Onset Of Disability Research Articles

Couple similarity with respect to physical and mental disabilities.

Existing research on relationships provides strong evidence of couple similarity on a wide range of variables including physical attributes, abilities, and attitudes. However, couple similarity with respect to disability has not been researched. This study investigated couple similarity with respect to both physical and mental disabilities, as well as associations with life satisfaction, among adult cohabiting couples in Denmark. The study analysed data on self-reported mental and physical disabilities from a national survey involving 18,957 participants aged 16 to 65 years. The results showed that participants with a disability were more likely to have a partner with a disability. Further, results showed similarity by type and severity of disability as well as age of onset of disability. Having a partner with a disability was found to be associated with low life satisfaction among men with a disability. Results also showed an association among men with a disability between low life satisfaction and the onset of their disability after (as opposed to before) the start of their relationship. These associations were not found among women with a disability. The findings provide clear evidence for couple similarity with respect to disability. Findings on life satisfaction showed gender differences that might be explained by cultural gender norms that may play a particular role with respect to disability. Longitudinal research is required to research the factors that mediate how having or developing a disability affects relationships and wellbeing over time.

Leveraging Observational Cohorts to Study Diet and Nutrition in Older Adults: Opportunities and Obstacles

By 2060, the number of adults aged ≥65 y is expected to double, and the ≥85 y segment of the population is expected to triple in the United States. US federal nutrition guidance is based on the premise that healthy diets contribute to delaying the onset and progression of many age-related diseases and disability. Yet, little is known about the dietary intakes or nutritional needs across the older adulthood age span. This review aims to identify community-based cohorts that collected information on dietary intake of adults≥65 y in the United States. Thirty-two cohorts met all inclusion criteria. We summarized information on the cohorts' design, demographics, and diet assessment. We also identified key gaps in the existing databases that, if filled, could enhance their utility to address certain research questions. This review serves as a valuable inventory of cohorts that can be leveraged to answer key questions about the diet and nutritional needs of the oldest old, who represent the fastest growing segment of the population in the United States.

Effect of the age of visual impairment onset on employment outcomes in South Korea: analysis of the national survey on persons with disabilities data

BackgroundOpportunities for paid employment provide meaningful ways for those with disabilities to participate in society and achieve financial independence. Although the onset age of disabilities can alter individuals’ attitudes toward accepting their disabilities and their desire for work, the lack of data limits relevant empirical research. The purpose of this study is to examine the effect of the onset age on employment, job security (permanent vs. temporary), and wage level among visually impaired adults in South Korea.MethodsWe used three years of the National Survey on Persons with Disabilities data, 2011, 2014, and 2017, and included 583 participants in this study. We used a logistic regression model for the employment status and a multinomial logistic regression model for job security. We analyzed log monthly wage by a multivariate linear regression model, which subdivided the age groups, with 20–49 years old denoting prime-aged (n = 245) and 50–64 years old denoting late-middle-aged (n = 338). For each age group, we conducted a sub-analysis by sex.ResultsFor prime-aged adults, the employment probability decreased as the age of visual impartment onset increased, and women in particular experienced a lower employment rate for both permanent and temporary jobs when their disability onset age was above 25. However, among permanent employees, monthly wages were higher if the onset age was 25 + compared to when the onset age was 0–5 years old. In late middle-aged adults, adult onset disabilities were associated with higher odds of employment and higher wages for temporary jobs, implying these individuals worked unskilled or manual jobs.ConclusionsIn prime-aged adults, higher monthly wages among permanent employees showed that they were more likely to continue their original work, whereas in late-middle-aged adults, adult-onset disabilities were associated with a higher employment rate and higher wages for temporary jobs, suggesting the need for further investigation into job quality. These findings indicate a need for differentiated policy approaches considering the onset age of visual impairment to improve labor market outcomes throughout individuals’ lifespans.

Physical performance measures in frailty screening: diagnostic and prognostic accuracy in the Toledo Study of Healthy Ageing

IntroductionThe present study aimed to explore the diagnostic and prognostic accuracy of standard and population-specific Physical Performance Measures (PPMs) cut-off points for frailty screening. DesignProspective cohort study. Setting and participantsPopulation-based study including 2328 subjects from the Toledo Study of Healthy Aging (age = 76.37 ± 6.78). Data related to frailty status and PPMs was collected at baseline visit (2011−2013). Mortality and hospitalization were ascertained up to March 2019 and December 2017, respectively, whereas disability onset and worsening were evaluated in the 2015–2017 visit. MethodsGait speed and Short Physical Performance Battery population-specific cut-off points for frailty were computed using receiver operating characteristics (ROC) curve analysis. Head-to-head comparison of associations with adverse events against existing reference values (SPPB≤6, GS < 0.8 m/s) and classical (Frailty Phenotype, Frailty Index) and newly incorporated frailty tools (12- and 5-item Frailty Trait Scale) were explored through logistic and Cox regressions. Predictive ability was compared through areas under the curves (AUCs) for disability onset/worsening and integrated AUCs for mortality and hospitalization (time-censoring adverse events). ResultsPPMs population-specific cut-off points (SPPB ≤7 and GS ≤ 0.75 m/s for males; SPPB ≤4 and GS ≤ 0.5 for females) outperformed published reference thresholds in terms of diagnostic accuracy. Frailty identified through PPMs was associated with adverse events (death, hospitalization and incident disability) similarly to that assessed using the newly incorporated tools and showed similar prognostic accuracy (mortality [IAUCs≈0.7], hospitalization [IAUCs≈0.8] and disability onset/worsening [AUCs≈0.62]), except for the tool used to assess frailty. ConclusionsOur results suggest that PPMs might serve as the first screen to identify candidates for further frailty assessment and exploration of underlying mechanisms, allowing opportunistic on-time screening in different settings (community and primary care) in which frailty instruments are rarely implementable.

Increased Longevity in Europe: Adding Years to Life or Life to Years?

In 1950, life expectancy at birth in Spain was 64.2 years for women and 59.3 years for men. Thereafter and to the present day, this life expectancy has risen practically uninterruptedly to reach, in 2020, 85.1 and 79.6 years, respectively. The case of Spain is not the only one, since the inhabitants of most countries in the world are living to ages that seemed unattainable only a few decades ago, and this represents a historic landmark for humanity (Vaupel et al., 2021). While it is true that the generalised postponement of mortality is an unprecedented collective success, it must be asked whether we are equally successful in our efforts to delay the onset of disease and disability (or, in other words, morbidity). If decreasing mortality rates are not matched by an equivalent decline in morbidity rates, people in these societies tend to live for more years but in a worse state of health (Gruenberg, 1977). This is a phenomenon with enormous consequences for the sustainability of health and pensions systems, as we know them. In this issue of Perspectives Demogràfiques we explore the extent to which the increases in longevity recorded in Spain over the last 30 years have happened with gains in years in good health (which is to say, “adding life to years”) or in bad health (“adding years to life”). Focusing not only on quantity but also on the quality of the years gained, we aim to shed new light on a pressing issue of today which should be taken into account in the designing of a wide range of public policies that must, as a matter of necessity, go beyond the confines of what is strictly understood as the domain of health.

Reference values of chair stand test and associations of chair stand performance with cognitive function in older adults

BackgroundChair stand performance is a good predictor of future disability onset among older adults. This study aimed to establish reference values of five-times chair-stand test stratified by age and gender, and to determine the association of chair stand performance with mild cognitive impairment (MCI) status and multidimensional cognitive function among community-dwelling older adults. MethodsThis cross-sectional study included 604 community-dwelling older adults (mean age, 74.0; women, 63.1%). The five-times chair-stand test was measured, and the mean and SD were calculated as reference values for each age category in intervals of five years. Participants were classified into three groups based on tertiles (good, medium, and poor) in the five-times chair-stand test in each age group. ResultsMean (SD) values of the five-times chair-stand test in men and women were 8.2 s (2.6 s) and 8.2 s (2.9 s). Chair stand performance declined with advancing age and a significant decline in participants aged 80 years and older was observed. Poor chair stand performance (the lowest performance tertile) was significantly associated with MCI (Odds Ratio (OR) 2.18, 95% CI 1.41–3.36), lower attention (OR 2.36, 95% CI 1.28–4.37), executive function (OR 2.69, 95% CI 1.63–4.45), and processing speed (OR 2.80, 95% CI 1.18–6.67) after controlling for covariates. ConclusionsSimilar mean values of the five-times chair-stand test, 8.2 s were presented in older men and women, poor performance of chair stand was associated with MCI, specific domains of attention, executive function, and processing speed. Chair stand performance would be useful for case-finding with a greater risk of cognitive impairment among community-dwelling older adults.

Implementing CAPABLE With Care Partners Through an Area Agency on Aging: Identifying Barriers and Facilitators Using the Consolidated Framework for Implementation Research.

Community Aging in Place, Advancing Better Living for Elders (CAPABLE) is an evidence-based intervention to promote aging in place. Although CAPABLE has been implemented in more than 40 community sites, wide variation in implementation exists. Guided by the Consolidated Framework for Implementation Research (CFIR), this study sought to determine key barriers and facilitators that may influence CAPABLE implementation with older adult and care partner dyads through an area agency on aging (AAA). A formative evaluation was completed using qualitative data from the pilot of a Hybrid Trial Type 1 study implementing CAPABLE in an AAA. Multiple sources of data were collected, including 2 focus groups, field notes, a tracking log, and meetings with CAPABLE interventionists. Data were analyzed using a framework method and validated through a negative case analysis approach in NVivo 12 Pro. Fourteen dyads enrolled in the pilot and 6 completed the CAPABLE intervention. Key themes aligned with 10 constructs from 5 domains of the CFIR. Facilitators included adaptability of the intervention, cost, networks and communication, and knowledge and belief of individuals. Barriers included intervention complexity, client needs and resources, and executing the planned process. Results enhance understanding of contextual factors that can influence the implementation of CAPABLE with care partners. Strategies to overcome barriers include simplifying recruitment materials and targeting older adults with recent onset of disability. The CFIR is a valuable resource for planning and evaluation of the implementation of evidence-based interventions to promote aging in place.

Biological aging in maltreated children followed up into middle adulthood

BackgroundChildhood adversity has been linked to many indicators of shorter healthy lifespan, including earlier onset of disease and disability as well as early mortality. These observations suggest the hypothesis that childhood maltreatment may accelerate aging. ObjectiveTo characterize the relationship between childhood maltreatment and accelerated biological aging in a prospective cohort of 357 individuals with documented cases of childhood maltreatment and 250 controls matched on demographic and socioeconomic factors. MethodsCases were drawn from juvenile and adult court records from the years 1967 through 1971 in a large Midwest metropolitan geographic area. Cases were defined as having court-substantiated cases of childhood physical or sexual abuse, or neglect occurring at age 11 or younger. Controls were selected from the same schools and hospitals of birth and matched on age, sex, race, and approximate socioeconomic status. We compared biological aging in these two groups using two blood-chemistry algorithms, the Klemera-Doubal method Biological Age (KDM BA) and the PhenoAge. Algorithms were developed and validated in data from the National Health and Nutrition Examination Surveys (NHANES) using published methods and publicly available software. ResultsParticipants (55% women, 49% non-White) had mean age of 41 years (SD=4). Those with court substantiated childhood maltreatment history exhibited more advanced biological aging as compared with matched controls, although this difference was statistically different for only the KDM BA measure (KDM BA Cohen’s D=0.20, 95% CI=[0.03,0.36], p = 0.02; PhenoAge Cohen’s D=0.09 95% CI=[−0.08,0.25], p = 0.296). In subgroup analyses, maltreatment effect sizes were larger for women as compared to men and for White participants as compared to non-White participants, although these differences were not statistically significant at the α= 0.05 level. Conclusions and relevanceAs of midlife, effects of childhood maltreatment on biological aging are small in magnitude but discernible. Interventions to treat psychological and behavioral sequelae of exposure to childhood maltreatment, including in midlife adults, have potential to protect survivors from excess burden of disease, disability, and mortality in later life.

Loneliness at Older Ages in the United States: Lonely Life Expectancy and the Role of Loneliness in Health Disparities.

We provide an empirical foundation for research on the demography of loneliness at older ages. First, we use published life tables and data from the U.S.-based Health and Retirement Study for the period 2008-2016 to calculate lonely life expectancy for Americans aged 55 or older. Using Sullivan's method, we demonstrate pronounced differences in lonely life expectancy by sex, race/ethnicity, and educational attainment that correspond to well-established patterns of stratification in other dimensions of well-being. Next, we estimate models that decompose observed sex, racial/ethnic, and educational differences in three key health outcomes into the part explained (in a statistical accounting sense) by loneliness and the part accounted for by other factors. We find little evidence of an important role for loneliness in understanding disparities in mortality and the onset of physical disability and cognitive impairment among Americans aged 55 or older, net of several established correlates of health disparities. These descriptive findings provide an empirical foundation for continued development of a demography of loneliness at older ages in response to the anticipated growth in scientific and policy emphasis on loneliness and the fundamental life changes that have accompanied the COVID-19 pandemic.

How does the onset of physical disability or dementia in older adults affect economic wellbeing and co-payments for health care? the impact of gender

BackgroundExisting studies have illustrated how the onset of physical disability or dementia negatively impacts economic wellbeing and increases out of pocket costs. However, little is known about this relationship in older individuals. Consequently, this study aimed to identify how the onset of physical disability or dementia in older adults affects economic wellbeing and out of pocket costs, and to explore the impact of gender in the context of Australia.MethodsThe data was collected from a large, randomized clinical study, ASPirin in Reducing Events in the Elderly (ASPREE). Two generalized linear models (with and without interaction effects) of total out of pocket costs for those who did and did not develop physical disability or dementia were generated, with adjustment for sociodemographic characteristics at baseline.ResultsWe included 8,568 older Australian individuals with a mean age of 74.8 years and 53.2% being females. After adjustment for the baseline sociodemographic characteristics, the onset of physical disability did statistically significantly raise out of pocket costs (cost ratio = 1.25) and costs among females were 13.1% higher than males.ConclusionsThis study highlights that classifying different types of health conditions to identify the drivers of out of pocket costs and to explore the gender differences in a long-term follow-up is of importance to examine the financial impact on the older population. These negative financial impacts and gender disparities of physical disability and dementia must be considered by policymakers.

Tooth retention, health, and quality of life in older adults: a scoping review

ObjectiveThis scoping review describes the relationship between tooth retention, health, and quality of life in older adults.MethodsSeven databases were searched for English language articles for subjects ≥ 65 y from 1981 to 2021. Exposure was tooth retention (≥ 20), and outcomes were general/systemic health and quality of life. Methodological quality was assessed using the Newcastle–Ottawa Scale and Cochrane Risk of Bias 2.0 tool.Results140 articles were included, only four were randomized trials. Inter-rater agreement (κ) regarding study inclusion was 0.924. Most were assessed with low risk of bias (n = 103) and of good quality (n = 96). Most studies were conducted in Japan (n = 60) and Europe (n = 51) and only nine in the US. Tooth retention was referred to as “functional dentition” in 132 studies and “shortened dental arch” in 19 studies. Study outcomes were broadly synthesized as (1) cognitive decline/functional dependence, (2) health status/chronic diseases, (3) nutrition, and (4) quality of life.DiscussionThere is a positive relationship between tooth retention, overall health, and quality of life. Older adults retaining ≥ 20 teeth are less likely to experience poorer health. Having < 20 teeth increases the likelihood for functional dependence and onset of disability, and may affect successful ageing. This review supports the general finding that the more teeth older adults retain as they age, the less likely they are to have adverse health outcomes. However, significant knowledge gaps remain which can limit decision-making affecting successful ageing for many older adults. This review highlights the need to consider, as an important marker of oral health and function, the retention of a functional minimum of a natural dentition, rather than a simple numeric score of missing teeth.

Sex Differences in Vitamin D Status as a Risk Factor for Incidence of Disability in Instrumental Activities of Daily Living: Evidence from the ELSA Cohort Study.

Vitamin D deficiency compromises elements underlying the disability process; however, there is no evidence demonstrating the association between vitamin D deficiency and the incidence of disability in instrumental activities of daily living (IADL). We investigated the association between vitamin D deficiency and the risk of incidence of IADL disability separately in men and women. A total of 4768 individuals aged ≥50 years from the English Longitudinal Study of Aging (ELSA) and without IADL disability according to the Lawton scale were available. Vitamin D was evaluated at baseline by serum 25(OH)D concentrations and classified as sufficient (>50 nmol/L), insufficient (>30 to ≤50 nmol/L) or deficient serum (≤30 nmol/L). IADL were reassessed after 4 years. Poisson models stratified by sex and controlled by covariates demonstrated that deficient serum 25(OH)D was a risk factor for the incidence of IADL disability in men (IRR: 1.43; 95% CI 1.02, 2.00), but not in women (IRR: 1.23; 95% CI 0.94, 1.62). Men appear to be more susceptible to the effect of vitamin D deficiency on the incidence of IADL disability, demonstrating the importance of early clinical investigation of serum 25(OH)D concentrations to prevent the onset of disability.

Predominant domains and associated demographic and clinical characteristics in multiple sclerosis-related cognitive impairment in mildly disabled patients

BackgroundCognitive impairment (CI) is a common finding in multiple sclerosis (MS); however, there is a limited information about its prevalence in mildly disabled cases. We aimed to determine the most affected domains, and also the relation between the demographic factors and cognitive outcomes in mildly disabled relapsing–remitting MS (RRMS).ResultsNinety-one mildly disabled RRMS patients with expanded disability status scale (EDSS) < 4 and literacy level above 9 years, were recruited. Based on Minimal Assessment of Cognitive Function in MS (MACFIMS) battery, CI was observed in 19.8% of the patients while 40.60% of the patients had at least one failure in cognitive tests. The most common impaired cognitive domain was information processing speed and working memory (27.5%). There was no significant difference between men and women in terms of CI in our sample (p-values > 0.05). Disease duration (p = 0.01), EDSS (p = 0.01), and education (p < 0.01) were significantly different between CI and non-CI patients, while age (p = 0.72), sex (p = 0.50), diagnostic gap (p = 0.89), and frequency of relapses (p = 0.22), did not differ considerably.ConclusionsRRMS patients experience some degrees of CI that may present even before the onset of remarkable physical disability; nevertheless, a higher EDSS score and longer disease duration increases the risk of CI. These findings suggest routine cognitive assessment of MS patients.

Lumbar spine metastasis from squamous cell carcinoma of tongue

Introduction: Acute anterior poliomyelitis (AAP) is an endemic human disease caused by a worldwide spreading enterovirus. The late consequences of AAP include a new picture of muscle weakness together with abnormal muscle fatigue, amyotrophy, and myoarticular pain, configuring a condition known as post-polio syndrome (PPS). This new condition comprises a specific set of health problems due to the polio virus, resulting in decreased functional capacity and/or the onset of new disabilities. Case Report: A 53-year-old female, human resources analyst, reported that she had been shaken by AAP at the age of 2. Currently she was presented with gait on the knees, osteo-myoarticular pain, inadequate synergies of movements. Imaging exams showed great disproportion in the pelvic region with marked amyotrophy and liposubstitution of the muscle, more evident in the left leg. Although there was some preservation of the plantar flexor muscles, interstitial edema was evident. In the thighs there was amyotrophy with liposubstitution of the muscle, more evident on the left. In the left knee joint there was a lesion of the cruciate ligaments with extensive deep chondral erosions in the load area of the femorotibial compartment, with exposure of the subchondral bone, without edema. Osteopenia also affected it. Conclusion: Through the data obtained in this study, it can be seen that there are many reasons why patients affected by post-polio syndrome develops bone deformities and joint interferences that cause the individual to suffer losses and aggravations in health and quality of life. Nevertheless, there is a lack of theoretical framework available in the literature, justifying the importance of further studies on this topic.

A painful skeleton disarticulated by acute anterior poliomyelitis

Introduction: Acute anterior poliomyelitis (AAP) is an endemic human disease caused by a worldwide spreading enterovirus. The late consequences of AAP include a new picture of muscle weakness together with abnormal muscle fatigue, amyotrophy, and myoarticular pain, configuring a condition known as post-polio syndrome (PPS). This new condition comprises a specific set of health problems due to the polio virus, resulting in decreased functional capacity and/or the onset of new disabilities. Case Report: A 53-year-old female, human resources analyst, reported that she had been shaken by AAP at the age of 2. Currently she was presented with gait on the knees, osteo-myoarticular pain, inadequate synergies of movements. Imaging exams showed great disproportion in the pelvic region with marked amyotrophy and liposubstitution of the muscle, more evident in the left leg. Although there was some preservation of the plantar flexor muscles, interstitial edema was evident. In the thighs there was amyotrophy with liposubstitution of the muscle, more evident on the left. In the left knee joint there was a lesion of the cruciate ligaments with extensive deep chondral erosions in the load area of the femorotibial compartment, with exposure of the subchondral bone, without edema. Osteopenia also affected it. Conclusion: Through the data obtained in this study, it can be seen that there are many reasons why patients affected by post-polio syndrome develops bone deformities and joint interferences that cause the individual to suffer losses and aggravations in health and quality of life. Nevertheless, there is a lack of theoretical framework available in the literature, justifying the importance of further studies on this topic.

RNA-based stable isotope probing provides no indication for rapid α-synuclein assimilation by murine gut bacteria.

In Parkinson’s disease (PD), α-synuclein is a key protein in the process of neurodegeneration. Besides motor symptoms, most PD patients additionally suffer from gastrointestinal tract (GIT) dysfunctions, even several years before the onset of motor disabilities. Studies have reported a dysbiosis of gut bacteria in PD patients compared to healthy controls and have suggested that the enteric nervous system (ENS) can be involved in the development of the disease. As α-synuclein was found to be secreted by neurons of the ENS, we used RNA-based stable isotope probing (RNA-SIP) to identify gut bacteria that might be able to assimilate this protein. The gut contents of 24 mice were pooled and incubated with isotopically labelled (13C) and unlabelled (12C) α-synuclein. After incubation for 0, 4 and 24 h, RNA was extracted from the incubations and separated by density gradient centrifugation. However, RNA quantification of density-resolved fractions revealed no incorporation of the 13C isotope into the extracted RNA, suggesting that α-synuclein was not assimilated by the murine gut bacteria. Potential reasons and consequences for follow-up-studies are discussed.

Parks/sports facilities in local communities and the onset of functional disability among older adults in Japan: The J-shaped spatial spillover effects.

We examined the associations between parks/sports facilities in local communities and the onset of functional disability among Japanese older adults. We further investigated the spatial spillover effects of parks/sports facilities in 1st-, 2nd-, and 3rd-degree neighboring communities. Data on the onset of functional disability, including date of onset, sex, age, and address (school district) of all older adults aged 65 years and older living in Kobe City were obtained from the public long-term care insurance database (163,348 men [190,831 person-year] and 200,443 women [230,464 person-year]). Multilevel proportional hazard regression analyses showed that the number of parks and sports facilities were negatively associated with the onset of functional disability among men. In particular, these associations were stronger for the adjacent district than for individuals' living districts. Our results imply that involving multiple neighboring communities as the intervention unit is effective when utilizing community built environments for long-term care prevention in men.

Community intervention programs prolong the onset of functional disability among older Japanese.

AimThis study examined the effects of a “community‐based center” intervention to prevent the onset of functional disability among residents in disaster‐affected areas.MethodsWe used data from a prospective cohort study conducted from 2010 to 2016 in Iwanuma City, Japan. Participants were community‐dwelling independent adults aged ≥65 years. The exposure variable was the experience of using a community‐based center. The outcome variable was functional disability onset. The average treatment effect on the treated (ATET) was estimated by adjusting for possible confounders. Additional analysis stratified by sex was conducted considering the sex differences in social participation rates.ResultsAmong 3794 participants (mean ± SD age = 72.9 ±5.3 years, 46.0% men), 196 (5.2%) used the community‐based center, and 849 (22.4%) exhibited disability onset. Of those with functional disabilities, 40 (20.4%) used the community‐based center, while 809 (22.5%) did not. The ATET for functional disability onset with community‐based center activities across all participants were not significant (ATET: 0.51 years [95% confidence interval [CI] = −0.23; 1.27]). However, the direction of the effect of community‐based center activities differed by sex (ATET: −0.14, 95% CI = −2.59; 2.31 for men [n = 18], and 0.66, 95% CI = 0.18; 1.16 for women [n = 178]). Women exhibited a 15.63% (95% CI = 3.58; 27.68) increase in the time until functional disability onset.ConclusionsThe use of community‐based centers was associated with a longer period without functional disability in women. Geriatr Gerontol Int 2022; 22: 465–470.

Metabolic changes of lymphocytes in a rat model of autoimmunity

Autoimmune diseases are highly prevalent in humans, being characterized by early onset and high risks of disability, thus determining the relevance of the present work and its aim, i.e., studying metabolic characteristics of lymphocytes upon the adjuvant-induced autoimmune disorder in rats. Modeling of the autoimmune process was performed in Wistar rats by subcutaneous administration of a Freund’s complete adjuvant, i.e., water-oil emulsion with heat-killed M. tuberculosis. Hematology testing (complete blood counts), biochemical markers (hydroperoxides, malondialdehyde (MDA), catalase), and cytobiochemical changes in lymphocytes (lactate dehydrogenase, succinate dehydrogenase; LDH, SDH) were followed in dynamics. X-ray examination was performed at the end of the experiment. At the initial stage of autoimmune arthritis (2 weeks), leukocytosis was registered (26.12±2.30 × 109/L, i.e., 65% over the controls, p &lt; 0.01), thrombocytosis (675±30 × 109/L, compared with 536±27 × 109/L in controls, p &lt; 0.01), and oxidative stress were also observed (hydroperoxides increased by 7%, and MDA, by 32%, p &lt; 0.001); energy levels of the lymphocytes increased due to activation of LDH by 6.5%, and SDH, by 49% against the controls. At chronic stage of the disorder (7 weeks), the systemic inflammation was milder (total WBC counts of 19.6±1.40 × 109/L, compared with 13.68±0.86 × 109 /L in controls, p &lt; 0.01, associated with shift to the right in differential conuts), along with persisting oxidative stress (MDA exceeds the control levels by 37%; decrease in catalase activity), and lower LDH activity in lymphocytes (by 43%, p &lt; 0.01) associated by their decrease in size (the correlation quotient between the lymphocyte radius and LDH activity is rxy= 0.87). Profound molecular changes were observed in the cell energy supply: the respiratory quotient for control animals (LDH/SDH ratio) varied within 4.6-5.0. Meanwhile, in autoimmune animals, metabolic contribution of glycolysis showed a significant decrease (the quotient of 3.2 by the 2ndweek, and 2.4 by the 7thweek). On the radiograph by 7thweek, the experimental animals show uneven joint space narrowing, cyst-like formations and subchondral sclerosis of the bone heads. Autoimmune rheumatoid arthritis in rats is characterized by metabolic disorders of lymphocytes manifesting as general energy deficiency, and imbalance between glycolysis and oxidative phosphorylation pathways. These findings allow of deeper insight into pathogenesis and suggesting further search for molecular targeted therapy and prevention of the disease.

Oral health problems and risk of incident disability in two studies of older adults in the United Kingdom and the United States.

BackgroundPreventing oral health problems can be crucial for maintaining physical independence in older adults. We aimed to examine the associations of a range of oral health problems with incidence of disability in older adults.MethodsWe used prospective data from the British Regional Health Study (BRHS) (N = 2147, 71–92 years), and the Health, Aging and Body Composition (HABC) study (USA) (N = 3075, 71–80 years). Oral health measures included tooth loss, periodontal disease, self‐rated oral health, and self‐reported dry mouth. Participants were followed for onset of disability over a follow‐up period of 3 years. Onset of disability was assessed through new cases of mobility limitations, activities of daily living (ADL), and instrumental activities of daily living (IADL). Logistic regression was performed to calculate the odds of incident disability.ResultsIn the BRHS, tooth loss was associated with greater odds of mobility limitations and ADL difficulties. Periodontal disease was associated with greater incidence of mobility limitations. Self‐report of ≥3 dry mouth symptoms was associated with increased odds of incident mobility limitations and ADL difficulties (OR = 2.08, 95% CI 1.27–3.42; OR = 1.73, 95% CI 1.03–2.90). Fair/poor self‐rated oral health was associated with greater incidence of IADL difficulties. In the HABC study, complete tooth loss was associated with greater incidence of mobility limitations (OR = 1.86, 95% CI 1.13–3.06), and fair/poor self‐rated oral health was associated with increased odds of incident ADL difficulties (OR = 1.42, 95% CI 1.04–1.94).ConclusionsOral health problems in older adults, particularly tooth loss, self‐reported dry mouth and self‐rated oral health were associated with greater incidence of disability. Poor oral health plays a potentially important role in the development of disability in older populations, which in turn is an essential part of quality of life and healthy aging.