Decade Of Age Research Articles

Postdischarge Survival After Sepsis: A Cohort Study.

After hospital discharge, patients who had sepsis have increased mortality. We sought to estimate factors associated with postdischarge mortality and how they vary with time after discharge. This was a retrospective study of hospital survivors of sepsis using time-varying Cox proportional hazard models, which produce a baseline hazard ratio (HR) and a second number (δHR) that reflects the amount by which the baseline HR changes with time. Of the 32,244 patients who survived sepsis at hospital discharge, 13,565 patients (42%) died (mean ± standard deviation: 1.41 ± 1.87 years) after discharge from the index hospitalization, while 18,679 patients were still alive at follow-up (4.98 ± 2.86 years). The mortality rate decreased with time after discharge: approximately 8.7% of patients died during the first month after discharge, 1.1% of patients died during the 12th month after discharge, and 0.3%% died during the 60th month; after Kaplan-Meier analysis, survival was 91% (95% confidence interval [CI], 91%-92%) at 1 month, 76% (95% CI, 76%-77%) at 1 year, 57% (95% CI, 56%-58%) at 5 years, and 48% (95% CI, 47%-48%) at 10 years after discharge. Organ dysfunction at discharge was associated with worse survival. In particular, elevated urea nitrogen at discharge (HR, 1.10 per 10 mg/dL, 95% CI, 1.08-1.12, P < .001) was associated with increased mortality, but the HR decreased with time from discharge (δHR, 0.98 per 10 mg/dL per year, 95% CI, 0.98-0.99, P < .001). Higher hemoglobin levels were associated with lower mortality (HR, 0.92 per g/dL, 95% CI, 0.91-0.93, P < .001), but this association increased with increasing time after discharge (δHR, 1.02 per g/dL per year, 95% CI, 1.01-1.02, P < .001). Older age was associated with an increased risk of mortality (HR, 1.29 per decade of age, 95% CI, 1.27-1.31, P < .001) that grew with increasing time after discharge (δHR, 1.01 per year of follow-up per decade of age, 95% CI, 1.00-1.02, P < .001). Compared to private insurances Medicaid as primary insurance was associated with an increased risk of mortality (HR, 1.17, 95% CI, 1.10-1.25, P < .001) that did not change with time after discharge. In contrast, Medicare status was initially associated with a similar risk of mortality as private insurance at discharge (HR, 1), but was associated with greater risk as time after discharge increased (δHR, 1.04 per year of follow-up, 95% CI, 1.03-1.05, P < .001). Acute physiologic derangements and organ dysfunction were associated with postdischarge mortality with the associations decreasing over time.

Prevalence of Overweight and Obesity, Its Complications, and Progression in a 10-Year Follow-Up in the Gutenberg Health Study (GHS)

Introduction: Overweight and obesity lead to numerous complications and their treatment. The associated costs represent a health and sociopolitical burden. Therefore, the development of overweight and obesity is of great importance for health policy. Methods: The Gutenberg Health Study (GHS), a population-based observational study of individuals aged 35–74 years in the city of Mainz and the district of Mainz-Bingen, examined current data on the prevalence and development of overweight and obesity and their association with concomitant diseases and medication use. Results: Among men, 48.1% were overweight and 26.3% had obesity. Among women, these proportions were 32.1% and 24.1%, respectively. Elevated body mass index (BMI) was associated with numerous complications, particularly insulin resistance and type 2 diabetes, arterial hypertension, elevated triglycerides and low HDL cholesterol, and cardiovascular disease. Accordingly, medications to treat these conditions were used significantly more often in individuals with elevated BMI. During the 10-year observation period, mean weight increased in the population. Both men and women had a moderate but significant increase in BMI compared to men and women of the same age at baseline. Individual weight changes over the 10-year observation period, on the other hand, were age-dependent. In the two younger age decades, weight gain was observed, while in the oldest age decade, mean body weight decreased. Conclusion: These current data confirm that overweight and obesity are associated with relevant complications and that these complications lead to significant use of appropriate medications. The study also suggests that there is a significant trend toward increased prevalence of obesity (BMI ≥30) over the 10-year period.

THU056 Reference Interval For Serum Soluble Alpha Klotho, A Sensitive Biomarker Of Growth Hormone (GH) Excess

Abstract Disclosure: J.R. Schweizer: None. K. Schilbach: None. M. Haenelt: None. A.P. Gagliardo: None. A. Peters: None. B. Thorand: None. S. Störmann: None. J. Schopohl: None. M. Bidlingmaier: None. Background: We recently have shown that serum concentrations of soluble alpha klotho (sαKL) are high in active acromegaly and decrease with disease control. This indicates it could be an interesting biomarker for growth hormone (GH)-related diseases. However, robust data on the reference interval of sαKL in healthy subjects are lacking. Furthermore, limited information is available about the potential impact of biological variables on sαKL in healthy subjects. Methods: SαKL was measured by ELISA (IBL, Hamburg, Germany) in healthy subjects (A, n = 890, ∼120 subjects/decade, 51% females, 20-89 years). Reference intervals were calculated by median (interquartile (IQR)) for each decade and 2.5-97.5% percentile for all healthy subjects. We also investigated the impact of biological variables (age, BMI, sex and use of estrogens). In addition, we analyzed samples from patients with non-functioning pituitary adenoma (NFPA) (B, n = 18, 50% females, 24-87 years) or prolactinoma (C, n = 66, 60% females, age 17-82 years). Results: In healthy subjects the median (IQR)) for the total group of IGF-I (μg/L), IGFBP 3 (μg/L) and sαKL (pg/mL) were 114.6 (88.4-152.7), 3869 (3318-4390) and 672 (543-846), respectively. The 2.5-97.5% percentiles for sαKL measured in the healthy subjects are 152-1303 pg/mL. SαKL in males was slightly lower than in females (651 (537-815) vs. 687 (546-881), p = 0.01). As expected, IGF-I and IGFBP 3 significantly differed between age decades, while sαKL mainly differed between individuals &amp;lt; 40 as compared to &amp;gt; 70 years (p &amp;lt; 0.05 for all comparisons). SαKL correlated to IGF-I (rs = 0.31, p &amp;lt; 0.0001), but not to IGFBP 3 (p = 0.56). SαKL exhibited a weak negative correlation to creatinine (rs = -0.12, p = 0.002), age and BMI (rs = -0.30 and rs = -0.13, respectively, p &amp;lt;0.0001 for both). These correlations were remarkably weaker than those observed for IGF-I to age and BMI (rs = -0.59 and rs = -0.24, respectively, p &amp;lt;0.0001 for both). Use of estrogen slightly reduced sαKL. SαKL was higher in prolactinoma (902 (754-1228) as compared to healthy subjects (673 (543-846), A vs. C, p &amp;lt; 0.0001), but not different between healthy subjects and NFPA (p &amp;gt; 0.05). Conclusion: Our study provides robust reference intervals for sαKL from a large sample of Caucasian subjects. They are similar to those previously reported from a smaller pilot study in an Asian population, indicating that ethnicity might have a minor impact. Notably, biological variables such as age, sex and BMI have less impact on sαKL than on IGF-I and IGFBP 3. Oral estrogens seem to slightly reduce sαKL, perhaps through induction of hepatic GH-resistance as described for IGF-I. In contrast, prolactin seems to somewhat increase sαKL concentrations within the reference intervals. This could be due to the somatotropic activity of prolactin. The availability of reference intervals might facilitate the use of sαKL as a biomarker in GH-related diseases. Presentation: Thursday, June 15, 2023

Computed tomography assessment of pelvic bone density: Associations with age and pelvic fracture in motor vehicle crashes

Motor vehicle crash (MVC) occupants routinely get a computed tomography (CT) scan to screen for internal injury, and this CT can be leveraged to opportunistically derive bone mineral density (BMD). This study aimed to develop and validate a method to measure pelvic BMD in CT scans without a phantom, and examine associations of pelvic BMD with age and pelvic fracture incidence in seriously injured MVC occupants from the Crash Injury Research and Engineering Network (CIREN) study. A phantom-less muscle-fat calibration technique to measure pelvic BMD was validated using 45 quantitative CT scans with a bone calibration phantom. The technique was then used to measure pelvic BMD from CT scans of 252 CIREN occupants (ages 16+) in frontal MVCs who had sustained either abdominal or pelvic injury. Pelvic BMD was analyzed in relation to age and pelvic fracture incidence. In the validation set, phantom-based calibration vs. phantom-less muscle-fat calibration yielded similar BMD values at the anterior superior iliac spine (ASIS; R2 = 0.95, p < 0.001) and iliac crest (R2 = 0.90, p < 0.001). Pelvic BMD was measured in 150 female and 102 male CIREN occupants aged 16–89, and 25% of these occupants sustained pelvic fracture. BMD at the ASIS and iliac crest declined with age (p < 0.001). For instance, iliac crest BMD decreased an average of 25 mg/cm3 per decade of age. The rate of iliac crest BMD decline was 7.6 mg/cm3 more per decade of age in occupants with pelvic fracture compared to those not sustaining pelvic fracture. Findings suggest pelvic BMD may be a contributing risk factor for pelvic fracture in MVCs.

O.4.1-4 Integrated geriatric care - a community approach to preventing falls and frailty of elderly Slovenian

Abstract Purpose The need for geriatric treatment is increasing with the aging of the population. Multimorbid patients with social care problems and increased need for rehabilitation and paliative care are more common. Mortality of the elderly, due to falls is 2.5 times higher in Slovenia than in the other EU countries. Until the national regulation of integrated geriatric care in Slovenian health system and in other relevant environments (community, long-term care, social care) and the establishment of appropriate, licensed postgraduate training for health professionals, it is necessary to start educating wider range of health and social care personnel, for most common geriatric syndromes such as frailty, falls and NCDs. Establishing a community approach to health is one effective way to address vulnerability of elderly population. Project description Project Integration of geriatric care for the elderly is implementing the existing commitment from WHO Decade of healthy ageing and the Slovenian Health Care Plan until 2025. With planned activities, it will ensure equal access to quality and safe health services, integrated and comprehensive treatment and will contribute to the deinstitutionalization of the Slovenian eldest population. It will develop a unified set of tools, for the systematic identification of elderly needs, new digital tools for optimization and better communication between different levels of providers and training a wider range of new and already employed health and social care personnel, for optimal health care. Evaluation of new competency models for health care personnel, training methods and proposed clinical pathways will be carried out at the end of the project. Based on final proposals, we will establish a new approach to the system level of integrated geriatric care and bring the treatment closer to the patient's home. Conclusions Project will also contribute to upgrading competences of physiotherapists, kinesiologists, standard health teams in Health Promotion Centers, community nurses, family medicine and internal medicine doctors and social care workers for the integrated geriatric care for the elderly. It will address especially treatment of the physical component in geriatric syndrome, such as decreased muscle strength, balance, impaired walking and frailty, at different levels of health care and communities.

Ageism in Birthday Cards: A Mixed-Method Content Analysis.

Ageism is oftentimes sugarcoated within humor. Paper birthday cards are 1 delivery approach in which ageist messages are perpetuated and reinforced through humor. A convenience sample of birthday cards (k = 227), all indicating a decade of age, were acquired from 7 national retail stores in Colorado Springs, CO. The decades sampled ranged from 21 to 100. With a predeveloped codebook, 3 raters coded the decade birthday cards on various variables, including age group, ageist tone, and humor. Birthday cards intended for age 30-60 contained significantly more ageist messages compared to cards intended for age 21 and age 70-100, which did not show a significant difference from each other. Additionally, birthday cards with humor showed more ageist messages than cards without humor. Characteristics of decade birthday cards were also explored. Consumers need to learn to evaluate these ageist messages in birthday cards to reduce the perpetuation of damaging stereotypes.

Exploring Healthy Retinal Aging with Deep Learning.

To study the individual course of retinal changes caused by healthy aging using deep learning. Retrospective analysis of a large data set of retinal OCT images. A total of 85 709 adults between the age of 40 and 75 years of whom OCT images were acquired in the scope of the UK Biobank population study. We created a counterfactual generative adversarial network (GAN), a type of neural network that learns from cross-sectional, retrospective data. It then synthesizes high-resolution counterfactual OCT images and longitudinal time series. These counterfactuals allow visualization and analysis of hypothetical scenarios in which certain characteristics of the imaged subject, such as age or sex, are altered, whereas other attributes, crucially the subject's identity and image acquisition settings, remain fixed. Using our counterfactual GAN, we investigated subject-specific changes in the retinal layer structure as a function of age and sex. In particular, we measured changes in the retinal nerve fiber layer (RNFL), combined ganglion cell layer plus inner plexiform layer (GCIPL), inner nuclear layer to the inner boundary of the retinal pigment epithelium (INL-RPE), and retinal pigment epithelium (RPE). Our counterfactual GAN is able to smoothly visualize the individual course of retinal aging. Across all counterfactual images, the RNFL, GCIPL, INL-RPE, and RPE changed by-0.1 μm ± 0.1 μm,-0.5 μm ± 0.2 μm,-0.2 μm ± 0.1 μm, and 0.1 μm ± 0.1 μm, respectively, per decade of age. These results agree well with previous studies based on the same cohort from the UK Biobank population study. Beyond population-wide average measures, our counterfactual GAN allows us to explore whether the retinal layers of a given eye will increase in thickness, decrease in thickness, or stagnate as a subject ages. This study demonstrates how counterfactual GANs can aid research into retinal aging by generating high-resolution, high-fidelity OCT images, and longitudinal time series. Ultimately, we envision that they will enable clinical experts to derive and explore hypotheses for potential imaging biomarkers for healthy and pathologic aging that can be refined and tested in prospective clinical trials. Proprietary or commercial disclosure may be found after the references.

Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021.

Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021-30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050. In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model. Globally, 595 million (95% uncertainty interval 535-656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8-8·4) of the global population, and an increase of 132·2% (130·3-134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4-89·9) for knee, 48·6% (35·9-67·1) for hand, 78·6% (57·7-105·3) for hip, and 95·1% (68·1-135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7-557·2) per 100 000 in 2020, a 9·5% (8·6-10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3-510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8-6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0-9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI -1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling. Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage. Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.

Influence of a long-term WB-EMS intervention on parameters of body composition and physical performance among individuals of different age decades between 19 and 81 years

Lifelong fitness training plays an essential role in building and maintaining health. Whole-body electromyostimulation (WB-EMS) is a time-efficient training method that could be used as an adequate training intervention for different persons due to the intensive, involuntary contraction of the musculature and the resulting increases in muscular performance. Therefore, the aim of the study was to investigate if WB-EMS has positive effects on body composition and physical performance parameters of individuals of different age decades. Subjects from age decades 20-80 years participated in a 24-week WB-EMS training intervention. PRE and POST diagnostics of trunk extension and flexion, knee extension and flexion, hand grip strength, skeletal muscle mass (SMM) and body fat were performed on three consecutive days and the daily maximum values were summarized as the total mean value and were used for the descriptive data interpretation. Strength parameters were summarized in an unweighted additive index, the muscular change index (MCI). Regarding the results obtained by using the MCI, remarkable increases were observed in participants from all decades (20: +12.02%; 30: +6.59%; 40: +6.85%; 50: +3.96%; 60: +10.95%; 70: +20.26%; 80: +20.86%). Therefore, WB-EMS seems to be a time-efficient and adequate form of training that can be conducted to enhance muscular performance at different ages.

Age- and sex-related trends in body composition among Beijing adults aged 20–60 years: a cross-sectional study

BackgroundObesity is the most serious global epidemic and body composition is the main indicator to evaluate obesity. This study aimed to investigate the changing trends of body composition by age and gender in Beijing adults aged 20–60 years and explore the distribution of obesity rates in different age groups of both sexes under different evaluation criteria.MethodsA total of 24,948 adults aged 20–60 years in Beijing, including 10,225 males and 14,192 females, were included, divided into four age groups (20–29, 30–39, 40–49, and ≥ 50 years) with each decade of age as an age group. Body composition indicators (BMI, fat mass, BF%, muscle mass, visceral fat area, and WHR) were measured in all subjects.ResultsBMI and total fat mass peaked in males aged 40–49 years (BMI = 25.75 kg/m2, total fat mass = 17.70 kg). Female BMI, fat mass and BF% all increased significantly with age (p < 0.01). Total muscle peaked in males aged 30–39 years and decreased significantly thereafter (p < 0.0001). Visceral fat area and WHR increased significantly with age in both sexes (p < 0.0001). Age was significantly positively correlated with BMI, BF%, fat mass, WHR, and visceral fat area in both sexes (p < 0.0001), and age was negatively correlated with muscle mass in males (standard β = − 0.14, p < 0.0001) while positive in female (standard β = 0.05, p < 0.0001). Under the BMI criterion, the obesity rate peaked at 27.33% in males at the age of 20–29 years. Under the BF% criterion, the obesity rate peaked at 17.41% in males at the age of 30–39 years, and increased in females with age. The central obesity rate of both sexes increased with age under the criteria of WHR and visceral fat area.ConclusionThe results of this study reveal that age- and sex-related patterns of body composition and obesity change among Beijing adults aged 20–60 years may differ across age groups and that such patterns of change should be considered when developing public health strategies.

The Impact of Age on Anthropometric Changes Following Rhinoplasty.

Background: There are several factors affecting the results of rhinoplasty, and the predictability of outcomes still remains insufficient. Objective: To associate the rhinoplasty results with patients' age by anthropometric measurements. Methods: Retrospective chart review of patients undergoing rhinoplasty who were divided into decades of age. Anthropometric measurements were carried out using Rhinobase® Software. Wilcoxon t test was used for the postoperative 3 months and 2 years analysis. p values of <0.05 were considered statistically significant. Results: A total of 243 patients (median age: 37.1; M:F = 68:175) were included in the study: group I (19-29 years) n: 80; group II (30-39 years) n:71; group III (40-49 years) n: 48; and group IV (50-61 years) n: 44. In group IV, the highest value of difference (Δ) was seen in the midfacial height with the number of 5.5 ± 1.1 (mm) (<0.001). The values of nasal length, tip projection, and midfacial height parameters showed significant differences in both group III and group IV. Conclusions: Unfavorable age-related changes in long-term postoperative period following rhinoplasty can occur in patients above 40 years of age.

Our Experience with Sinonasal Glomangiopericytoma in North India: A Case Series.

Glomangiopericytoma (GPC) is a rare benign sinonasal tumor originating from Zimmerman's Pericytes surrounding capillaries and accounting for less than 0.05% of all sinonasal tumors. Glomangiopericytoma has low malignant potential (5-10%) and is mostly diagnosed in the 6th or 7th decade of age with slight female preponderance. We presented here a case series of 5 patients with sinonasal GPC. This research was conducted at a tertiary healthcare centre in North India. In our case series, all the patients were evaluated and underwent endoscopic surgical resection. All patients underwent digital subtraction angiography (DSA) and preoperative embolization. The coblation technique used for haemostasis proved very effective and time-saving. All patients exhibited cytoplasmic SMA positivity (a marker of GPC) and CD34 negativity, while one patient exhibited a high Ki-67 index (> 10%), which is a predictor of aggressive tumor behavior. None of the patients showed any recurrence in follow-up. We recommend performing complete endoscopic surgical excision to prevent recurrence. The use of DSA, preoperative embolization, and intraoperative use of the coblation technique provides a cleaner surgical field and reduced operating time.

Effects of the COVID-19 Pandemic on Primary Health Care for Chronic Conditions in Canada: Protocol for a Retrospective Pre-Post Study Using National Practice-Based Research Network Data.

Since the COVID-19 pandemic began, there have been concerns that interruptions to the health care system may have led to changes in primary care, especially for care of chronic conditions such as diabetes and heart failure. Such changes may have longer term implications for population health. This study aims to describe the impacts of the COVID-19 pandemic on indicators of primary care access, comprehensiveness, and appropriateness among adult patients, as well as on specific indictors of chronic conditions. Additionally, this study aims to determine whether any identified changes were associated with patient sociodemographic characteristics and multimorbidity. This is a retrospective, single-arm, pre-post study using Canadian Primary Care Sentinel Surveillance Network (CPCSSN) data. CPCSSN is a research network supported by a primary care electronic medical record database, comprising over 1500 physicians and nearly 2 million patients. We are examining changes in care (eg, frequency of contacts, laboratory tests and investigations, referrals, medications prescribed, etc) among adults. We will also examine indicators specific to evidence-based recommendations for care in patients with diabetes and those with heart failure. We will compare rates of outcomes during key periods of the pandemic between March 13, 2020, and December 31, 2022, with equal time periods before the pandemic. Differences will be examined among specific subgroups of adults, including by decade of age, number of comorbidities, and socioeconomic status. Regression models appropriate to outcome distributions will be used to estimate changes, adjusting for potential confounders. This analysis is part of a mixed-methods study with a qualitative component investigating how patients with diabetes with or without concurrent heart failure perceived the impact of the pandemic on access to primary care and health care-related decisions. This study was approved by the Hamilton Integrated Research Ethics Board (14782-C). The start date of this study was October 5, 2022, and the prospective end date is January 31, 2024. As of May 2023, the study cohort (n=875,934) is defined, data cleaning is complete, and exploratory analyses have begun. Extended analyses using 2022 data are planned once the new data becomes available. We will disseminate results through peer-reviewed publications and academic conference, as well as creating evidence briefs, infographics, and a video for policy maker and patient audiences. This study will investigate whether the COVID-19 pandemic has resulted in changes in the provision of primary care in Canada and whether these potential changes have led to gaps in care. This study will also identify patient-level characteristics associated with changes in care patterns across the COVID-19 pandemic. Indicators specific to chronic conditions, namely diabetes and heart failure, will also be explored to determine whether there were changes in care of these conditions. ClinicalTrials.gov NCT05813652; https://clinicaltrials.gov/ct2/show/NCT05813652. RR1-10.2196/49131.

The Rey Auditory Verbal Learning Test: Age-, Gender- and Education-Related Normative Data for The Iranian Healthy Population

Purpose: Memory and learning have particular importance due to their ubiquitous nature in everyday life and the high prevalence of related complaints. The present study aimed to provide normative data for one of the most widely used tests of verbal memory and learning in Iran and to assess the effect of demographic variables of age, gender, and education on its various measures.&#x0D; Materials and Methods: The study was conducted as part of the Iranian Brain Imaging Database (IBID) project. The sample consisted of 300 normal individuals in the age range of 20 to 70 years, with an equal number of participants in each age decade (#60). The sample was classified by five decades, including 20-30-year-olds, 31-40-year-olds, 41-50-year-olds, 51-60-year-olds, and 61-70-year-olds. Each age decade was divided equally between the genders. The Rey Auditory Verbal Learning Test (RAVLT), which was defined in terms of 10 scores on learning, recall, and recognition, was used to assess verbal learning and memory.&#x0D; Results: The correlation matrix among the variables shows that all three variables of age, gender, and education had a significant correlation with most RAVLT measures. Among the three demographic variables, age had the strongest correlation with most RAVLT scores. Three-way Analysis of Variance (ANOVA) showed that the effect of age and gender on memory and learning measures was significant. On the other hand, the effect of education on some measures was statistically significant. In addition, the mean and standard deviation of 10 RAVLT measures classified by gender and education years in the five age groups are provided.&#x0D; Conclusion: The findings show that while increasing age, verbal memory, and learning performance decline, women outperform men, and education affects some indicators of learning and memory. These findings emphasize the importance of using age-, gender- and education-related normative data in clinical, educational, and research settings.

Vertical migration in the soil of Cr(VI) and chromite ore processing residue: Field sampling and benchtop simulation

Chromite ore processing residue (COPR) keeps releasing Cr(VI) over time, and the mixing of residual COPR into soil makes the remediation of COPR-contaminated sites challenging. In this study, a sample of COPR and two soil profiles were collected from a typical historical COPR-contaminated site, and the vertical migration of Cr(VI) and COPR particles in contaminated soil was simulated in the laboratory. Cr(VI) was detected in the upper layer of the field samples at thousands of milligrams per kilogram even after decades of aging, and it can be leached out and migrate vertically deep into the surrounding soil and groundwater. In the COPR-containing soil, more diverse hydrated minerals of brownmillerite were produced than the COPR in the open air on the site. Minerals with high Cr content in COPR-containing soils have a relatively high proportion of particles smaller than 10 µm. COPR particles smaller than 5 µm were found to have migrated downward into the deep soil. During simulated one-year of precipitation, 578.9 mg Cr(VI)/kg was leached from COPR, while 35.5% of the COPR particles smaller than 5 µm had the potential to migrate vertically. The management of COPR particles should be emphasized during risk management or remediation of COPR-contaminated sites.

Determinación de intersecciones probabilísticas relacionadas con daño cerebral adquirido a partir de la determinación de probabilidades a priori y a posteriori.

The acquired brain damage is a common neurological disorder. Determine the probabilistic intersections of variables related to acquired brain damage from the determination of a priori and a posteriori probabilities. Analytical retrospective study. A descriptive analysis was carried out, confidence intervals were calculated to obtain the mean and the proportion with α = 0.05 considering the age of the patient and the diagnosis. An analysis of probabilistic intersection, a priori and a posteriori probability was performed considering diagnosis, sex and age decade; finally, chi squared was calculated. 736 patients were analyzed. The most frequent diagnosis was language disorder. The patients diagnosed with memory disorder were the youngest and those diagnosed with degenerative cognitive disorder the oldest. The probability that a patient with sequelae due to acquired brain damage arrives at the hospital, at the language pathology service, to be diagnosed with a language disorder and that this patient is also a man is 29.06%. The high prevalence of short and long-term disability generated by acquired brain damage highlights the importance of an early and timely detection and diagnosis so that it favors prompt and efficient specialized care.

Trends in cardiac implantable electronic device utilization in adults with congenital heart disease: a US nationwide analysis.

Adults with congenital heart disease (ACHD) have increased risk of arrhythmias warranting implantation of cardiac implantable electronic devices (CIEDs), which may parallel the observed increase in survival of ACHD patients over the past few decades. We sought to characterize the trends and outcomes of CIED implantation in the inpatient ACHD population across US from 2005 to 2019. A retrospective analysis of the Nationwide Inpatient Sample (NIS) identified 1,599,519 unique inpatient ACHD admissions (stratified as simple (85.1%), moderate (11.5%), and complex (3.4%)) using the International Classification of Diseases 9/10-CM codes. Hospitalizations for CIED implantation (pacemaker, ICD, CRT-p/CRT-d) were identified and the trends analyzed using regression analysis (2-tailed p < 0.05 was considered significant). A significant decrease in the hospitalizations for CIED implantation across the study period [3.3 (2.9-3.8)% in 2005 vs 2.4 (2.1-2.6)% in 2019, p < 0.001] was observed across all types of devices and CHD severities. Pacemaker implantation increased with each age decade, whereas ICD implantation rates decreased over 70years of age. Complex ACHD patients receiving CIED were younger with a lower prevalence of age-related comorbidities, however, had a greater prevalence of atrial/ventricular tachyarrhythmias and complete heart block. The observed inpatient mortality rate was 1.2%. In a nationwide analysis, we report a significant decline in CIED implantation between 2005 and 2019 in ACHD patients. This may either be due to a greater proportion of hospitalizations resulting from other complications of ACHD or reflect a declining need for CIED due to advances in medical/surgical therapies. Future prospective studies are needed to elucidate this trend further.

Functional Ability and Its Associated Factors Among Chinese People Aged 50 Years and Above from the Perspective of Healthy Aging: A 7-Year Longitudinal Study

ABSTRACT Although a new conceptualization of functional ability was proposed in the Decade of Healthy Aging, few studies attempted to understand functional ability among older adults from a holistic review. Based on the China Health and Retirement Longitudinal Study from 2011 to 2018, the study investigated the current situation of five domains of functional ability (ability to self-care, being mobile, building/maintaining relationships, contributing to society, learning, and growing), the overall functional ability score and their associated factors among older people. Compared to other functional ability domains, the ability to contribute to society and learn/grow has been largely underdeveloped. Rural respondents were 23% ~ 48% less likely to preserve the five functional ability domains than their urban peers. The findings in this study suggest that China should shift the paradigm to healthy aging by providing more opportunities for the aged to pursue their ability to contribute to society, and the ability to learn, grow and make decisions. Timely policies to maintain functional ability should target those with rural hukou, low education, and low income, especially those with poor cognition.

Associations of self-reported skin symptoms with age, sex, and living with a partner: Findings from a representative survey in view of the biomedical and the biopsychosocial model.

Social and demographic characteristics are crucial determinants of health. The objective of this contribution is to study the associations of skin symptoms and sociodemographic variables in the general population, and to discuss these findings in view of the biomedical and the biopsychosocial models of skin diseases. A national face-to-face household survey with a representative sample of the German general population assessed 19 self-reported skin symptoms (N = 2,487). Associations with age, sex, and living situation (alone vs. with partner) were analyzed using logistic regression analyses. The frequencies of pimples and biting of the nails decreased by approximately 30% per age decade, and oily skin, the feeling of disfigurement, excoriations, and sun damages decreased by 8%-15% per age decade. Dryness of the skin increased by 7% per decade. Sensitive skin and dryness were approx. twice as likely in females as in males. Dryness of the skin, itch, and excoriations were 23%-32% more frequent in participants living without a partner. The biomedical model explains some of the findings well (e.g., reduction of pimples with age). The interpretation of other results is facilitated by the biopsychosocial model (e.g., association of living without a partner and itch). This suggests a stronger integration of psychological and social factors into the understanding and treatment of symptoms of the skin.

Functional dentition and well-being among Chilean 80-year-olds.

The Decade of Healthy Aging 2021-2030 calls for a strengthening of the policies for older people in Latin America. An example of successful oral aging is the Japanese "8020" campaign, which achieved 50% of people aged 80 years having ≥20 teeth by 2016. To evaluate the association between having a functional dentition (≥20 teeth) and cognitive health, social participation, and quality of life in people aged ≥80 years. Cross-sectional data from 299 complete observations (weighted N = 436 981) of individuals aged ≥80 years from Chile's National Health Survey 2016-2017 were included (3% of the population; total = 5520 clinical observations/weighted N = 14 518 969). Generalised structural equation models (GSEM) evaluated the association between having a functional dentition and cognitive health, measured with the Mini-mental score, between having a functional dentition and social participation, and between having a functional dentition and quality of life, measured with the EQ-5D-3L. Models included the effect of mediators (daily fruit and vegetable consumption; oral health-related quality of life score) and controlled for the exposure-induced mediator-outcome variables: sex, educational level, and location. Data were analysed using the STATA-17 survey module. Statistical significance was set at P < .05 (95% confidence interval [CI]). The sample was mostly female, had <8 years of education, and lived in urban areas. The prevalence of a functional dentition was 9.2% (95% CI 3.6,21.3/n = 21). GSEM demonstrated that the association between functional dentition and cognitive health was mediated by daily fruits and vegetables consumption (β = 0.12/95% CI 0.02,0.21/P = .015), with moderate strength of evidence. Additionally, there was strong evidence of an association between functional dentition and social participation frequency (β = 2.76/95% CI 0.60,4.73/P = .009). Finally, the association between functional dentition and quality of life was mediated by cognitive health (β =0.05/95% CI 0.02,0.09/P = .002) and oral health-related quality of life (β = -0.04/95% CI -0.08 to -0.01/P = .025), with strong and moderate evidence, respectively. Given the beneficial implications of functional dentition in social participation, nutritional benefits and quality of life and well-being of individuals aged ≥80 years.