Decline In Men Research Articles

Association between anxiety and cognitive decline in community-dwelling elderly

The present study was conducted to determine whether anxiety among community-dwelling elders is associated with cognitive decline over a period of one year as well as to verify whether there are sex differences in the association between anxiety and cognitive decline. Participants (n=1942) were community-dwelling adults aged 65-96 years assessed at study entry (T0) and one year later (T1). Anxiety was identified with a semi-structured interview and cognitive functioning was assessed using the Mini-Mental State Examination. Results revealed that the presence of a clinically significant anxiety disorder did not predict cognitive decline in men and women. Subclinical anxiety symptoms predicted cognitive decline in women only. Moreover, for men, the presence of symptoms from at least two anxiety disorders predicted cognitive decline. For women, cognitive decline was predicted by the presence of symptoms from one anxiety disorder only. Overall, the results illustrate the role of anxiety in cognitive decline in community-dwelling older adults.

Similarities Among Factors Associated With Components of Frailty in Elderly

To analyze similarities among factors associated with the components of frailty in elderly. We studied 1,413 elderly from the second wave of the SABE Study in 2006. Each of the five components of the frailty phenotype was considered a dependent variable in the hierarchical logistic regression models. In both genders, age, schooling, sedentary lifestyle, and screening positive for depression were associated similarly with more than one component of frailty. Other similarities were also observed with stroke and screening positive for cognitive decline in men, and number of diseases and gait speed in women. The most similar associations happened between weakness and slowness; weakness, slowness, and LPAL; or weakness, slowness, and exhaustion. Encouraging physical activity, screening for and treating depression and treating both diseases of the central nervous system and chronic diseases must be the focus of strategies to avoid, delay, or even remedy frailty.

Trends in mortality rates from coronary heart disease in Belgrade (Serbia) during the period 1990–2010: a joinpoint regression analysis

BackgroundCoronary heart disease (CHD) causes an estimated 7 million deaths worldwide each year. In the last few decades, mortality from CHD has been decreasing in many countries. The aim of this study was to analyze the trends of mortality from CHD and myocardial infarction (MI) in the population of Belgrade during the period 1990–2010.MethodsMortality data for CHD and MI were obtained from the Municipal Institute of Statistics in Belgrade and used to calculate age- and sex-specific and age-adjusted mortality rates. Joinpoint regression analysis was used to estimate annual percent changes (APCs) in mortality and to identify points in time where significant changes in trend occur.ResultsTrends in CHD mortality rates showed significant decline in men during the period studied (APC -0.5%, no joinpoints detected), but no significant change among women (APC +0.4%, no joinpoints detected). While we observed significant declines in CHD mortality in men aged 35–44, 55–64 and 65–74 and women aged 55–64, there was a significant increase in mortality in men aged ≥85 and women aged 75–84 and ≥85. Trends in MI mortality rates showed similar patterns in both genders, with a significant decline from the mid-1990s. Significant decline in MI mortality was observed in almost all age groups, except the two oldest (75–84 and ≥85) in women population.ConclusionsGiven that CHD and MI mortality trends showed different patterns during the period studied, especially in women, our results imply that further observation of trend is needed.

Abstract 9607: Factors Associated With Cognitive Deficits in Heart Failure Differ by Gender

Background: In 2005 Bennett proposed a conceptual model of cognitive deficits (CD) in heart failure (HF). The purpose of this study was to test the model and to identify if results differ by gender. Methods: Data from 280 HF patients were analyzed using generalized linear modeling to predict CD measured as the number of neuropsychological tests on which participants scored in the abnormal range. Five tests (Trail-Making Tests A and B, Digit Symbol-Substitution, Probed-Recall Memory, Letter Number Sequencing) were used; the number on which subjects scored below their age-based norm was used as the measure of CD (0-5 range). Predictors entered into the model were age, sex, education, Charlson Comorbidity score, hypertension (yes/no), depression measured with the PHQ-9, HF type (systolic/mixed or diastolic), HF etiology (ischemic/nonischemic), ejection fraction, NYHA functional class, duration since diagnosis, and number of medications taken daily. Only oxygen saturation proposed in the original model was unavailable. Results: Overall, the model was adequate to describe CD but several of the variables were poor predictors so the model was rerun separately in men (n=180, mean age 63±12.3, 33% black) and women (n=100, mean age 60±12.7, 36% black). In men the model fit well (p=0.005) but not in women (p=0.969). In men the best indicators of CD were older age, less education, and poor functional class; these variables explained 36.3% of the variance in CD. In women, a new model was proposed that focused on behavior (smoking, drinking, exercise, medication adherence, taking vitamins, body weight, sleep hygiene), symptoms (NYHA functional class, sleep quality, fatigue, daytime sleepiness, depression), and social support. Demographic characteristics of age and education were included, as these are known to predict CD. In women the best predictors of CD were older age, lower medication adherence, worse NYHA functional class, and less social support. These 4 variables explained 55.9% of the variance in CD in women. When the new model was tested in men, only NYHA class was associated with CD, explaining 1.5% of the variance. Conclusion: Different factors are associated with cognitive decline in men and women. Different interventions targeting CD may be needed.

Functional decline over 2 years in older Spanish adults: Evidence from the Survey of Health, Ageing and Retirement in Europe

To evaluate the social, educational, health and behavioral predictors of physical functional decline in older Spanish adults. A 2-year longitudinal study based on 699 community-dwelling Spanish adults aged over 65 years participating in the Survey of Health, Ageing and Retirement in Europe was carried out. Several predictors of a combined measure of functional disability were examined using logistic regressions. A decline in function was experienced by 166 individuals. Functional decline in men was associated with an increased number of chronic diseases (OR 2.25, 95% CI 1.21-4.19) and depressive symptoms (OR 5.05, 95% CI 2.42-10.54) over a 2-year period, whereas among women it was associated with decreased numeracy score (OR 1.88, 95%CI 1.05-3.34). Longitudinal changes in predictors are strongly associated with longitudinal changes in function between baseline and a 2-year follow up, most clearly among men. A decrease in cognitive functioning and increased depressive symptoms are associated with a decline in physical functioning, and can serve as useful clinical predictors to prevent disability in older Spanish adults.

O17.3 Do We Need to Vaccinate Males Against HPV?

BackgroundFrom mid-2007 Australia funded a universal HPV vaccination programme for young females, which achieved high coverage rates. In 2013, Australia has become the first country to extend the HPV vaccination...

Coffee intake and cognitive functioning in men

More than 50% of US adults consume coffee daily. Coffee contains antioxidants and other compounds that may be protective against age‐related cognitive decline. However, few longitudinal studies have investigated these associations. This study examined the up to 17‐y prospective association between coffee intake and cognitive function among 554 men aged 21–81 y, from the Veteran's Administration Normative Aging Study. Dietary intakes from food frequency questionnaires were assessed beginning in 1987 and cognitive data were assessed from 1993. Follow‐up questionnaires were given every 3–5 y. Coffee intake was calculated as an average of all reported intakes prior to the final cognitive measure. Multivariable linear regression models were adjusted for age, education, smoking, BMI, homocysteine concentration, baseline cognitive test, and time between cognitive measures. Each serving of total coffee (regular/decaffeinated) intake was associated with a 0.17 point higher Mini‐Mental State Examination (score range 0–30, P=0.028), but not with other cognitive tests. Total caffeine intake tended to be associated with cognitive functioning, but this did not reach significance (P=0.11). Greater coffee intake may be associated with less cognitive decline in men, as measured by global cognitive function, but this may be due to protective factors other than caffeine. Kraft Foods Global, Inc. supported this study.

Associations between body composition and gait-speed decline: results from the Health, Aging, and Body Composition study

In older adults, every 0.1-m/s slower gait speed is associated with a 12% higher mortality. However, little research has identified risk factors for gait-speed decline. We assessed the association between several measures of body composition and age-related decline in gait speed. Data were from 2306 older adults who were participating in the Health, Aging, and Body Composition cohort and were followed for 4 y (50% women; 38% black). Usual walking speed (m/s) over 20 m was measured in years 2 through 6, and the baseline and changes in several measures of body composition were included in mixed-effects models. Gait speed declined by 0.06 ± 0.00 m/s over the 4-y period. Baseline thigh intermuscular fat predicted the annual gait-speed decline (±SE) in both men and women (-0.01 ± 0.00 and -0.02 ± 0.00 m/s per 0.57 cm(2), respectively; P < 0.01). In men, but not in women, this relation was independent of total body adiposity. In longitudinal analyses, changes in thigh intermuscular fat and total thigh muscle were the only body-composition measures that predicted gait-speed decline in men and women combined. When modeled together, every 5.75-cm(2) increase in thigh intermuscular fat was associated with a 0.01 ± 0.00-m/s decrease in gait speed, whereas every 16.92-cm(2) decrease in thigh muscle was associated with a 0.01 ± 0.00-m/s decrease in gait speed. High and increasing thigh intermuscular fat are important predictors of gait-speed decline, implying that fat infiltration into muscle contributes to a loss of mobility with age. Conversely, a decreasing thigh muscle area is also predictive of a decline in gait speed.

Flexibility of Older Adults Aged 55–86 Years and the Influence of Physical Activity

Cross-sectional age-related differences in flexibility of older adults aged 55–86 years of varying activity levels were examined. Shoulder abduction and hip flexion flexibility measurements were obtained from 436 individuals (205 men, 71 ± 9 years; 231 women, 72 ± 8 years). Total physical activity was assessed using the Minnesota Leisure-Time Physical Activity Questionnaire. Shoulder abduction showed a significant decline averaging 5 degrees/decade in men and 6 degrees/decade in women. Piecewise linear regression showed an accelerated decline in men starting at the age of 71 years of 0.80 degrees/year, whereas in women the onset of decline (0.74 degrees/year) was 63 years. Men and women showed a significant decline in hip flexion (men: 6 degrees/decade; women: 7 degrees/decade). Piecewise linear regression revealed a rate of decline of 1.16 degrees/year beginning at 71 years in men and in women a single linear decline of 0.66 degrees/year. Multiple regression analysis showed that age and physical activity accounted for only 9% of the variance in hip flexion in women and 10% in men, with age but not physical activity remaining significant. Similarly for shoulder abduction, age was significant but not physical activity, in a model that described 8% of the variance for both sexes.

Monitoring progress in the management of hip fractures in South Australia, Australia

The aim of this study was to assess trends in hip fracture rates and outcomes following hospitalisation for hip fracture. Hip fracture admissions increased over the study period. Men fared worst in terms of higher absolute mortality. Refracture rates and male health outcomes require further attention. The aim of this study was to assess trends in hip fracture rates and outcomes following hospitalisation for hip fracture in South Australia (SA). Analysis of routinely collected, linked hospital separations data, of patients admitted to public and private hospitals in SA with a principal diagnosis of femoral neck fracture between July 2002 and June 2008 was done. Main outcome measures include number and rates of hospital admissions, 30-day in-hospital and 1-year mortality following a first hip fracture and subsequent event rates, by age and sex. Unadjusted hip fracture admissions increased in SA from 2002 to 2008 by 20 %, age-standardised (adjusted) admission rates increased overall (+5 %, p = 0.215) and significantly amongst males (+26 %, p = 0.001), while there was no change among women (−1 %, p = 0.763). Within 1 year of a hip fracture, 7 % had broken another bone (5 % had refractured a hip). At 1 year post-fracture, unadjusted mortality was consistently and considerably higher amongst men compared to women (33 versus 19 %, p < 0.001). Age-standardised mortality from admission to 1 year fell but not statistically significantly by 15 % in women (p = 0.131) and 8 % in men (p = 0.510). Women had a reduction in age-standardised in-hospital mortality over time (p = 0.048); there was a non-significant decline in men (p = 0.080). Hip fracture admissions in SA increased over the study period and this appears to be driven by an increase in admissions amongst men. Men fared worst in terms of higher absolute mortality. There is some evidence to suggest refracture rates and male health outcomes require further attention.

Androgen deficiency in older men: Indications, advantages, and pitfalls of testosterone replacement therapy

The decline in testosterone with age has been associated with specific physical changes that affect quality of life and life expectancy, although a cause-and-effect relationship is yet to be established. While female menopause is rapid and well described, "male menopause" or androgen decline in older men is gradual and marked by nonspecific symptoms. This makes diagnosis of true testosterone deficiency and prediction of response to testosterone replacement therapy (TRT) challenging. This article reviews androgen decline in men, focusing on those over age 40, and covers symptoms, indications, contraindications,diagnosis, treatments, and the risks and benefits of treatment [corrected].

Associations between gonadotropins, testosterone and β amyloid in men at risk of Alzheimer’s disease

Testosterone and gonadotropins have been associated with cognitive decline in men and the modulation of β amyloid (Aβ) metabolism. The relatively few studies that have investigated whether changes in one or a combination of these hormones influence Aβ levels have focused primarily on plasma Aβ(1-40) and not on the more pathogenic Aβ(1-42). Currently, no study has investigated whether these hormones are associated with an increase in brain amyloid deposition, ante mortem. Through the highly characterised Australian imaging, biomarkers and lifestyle study, we have determined the impact of these hormones on plasma Aβ levels and brain amyloid burden (Pittsburgh compound B (PiB) retention). Spearman's rank correlation and linear regression analysis was carried out across the cohort and within subclassifications. Luteinizing hormone (LH) was the only variable shown, in the total cohort, to have a significant impact on plasma Aβ(1-40) and Aβ(1-42) levels (beta=0.163, P<0.001; beta=0.446, P<0.001). This held in subjective memory complainers (SMC) (Aβ(1-40); beta=0.208, P=0.017; Aβ(1-42); beta=0.215, P=0.017) but was absent in mild cognitive impairment (MCI) and Alzheimer's disease (AD) groups. In SMC, increased frequency of the APOE-ɛ4 allele (beta=0.536, P<0.001) and increasing serum LH levels (beta=0.421, P=0.004) had a significant impact on PiB retention. Whereas in MCI, PiB retention was associated with increased APOE-ɛ4 allele copy number (beta=0.674, P<0.001) and decreasing calculated free testosterone (beta=-0.303, P=0.043). These findings suggest a potential progressive involvement of LH and testosterone in the early preclinical stages of AD. Furthermore, these hormones should be considered while attempting to predict AD at these earliest stages of the disease.

CRP is associated with lung function decline in men but not women: A prospective study

Systemic inflammation is associated with impaired lung function. Studies, most cross-sectional, report a stronger association between systemic inflammation and lung function impairment in men than women. The aim was to evaluate gender differences in the longitudinal association between systemic inflammation and lung function. We used data from randomly chosen residents of Reykjavík, born 1940-54, who were investigated in three stages: Baseline (1973-75; 1983-85) and follow-up (2001-03). The participants (n = 1049, 574 women) had a mean age of 28 ± 6 years at baseline and mean follow-up time of 27 ± 4 years. At each stage lung function (FEV(1) and FVC) and C-reactive protein (CRP) were evaluated. Change in FEV(1) (p = 0.04) and FVC (p = 0.01) was associated with baseline CRP in men but not in women. In the multiple variable analysis, CRP at baseline was associated with a decline in FEV(1) (-3.1 mL/year, 95% CI: -5.1, -0.99) and FVC (-2.5 mL/year, 95% CI: -4.4, -0.65) in men but not in women. Similarly during follow-up, change in CRP, standardised to 1SD, was associated with a decline in FEV(1) (-0.19 mL/year, 95% CI: -0.30, -0.07) and FVC (-0.11 mL/year, 95% CI: -0.22, -0.01)) in men but not in women. This prospective study confirms a stronger association between systemic inflammation and lung function decline in men than in women. This may indicate a gender difference in the mechanisms of lung function decline.

Forecasts of COPD mortality in Australia: 2006-2025

BackgroundChronic Obstructive Pulmonary Disease (COPD) is currently the fifth leading cause of death in Australia, and there are marked differences in mortality trends between men and women. In this study, we have sought to model and forecast age related changes in COPD mortality over time for men and women separately over the period 2006-2025.MethodsAnnual COPD death rates in Australia from 1922 to 2005 for age groups (50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, 85+) were used. Functional time series models of age-specific COPD mortality rates for men and women were used, and forecasts of mortality rates were modelled separately for men and women.ResultsFunctional time series models with four basis functions were fitted to each population separately. Twenty-year forecasts were computed, and indicated an overall decline. This decline may be slower for women than for men. By age, we expect similar rates of decline in men over time. In contrast, for women, forecasts for the age group 75-79 years suggest less of a decline over time compared to younger age groups.ConclusionsBy using a new method to predict age-specific trends in COPD mortality over time, this study provides important insights into at-risk age groups for men and women separately, which has implications for policy and program development.

Cancer statistics, 2012

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. A total of 1,638,910 new cancer cases and 577,190 deaths from cancer are projected to occur in the United States in 2012. During the most recent 5 years for which there are data (2004-2008), overall cancer incidence rates declined slightly in men (by 0.6% per year) and were stable in women, while cancer death rates decreased by 1.8% per year in men and by 1.6% per year in women. Over the past 10 years of available data (1999-2008), cancer death rates have declined by more than 1% per year in men and women of every racial/ethnic group with the exception of American Indians/Alaska Natives, among whom rates have remained stable. The most rapid declines in death rates occurred among African American and Hispanic men (2.4% and 2.3% per year, respectively). Death rates continue to decline for all 4 major cancer sites (lung, colorectum, breast, and prostate), with lung cancer accounting for almost 40% of the total decline in men and breast cancer accounting for 34% of the total decline in women. The reduction in overall cancer death rates since 1990 in men and 1991 in women translates to the avoidance of about 1,024,400 deaths from cancer. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population, with an emphasis on those groups in the lowest socioeconomic bracket.

HIV-1 Dual Infection Is Associated With Faster CD4+ T-Cell Decline in a Cohort of Men With Primary HIV Infection

In vitro, animal, and mathematical models suggest that human immunodeficiency virus (HIV) co- or superinfection would result in increased fitness of the pathogen and, possibly, increased virulence. However, in patients, the impact of dual HIV type 1 (HIV-1) infection on disease progression is unclear, because parameters relevant for disease progression have not been strictly analyzed. The objective of the present study is to analyze the effect of dual HIV-1 infections on disease progression in a well-defined cohort of men who have sex with men. Between 2000 and 2009, 37 men who had primary infection with HIV-1 subtype B, no indication for immediate need of combination antiretroviral therapy (cART), and sufficient follow-up were characterized with regard to dual infection or single infection and to coreceptor use. Patients were followed to estimate the effect of these parameters on clinical disease progression, as defined by the rate of CD4(+) T-cell decline and the time to initiation of cART. Four patients presented with HIV-1 coinfection; 6 patients acquired HIV-1 superinfection, on average 8.5 months from their primary infection; and 27 patients remained infected with a single strain. Slopes of longitudinal CD4(+) T-cell counts and time-weighted changes from baseline were significantly steeper for patients with dual infection compared with patients with single infection. Multivariate analysis showed that the most important parameter associated with CD4(+) T-cell decline over time was dual infection (P = .001). Additionally, patients with HIV-1 coinfection had a significantly earlier start of cART (P < .0001). Dual HIV-1 infection is the main factor associated with CD4(+) T-cell decline in men who have untreated primary infection with HIV-1 subtype B.

Female platelets are hard to control.

Female platelets are hard to control.

HIV-1 dual infection is associated with faster CD4+T cell decline in a cohort of men with primary HIV infection

BACKGROUND In vitro, animal, and mathematical models suggest that human immunodeficiency virus (HIV) co- or superinfection would result in increased fitness of the pathogen and, possibly, increased virulence. However, in patients, the impact of dual HIV type 1 (HIV-1) infection on disease progression is unclear, because parameters relevant for disease progression have not been strictly analyzed. The objective of the present study is to analyze the effect of dual HIV-1 infections on disease progression in a well-defined cohort of men who have sex with men. METHODS Between 2000 and 2009, 37 men who had primary infection with HIV-1 subtype B, no indication for immediate need of combination antiretroviral therapy (cART), and sufficient follow-up were characterized with regard to dual infection or single infection and to coreceptor use. Patients were followed to estimate the effect of these parameters on clinical disease progression, as defined by the rate of CD4(+) T-cell decline and the time to initiation of cART. RESULTS Four patients presented with HIV-1 coinfection; 6 patients acquired HIV-1 superinfection, on average 8.5 months from their primary infection; and 27 patients remained infected with a single strain. Slopes of longitudinal CD4(+) T-cell counts and time-weighted changes from baseline were significantly steeper for patients with dual infection compared with patients with single infection. Multivariate analysis showed that the most important parameter associated with CD4(+) T-cell decline over time was dual infection (P = .001). Additionally, patients with HIV-1 coinfection had a significantly earlier start of cART (P < .0001). CONCLUSIONS Dual HIV-1 infection is the main factor associated with CD4(+) T-cell decline in men who have untreated primary infection with HIV-1 subtype B.

The long and short term effects of alcohol consumption on cognitive decline

BackgroundWith an increase in ageing population, cognitive decline represents a major reason of concern. Alcohol has been shown to have a differential impact on cognitive decline according to the level...

Predictive utility of the Framingham general cardiovascular disease risk profile for cognitive function: evidence from the Whitehall II study

AimsVascular risk factors are associated with cognitive impairment and dementia, although most of the research in this domain focuses on cerebrovascular factors. We examined the relationship between the recently developed Framingham general cardiovascular risk profile and cognitive function and 10-year decline in late midlife.Methods and resultsStudy sample comprised of 3486 men and 1341 women, mean age 55 years [standard deviation (SD)=6], from the Whitehall II study, a longitudinal British cohort study. The Framingham General Cardiovascular Risk profile, assessed between 1997 and 1999, included age, sex, HDL cholesterol, total cholesterol, systolic blood pressure, smoking status, and diabetes status. Measures of cognitive function consisted of tests of reasoning (Alice Heim 4-I), memory, phonemic and semantic fluency, and vocabulary (Mill-Hill), assessed three times (1997–1999, 2002–2004, 2007–2009) over 10 years. In cross-sectional age-adjusted models, 10% point increments in cardiovascular risk were associated with poor performance in all cognitive domains in both men and women (all P-values <0.001). In models adjusted for age, ethnicity, marital status, and education, 10% higher cardiovascular risk was associated with greater overall 10-year cognitive decline in men, reasoning in particular (−0.47; 95% CI: −0.81, −0.11).ConclusionIn middle-aged individuals free of cardiovascular disease, an adverse cardiovascular risk profile is associated with poor cognitive function, and decline in at least one cognitive domain in men.