Decade Of Age Research Articles

Abstract 9990: Hypertension Risk Differs by Asian Ethnicity Across the Adult Lifespan

Introduction: Hypertension risk increases with higher age and body mass index (BMI). We previously found that the prevalence of diagnosed hypertension among Filipino adults is similar to Black adults and higher than White, Chinese, and South Asian adults aged 45-84y. Among young women, the difference between Filipina and Chinese adults was >2-fold. We now examine disparities in hypertension prevalence across the adult lifespan, accounting for differences in weight status. Methods: This cross-sectional study used electronic health record data for 1,018,159 non-Hispanic White (White), 146,517 Black, 348,715 Hispanic, 128,124 Filipino, 126,321 Chinese, and 80,723 South Asian adults aged 30-79 who were members of a Northern California health plan in 2016. Hypertension prevalence (ICD 9/10 diagnosis in 2016) was examined by race/ethnicity and sex for ages 30-39, 40-49, 50-59, 60-69, 70-79y. Poisson regression was used to estimate prevalence ratios (aPRs) for hypertension compared to White adults in each age decade, adjusting for age, English language, current smoking, and BMI category (underweight, healthy weight, overweight, obesity class 1, 2, 3). Lower BMI thresholds were used for Asian adults. Results: Across all age decades, Filipino adults had a prevalence of hypertension similar to Black adults and higher than White, Chinese, and South Asian adults. In each age decade, the Filipino:White aPRs approached or exceeded the Black:White aPRs and were much higher than South Asian:White and Chinese:White aPRs (Figure). Differences in hypertension risk were greatest for those aged 30-59y. Conclusions: Filipino adults, similar to Black adults, had earlier onset and higher prevalence of hypertension than White, Chinese, and South Asian adults across 5 age decades, a disparity that persisted after adjusting for weight status, smoking, and language. These results support the need for earlier and more aggressive blood pressure screening in high-risk populations.

Neurometabolic timecourse of healthy aging

PurposeThe neurometabolic timecourse of healthy aging is not well-established, in part due to diversity of quantification methodology. In this study, a large structured cross-sectional cohort of male and female subjects throughout adulthood was recruited to investigate neurometabolic changes as a function of age, using consensus-recommended magnetic resonance spectroscopy quantification methods. Methods102 healthy volunteers, with approximately equal numbers of male and female participants in each decade of age from the 20s, 30s, 40s, 50s, and 60s, were recruited with IRB approval. MR spectroscopic data were acquired on a 3T MRI scanner. Metabolite spectra were acquired using PRESS localization (TE=30 ms; 96 transients) in the centrum semiovale (CSO) and posterior cingulate cortex (PCC). Water-suppressed spectra were modeled using the Osprey algorithm, employing a basis set of 18 simulated metabolite basis functions and a cohort-mean measured macromolecular spectrum. Pearson correlations were conducted to assess relationships between metabolite concentrations and age for each voxel; Spearman correlations were conducted where metabolite distributions were non-normal. Paired t-tests were run to determine whether metabolite concentrations differed between the PCC and CSO. Finally, robust linear regressions were conducted to assess both age and sex as predictors of metabolite concentrations in the PCC and CSO and separately, to assess age, signal-noise ratio, and full width half maximum (FWHM) linewidth as predictors of metabolite concentrations. ResultsData from four voxels were excluded (2 ethanol; 2 unacceptably large lipid signal). Statistically-significant age*metabolite Pearson correlations were observed for tCho (r(98)=0.33, p<0.001), tCr (r(98)=0.60, p<0.001), and mI (r(98)=0.32, p=0.001) in the CSO and for NAAG (r(98)=0.26, p=0.008), tCho(r(98)=0.33, p<0.001), tCr (r(98)=0.39, p<0.001), and Gln (r(98)=0.21, p=0.034) in the PCC. Spearman correlations for non-normal variables revealed a statistically significant correlation between sI and age in the CSO (r(86)=0.26, p=0.013). No significant correlations were seen between age and tNAA, NAA, Glx, Glu, GSH, PE, Lac, or Asp in either region (all p>0.20). Age associations for tCho, tCr, mI and sI in the CSO and for NAAG, tCho, and tCr in the PCC remained when controlling for sex in robust regressions. CSO NAAG and Asp, as well as PCC tNAA, sI, and Lac were higher in women; PCC Gln was higher in men. When including an age*sex interaction term in robust regression models, a significant age*sex interaction was seen for tCho (F(1,96)=11.53, p=0.001) and GSH (F(1,96)=7.15, p=0.009) in the CSO and tCho (F(1,96)=9.17, p=0.003), tCr (F(1,96)=9.59, p=0.003), mI (F(1,96)=6.48, p=0.012), and Lac (F(1,78)=6.50, p=0.016) in the PCC. In all significant interactions, metabolite levels increased with age in females, but not males. There was a significant positive correlation between linewidth and age. Age relationships with tCho, tCr, and mI in the CSO and tCho, tCr, mI, and sI in the PCC were significant after controlling for linewidth and FWHM in robust regressions. ConclusionThe primary (correlation) results indicated age relationships for tCho, tCr, mI, and sI in the CSO and for NAAG, tCho, tCr, and Gln in the PCC, while no age correlations were found for tNAA, NAA, Glx, Glu, GSH, PE, Lac, or Asp in either region. Our results provide a normative foundation for future work investigating the neurometabolic time course of healthy aging using MRS.

Accelerometer-measured physical activity in mid-age Australian adults

BackgroundRaw data from accelerometers can provide valuable insights into specific attributes of physical activity, such as time spent in intensity-specific activity. The aim of this study was to describe physical activity assessed with raw data from triaxial wrist-worn accelerometers in mid-age Australian adults.MethodsData were from 700 mid-age adults living in Brisbane, Australia (mean age: 60.4; SD:7.1 years). Data from a non-dominant wrist worn triaxial accelerometer (Actigraph wGT3X-BT), expressed as acceleration in gravitational equivalent units (1 mg = 0.001 g), were used to estimate time spent in moderate-vigorous intensity physical activity (MVPA; >100 mg) using different bout criteria (non-bouted, 1-, 5-, and 10-min bouts), and the proportion of participants who spent an average of at least one minute per day in vigorous physical activity.ResultsMean acceleration was 23.2 mg (SD: 7.5) and did not vary by gender (men: 22.4; women: 23.7; p-value: 0.073) or education (p-value: 0.375). On average, mean acceleration was 10% (2.5 mg) lower per decade of age from age 55y. The median durations in non-bouted, 1-min, 5-min and 10-min MVPA bouts were, respectively, 68 (25th -75th : 45–99), 26 (25th -75th : 12–46), 10 (25th -75th : 3–24) and 8 (25th -75th : 0–19) min/day. Around one third of the sample did at least one minute per day in vigorous intensity activities.ConclusionThis population-based cohort provided a detailed description of physical activity based on raw data from accelerometers in mid-age adults in Australia. Such data can be used to investigate how different patterns and intensities of physical activity vary across the day/week and influence health outcomes.

Impact of Chronological Age and Biological Sex on Cerebrovascular Reactivity in Moderate/Severe Traumatic Brain Injury: A CAnadian High-Resolution Traumatic Brain Injury (CAHR-TBI) Study.

Impaired cerebrovascular reactivity has emerged as an important associate with poor long-term outcome after moderate/severe traumatic brain injury (TBI). However, our understanding of what drives or modulates the degree of impaired cerebrovascular function remains poor. Age and biological sex remain important modifiers of cerebrovascular function in health and disease, yet their impact on cerebrovascular reactivity after TBI remains unclear. The aim of this study was to explore subgroup responses based on age and biological sex on cerebral physiology. Data from 283 TBI patients from the CAnadian High Resolution TBI (CAHR-TBI) Research Collaborative were evaluated. Cerebrovascular reactivity was determined using high-frequency cerebral physiology for the derivation of three intracranial pressure (ICP)-based indices: 1) pressure reactivity index (PRx)-correlation between ICP and mean arterial pressure (MAP); 2) pulse amplitude index (PAx)-correlation between pulse amplitude of ICP (AMP) and MAP; and 3) RAC-correlation between AMP and cerebral perfusion pressure (CPP). Insult burden (% time above clinically defined thresholds) were calculated for these indices. These cerebral physiology indices were studied for their relationship with age via linear regression, age trichotomization (< 40, 40 - 60, > 60), and decades of age (< 30, 30-39, 40-49, 50-59, 60-69, > 69) schemes. Similarly, differences based on biological sex were assessed. A statistically significant positive linear correlation was found between PAx, RAC, and age. In corollary, a statistically significant relationship was found between increasing age on trichotomized and decades of age analysis with PAx and RAC measures. PRx failed to demonstrate such relationships to advancing age. There was no clear difference in cerebrovascular reactivity profiles between biological sex categories. These findings suggest that AMP-based cerebrovascular reactivity indices may be better positioned to detect impairment in TBI patients with advancing age. Further investigation into the utility of PAx and RAC is required, as they may prove useful for certain subgroups of patients.

Normative Data and Conversion Equation for Spectral-Domain Optical Coherence Tomography in an International Healthy Control Cohort.

Spectral-domain (SD-) optical coherence tomography (OCT) can reliably measure axonal (peripapillary retinal nerve fiber layer [pRNFL]) and neuronal (macular ganglion cell + inner plexiform layer [GCIPL]) thinning in the retina. Measurements from 2 commonly used SD-OCT devices are often pooled together in multiple sclerosis (MS) studies and clinical trials despite software and segmentation algorithm differences; however, individual pRNFL and GCIPL thickness measurements are not interchangeable between devices. In some circumstances, such as in the absence of a consistent OCT segmentation algorithm across platforms, a conversion equation to transform measurements between devices may be useful to facilitate pooling of data. The availability of normative data for SD-OCT measurements is limited by the lack of a large representative world-wide sample across various ages and ethnicities. Larger international studies that evaluate the effects of age, sex, and race/ethnicity on SD-OCT measurements in healthy control participants are needed to provide normative values that reflect these demographic subgroups to provide comparisons to MS retinal degeneration. Participants were part of an 11-site collaboration within the International Multiple Sclerosis Visual System (IMSVISUAL) consortium. SD-OCT was performed by a trained technician for healthy control subjects using Spectralis or Cirrus SD-OCT devices. Peripapillary pRNFL and GCIPL thicknesses were measured on one or both devices. Automated segmentation protocols, in conjunction with manual inspection and correction of lines delineating retinal layers, were used. A conversion equation was developed using structural equation modeling, accounting for clustering, with healthy control data from one site where participants were scanned on both devices on the same day. Normative values were evaluated, with the entire cohort, for pRNFL and GCIPL thicknesses for each decade of age, by sex, and across racial groups using generalized estimating equation (GEE) models, accounting for clustering and adjusting for within-patient, intereye correlations. Change-point analyses were performed to determine at what age pRNFL and GCIPL thicknesses exhibit accelerated rates of decline. The healthy control cohort (n = 546) was 54% male and had a wide distribution of ages, ranging from 18 to 87 years, with a mean (SD) age of 39.3 (14.6) years. Based on 346 control participants at a single site, the conversion equation for pRNFL was Cirrus = -5.0 + (1.0 × Spectralis global value). Based on 228 controls, the equation for GCIPL was Cirrus = -4.5 + (0.9 × Spectralis global value). Standard error was 0.02 for both equations. After the age of 40 years, there was a decline of -2.4 μm per decade in pRNFL thickness ( P < 0.001, GEE models adjusting for sex, race, and country) and -1.4 μm per decade in GCIPL thickness ( P < 0.001). There was a small difference in pRNFL thickness based on sex, with female participants having slightly higher thickness (2.6 μm, P = 0.003). There was no association between GCIPL thickness and sex. Likewise, there was no association between race/ethnicity and pRNFL or GCIPL thicknesses. A conversion factor may be required when using data that are derived between different SD-OCT platforms in clinical trials and observational studies; this is particularly true for smaller cross-sectional studies or when a consistent segmentation algorithm is not available. The above conversion equations can be used when pooling data from Spectralis and Cirrus SD-OCT devices for pRNFL and GCIPL thicknesses. A faster decline in retinal thickness may occur after the age of 40 years, even in the absence of significant differences across racial groups.

Futility of Resuscitation among Geriatric Trauma Patients: Do We Need to Define When to Withdraw Care?

Introduction: Survival<10% has been described as the point where risks outweigh benefits for trauma patients, and where withdrawal-of-care may be considered. There is little to no data describing futility of resuscitation (FR) in geriatric trauma. Such data would inform withdrawal-of-care decision-making for injured geriatric patients and their families while reducing potentially inappropriate healthcare resource-use. Study aims to identify characteristics associated with FR among geriatric trauma patients. Methods: We analyzed the 2018 ACS-TQIP. We included all severely injured (ISS>15) geriatric trauma patients(≥65yrs). FR was. Patients were stratified into decades of age and resuscitative endpoints and intervention employed were identified. Outcome was FR (any intervention/endpoint that was associated with >90% mortality). Results: 46,339 patients were identified (65-75yrs: 42%; 75-85yrs: 40%; ≥85yrs: 18%). Mortality was 18%, ISS was 21[17-26], 57% male, and 85% blunt-injury. ED-thoracotomy among those >65yrs, and prehospital cardiac-arrest and REBOA among those >85yrs were associated with FR. Transfusion of >40U PRBC or FFP within 24hrs was associated with FR. 4-hour PRBC volumes associated with FR were: 65-75yrs:>30U; 75-85yrs:>27U; >85yrs:>21U. Increasing age was associated with increasing mortality among those who received emergency laparotomy or vasopressors, but did not reach FR. Lowest in-hospital SBP < 50mmHg was associated with FR among those>85yrs. Conclusion: ED-thoracotomy and transfusions >40U of product are futile in anyone over 65. REBOA is futile in anyone over 85. Resuscitation is futile in all super-elderly with prehospital cardiac arrest or an episode of profound hypotension. Further studies redefining FR among the geriatric trauma patient population to include lower mortality rates may be warranted.

Abstracts 16de Nationaal Gerontologiecongres: Een ‘decade of healthy ageing’. Droom of realiteit?

Abstracts 16th National Gerontology conference 2022: A 'decade of healthy ageing' Dream or reality?

Validation of a simple risk stratification tool for COVID-19 mortality.

Risk prediction is an essential part of clinical care, in order to allocate resources and provide care appropriately. During the COVID-19 pandemic risk prediction became a matter of political and public debate as a major clinical need to guide medical and organizational decisions. We previously presented a simplified risk stratification score based on a nomogram developed in Wuhan, China in the early phase of the pandemic. Here we aimed to validate this simplified risk stratification score in a larger patient cohort from one city in Austria. Age, oxygen saturation, C-reactive protein levels and creatinine levels were used to estimate the in-hospital mortality risk for COVID-19 patients in a point based score: 1 point per age decade, 4 points for oxygen saturation <92%, 8 points for CRP > 10 mg/l and 4 points for creatinine > 84 μmol/l. Between June 2020 and March 2021, during the “second wave” of the pandemic, 1,472 patients with SARS-CoV-2 infection were admitted to two hospitals in Graz, Austria. In 961 patients the necessary dataset to calculate the simplified risk stratification score was available. In this cohort, as in the cohort that was used to develop the score, a score above 22 was associated with a significantly higher mortality (p < 0.001). Cox regression confirmed that an increase of one point in the risk stratification score increases the 28-day-mortality risk approximately 1.2-fold. Patients who were categorized as high risk (≥22 points) showed a 3–4 fold increased mortality risk. Our simplified risk stratification score performed well in a separate, larger validation cohort. We therefore propose that our risk stratification score, that contains only two routine laboratory parameter, age and oxygen saturation as variables can be a useful and easy to implement tool for COVID-19 risk stratification and beyond. The clinical usefulness of a risk prediction/stratification tool needs to be assessed prospectively (https://www.cbmed.at/covid-19-risk-calculator/).

Triglyceride to high-density lipoprotein cholesterol ratio and total cholesterol to high-density lipoprotein cholesterol ratio and risk of benign prostatic hyperplasia in Chinese male subjects.

BackgroundLipid metabolism disorders contribute to the risk factor of prostatic hyperplasia. Lipid ratios have also attracted a lot of attention. Yet, research about the correlation of lipid ratios with prostatic hyperplasia is limited. Hence, the aim of this study was to investigate the association of lipid ratios with the risk of benign prostatic hyperplasia (BPH) in Chinese male subjects.MethodsHealthy men who underwent routine health check-ups from January 2017 to December 2019 were recruited. Twenty-four thousand nine hundred sixty-two individuals were finally enrolled in this research. Binary logistic regression analysis was performed to investigate the relationship between lipid ratios and BPH in Chinese adults.ResultsAfter health examinations for more than 2 years, 18.46% of subjects were ascertained as incident BPH cases. Higher age, body mass index (BMI), prostate-specific antigen (PSA), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio, and lower high-density lipoprotein cholesterol (HDL-C) were significantly associated with BPH risk, while total cholesterol (TC) was not significant. When quartiles of TG/HDL-C and TC/HDL-C were analyzed in multivariable model, higher TG/HDL-C and TC/HDL-C were associated with a risk of BPH (odds ratio [OR] = 2.11; 95% confidence interval [CI]: 1.89, 2.36; P-trend < 0.001; and OR = 1.67; 95% CI: 1.50, 1.85; P-trend < 0.001, respectively). In addition, stratified analyses based on the general population exhibited that with increasing age (≥35 years) the relationship of TG/HDL-C ratio with BPH risk was dominantly positive (all P-trend < 0.001, P-interaction = 0.001), and significant associations were also found in blood pressure strata and FBG strata (all P-trend < 0.001), except men with BMI ≥ 28 kg/m2 were slightly weakened (OR = 2.01, 95% CI: 1.41, 2.85; P-trend = 0.04). Moreover, there were significant associations between quartiles of TC/HDL-C and the risk of BPH was observed mainly in age 55–64 years, BMI 18.5–23.9 Kg/m2, blood pressure strata, and FBG strata. However, the P-value for a linear trend among those with BMI ≥ 28 Kg/m2 in which participants at the highest quartile of TC/HDL-C had an OR of 1.45 (95% CI: 1.09, 1.93) was 0.594. Additionally, higher TG/HDL-C ratio (≥0.65) may be a risk factor for BPH in China adults of different age decades (≥35 years) with normal TG and HDL-C.ConclusionsTG/HDL-C and TC/HDL-C were associated with BPH risk, TG/HDL-C was a powerful independent risk factor for BPH in Chinese adults, and higher TG/HDL-C ratio should be valued in male subjects with normal TG and HDL-C levels.

CLINICAL, EPIDEMIOLOGICAL AND IMMUNOLOGICAL ASPECTS IN AUTOIMMUNE HEPATITIS

"The typical phenotype of autoimmune hepatitis (AIH) is well recognized, but special subforms such as AIH with sero-negativity for autoantibodies, severe and acute forms of AIH, forms that have concomitant features of primary biliary cirrhosis or occur in the context of other liver diseases, making diagnosis and therapy a challenge for the clinician. The objective of this study was the complex analysis in terms of clinical and phenotypic characteristics of patients with AIH diagnosed at the County Clinical Emergency Hospital of Craiova, between November 2015 and September 2019. In order to carry out this study, we set the following specific objectives: • Determining the demographic and clinical characteristics of patients diagnosed with AIH compared to a group of patients diagnosed with chronic viral hepatitis C (CHC), in terms of age of onset, location, severity of inflammatory lesions and intestinal and extra-intestinal complications; • Evaluation of the biochemical profile in the studied groups by dosing the serum levels of liver enzymes such as transaminases [Aspartate-amino-transferase (AST), Alanine-amino-transferase (ALT), total bilirubin (TBIL), γ-glutamyl-transpeptidase (γ-GT), alkaline phosphatase (ALP)], and total γ-globulins (IgG, IgM, IgA)]; • Evaluation of the serological profile of patients with AIH by determining the presence of autoantibodies [ANA, anti-SMA, anti-soluble-liver-antigen (anti-SLA) antibodies, anti-liver kidney microsomal type 1 (anti-LKM-1) antibodies, anti-liver cytosol antigen type 1 (anti-LC1) antibodies, anti-mitochondrial antibodies (AMA)]. In our study we obtained the following patient profile: female patient, from an urban areas, aged at the time of diagnosis in the decade of age 45-55 years, with sero-positivity for antinuclear autoantibodies (ANA), with elevated levels of liver enzymes, accompanied by polyclonal hyper-gamaglobulinemia (IgG)."

Reference Interval for Serum L-Homoarginine Determined with Enzyme-Linked Immunosorbent Assay in the Population-Based Study of Health in Pomerania.

Low levels of the endogenous amino acid L-homoarginine are a risk factor for cardiovascular morbidity and mortality. For individual risk prediction, commercially available test systems are mandatory. This study aims at formulating sex- and age-specific reference intervals of serum L-homoarginine determined with an ELISA. We determined reference intervals for serum L-homoarginine stratified by age and sex in a sample of 1285 healthy participants of the Study of Health in Pomerania (SHIP)-TREND cohort after exclusion of participants with cardiovascular diseases, diabetes mellitus, hypertension, metabolic syndrome, elevated liver enzymes, chronic kidney disease stages III or IV, or body mass index &gt;25 kg/m2. Serum L-homoarginine was determined applying a commercially available ELISA. The reference cohort included 836 women (median age 41, 25th and 75th percentiles are 32 and 50 years) and 449 men (median age 38, 25th, and 75th percentiles are 30 and 49 years). The median serum concentration of L-homoarginine was 1.93 (25th 1.49; 75th 2.60) µmol/L in women and 2.02 (25th 1.63; 75th 2.61) µmol/L in men (P = 0.04). The reference intervals (2.5th to 97.5th percentile) were 0.89-5.29 µmol/L for women and 1.09-3.76 µmol/L for men. The L-homoarginine serum concentration declined over age decades in both sexes and a notable interaction with sex hormone intake in women was observed. The novelty of our study is that we determined reference intervals specific for the L-isomer being lower than those previously reported for homoarginine in SHIP and thus might be helpful in identifying individuals suitable for oral L-homoarginine supplementation.

Hearing Loss Among People With Schizophrenia: Implications for Clinical Practice.

The authors characterized hearing loss among individuals diagnosed as having schizophrenia to inform provision of routine behavioral health services to this population. Audiometry data collected between October 2019 and December 2021 from 84 community-dwelling adults with schizophrenia and 81 age-matched participants without the condition were analyzed. Rates of hearing loss were identified within groups and across age decades (20-50 years). Hearing threshold and rates of hearing loss were compared between groups. Participants with schizophrenia had significantly higher mean hearing thresholds (p=0.006), indicating worse hearing. This difference remained significant after controlling for age (p=0.01). A significantly larger proportion of participants with schizophrenia had mild hearing loss (24%) compared with age-matched participants (6%) (p=0.002), with higher rates of mild hearing loss observed across all ages. Screening for and detection of hearing loss among adults with schizophrenia may be an unmet need. Hearing loss is a treatable source of cognitive and psychosocial disability, warranting scalable assessment and intervention practices.

2011–2021 rising prevalence of HPV infection among oropharyngeal carcinoma in France

BackgroundThe objective of our study was to investigate changes over the past decade in patient age and the prevalence of HPV in the population of patients with oropharyngeal carcinoma (OPC) treated at our center.MethodsWe performed a retrospective cohort study of patients treated at our cancer center for OPC between 2011 and 2021. Tissue biopsies were assessed for HPV status based on p16 staining for all patients.ResultsThere were 1,365 treated patients. The proportion of p16-positive patients increased from 43% in 2011 to 57.3% in 2021 (p = 0.01). The sex ratio was 3.6 M/1F for p16-positive and 3.7 M/1F for p16-negative patients (p = 0.94). The mean age increased from 60.2 y in 2011 to 63.6 y in 2021. The mean ages were 61.9 y for p16-positive and 61.7 y for p16-negative patients (p = 0.71), but there was a broader age distribution for the p16-positive patients (p = 0.03). The proportion of patients older than 70 y increased from 11% in 2011 to 28.2% in 2021, and this aging was similar between p16-positive (30.7% in 2021) and p16-negative (26.3% in 2021) patients. The 2-year and 5-year OS rates were 73.7% and 56.5% for the entire cohort. p16-positive patients had 2-year and 5-year OS rates of 86.8% and 77.4%, respectively, whereas p16-negative patients had 2-year and 5-year OS rates of 63.9% and 40.5%.ConclusionsAssessment of the change over the past decade in the population of patients with OPC at our center showed that HPV-positive OPC now appear to have overtaken HPV-negative cases in France, with 57.3% in 2021, and showed significant aging, with almost thirty percent of patients now older than 70 years. Those combined changes emphasize some of the challenges to be addressed in future OPC management.

Implications of age in mammographic density interpretation

&#x0D; Abstract&#x0D; Objective. The importance of breast density correlated with its significant impaction in Mammogram’s interpretation and to the increased risk of development of breast cancer, we examined the breast density of 1051 of screening and diagnostic Mammography in Mammography unit in Benghazi medical center, our study aimed to find the relationship between the age and mammographic breast density. Materials and Methods. This is a retrospective review of the diagnostic and screening Mammography underwent in Benghazi Medical Center’s in Mammography unit during 2016-2917. Analysis of variance and descriptive analyses were used to evaluate the relationship between patient age and breast density. Results. A total of 1051 women were examined by digital mammography at Department of Radiology in Benghazi Medical Center during the period from 2016-2017, the women age was ranged from 22 to 88 years with a median age of 48 years, the subgroups are Classified by the age decade, and we find that the relationship between the age and the breast density is significant inverse relation (p=0.000) 60.9% of patients between40 and 49 years old had dense breasts. and it reduced to 36.6% of women in their 50s. However, 28.7% of females in their 60s and 5.3% of patients in their 70s had dense breasts as interpreted on their screening and diagnostic mammograms. &#x0D; Conclusion. We found that the age of the patient and the breast density are related inversely, but the interest is that we also found extreme value at the extremes of age where a considerable percentage of young women had mostly fatty tissue rather than glandular tissue and at the same time there's also a meaningful group of old women has dense breast tissue instead of fatty tissue.

One-year mortality and years of potential life lost following bloodstream infection among adults: A nation-wide population based study.

SummaryBackgroundLimited data exist on long-term consequences of bloodstream infections (BSIs). We aimed to examine incidence, 1-year mortality, and years of potential life lost (YPLL) following BSI. We estimated the relative contribution of hospital-onset BSI (HO-BSI) and antibiotic-resistant BSI to incidence, mortality and YPLL.MethodsWe used data from Israel's national BSI surveillance system (covering eight sentinel bacteria, comprising 70% of all BSIs) and the national death registry. Adults with BSI between January 2018 and December 2019 were included. The outcomes were all-cause 30-day and 1-year mortality, with no adjustment for co-morbidities. We calculated the age-standardized mortality rate and YPLL using the Global Burden of Disease reference population and life expectancy tables.FindingsIn total, 25,376 BSIs occurred over 2 years (mean adult population: 6,068,580). The annual incidence was 209·1 BSIs (95% CI 206·5–211·7) per 100,000 population. The case fatality rate was 25·6% (95% CI 25·0-26·2) at 30 days and 46·4% (95% CI 45·5-47·2) at 1 year. The hazard of death increased by 30% for each decade of age (HR=1·3 [95% CI 1·2-1·3]). The annual age-standardized mortality rate and YPLL per 100,000 were 50·8 (95% CI 49·7-51·9) and 1,012·6 (95% CI 986·9-1,038·3), respectively. HO-BSI (6,962 events) represented 27·4% (95% CI 26·9-28·0) of BSIs, 33·9% (95% CI 32·6-35·0) of deaths and 39·9% (95% CI 39·5-40·2) of YPLL. HO-BSI by drug-resistant bacteria (3,072 events) represented 12·1% (95% CI 11·7-12·5) of BSIs, 15·6% (95% CI 14·7-16·5) of deaths, and 18·4% (95% CI 18·1-18·7) of YPLL.InterpretationOne-year mortality following BSI is high. The burden of BSI is similar to that of ischemic stroke. HO-BSI and drug-resistant BSI contribute disproportionately to BSI mortality and YPLL.FundingNone.

Determination of the Anthropometric Measures of the Lips by Age Groups in the Mestiza Population.

Measurements from a certain population may show a similar pattern that allows an alteration to be easily recognized and enable a better surgical approach. In our population, the changes in the anthropometric measurements of the lips are unknown, so our objective is to determine the variations in these measurements by decades of age to achieve a better aesthetic and reconstructive surgical approach. Anthropometric measurements of the lips were taken with a vernier in relation to the previously marked anatomical points. The sample consists of 174 patients who came for care not related to labial pathologies with ages between 20 and 80 years with Mexican nationality. We use the sample calculation formula to estimate an average, with an alpha error of 0.5 and a tolerance of 2mm of the data for the measurements of the height of the lower face with an average measurement of 56.2mm and a SD of 8.87mm of the Marzena's article. Wyganowska-Świątkowska and colleagues Average measurements were obtained, where a progressive longitudinal increase in measures: al-ch, sbl-cph, sn-Is, li-sto, cph-Is, li-sl, ch-li, li-pg according to aging is confirmed. In contrast, the ch-cph and ch-sbl measures, remain the same despite the aging, showing greater changes in the sagittal plane than in the parasagittal. The study only shows measures of length, so caring out a magnetic resonance imaging study to also measure the volume and perform it with a larger sample to have the optimal standard is further needed.

Variability of body mass index and risks of prostate, lung, colon, and ovarian cancers.

ObjectiveWe investigated the association between cancer incidence and body mass index (BMI) variability calculated from the recall of weight at decades of age by participants in the USA Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.MethodsA total of 89,822 individuals' BMI were recorded as recalled the participant's aged 30, 40, 50, 60, 70 years, and baseline. BMI variability was assessed using four indices: SD, coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV). The multivariate Cox regression analysis was performed to calculate hazard ratios (HRs) of these measures for incident cancers and corresponding 95% CIs.ResultsDuring the median follow-up of 11.8 years, there were newly diagnosed 5,012 cases of prostate cancer, 792 cases of lung cancer, 994 cases of colon cancer, and 132 cases of ovarian cancer. Compared with the lowest quartile (Q1) group, the highest quartile (Q4) group of BMI variability indices was associated with increased lung cancer risk, including BMI_SD (HR, 1.58; 95% CI, 1.17–2.12), BMI_CV (HR, 1.46; 95% CI, 1.10–1.94), BMI_VIM (HR, 1.73; 95% CI, 1.33–2.25), and BMI_ARV (HR, 2.17; 95% CI, 1.62–2.91). Associations between BMI variability and prostate, colon, and ovarian cancer incidences were of limited significance.ConclusionThe findings imply that maintaining a stable weight across adulthood is associated with a decreased incidence of lung cancer.

SCREENING OF OSTEOPOROSIS IN MEN

Underestimation of the disease osteoporosis in men is a serious problem, as osteoporotic fractures among men are frequent and they are accompanied by serious complications. Conducting DXA scans in men in Bulgaria is important to determine the state of their bone health.&#x0D; The aim of the study was to assess the bone mineral density (BMD) and T-score of the lumbar spine and of the hip through dual-energy X-ray absorptiometry (DXA) in men and to compare their values ​​in different age groups.&#x0D; Object of the study. Height, weight, body mass index (BMI) were assessed in 359 men with a mean age of 56 years (yrs.) ± 14 yrs., BMD and T-score of the lumbar spine and femoral neck were also examined.&#x0D; Methodology. Men are divided into the following age decades: 20-29 yrs., 30-39 yrs., 40-49 yrs., 50-59 yrs., 60-69 yrs., 70-79 yrs. and ≥80 yrs. Statistical program SPSS version 19.0 was used to access the data. The ANOVA test analyzes was applied to investigate if there are any statistically significant differences in BMD and T-score of the lumbar spine and femoral neck between the different age decades.&#x0D; Results and conclusions. 264 men were evaluated for total BMD of the lumbar spine and 95 men had results for BMD of the femoral neck. The mean total BMD of the lumbar spine differed significantly between the individual age decades in men (p = 0.000). The mean BMD values ​​of the femoral neck did not differ significantly in the different age decades in men (p = 0.07). 34 of 264 men (12.9%) were diagnosed with lumbar spine osteoporosis and 13 out of 93 men (14%) were diagnosed with femoral neck osteoporosis. The data obtained show a widespread prevalence of osteoporosis among men with a predominance of low values ​​of BMD on the axial skeleton in the age range between 60 and 79 years.

Readmission and In-Hospital Outcomes After Transcatheter Aortic Valve Replacement in Patients With Dementia

Background/purposeThe prevalence of dementia and aortic stenosis (AS) increases with each decade of age. Transcatheter aortic valve replacement (TAVR) is a definitive treatment for AS, but there are scarce data on morbidity, mortality, and readmission risk after TAVR in patients with dementia. Methods/materialsWe identified all admissions for TAVR in patients with AS in the National Readmissions Database in 2017–2018 and stratified them according to the presence or absence of a secondary diagnosis of dementia. Inpatient outcomes were compared using logistic regression. Cox proportional-hazards models were used to compare 30-, 60-, and 90-day readmissions. ResultsA total of 48,923 index hospitalizations for TAVR were identified, of which 2192 (4.5 %) had a secondary diagnosis of dementia. Presence of dementia was associated with higher odds of delirium, pacemaker placement, acute kidney injury, and fall in hospital. The hazard of 30-day readmission was not significantly different between patients with and without dementia, but patients with dementia experienced a higher hazard of 60-day readmission (HR 1.15, 95 % CI 1.03–1.26, p = 0.011) in the unadjusted model and higher hazard of 90-day readmission in both unadjusted (HR 1.18, 95 % CI 1.08–1.30, p < 0.001) and adjusted models (aHR 1.14, 95 % CI 1.04–1.25, p = 0.004). ConclusionsPatients with dementia who undergo TAVR are at higher risk of in-hospital adverse outcomes and 60- and 90-day readmissions compared with patients without dementia. These estimates should be integrated into shared decision-making discussions with patients and families.

The effect of subjective age on loneliness in the old adults: The chain mediating role of resilience and self-esteem.

ObjectivesThis study aimed to explore the effect of subjective age on loneliness in old adults, and the mediating role of resilience and self-esteem in subjective age and loneliness.MethodsApproximately 450 old adults from Jiangxi, Hunan, Henan provinces completed the third edition of the Loneliness Scale (UCLA-LS III), Age Decade Scale (ADS), Connor-Davidson Resilience Scale (CD-RISC), and Self-Esteem Scale (SES).Results(1) Subjective age was significantly positively correlated with loneliness. (2) Resilience, self-esteem, and loneliness were significantly negatively correlated. (3) Subjective age affected loneliness through the mediating effects of resilience and self-esteem, respectively. (4) Resilience and self-esteem played a chain mediating role between subjective age and loneliness.ConclusionResilience and self-esteem can directly affect the loneliness of the old adults alone and can also affect the loneliness of the old adults through the chain mediating effect of resilience and self-esteem.