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Background and aim Iron deficiency is associated with increased morbidity and mortality in older adults. However, data on its prevalence and incidence among older adults is limited. The aim of this study was to investigate the prevalence and incidence of iron deficiency in European community-dwelling older adults aged ≥ 70 years. Methods Secondary analysis of the DO-HEALTH trial, a 3-year clinical trial including 2157 community-dwelling adults aged ≥ 70 years from Austria, France, Germany, Portugal and Switzerland. Iron deficiency was defined as soluble transferrin receptor (sTfR) > 28.1 nmol/L. Prevalence and incidence rate (IR) of iron deficiency per 100 person-years were examined overall and stratified by sex, age group, and country. Sensitivity analysis for three commonly used definitions of iron deficiency (ferritin 1.5) were also performed. Results Out of 2157 participants, 2141 had sTfR measured at baseline (mean age 74.9 years; 61.5% women). The prevalence of iron deficiency at baseline was 26.8%, and did not differ by sex, but by age (35.6% in age group ≥ 80, 29.3% in age group 75–79, 23.2% in age group 70–74); P ) and country (P = 0.02), with the highest prevalence in Portugal (34.5%) and the lowest in France (24.4%). As for the other definitions of iron deficiency, the prevalence ranged from 4.2% for ferritin 1.5. Occurrences of iron deficiency were observed with IR per 100 person-years of 9.2 (95% CI 8.3–10.1) and did not significantly differ by sex or age group. The highest IR per 100 person-years was observed in Austria (20.8, 95% CI 16.1–26.9), the lowest in Germany (6.1, 95% CI 4.7–8.0). Regarding the other definitions of iron deficiency, the IR per 100 person-years was 4.5 (95% CI 4.0–4.9) for ferritin 1.5. Conclusions Iron deficiency is frequent among relatively healthy European older adults, with people aged ≥ 80 years and residence in Austria and Portugal associated with the highest risk.

Background To compare the prevalence of healthy aging among adults age 70 and older from 5 European countries recruited for the DO-HEALTH clinical trial. Participants were selected for absence of prior major health events. Methods Cross-sectional analysis of DO-HEALTH baseline data. All 2,157 participants (mean age 74.9, SD 4.4; 61.7% women) were included and 2,123 had data for all domains of the healthy aging status (HA) definition. HA was assessed based on the Nurses` Health Study (NHS) definition requiring four domains: no major chronic diseases, no disabilities, no cognitive impairment (Montreal Cognitive Assessment, MoCA ≥25), no mental health limitation (GDS-5 Results Overall, 41.8% of DO-HEALTH participants were healthy agers with significant variability by country: Austria (Innsbruck) 58.3%, Switzerland (Zurich, Basel, Geneva) 51.2%, Germany (Berlin) 37.6%, France (Toulouse) 36.7% and Portugal (Coimbra) 8.8% (p Conclusions Despite the same inclusion and exclusion criteria preselecting relatively healthy adults age 70 years and older, HA prevalence in DO-HEALTH varied significantly between countries and was highest in participants from Austria and Switzerland, lowest in participants from Portugal. Independent of country, younger age, female gender, lower BMI and better physical function were associated with HA. Trial registration DO-HEALTH was registered under the protocol NCT01745263 at the International Trials Registry (clinicaltrials.gov), and under the protocol number 2012–001249-41 at the Registration at the European Community Clinical Trial System (EudraCT).

Objectives To assess the validity of 4 functional tests in predicting falls within the first year after hip fracture. Design Prospective study of functional tests shortly after hip surgery and incident falls during 12 months' follow-up. Setting and Participants The sample comprised 173 adults with acute hip fracture, aged 65 years and older (79% women, 77% community dwelling, mean age 84.2 years), who participated in a clinical trial of vitamin D or home exercise. Methods We assessed 4 functional tests [Timed Up and Go test (TUG), grip strength, and knee flexor and extensor strength in the nonoperated leg] by trained study physiotherapists at baseline (1-12 days after hip fracture surgery). During 12 months' follow-up, we ascertained all fall events by monthly personal phone calls, a telephone hotline, and a patient diary. Then we compared TUG and strength test performance at baseline between future single fallers, recurrent fallers, and nonfallers over the 12-month follow-up. All analyses adjusted for age, body mass index, gender, 25-hydroxyvitamin D status at baseline, days of follow-up, and treatment allocation (the original trial tested vitamin D treatment and/or a home exercise program). Results Ninety-two of 173 (53%) participants fell and experienced 212 falls. Participants who became recurrent fallers (n = 54) had significantly longer TUG times at baseline than those who did not fall (n = 81) in the following 12 months (mean TUG for recurrent fallers = 71.6 seconds, SD = 8.2 seconds, vs mean TUG for nonfallers = 51.4 seconds, SD = 6.9 seconds; P = .02). There were no significant differences in TUG times between single fallers and nonfallers. For all 3 strength tests, there were no significant differences between single fallers, recurrent fallers, and nonfallers. Conclusions and Implications In this population of frail older adults recruited shortly after hip fracture surgery, only the TUG test discriminated between future recurrent fallers and nonfallers over a 12-month follow-up. Because of the high incidence and serious consequences of falls in older adults after a hip fracture, it is very important to identify practical and clinically related tests to predict repeated falls in the first year after a hip fracture, which is of great public health importance.

Objectives: To describe the rationale, organization, and procedures of the Corona Immunitas Digital Follow-Up (CI-DFU) eCohort and to characterize participants at baseline.Methods: Participants of Corona Immunitas, a population-based nationwide SARS-CoV-2 seroprevalence study in Switzerland, were invited to join the CI-DFU eCohort in 11 study centres. Weekly online questonnaires cover health status changes, prevention measures adherence, and social impacts. Monthly questionnaires cover additional prevention adherence, contact tracing apps use, vaccination and vaccine hesitancy, and socio-economic changes.Results: We report data from the 5 centres that enrolled in the CI-DFU between June and October 2020 (covering Basel City/Land, Fribourg, Neuchâtel, Ticino, Zurich). As of February 2021, 4636 participants were enrolled and 85,693 weekly and 27,817 monthly questionnaires were collected. Design-based oversampling led to overrepresentation of individuals aged 65+ years. People with higher education and income were more likely to enroll and be retained.Conclusion: Broad enrolment and robust retention of participants enables scientifically sound monitoring of pandemic impacts, prevention, and vaccination progress. The CI-DFU eCohort demonstrates proof-of-principle for large-scale, federated eCohort study designs based on jointly agreed principles and transparent governance., + ID der Publikation: unilu_58669 + Sprache: Englisch + Letzte Aktualisierung: 2022-03-02 15:24:20

IntroductionEarly identification of frailty by clinical instruments or accumulation of deficit indexes can contribute to improve healthcare for older adults, including the prevention of negative outcomes in acute care. However, conflicting evidence exists on how to best capture frailty in this setting. Simultaneously, the increasing utilisation of electronic health records (EHRs) opens up new possibilities for research and patient care, including frailty.Methods and analysisThe Swiss Frailty Network and Repository (SFNR) primarily aims to develop an electronic Frailty Index (eFI) from routinely available EHR data in order to investigate its predictive value against length of stay and in-hospital mortality as two important clinical outcomes in a study sample of 1000–1500 hospital patients aged 65 years and older. In addition, we will examine the correlation between the eFI and a test-based clinical Frailty Instrument to compare both concepts in Swiss older adults in acute care settings. As a Swiss Personalized Health Network (SPHN) driver project, our study will report on the characteristics and usability of the first nationwide eFI in Switzerland connecting all five Swiss University Hospitals’ Geriatric Departments with a representative sample of patients aged 65 years and older admitted to acute care.Ethics and disseminationThe study protocol was approved by the competent ethics committee of the Canton of Zurich (BASEC-ID 2019-00445). All acquired data will be handled according to SPHN’s ethical framework for responsible data processing in personalised health research. Analyses will be performed within the secure BioMedIT environment, a national infrastructure to enable secure biomedical data processing, an integral part of SPHN.Trial registration numberNCT04516642.

Background Frailty is a geriatric syndrome associated with multiple negative health outcomes. However, its prevalence varies by population and instrument used. We investigated frailty and pre-frailty prevalence by 5 instruments in community-dwelling older adults enrolled to a randomized-controlled trial in 5 European countries. Methods Cross-sectional baseline analysis in 2,144 DO-HEALTH participants recruited from Switzerland, Austria, France, Germany, and Portugal with complete data for frailty. Frailty status was assessed by the Physical Frailty Phenotype [PFP], SOF-Frailty Index [SOF-FI], FRAIL-Scale, SHARE-Frailty Instrument [SHARE-FI], and a modified SHARE-FI, and compared by country, age, and gender. Logistic regression was used to determine relevant factors associated with frailty and pre-frailty. Results Mean age was 74.9 (��4.4) years, 61.6% were women. Based on the PFP, overall frailty and pre-frailty prevalence was 3.0% and 43.0%. By country, frailty prevalence was highest in Portugal (13.7%) and lowest in Austria (0%), and pre-frailty prevalence was highest in Portugal (57.3%) and lowest in Germany (37.1%). By instrument and overall, frailty and pre-frailty prevalence was highest based on SHARE-FI (7.0% / 43.7%) and lowest based on SOF-FI (1.0% / 25.9%). Frailty associated factors were residing in Coimbra (Portugal) [OR 12.0, CI 5.30���27.21], age above 75 years [OR 2.0, CI 1.17���3.45], and female gender [OR 2.8, CI 1.48���5.44]. The same three factors predicted pre-frailty. Conclusions Among relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.

IMPORTANCE: The benefits of vitamin D, omega-3 fatty acids, and exercise in disease prevention remain unclear. OBJECTIVE: To test whether vitamin D, omega-3s, and a strength-training exercise program, alone or in combination, improved 6 health outcomes among older adults. DESIGN, SETTING, AND PARTICIPANTS: Double-blind, placebo-controlled, 2 × 2 × 2 factorial randomized clinical trial among 2157 adults aged 70 years or older who had no major health events in the 5 years prior to enrollment and had sufficient mobility and good cognitive status. Patients were recruited between December 2012 and November 2014, and final follow-up was in November 2017. INTERVENTIONS: Participants were randomized to 3 years of intervention in 1 of the following 8 groups: 2000 IU/d of vitamin D(3), 1 g/d of omega-3s, and a strength-training exercise program (n = 264); vitamin D(3) and omega-3s (n = 265); vitamin D(3) and exercise (n = 275); vitamin D(3) alone (n = 272); omega-3s and exercise (n = 275); omega-3s alone (n = 269); exercise alone (n = 267); or placebo (n = 270). MAIN OUTCOMES AND MEASURES: The 6 primary outcomes were change in systolic and diastolic blood pressure (BP), Short Physical Performance Battery (SPPB), Montreal Cognitive Assessment (MoCA), and incidence rates (IRs) of nonvertebral fractures and infections over 3 years. Based on multiple comparisons of 6 primary end points, 99% confidence intervals are presented and P

AIMS OF THE STUDY Mobility disability due to spinal stenosis is common in the senior population and often surgery is warranted for patients with severe symptoms and neurological dysfunction. However, although current clinical guidelines recommend stabilisation surgery in addition to decompression in patients with spinal stenosis and instability due to degenerative spondylolisthesis, the relationship between outcomes and the specific type of surgery have not been well studied. We therefore assessed the postoperative recovery timeline for 12 months and compared patient-reported outcomes dependent on the extent of decompression and additional stabilisation among seniors undergoing spinal stenosis surgery. METHODS We investigated 457 patients (mean age 76.0 ± 10.7 years, 58% women) from a consecutive cohort prior to spinal stenosis surgery. Follow-up was at 3 or 6months and at 12 months postoperatively. At each visit, pain, neurological dysfunction and disability were assessed using the North American Spine Society questionnaire. Repeated-measures analysis compared outcomes by type of surgery adjusting for baseline symptoms, gender, age, number of comorbidities, centre and year of surgery. RESULTS Most improvement occurred within the first 3 to 6 months with little or no further improvement at 12 months. Over 12 months and in adjusted models, patients receiving one-segment versus multi-segment decompression experienced significantly greater reduction of pain (−49.2% vs −41.9%, p = 0.013) and neurological dysfunction (−37.1% vs −25.9%, p

Key Points Question Are dance-based mind-motor activities associated with benefits for fall prevention and better physical functions, such as balance, mobility, and strength, in healthy adults 65 years and older? Findings This systematic review and meta-analysis of 29 randomized clinical trials found that dance-based mind-motor interventions were associated with a statistically significant reduction (37%) in fall risk and a statistically significant reduced rate (31%) of falls. There was a statistically significant association between favorable physical function outcomes and dance-based mind-motor activities for participants in the dance-based mind-motor intervention groups compared with those in the control groups. Meaning Dance-based mind-motor activities may help fall prevention efforts in healthy older adults., Importance Falls increase morbidity and mortality in adults 65 years and older. The role of dance-based mind-motor activities in preventing falls among healthy older adults is not well established. Objective To assess the effectiveness of dance-based mind-motor activities in preventing falls. Data Sources Systematic search included the PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsychINFO, Abstracts in Social Gerontology, AgeLine, AMED, and Scopus databases from database inception to February 18, 2018, using the Medical Subject Headings aged 65 and older, accidental falls, and dancing. Study Selection This systematic review and meta-analysis included 29 randomized clinical trials that evaluated a dance-based mind-motor activity in healthy older adults with regard to fall risk, fall rate, or well-established measures of physical function in the domains of balance, mobility, and strength. The included studies targeted participants without comorbidities associated with higher fall risk. Dance-based mind-motor activities were defined as coordinated upright mind-motor movements that emphasize dynamic balance, structured through music or an inner rhythm (eg, breathing) and distinctive instructions or choreography, and that involve social interaction. Data Extraction and Synthesis Standardized independent screening, data extraction, and bias assessment were performed. Data were pooled using random-effects models. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Main Outcomes and Measures Primary outcomes were risk of falling and rate of falls. For the secondary end points of physical function (balance, mobility, and strength), standardized mean differences (SMDs) were estimated and pooled (Hedges g). Results In this systematic review and meta-analysis of 29 randomized clinical trials, dance-based mind-motor activities were significantly associated with reduced (37%) risk of falling (risk ratio, 0.63; 95% CI, 0.49-0.80; 8 trials, 1579 participants) and a significantly reduced (31%) rate of falls (incidence rate ratio, 0.69; 95% CI, 0.53-0.89; 7 trials, 2012 participants). In addition, dance-based mind-motor activities were significantly associated with improved physical function in the domains of balance (standardized mean difference [SMD], 0.62; 95% CI, 0.33-0.90; 15 trials, 1476 participants), mobility (SMD, −0.56; 95% CI, −0.81 to −0.31; 13 trials, 1379 participants), and lower body strength (SMD, 0.57; 95% CI, 0.23-0.91; 13 trials, 1613 participants) but not upper body strength (SMD, 0.18; 95% CI, −0.03 to 0.38; 4 trials, 414 participants). Conclusion and Relevance Among healthy older adults, dance-based mind-motor activities were associated with decreased risk of falling and rate of falls and improved balance, mobility, and lower body strength. This type of activity may be useful in preventing falls in this population., This systematic review and meta-analysis assesses the association of dance-based mind-motor activities with falls and physical function among healthy older adults.

There is no consensus on the most reliable method of ascertaining falls among the elderly. Therefore, we investigated which method captured the most falls among prefrail and frail seniors from 2 randomized controlled trials conducted in Zurich, Switzerland: an 18-month trial (2009-2010) including 200 community-dwelling prefrail seniors with a prior fall and a 12-month trial (2005-2008) including 173 frail seniors with acute hip fracture. Both trials included the same methods of fall ascertainment: monthly active asking, daily self-report diary entries, and a call-in hotline. We compared numbers of falls reported and estimated overall and positive percent agreement between methods. Prefrail seniors reported 499 falls (fall rate = 2.5/year) and frail seniors reported 205 falls (fall rate = 1.4/year). Most falls (81% of falls in prefrail seniors and 78% in frail seniors) were reported via active asking. Among prefrail seniors, diaries captured an additional 19% of falls, while the hotline added none. Among frail seniors, the hotline added 16% of falls, while diaries added 6%. The positive percent agreement between active asking and diary entries was 100% among prefrail seniors and 88% among frail seniors. While monthly active asking captures most falls in both groups, this method alone missed 19% of falls in prefrail seniors and 22% in frail seniors. Thus, a combination of active asking and diaries for prefrail seniors and a combination of active asking and a hotline for frail seniors is warranted.

BACKGROUND/OBJECTIVES: Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients. SUBJECTS/METHODS: We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score 23.5=normal). At the same examination, we assessed mental (Geriatric Depression Scale; GDS) and cognitive function (Mini-Mental State Examination; MMSE), frailty status (Fried Scale), and number of comorbidities and medications. Further, discharge destination was documented. All analyses were adjusted for age and gender. RESULTS: A total of 7.1% of patients were malnourished and 49.1% were ARM. Patients with reduced mental health (GDS⩾5: 30.5 vs 11.5%; P=0.004), impaired cognitive function (MMSE⩽26: 23.6±0.5 vs 26.0±0.6; P=0.004), prevalent frailty (32.5 vs 8%; P

Elucidating behavioral protective factors for cognitive decline and dementia can have a far-reaching impact. To describe the association of present and past musical instrument playing with cognitive function in cognitively intact older adults. A post hoc observational analysis of the Zurich Disability Prevention Trial. Past and present musical instrument playing was correlated with Mini-Mental State Examination (MMSE) and EuroQol-Visual Analogue Scale (EQ-VAS) using linear regression at baseline and mixed-model linear regression over 1 year. Two hundred community dwelling adults age 70 and older (mean age 77.7) were included. There were 48.5% (97/200) participants, who ever played a musical instrument; 35% (70/200) played in the past and 13.5% (27/200) played at present. At baseline, present players had a suggestively higher adjusted-MMSE than never players (28.9 vs. 28.5, p value 0.059). Over 12 months, compared to never players, ever players showed a significantly better improvement from baseline in adjusted-MMSE (0.29 vs. − 0.12, p value 0.007). The association remained significant even after restricting to participants without higher education (p value 0.03). Over time, no differences were observed for EQ-VAS (p value 0.45). However, past players had the largest decline in health-related quality of life at 12 months. The support for a protective association in our observational study suggests the need for clinical trials to examine the effect of playing a musical instrument on cognitive function and decline. Both returning to play after an interruption and learning to play from the beginning should be examined. Present and past musical instrument playing may assist in preserving cognitive function in community-dwelling older adults.

Diet is a modifiable factor that can affect bone strength and integrity, and the risk of fractures. Currently, a hierarchy of scientific evidence contributes to our understanding of the role of diet on bone health and fracture risk. The strength of evidence is generally based on the type of study conducted, the quality of the methodology employed, the rigor and integrity of the data collected and analysis plan, and the transparency and completeness of the results. Randomized controlled trials (RCTs) are considered to be the gold standard from a clinical research paradigm, but there is a dearth of high-quality diet-related intervention trials with bone as the primary outcome, forcing the use of observational research to inform research and clinical practices. However, for observational research to be of the most utility, standardization and optimization of the study design, accurate and reliable measurement of key variables, and appropriate data analysis and data reporting are paramount. Although there have been recommendations made in relation to RCTs in the field of nutrition, no clear rubric exists for best practices in conducting observational research with regard to nutrition and bone health. Therefore, the purpose of this paper is to describe the best practices and considerations for designing, conducting, analyzing, interpreting, and reporting observational research specifically for understanding the role of nutrition in bone health, amassed by a global panel of scientific experts with strengths in bone, nutrition epidemiology, physical activity, public health, clinical and translational trials, and observational study methods. The global panel of scientific experts represents the leadership and selected participants from the 10th annual International Symposium for the Nutritional Aspects of Osteoporosis. The topics selected and best practices presented reflect expert opinion and areas of scientific expertise of the authors rather than a systematic or comprehensive literature review or professional reporting guidelines.

Objectives To evaluate 2 simple strategies, vitamin D3 and a home exercise program, in functional recovery during the first year after hip fracture. Design Secondary analysis of a factorial clinical trial. Patients were randomly allocated to 800 IU (standard of care) or 2000 IU vitamin D3 and a daily instruction of a simple home exercise program (SHEP) or standard physiotherapy alone during acute care. Setting and participants Acute hip fracture patients aged ≥65 years, after hip fracture surgery, admitted to a large hospital in Zurich, Switzerland. Measures Three objective measures of lower extremity function were assessed at baseline and 6 and 12 months, with the Timed Up and Go test (TUG) as the primary endpoint, and knee flexor and extensor strength, and a self-reported physical function score (PF-10) as secondary endpoints. Linear mixed model regression analyses were based on intention to treat, adjusting for baseline function, time, age, sex, and baseline 25-hydroxyvitamin D level. Results We enrolled 173 patients (79.2% women; mean age 84 years; 77.5% living at home). A significant interaction was found between vitamin D3 dose and SHEP for TUG (P = .045). Thus, findings compared the standard of care reference arm with 800 IU vitamin D3 without SHEP to 3 interventions arms (800 IU vitamin D3+SHEP; 2000 IU vitamin D3 without SHEP; 2000 IU vitamin D3+SHEP). For TUG, over 12 months the 800 IU vitamin D3+SHEP group performed significantly better than the standard-of-care group (13.8 vs 19.5 seconds; P = .01). Findings for knee flexor strength were in line with TUG results and approached significance (P = .07), whereas knee extensor strength and PF-10 did not differ by treatments. Conclusions/Implications For functional recovery after hip fracture, combining home exercise with 800 IU vitamin D3 is superior to no home exercise or 2000 IU vitamin D3. None of the interventions improved subjective physical functioning.

Summary In this prospective study, half of all falls resulted in injury. Pre-frail adults sustained more injuries, while more frail adults had injuries requiring hospitalization or fractures. Pre-frail adults fell more often when in movement compared with frail adults who fell more often when standing and in indoor public spaces. Purpose To assess prospectively how fall environment and direction are related to injury among pre-frail and frail adults. Methods We included 200 community-dwelling adults with a prior fall (pre-frail, mean age 77 years) and 173 adults with acute hip fracture (frail, mean age 84 years; 77% community-dwelling). Falls were prospectively recorded using standardized protocols in monthly intervals, including date, time, fall direction and environment, and injury. We used logistic regression to assess the odds of injury adjusting for age, body mass index (BMI), and gender. Results We recorded 513 falls and 331 fall-related injuries (64.5%) among the 373 participants. While the fall rate was similar between groups, pre-frail adults had more injuries (71% among pre-frail vs. 56% among frail, p = 0.0004) but a lower incidence of major injuries (9% among pre-frail vs. 27% among frail, p = 0.003). Pre-frail adults fell more often while in movement (84% among pre-frail vs. 55% among frail, p

DO-HEALTH is a randomized trial aiming to evaluate the role of omega-3 fatty acids and a simple home exercise program next to vitamin D on five primary endpoints including fracture risk, muscle function, cognitive function, rate of infections, and blood pressure. The trial includes 2157 community-dwelling seniors 70 years and older recruited across seven European centers (Zurich, Basel, Geneva, Berlin, Toulouse, Innsbruck, and Coimbra). As part of the extensive phenotyping of DO-HEALTH participants, during the first baseline clinical visit and at the end of follow-up, participants completed a touchscreen food frequency questionnaire assessing usual intake of more than 180 food items. Using factor analysis with principal components, we identified three dietary patterns in each of the five countries included in DO-HEALTH. All five countries had a similar “vegetable pattern,” most countries (except Portugal) had a “high meat pattern,” and most of the differences between countries were found in the “miscellaneous” less healthy patterns. In future analyses in DO-HEALTH, we will explore the associations between these patterns and the risks of age-related chronic diseases.

Depression is common among senior adults, yet understudied among trauma patients. The purpose of this study was to assess the prevalence of depressive symptoms among seniors hospitalized in acute trauma care, to compare patients with depressive symptoms vs. those without, and to evaluate whether depression symptoms affects discharge destination.This cross-sectional and prospective analysis was conducted among community-dwelling patients ≥70 years old, hospitalized at the Senior Trauma Center of the University Hospital Zurich, Switzerland. We used the Geriatric Depression Scale (GDS-15) to assess presence of depressive symptoms. Using a cutoff value of 5 points, we compared age- and gender-adjusted characteristics of patients with and without depressive symptoms. Multinomial logistic regression models were used to estimate the odds of returning home vs. not adjusting for age, gender, nutritional status, cognitive function and others.Of the 273 seniors enrolled, 104 (38.1%) were men and the mean age was 79.4 (SD = 6.5) years. We identified 52 (19.0%) patients with depressive symptoms. These patients were more likely to be older (p = 0.04), at risk for malnutrition (p0.0001), at least pre-frail (p = 0.005), and have decreased cognitive function (p = 0.001). They were also more than twice as likely to be discharged to acute geriatric care compared to home (OR = 2.28 (CI = 1.12-4.68)).Depressive symptoms were assessed during acute care without data before hospitalization.Senior trauma patients with depressive symptoms during acute care were more likely to be at higher risk of malnutrition, have cognitive decline and are more likely to receive additional geriatric care.

Objective With advancing age, the prevalence of vitamin D deficiency and musculoskeletal pain increases. However, published data on the effectiveness of vitamin D supplementation in reducing chronic pain are inconclusive. The purpose of this study was to test the effect of 3 different monthly doses of vitamin D on chronic pain in seniors 70 years and older with a prior fall event. Design 1-year, double-blind randomized clinical trial. Setting The trial was conducted in Zurich, Switzerland. Participants were 200 community-dwelling men and women 70 years and older with a prior fall. Intervention Three study groups with monthly treatments were randomized to either a low-dose control group of vitamin D (24,000 IU vitamin D3/mo), a high dose of vitamin D3 (60,000 IU vitamin D3/mo), or a combination of calcifediol and vitamin D3 (24,000 IU vitamin D3 plus 300 μg calcifediol/mo). Measurements The primary endpoint was the change in the mean number of painful areas using the McGill Pain map over 12 months of follow-up. All analyses were adjusted for age, sex, body mass index, 25-hydroxyvitamin (OH)D3 levels, and pain scores at baseline. A predefined subgroup analysis was performed by baseline 25(OH)D status ( Results The mean age of the participants was 78 years, 67.0% (134 of 200) were female, and 58.0% (116 of 200) were vitamin D deficient ( Conclusion Our results suggest that both starting level of 25(OH)D3 and monthly treatment dose of vitamin D may be important with respect to chronic pain reduction—with the only benefit seen among vitamin D–replete seniors treated with a monthly dose of 24,000 IU vitamin D3.

Despite an extensive literature on the role of inflammation and depression, few studies have evaluated the association between inflammatory biomarkers and depression in a prospective manner, and results are inconclusive.We conducted a prospective analysis of blood levels of CRP, IL-6 and TNFα-R2 in 4756 women participating in the Nurses׳ Health Study who donated blood in 1990 and were depression-free up to 1996. Participants were followed between 1996 and 2008 for reports of clinical diagnosis depression or antidepressant use. Additionally, we conducted cross-sectional analyses for CRP, IL-6 and TNFα-R2 and antidepressant use at time of blood draw.After adjustment for body mass index, menopause status, use of anti-inflammatory drugs and other covariates, no significant associations between CRP, IL-6 and TNFα-R2 and incident depression were observed after a follow-up of 6-18 years. However, menopause status appears to modify the association between IL-6 and depression risk. In cross-sectional analyses, TNFα-R2 was associated with antidepressant use (OR=1.96, 95% CI=1.23-3.13, P-trend=0.001), but no significant associations were found for CRP and IL-6.Depression diagnosis was first assessed in 1996, 6 years after blood draw. However the biomarkers have high within-person correlations with measurements 4 years apart.Blood levels of CRP, IL-6 and TNFα-R2 were not associated with incident depression over a follow-up of 6-18 years. In cross-sectional analyses, antidepressant use may be associated with higher levels of TNFα-R2 but no associations with depression or antidepressant use were observed in the prospective analysis.

Diet patterns associated with low chronic inflammation may modulate cognitive decline. We investigated an empirical dietary pattern (EDP) associated with inflammation in five European countries and its association with cognitive changes over 3-years. This prospective study included 2157 community dwelling-seniors 70 years and older, followed for 3 years as part of DO-HEALTH, a randomized clinical trial. At baseline, participants completed a food frequency questionnaire and C-Reactive Protein (CRP) and interleukin-6 (IL-6) was measured. We used the Montreal Cognitive Assessment (MoCA) every year of the study. Based on reduced rank regression, we estimated a dietary pattern associated with CRP and IL-6. To evaluate the association between the EDP and cognitive changes over time, we used repeated measure linear regression models adjusting for age, total calories, BMI, study center, time, alcohol intake, education, physical activity, presence of depression symptoms, hypertension, diabetes or heart disease. The EDP was characterized by higher intakes of red and organ meat, refined grains, legumes, poultry and white fish, and lower intakes of coffee, tea, ginger, nuts and cheese. In multivariate adjusted models, participants with lowest adherence to the EDP (range -7.3 to -0.3) increased their MoCA scores 0.7 points over three years whereas those with highest adherence (range 0.4-10.1) increased their MoCA scores only by 0.2 points (p=0.01). In conclusion, a low inflammatory diet was associated with better cognitive function over time among adults ≥70 years from five European countries. This finding supports the role of diet in the promotion of cognitive health among older adults.

Background: Although individual nutrients have been investigatedin relation to depression risk, little is known about the overall role ofdiet in depression.Objective: We examined whether long-term dietary patterns de-rived from a food-frequency questionnaire (FFQ) predict the devel-opment of depression in middle-aged and older women.Design: We conducted a prospective study in 50,605 participants (agerange: 50–77 y) without depression in the Nurses’ Health Study atbaseline (1996) who were followed until 2008. Long-term diet wasassessedbyusingFFQsevery4ysince1986.Prudent(highinveg-etables) and Western (high in meats) patterns were identified by usinga principal component analysis. We used 2 definitions for clinicaldepression as follows: a strict definition that required both a reportedclinical diagnosis and use of antidepressants (3002 incident cases) anda broad definition that further included women who reported eithera clinical diagnosis or antidepressant use (7413 incident cases).Results: After adjustment for age, body mass index, and otherpotential confounders, no significant association was shown betweenthe diet patterns and depression risk under the strict definition. Underthe broad definition, women with the highest scores for the Westernpattern had 15% higher risk of depression (95% CI: 1.04, 1.27; P-trend = 0.01) than did women with the lowest scores,but afteradditionadjustment for psychological scores at baseline, results were no longersignificant (RR: 1.09; 95% CI: 0.99, 1.21; P-trend = 0.08).Conclusion: Overall, results of this large prospective study do notsupport a clear association between dietary patterns from factoranalysis and depression risk. Am J Clin Nutr doi: 10.3945/ajcn.112.052761.INTRODUCTIONAccording to the WHO, depression is the fourth leading causeof disease burden in the world (1). Depressive episodes may berecurrent or chronic and have a substantial impact on lifefunctioning. In the United States, the lifetime prevalence ofdepression is 19.2%, and women are, on average, 1.7 times morelikely to have depression than men (2).Numerous studies have examined the relation between theintake of individual nutrients or foods and depression. Many ofthese studies have been cross-sectional, and results have beeninconsistent (3). Some prospective studies have shown that fish(4), folate (5, 6), and caffeine (7) may each individually reducerisk of depression. Other studies have evaluated the role ofpolyunsaturated fatty acids (8–10), zinc (11), vitamin D (12) andother micronutrients with inconclusive results. But the study ofthe role of individual nutrients is challenging because manynutrients are highly correlated with each other because they maycome from the same food sources, and some nutrients can affectthe intestinal absorption of nutrients. Therefore, the study of anoverall dietary pattern analysis has been recommended to ex-amine the complex relation between diet and disease risk (13).Previous studiesontherole of dietpatternsanddepressionhavebeen scarce, and, in their majority, cross-sectional studies (14–17).To our knowledge, only 3 previous prospective studies haveevaluated the role of dietary patterns and depressive symptoms inadulthood (18–20), and one previous prospective study evaluatedthe role of dietary patterns and depressive symptoms in adoles-cents (21). Although the study by Sanchez-Villegas et al (18) usedthe Mediterranean diet score, which is an a priori quality scoreselected on the basis of previous knowledge (13), the studies byAkbaraly et al (United Kingdom) (19) and Le Port et al (France)(20) have evaluated the associations between a posteriori dietarypatterns and depression, in which diet patterns were selected fromthe dietary data collected in the specific population by using factoranalysis (13). Overall,these prospective studies reported lower riskof depression with healthier diet patterns; however, all of thestudies relied on a single measurement of diet over time.In the Nurses’ Health Study (NHS)

Tuberculosis is highly prevalent worldwide, accounting for nearly two million deaths annually. Vitamin D influences the immune response to tuberculosis, and vitamin D deficiency has been associated with increased tuberculosis risk in different populations. Genetic variability may influence host susceptibility to developing active tuberculosis and treatment response. Studies examining the association between genetic polymorphisms, particularly the gene coding for the vitamin D receptor (VDR), and TB susceptibility and treatment response are inconclusive. However, sufficient evidence is available to warrant larger epidemiologic studies that should aim to identify possible interactions between VDR polymorphisms and vitamin D status.

Inflammation is considered as a mechanism leading to depression, but the association between inflammatory dietary pattern and depression risk is unknown.Using reduced-rank regression, we identified a dietary pattern that was related to plasma levels of inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor α receptor 2), and we conducted a prospective analysis of the relationship of this pattern and depression risk among participants in the Nurses' Health Study. A total of 43,685 women (aged 50-77) without depression at baseline (1996) were included and followed up until 2008. Diet information was obtained from food frequency questionnaires completed between 1984 through 2002 and computed as cumulative average of dietary intakes with a 2-year latency applied. We used a strict definition of depression that required both self-reported physician-diagnosed depression and use of antidepressants, and a broader definition that included women who reported either clinical diagnosis or antidepressant use.During the 12-year follow-up, we documented 2594 incident cases of depression using the stricter definition and 6446 using the broader definition. After adjustment for body mass index and other potential confounders, relative risks comparing extreme quintiles of the inflammatory dietary pattern were 1.41 (95% confidence interval [CI], 1.22, 1.63; P-trend.001) for the strict definition and 1.29 (95% CI, 1.18, 1.41; P-trend.001) for the broader definition of depression.The inflammatory dietary pattern is associated with a higher depression risk. This finding suggests that chronic inflammation may underlie the association between diet and depression.

Iron, potassium, zinc, and other minerals might impact the development of premenstrual syndrome (PMS) through multiple mechanisms, but few studies have evaluated these relations. We conducted a case-control study nested within the prospective Nurses' Health Study II (1991–2001). Participants were free from PMS at baseline. After 10 years, 1,057 women were confirmed as PMS cases and 1,968 as controls. Mineral intake was assessed using food frequency questionnaires completed in 1991, 1995, and 1999. After adjustment for calcium intake and other factors, women in the highest quintile of nonheme iron intake had a relative risk of PMS of 0.64 (95% confidence interval (CI): 0.44, 0.92; P for trend = 0.04) compared with women in the lowest quintile. Women in the highest quintile of potassium intake had a relative risk of 1.46 (95% CI: 0.99, 2.15; P for trend = 0.04) compared with women in the lowest quintile. High intake of zinc from supplements was marginally associated with PMS (for intake of ≥25 mg/day vs. none, relative risk = 0.69, 95% CI: 0.46, 1.02; P for trend = 0.05). Intakes of sodium, magnesium, and manganese were unrelated to PMS risk. These findings suggest that dietary minerals may be useful in preventing PMS. Additional studies are needed to confirm these relations.

Background: Thiamine, riboflavin, niacin, vitamin B-6, folate, and vitamin B-12 are required to synthesize neurotransmitters that are potentially involved in the pathophysiology of premenstrual syndrome (PMS). Objective: The objective was to evaluate whether B vitamin intake from food sources and supplements is associated with the initial development of PMS. Design: We conducted a case-control study nested within the Nurses’ Health Study II cohort. Participants were free of PMS at baseline (1991). After 10 y of follow up, 1057 women were confirmed as cases and 1968 were confirmed as controls. Dietary information was collected in 1991, 1995, and 1999 by using food-frequency questionnaires. Results: Intakes of thiamine and riboflavin from food sources were each inversely associated with incident PMS. For example, women in the highest quintile of riboflavin intake 2‐4 y before the diagnosis year had a 35% lower risk of developing PMS than did those in the lowest quintile (relative risk: 0.65; 95% CI: 0.45, 0.92; P for trend = 0.02). No significant associations between incident PMS and dietary intakes of niacin, vitamin B-6, folate, and vitamin B-12 were observed. Intake of B vitamins from supplements was not associated with a lower risk of PMS. Conclusions: We observed a significantly lower risk of PMS in women with high intakes of thiamine and riboflavin from food sources only. Further research is needed to evaluate the effects of B vitamins in the development of premenstrual syndrome. Am J Clin Nutr 2011;93:1080‐6.

High dietary intake of vitamin D may reduce the risk of premenstrual syndrome (PMS), perhaps by affecting calcium levels, cyclic sex steroid hormone fluctuations, and/or neurotransmitter function. Only a small number of previous studies have evaluated this relationship and none have focused on young women. We assessed this relationship in a cross-sectional analysis within the UMass Vitamin D Status Study. Between 2006 and 2008, 186 women aged 18-30 (mean age=21.6 years) completed a validated food frequency questionnaire, additional questionnaires to assess menstrual symptoms and other health and lifestyle factors, and provided a fasting blood sample collected during the late luteal phase of their menstrual cycle. Among all study participants, results suggested the possibility of an inverse association between intake of vitamin D from food sources and overall menstrual symptom severity, though were not statistically significant; mean intakes in women reporting menstrual symptom severity of none/minimal, mild, and moderate/severe were 253, 214, and 194 IU/day, respectively (P=0.18). From among all study participants, 44 women meeting standard criteria for PMS and 46 women meeting control criteria were included in additional case-control analyses. In these women, after adjustment for age, body mass index, smoking status and total calcium intake, higher intake of vitamin D from foods was associated with a significant lower prevalence of PMS. Women reporting vitamin D intake from food sources of >or=100 IU/day had a prevalence odds ratio of 0.31 compared to those reporting

Please cite this article in press as: Lucas, M., et al. Erratum to ‘‘Inflammatory dietary pattern and risk of depression among women’’ [Brain Behav. I 36 (2014) 46–53]. Brain Behav. Immun. (2014), http://dx.doi.org/10.1016/j.bbi.2014.03.011 Michel Lucas a,b,⇑, Patricia Chocano-Bedoya , Matthias B. Schulze , Fariba Mirzaei , Eilis J. O’Reilly , Olivia I. Okereke , Frank B. Hu , Walter C. Willett , Alberto Ascherio a,d,e