 64 to 74 years, most opacities were of the nuclear type. There was no association between birthweight and nuclear lens opacities. Weight at 1 year was negatively correlated with nuclear opacity score in adult life (P=0.001). Subjects in the highest tertile for weight at 1 year (>23 pounds) had an odds ratio of 0.35 (95% confidence interval, 0.17 to 0.74) for having a significant nuclear lens opacity (LOCS score of > or = 3) compared with people in the lowest tertile for weight at 1 year (<21 pounds). This association remained after controlling for age, sex, smoking, social class, adult height, and diabetes., Conclusions: To our knowledge, this is the first time that such an association has been reported; it needs to be replicated in other populations. It could provide part of the explanation for the observed excess risk of cataract in developing countries.

Diet restriction is a well-recognised method of slowing aging and prolonging life span in animals. However, previous studies of this have tended to start after weaning and the effects of prenatal or early postnatal diet restriction have rarely been considered. Here we summarise the existing literature, which suggests that reducing nutrition at this earlier stage of life has opposite effects, resulting in accelerated aging and a reduction in life span. These findings support emerging epidemiological evidence in man that poor nutrition in early life may programme accelerated aging and predispose to a variety of age-related diseases.