Risk Of Mortality In Adults Research Articles

Impact of serum carotenoids on cardiovascular mortality risk in middle-aged and elderly adults with metabolic syndrome

BackgroundMetabolic syndrome (MetS), characterized by abdominal adiposity, hypertension, hyperglycemia, and dyslipidemia, is associated with dysregulated immune function, elevated oxidative stress, and chronic low-grade inflammation. Aging exacerbates insulin resistance and the prevalence of MetS. Dietary antioxidants, such as carotenoids, may play a role in preventing cardiovascular disease (CVD) mortality, but evidence remains mixed, particularly among middle-aged and elderly individuals with MetS.MethodsWe analyzed data from 6,601 participants aged 40 years and above with MetS from the National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and NHANES 2001–2006 cycles. Serum concentrations of α-carotene, β-carotene, lycopene, β-cryptoxanthin, and combined lutein/zeaxanthin were quantified. Participants were followed for a median of 16.8 years. Cox proportional-hazards models were used to assess the association between serum carotenoid concentrations and CVD mortality risk, with adjustment for potential confounders.ResultsDuring the follow-up period, 1,237 CVD deaths were identified. Analysis revealed an inverse dose–response relationship between serum lycopene levels and cardiovascular mortality risk. Compared to the lowest quartile, the multivariable-adjusted hazard ratios (95% confidence intervals) for ascending quartiles of serum lycopene were 0.84 (0.71, 1.00), 0.87 (0.74, 1.03), and 0.77 (0.61, 0.97), with a significant trend (p = 0.039). No significant associations were observed for other carotenoids.ConclusionIn this prospective cohort study of 40-year-old and older individuals with MetS, we observed an inverse association between serum lycopene levels and CVD mortality risk.

Abstract 4138620: Assessment of the Accuracy of the Perioperative Mortality Risk in Adults with Congenital Heart Disease (PEACH) Score

INTRODUCTION: Previous mortality risk scores for adult cardiac surgery patients did not include adult congenital heart disease (ACHD) patients. Development of ACHD specific mortality risk scores include the procedure-specific ACHS score and recently derived PEACH score. While validated in Europe, further evaluation of the PEACH score in additional settings is necessary. RESEARCH QUESTION: We assessed the efficacy of the PEACH score to predict mortality in ACHD patients undergoing congenital cardiac surgery at our institution. We compared the PEACH score to the ACHS and STS scores and assessed for additional risk factors which may further augment the PEACH score. Methods: A retrospective cohort study was conducted of patients who underwent congenital cardiac surgery at the University of Colorado Hospital and Children’s Hospital Colorado between 2010-2022. Patients were identified by the institutional STS congenital cardiac surgery database and were eligible if 18 years or older and underwent congenital cardiac surgery. Components of the PEACH score and additional postulated risk factors were evaluated by univariate analysis. A receiver operating characteristic (ROC) curve was used to compare the PEACH score to existing risk models. Logistic regression analysis determined additional risk factors to augment the PEACH score. Results: A total of 516 patients were included with a median age of 30 (IQR 23-42) and 51% were male. There were nine deaths overall. The PEACH score was predictive of mortality (OR: 2.09, p<0.001) with a score of 0: 0 deaths/240 patients (0%); 1-2: 6 deaths/229 patients (2.6%); 3+: 3 deaths/41 patients (7.3%). Of additional risk factors tested, platelets less than 184,000 per mcL (OR: 8.36, p=0.01) was significantly associated with mortality. Comparison of the models revealed PEACH score AUC 0.832 (95% CI: 0.740,0.924), ACHS score AUC 0.869 (95% CI: 0.806, 0.932), and STAT AUC 0.769 (95% CI: 0.616, 0.922, Figure 1). The addition of platelet level improved the predictive ability of the PEACH score (AUC 0.881). Conclusion: In this single-center analysis, the PEACH score provided strong predictive ability for peri-operative mortality. The addition of platelet levels may further augment this score.

Light Walking Patterns and Postprandial Cardiometabolic Responses in Young Obese Adults: A Randomized Crossover Study.

Recent studies suggest that light-intensity physical activity may enhance cardiometabolic health and reduce mortality risk in adults. However, more information is required to understand the patterns of light-intensity physical activity and postprandial cardiometabolic health. This study examined the effects of different light-intensity walking patterns on postprandial cardiometabolic responses in young obese adults. A randomized crossover trial was conducted. The study was conducted in the laboratory. The study analyzed baseline (fasting) and 6-hour postprandial concentrations of glucose, insulin, triglycerides, and blood pressure (BP) in 16 young obese adults. Participants underwent four 7-hour experimental conditions with a 7-20-day washout period: uninterrupted sitting (SIT), 30-minute light-intensity walking (EX+SIT), 3-minute light-intensity walking every 30 minutes (BR), and 30-minute light-intensity walking with 3-minute light-intensity walking every 30 minutes (EX+BR). Incremental areas under the curve (iAUC) for each outcome and average BP were compared between SIT and walking conditions. Compared with SIT, all walking conditions reduced iAUCs for glucose and average diastolic BP (all p<0.05). Only EX+SIT and EX+BR reduced iAUCs for insulin (p<0.05). No significant differences were found for triglycerides iAUC and systolic BP between the four conditions (all p>0.05). All patterns of light-intensity walking reduced postprandial glucose concentrations and diastolic BP in young obese adults, suggesting benefits for glycemic control. Continuous 30-minute light-intensity walking alone, or combined with brief 3-min bouts also attenuated postprandial insulin concentrations, highlighting light-intensity walking as a promising strategy for improving cardiometabolic health in young obese adults.

Associations of saccharin intake with all-cause, cardiovascular and cancer mortality risk in USA adults.

Saccharin is a widely used sugar substitute, but little is known about the long-term health effects of saccharin intake. Our study aimed to examine the association between saccharin intake and mortality in diabetic and pre-diabetic population and overweight population from NHANES 1988-1994. Cox proportional hazard models were used to evaluate the association between saccharin intake and CVD, cancer and all-cause mortality. After multivariable adjustment, increased absolute saccharin intake was associated with the risk of all-cause mortality (hazard ratio (HR): 1·41, 95 % CI: 1·05, 1·90), CVD mortality (HR: 1·93, 95 % CI: 1·15, 3·25) and cancer mortality (HR: 2·26, 95 % CI: 1·10, 4·45) in diabetic and pre-diabetic population. Among overweight population, higher absolute saccharin intake was associated with the risk of cancer mortality (HR: 7·369, 95 % CI: 2·122, 25·592). Replacing absolute saccharin intake with total sugar significantly reduced all-cause mortality by 12·5 % and CVD mortality by 49·7 % in an equivalent substitution analysis in the diabetic and pre-diabetic population. Aspartame substitution reduced all-cause mortality by 29·2 % and cancer mortality by 30·2 %. Notably, the relative daily intake of saccharin also had similar effects as the absolute intake on all-cause, cardiovascular and cancer mortality in all analyses. This was despite the fact that the relative daily intake in our study was below the Food and Drug Administration limit of 15 mg/kg. In conclusion, our study showed a considerable risk of increased saccharin intake on the all-cause, CVD mortality and cancer mortality.

Association of Psychotropic Prescriptions With Non-Registered Indications and the Risk of Mortality in Older Adults: A Danish Nationwide Cohort Study.

Psychotropic drug use is common in older adults, with off-label use reported despite limited understanding of the safety outcomes compared to on-label use. Incomplete recordings of treatment indications in the Danish National Prescription Register (DNPR) raise concerns about potential off-label medication use, particularly among older adults. We, therefore, investigated the association between psychotropic prescriptions with non-registered indications in DNPR and the 1-year all-cause mortality in older adults, including subgroups with any psychiatric disorders, depression, or dementia. Register-based cohort study following all older adults (≥ 65) who redeemed a first-time (since 1995) prescription of either antidepressants, antipsychotics, or benzodiazepine during 2006-2017. Redemption of a prescription with non-registered indications in the DNPR was the exposure. The outcome, 1-year all-cause mortality was analyzed using Poisson regression, estimating incidence rate ratios with 95% confidence intervals, adjusting for socio-demographics and clinical factors. 32% of prescriptions filled by 202,067 individuals for antidepressants, 37% of 97,387 for antipsychotics, and 22% of 130,471 for benzodiazepines had non-registered indications. No significant differences in mortality rates were found for antidepressants and antipsychotics with non-registered indications, while higher mortality rates were associated with benzodiazepines, mitigated when excluding individuals receiving intravenous administrations representing end-of-life treatment. The results remained consistent in subgroup analyses in patients with any psychiatric disorders, depression, or dementia and further stratified analyses by sex and age. We found that while psychotropic prescriptions with non-registered indications in DNPR were prevalent in older adults, they were not associated with excess mortality.

Diabetes and the risk of cardiovascular events and all-cause mortality among older adults: an individual participant data analysis of five prospective studies.

Guidelines and studies provide conflicting information on whether type 2 diabetes (T2D) should be considered a coronary heart disease risk (CHD) equivalent in older adults. We synthesized participant-level data on 82,723 individuals aged ≥65 years from five prospective studies in two-stage meta-analyses. We estimated multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of T2D (presence versus absence) on a primary composite outcome defined as cardiovascular events or all-cause mortality. Secondary outcomes were the components of the composite. We evaluated CHD risk equivalence by comparing outcomes between individuals with T2D but no CHD versus CHD but no T2D. The median age of participants was 71 years, 20% had T2D and 17% had CHD at baseline. A total of 29,474 participants (36%) experienced the composite outcome. Baseline T2D was associated with higher risk of cardiovascular events or all-cause mortality versus no T2D (HR 1.44, 95% CI [1.40-1.49]). The association was weaker in individuals aged ≥75 years versus 65-74 years (HR 1.32 [1.19-1.46] vs. 1.56 [1.50-1.62]; p-value for interaction = .032). Compared to individuals with CHD but no T2D, individuals with T2D but no CHD had a similar risk of the composite outcome (HR 0.95 [0.85-1.07]), but a lower risk of cardiovascular events (HR 0.76 [0.59-0.98]). T2D was associated with increased risk of cardiovascular events and all-cause mortality in older adults, but T2D without CHD conferred lower risk of cardiovascular events compared to CHD without T2D. Our results suggest that T2D should not be considered a CHD risk equivalent in older adults.

Association of cardio-cerebrovascular death with isolated diastolic hypertension: a nationally representative survey of 85, 138 adults

Abstract Background Recently, the 2023 European Society of Hypertension (ESH) guideline for hypertension management include isolated diastolic hypertension (IDH) as a distinct classification. But, studies have yielded inconsistent associations between IDH and cardiovascular disease (CVD) events. Method We obtained data from 85138 participants without CVD and antihypertensive medication use who included in the China Chronic Disease and Risk Factors Surveillance (CCDRFS) project 2010. We extracted data on deaths from any cause, cardiovascular diseases, and stroke during follow up. The hazard ratios (HR) and 95% confidence intervals (CI) for all-cause mortality, cardiovascular mortality, and stroke mortality associated with each blood pressure (BP) group were calculated using Cox proportional hazards models, with the normotension group as the reference. Our analyses were performed with sequential adjustment. In the first step, we carried out unadjusted analyses (model 1). In model 2, we added age, sex, ethnic, location, educational attainment, smoking status, alcohol drinking status, exercise, BMI, high-density-lipoprotein cholesterol, low-density-lipoprotein cholesterol, fasting glucose level as adjustment covariates. Results Overall, 57144 (67.1%) participants had normotension, 3826 (4.5%) participants had IDH, 11013 (12.9%) participants had isolated systolic hypertension (ISH), 13155 (15.5%) participants had systolic and diastolic hypertension (SDH). Compared with normotension, IDH was not statistically associated with a significantly increased risk of all-cause mortality (HR, 1.09 [95% CI, 0.86–1.39], model 2), or cardiovascular mortality (HR, 1.21 [95% CI, 0.74–1.96], model 2). On the contrary, IDH was significantly associated with a modestly higher risk of stroke mortality (HR, 1.84 [95% CI, 1.13–3.00], model 2). IDH was significantly associated with a modestly higher risk of stroke mortality in middle aged and older adults, but not young adults (age &amp;lt;45years). Similar results were obtained for men, while for women the associations between the prevalence of IDH and a higher incidence of stroke mortality were not significant. Stage 1 to stage 3 ISH or SDH were associated with a higher risk for all-cause mortality, cardiovascular mortality, and stroke mortality. Conclusion IDH was associated with an increased risk of stroke mortality among the large nationally representative Chinese population. Intervention for IDH may be effective in reducing the burden of stroke in China.

Graded association of muscle strength with all-cause and cause-specific mortality in older adults with diabetes: Prospective cohort study across 28 countries.

The worldwide prevalence of diabetes is increasing, particularly among older adults. Understanding the association between muscle strength and mortality in this population is crucial for developing targeted exercise recommendations. To assess the prospective association of muscle strength with mortality in older adults with diabetes. From the Survey of Health, Ageing and Retirement in Europe (SHARE) study, spanning 28 countries, we included 16 149 diabetic adults aged 50 years and older (mean age 68.2 [standard deviation, SD, 9.2] years). Participants fulfilled two criteria: (1) diabetes diagnosis (ever) and (2) current use of diabetes medication. Muscle strength was assessed using handgrip dynamometry (unit: kg). Using time-varying Cox regression with restricted cubic splines, we determined the prospective association of muscle strength with all-cause and cause-specific mortality, controlling for various confounders. Over a mean follow-up of 5.9 years (SD 3.8), 2754 participants died (17%). Using the median level of muscle strength as reference (30 kg), lower and higher levels were associated in a curvilinear fashion with higher and lower all-cause mortality risk, respectively. The 10th percentile of muscle strength (17 kg) showed a hazard ratio (HR) of 1.65 (95% confidence interval (CI) 1.53-1.79). The 90th percentile (47 kg) of muscle strength showed a HR of 0.55 (95% CI 0.49-0.63). A somewhat similar pattern, with varying strength of associations, was seen for mortality due to cardiovascular disease (CVD), respiratory disease, severe infectious disease, digestive system disease and cancer. Muscle strength is gradually and inversely associated with all-cause and cause-specific mortality risk in older adults with diabetes. As muscle strength is highly adaptable to resistance training at all ages, the present findings highlight the importance of improving muscle strength in older adults with diabetes.

Association between dietary inflammatory index and all-cause mortality risk in adults with coronary heart disease in the United States

Diet and inflammation are crucial in the incidence and progression of coronary heart disease (CHD). This study aimed to investigate the correlation between the Dietary inflammatory index (DII) and all-cause mortality in CHD patients. A total of 1,303 CHD patients from the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2018 were included. Multivariate Cox regression was used to explore the correlation between the DII and the risk of all-cause mortality in these patients. Restricted cubic spline (RCS) analysis was also utilized to examine the relationship between the DII and all-cause mortality risk in CHD patients. Additionally, subgroup analyses were conducted to determine how the correlation between the DII and all-cause mortality varied across different demographics. During a median follow-up period of 77 months among 1,303 CHD patients, 536 died from all causes. The DII scores were significantly higher in deceased patients compared to survivors. After adjusting for confounding factors, the multivariate Cox regression analysis indicated a strong positive correlation between the DII and all-cause mortality in CHD patients. RCS analysis suggested a non-linear relationship between the DII and all-cause mortality among CHD patients. Additionally, an increase in DII was more pronounced in its impact on female patients. The DII is strongly correlated with the risk of all-cause mortality among CHD patients, particularly among females. Thus, managing dietary inflammation is vital for the prevention and treatment of CHD, especially in female patients.

Impact of mental disorders on the all-cause mortality and cardiovascular disease outcomes in adults with new-onset type 1 diabetes: A nationwide cohort study

AimsThis population-based study aimed to investigate the impact of mental disorders on the risk of mortality and cardiovascular disease (CVD) outcomes in adults with new-onset type 1 diabetes. Materials and methodsWe included 17,429 patients with new-onset type 1 diabetes without CVD from the Korean National Health Insurance Service database. Mental disorders include depression, bipolar, persistent affective and other affective disorders, anxiety, eating disorders, personality and behavioral disorders, and substance abuse. Individuals with or without mental disorders were matched 1:1 by age, sex, and year of the index date. The primary outcomes were all-cause mortality and composite CVD events. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using multivariate Cox proportional hazards regression models. ResultsDuring a median follow-up of 7.99 years, all-cause mortality (composite CVD outcomes) occurred in 1,562 patients (1,993 patients with CVD outcomes) with mental disorders and 1,211 patients (1,611 patients with CVD outcomes) without mental disorders. The adjusted HR for all-cause mortality and composite CVD outcomes in patients with mental disorders was 1.35 and 1.32, respectively, compared to those without mental disorders. The aHR for the all-cause mortality and composite CVD events was 1.27 and 1.28 in the subgroup with one mental disorder and 1.57 and 1.43 in the subgroup with multiple mental disorders, compared to those without mental disorders. ConclusionsMental disorders are associated with an elevated risk of all-cause mortality and CVD in adults with newly diagnosed type 1 diabetes. Early detection and greater attention to premature death and CVD development are required in patients with new-onset type 1 diabetes and mental disorders.

Frailty or sarcopenia: which is a better indicator of mortality risk in older adults?

BackgroundDespite the different conditions, frailty and sarcopenia overlap regarding their common link: the assessment of walking speed and muscle strength. This study aimed to compare the frailty phenotype to the...

Association of Energy Intake and Dietary Glycemic Load in Different Time Periods With Cardiovascular Disease Mortality Among U.S. Adults With Type 2 Diabetes.

To examine the associations of energy intake and glycemic load (GL) in different time periods during the day with cardiovascular disease (CVD) mortality risk in adults with type 2 diabetes. This cohort study included 2,911 adults with diabetes from who were part of the U.S. National Health and Nutrition Examination Survey 2003-2014 (baseline), and CVD mortality data obtained by linkage to the National Death Index through 2019. Energy intake and GL in early morning (6:00-7:59 a.m.), late morning (8:00-10:59 a.m.), afternoon (11:00 a.m.-5:59 p.m.), evening (6:00-11:59 p.m.), and night (0:00-5:59 a.m.) were derived from two 24-h dietary recalls at baseline. Cox models were used to estimate hazard ratios (HRs) for CVD mortality, adjusted for total energy intake, diet quality, sociodemographic and lifestyle characteristics, and medical conditions. At baseline, the study population (51.8% female, 62.3% non-Hispanic White) had a mean age of 57.4 (SE, 0.4) years. Over a median follow-up of 9.3 (interquartile range = 6.8, 12.1) years, 190 CVD deaths were documented. Energy intake and GL in late morning were inversely associated with CVD mortality risk (per 100-kcal energy intake increment, HR 0.90 [95% CI 0.83-0.98]; per 10-unit GL increment, HR 0.86 [95% CI 0.77-0.95]). In contrast, energy intake and GL at night were positively associated with CVD mortality risk (per 100-kcal energy intake increment, HR 1.22 [95% CI 1.07-1.40]; per 10-unit GL increment, HR 1.44 [95% CI 1.17-1.77]). For adults with type 2 diabetes, late morning may be a protective eating time against CVD mortality, whereas night may be a detrimental eating time.

Cluster-Based White Matter Signatures and the Risk of Dementia, Stroke, and Mortality in Community-Dwelling Adults.

Markers of white matter (WM) injury on brain MRI are important indicators of brain health. Different patterns of WM atrophy, WM hyperintensities (WMHs), and microstructural integrity could reflect distinct pathologies and disease risks, but large-scale imaging studies investigating WM signatures are lacking. This study aims to identify distinct WM signatures using brain MRI in community-dwelling adults, determine underlying risk factor profiles, and assess risks of dementia, stroke, and mortality associated with each signature. Between 2005 and 2016, we measured WMH volume, WM volume, fractional anisotropy (FA), and mean diffusivity (MD) using automated pipelines on structural and diffusion MRI in community-dwelling adults aged older than 45 years of the Rotterdam study. Continuous surveillance was conducted for dementia, stroke, and mortality. We applied hierarchical clustering to identify separate WM injury clusters and Cox proportional hazard models to determine their risk of dementia, stroke, and mortality. We included 5,279 participants (mean age 65.0 years, 56.0% women) and identified 4 distinct data-driven WM signatures: (1) above-average microstructural integrity and little WM atrophy and WMH; (2) above-average microstructural integrity and little WMH, but substantial WM atrophy; (3) poor microstructural integrity and substantial WMH, but little WM atrophy; and (4) poor microstructural integrity with substantial WMH and WM atrophy. Prevalence of cardiovascular risk factors, lacunes, and cerebral microbleeds was higher in clusters 3 and 4 than in clusters 1 and 2. During a median 10.7 years of follow-up, 291 participants developed dementia, 220 had a stroke, and 910 died. Compared with cluster 1, dementia risk was increased for all clusters, notably cluster 3 (hazard ratio [HR] 3.06, 95% CI 2.12-4.42), followed by cluster 4 (HR 2.31, 95% CI 1.58-3.37) and cluster 2 (HR 1.67, 95% CI 1.17-2.38). Compared with cluster 1, risk of stroke was higher only for clusters 3 (HR 1.55, 95% CI 1.02-2.37) and 4 (HR 1.94, 95% CI 1.30-2.89), whereas mortality risk was increased in all clusters (cluster 2: HR 1.27, 95% CI 1.06-1.53, cluster 3: HR 1.65, 95% CI 1.35-2.03, cluster 4: HR 1.76, 95% CI 1.44-2.15), compared with cluster 1. Models including clusters instead of an individual imaging marker showed a superior goodness of fit for dementia and mortality, but not for stroke. Clustering can derive WM signatures that are differentially associated with dementia, stroke, and mortality risk. Future research should incorporate spatial information of imaging markers.

7465 Impact Of Geography And Insurance On Healthcare Utilization Preferences Of Individuals With Congenital Adrenal Hyperplasia In The United States

Abstract Disclosure: P.N. Surampudi: Research Investigator; Self; Spruce Biosciences. A.H. Hamrahian: Consulting Fee; Self; Spruce Biosciences. Research Investigator; Self; Spruce Biosciences. R. Charlton: Employee; Self; Spruce Biosciences. P. Ramtin: Employee; Self; Spruce Biosciences. M.E. Geffner: Consulting Fee; Self; Spruce Biosciences, Ferring Pharmaceuticals, Adrenas, Neurocrine Biosciences, Novo Nordisk, Eton, Pfizer, Inc., Nutritional Growth Solutions, Nutritional Growth Solutions. Research Investigator; Self; Novo Nordisk. Background: Relative to the general population, patients with classic congenital adrenal hyperplasia (CAH) have increased risks for morbidity and mortality which require specialized management across life stages[1]. Endocrine care, particularly as part of multi-disciplinary teams, can help mitigate risks of developing adrenal crises as well as the impact of glucocorticoid under- or overexposure, including adrenal insufficiency; cardiometabolic risk associated with insulin resistance and excess weight gain; fertility issues associated with irregular menses and gonadal adrenal rest tumors; diminished quality of life; increased mental health issues, including anxiety, depression, and sleep disturbance; and increased fracture risk associated with decreased bone mineral density. Study Objectives and Design: We hypothesized that the utilization of endocrine and multi-disciplinary care by patients with CAH in the United States (U.S.) could be adversely affected by non-therapeutic factors related to geographic location and access to health care. In this cross-sectional study, we utilized the Definitive Healthcare database (Nov. 2020-Nov. 2022) to gain insight into these factors in adults with CAH. Study Findings: Analysis of healthcare provider utilization revealed that only ∼30% of U.S. adults with CAH received care from endocrinologists. The rest utilized primary-care providers (PCPs: IM, FP, NP, PA, and Ob-Gyn) to obtain care. A review of insurance coverage of U.S. adults with CAH suggests that ∼70% had access to commercial insurance and over 50% resided in states with the largest populations (California, Texas, New York, Florida, Ohio, Michigan, and Illinois), both factors which should ordinarily increase accessibility of subspecialty endocrine and multi-disciplinary care. Conclusions: In our study, only 30% of U.S. CAH adults received care from an endocrinologist. Limited utilization of specialty care does not appear to be due to either diverse geographical distribution or access to healthcare. The gap in expert care may adversely affect the management of CAH and contribute to associated comorbidities. Increased partnership between PCPs and endocrinologists, and increased awareness and education regarding specialty care among patients with CAH are needed to improve health outcomes and thereby reduce the risk of morbidity and mortality in adults with CAH.

Associations Between Changes in Physical Activity and Risk of All-Cause Mortality in Adults With/Without Hypertension - China, 2010-2022.

Previous studies indicate that an increase in physical activity can diminish the risk of mortality. However, the relationship between longitudinal changes in physical activity and health improvement among Chinese adults with or without hypertension has not been explored. This study found that increasing or maintaining moderate to high physical activity levels reduced the risk of all-cause mortality, irrespective of the baseline physical activity level. In addition, the beneficial effects were particularly pronounced in people with hypertension. It may be beneficial to encourage adults in China, especially those with hypertension, to actively increase physical activity and deter the issue of physical inactivity that accompanies aging.

Mild Cognitive Impairment, Religiosity, Spirituality and all-Cause Mortality Among Chinese Older Adults in Ethnic Minority Communities.

The relationship between mild cognitive impairment (MCI), religiosity and/or spirituality (R/S), and all-cause mortality among older adults has yet to be clarified. The current study aims to examine this relationship using a longitudinal cohort from ethnic minority communities in mainland China. The Cox proportional hazards regression modeling revealed that MCI predicted an increased risk of all-cause mortality, and high R/S buffered this association. Those findings suggest that a religious-spiritual integrated community intervention program may reduce the mortality risk in older adults with MCI in ethnically disadvantaged populations.

Healthy Lifestyle And All-cause Mortality Risk In Adults And Older Adults

Healthy Lifestyle And All-cause Mortality Risk In Adults And Older Adults

Serum Uric Acid and the Risk of Cardiovascular and All-Cause Mortality in Community-Dwelling Older Adults

Serum Uric Acid and the Risk of Cardiovascular and All-Cause Mortality in Community-Dwelling Older Adults

Sarcopenia and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Narrative Review

The primary objective of modern medicine is to extend human life expectancy. Currently, the majority of hospital patients across various clinical settings are elderly or advanced-age individuals, often with multiple comorbidities and age-related alterations in peripheral tissues. One such alteration is sarcopenia, a progressive decline in muscle mass, strength, and function, which significantly increases the risk of disability and mortality in older adults. Sarcopenia is associated with numerous adverse outcomes, and its underlying mechanisms are the subject of ongoing research. This narrative review discusses the epidemiology, pathophysiology, and diagnostic criteria for sarcopenia. It also examines the connections between sarcopenia and metabolic dysfunction-associated steatotic liver disease (MASLD), highlighting potential treatment approaches for the coexistence of these two pathologies.

Association between nut consumption and mortality risk: a 20-year cohort study in Korea with a stratified analysis by health-related variables.

Although nuts are a well-known healthy food group, the relationship between nut consumption and mortality remains unclear, particularly among Asians. This prospective cohort study examined the association between nut consumption and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in Korean adults. Data from two cohorts (the Ansan-Ansung and Health-Examinees) from the Korean Genome and Epidemiology Study were used. A total of 114,140 individuals aged 40-79 years were included in the data analyses. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized into four groups: non-consumers, less than 1 serving/week, 1-2 servings/week, and 2 or more servings/week (one serving was 15g of nuts). Mortality outcomes were determined based on the 2001-2021 death records from Statistics Korea. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across nut consumption categories. A stratified subgroup analysis by health-related variables was also performed. During a mean follow-up of 12.3 years, 4,559 deaths were recorded. After adjusting for covariates, the HR for all-cause mortality was 0.877 (95% CI = 0.772-0.996, p for trend = 0.006) in individuals with a nut consumption of 2 or more servings/week compared with that in non-consumers. Multivariable HRs for CVD mortality were 0.800 (95% CI = 0.681-0.939) in individuals consuming less than 1 serving/week, 0.656 (95% CI = 0.469-0.918) in those consuming 1-2 servings/week, and 1.009 (95% CI = 0.756-1.347) in those consuming 2 or more servings/week compared with that in non-consumers (p for trend = 0.080). No association was observed between nut consumption and cancer mortality. Stratified analysis identified significant interactions in the association between nut consumption and all-cause mortality by age, body mass index, and physical activity. Nut consumption was linearly associated with the reduced risk of all-cause mortality and showed a non-linear dose-response relationship with CVD mortality in Koreans, but had no association with cancer mortality. The effects of nut consumption, which have been inadequately investigated in this population, varied across different subgroups. These findings suggest that incorporating nuts into the diet should be encouraged for long-term health of Korean adults.