scholarly journals Nonfatal Stroke and All-Cause Mortality among Community-Dwelling Older Adults Living in Rural Ecuador: A Population-Based, Prospective Study

2018 ◽  
Vol 09 (04) ◽  
pp. 551-555
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Victor J. Del Brutto
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Rural Setting ◽  
Nonfatal Stroke ◽  
All Cause Mortality ◽  
History Of ◽  
Univariate Analyses

ABSTRACT Background: Stroke is a leading cause of disability in developing countries. However, there are no studies assessing the impact of nonfatal strokes on mortality in rural areas of Latin America. Using a population-based, prospective cohort study, we aimed to assess the influence of nonfatal strokes on all-cause mortality in older adults living in an underserved rural setting. Methods: Deaths occurring during a 5-year period in Atahualpa residents aged ≥60 years were identified from overlapping sources. Tests for equality of survivor functions were used to estimate differences between observed and expected deaths for each covariate investigated. Cox proportional hazards models were used to estimate Kaplan–Meier survival curves of variables reaching significance in univariate analyses. Results: Of 437 individuals enrolled over 5 years, follow-up was achieved in 417 (95%), contributing 1776 years of follow-up (average 4.3 ± 1.3 years). Fifty-one deaths were detected, for an overall cumulative 5-year mortality rate of 12.2% (8.9%–15.6%). Being older than 70 years of age, having poor physical activity, edentulism, and history of a nonfatal stroke were related to mortality in univariate analyses. A fully adjusted Cox proportional hazards model showed that having history of a nonfatal stroke (P = 0.024) and being older than 70 years of age (P = 0.031) independently predicted mortality. In contrast, obesity was inversely correlated with mortality (P = 0.047). Conclusions: A nonfatal stroke and increasing age increase the risk of all-cause mortality in inhabitants of a remote rural village. The body mass index is inversely related to death (obesity paradox).

scholarly journals Association of dairy intake with all-cause, cancer, and cardiovascular disease mortality in Japanese adults: a 25-year population-based cohort

2021 ◽  
Author(s):  
Yukai Lu ◽  
Yumi Sugawara ◽  
Sanae Matsuyama ◽  
Akira Fukao ◽  
Ichiro Tsuji
Keyword(s):  
Cardiovascular Disease ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Dairy Intake ◽  
Japanese Adults ◽  
All Cause Mortality ◽  
History Of ◽  
Using Data ◽  
Cvd Mortality

Abstract Purpose The association between dairy intake and mortality remains uncertain, and evidence for the Japanese population is scarce. We aimed to investigate the association between dairy intake and all-cause, cancer, and cardiovascular disease (CVD) mortality in Japanese adults. Methods A total of 34,161 participants (16,565 men and 17,596 women) aged 40–64 years without a history of cancer, myocardial infarction, or stroke at baseline were included in the analysis, using data from the Miyagi Cohort Study initiated in 1990. Milk, yogurt, and cheese intake were obtained using a validated food frequency questionnaire. Total dairy intake was calculated as the sum of milk, yogurt, and cheese intake and then categorized by quartile. The outcomes were all-cause, cancer, and CVD mortality. Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality risks. Results During 750,016 person-years of follow-up, the total number of deaths was 6498, including 2552 deaths due to cancer and 1693 deaths due to CVD. There was no association between total dairy intake and all-cause, cancer, and CVD mortality for both men and women. We also examined the associations between subgroup dairy products and mortality. For milk and yogurt intake, our results suggest null associations. However, cheese intake was modestly associated with lower all-cause mortality in women; compared with non-consumers, the multivariable HRs (95%CIs) were 0.89 (0.81–0.98) for 1–2 times/month, 0.88 (0.78–1.00) for 1–2 times/week, and 0.89 (0.74–1.07) for 3 times/week or almost daily (p trend = 0.016). Conclusion Dairy intake was not associated with mortality in Japanese adults, except for limited evidence showing a modest association between cheese intake and a lower all-cause mortality risk in women.

scholarly journals Lower values of a novel index of Vagal-Neuroimmunomodulation are associated to higher all-cause mortality in two large general population samples with 18 year follow up

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marc N. Jarczok ◽  
Julian Koenig ◽  
Julian F. Thayer
Keyword(s):  
General Population ◽  
Proportional Hazards ◽  
Population Studies ◽  
Large Population ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Models ◽  
Cox Proportional Hazards Models ◽  
All Cause Mortality

AbstractIn recent clinical practice, a biomarker of vagal neuroimmunomodulation (NIM), namely the ratio of vagally-mediated heart rate variability (vmHRV) and CRP, was proposed to index the functionality of the cholinergic anti-inflammatory pathway. This study aims to transfer and extend the previous findings to two general population-based samples to explore the hypothesis that NIM-ratio is associated with all-cause mortality. Two large population studies (MIDUS 2: N = 1255 and Whitehall II wave 5: N = 7870) with complete data from a total of N = 3860 participants (36.1% females; average age = 56.3 years; 11.1% deaths, last exit 18.1 years post inclusion) were available. NIM indices were calculated using the vagally-mediated HRV measure RMSSD divided by measures of CRP (NIMCRP) or IL-6 (NIMIL6). The NIM-ratios were quartiled and entered into age, ethnicity and body mass index adjusted Cox proportional hazards models. For NIMIL6 the lowest quartile was 45% more likely to die during the observed period (max. 18 years follow-up) compared to the highest quartile (HR = 0.55 CI 0.41–0.73; p < .0001). NIMCRP parallel these results. Here we show that an easily computable index of IL-6 inhibition is associated with all-cause mortality in two large general population samples. These results suggest that this index might be useful for risk stratification and warrant further examination.

Faster Transport Status and Mortality in Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

2015 ◽  
Vol 40 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Liping Xiong ◽  
Li Fan ◽  
Qingdong Xu ◽  
Qian Zhou ◽  
Huiyan Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
All Cause Mortality ◽  
History Of ◽  
The Relationship

Background: There are limited data regarding the relationship between transport status and mortality in anuric continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: According to the dialysate to plasma creatinine ratio (D/P Cr), 292 anuric CAPD patients were stratified to faster (D/P Cr ≥0.65) and slower transport groups (D/P Cr <0.65). The Cox proportional hazards models were used to evaluate the association of transport status with mortality. Results: During a median follow-up of 22.1 months, 24% patients died, 61.4% of them due to cardiovascular disease (CVD). Anuric patients with faster transport were associated with an increased risk of all-cause mortality (HR (95% CI) = 2.16 (1.09-4.26)), but not cardiovascular mortality, after adjustment for confounders. Faster transporters with pre-existing CVD had a greater risk for death compared to those without any history of CVD. Conclusion: Faster transporters were independently associated with high all-cause mortality in anuric CAPD patients. This association was strengthened in patients with pre-existing CVD.

scholarly journals Cardiorespiratory Fitness without Exercise Testing Can Predict All-Cause Mortality Risk in a Representative Sample of Korean Older Adults

2019 ◽  
Vol 16 (9) ◽  
pp. 1633 ◽  
Author(s):  
Moongu Song ◽  
Inhwan Lee ◽  
Hyunsik Kang
Keyword(s):  
Older Adults ◽  
Cardiorespiratory Fitness ◽  
Exercise Testing ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Geriatric Population ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Using Data

This study examined the association between cardiorespiratory fitness (CRF) without exercise testing and all-cause mortality in Korean older adults. The present study was carried out using data from the 2008 and 2011 Living Profiles of Older People Survey. A total of 14,122 participants aged 60 years and older (57% women) completed the 2008 baseline and 2011 follow-up assessments (i.e., socioeconomic status, health behaviors and conditions, and prevalence of chronic diseases), and they were included for the final analyses. CRF was estimated (eCRF) with sex-specific algorithms and classified as lower (lowest 25%), middle (middle 50%), and upper (highest 25%). Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) across eCRF categories. In total, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.059 (0.814~1.378) for the middle eCRF group, and 1.714 (1.304~2.253) for the lower eCRF group. In men, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.011 (0.716~1.427) for the middle eCRF group, and 1.566 (1.098~2.234) for the lower eCRF group. In women, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.064 (0.707~1.602) for the middle eCRF group, and 1.599 (1.032~2.478) for the lower eCRF group. The current findings suggest that eCRF may have an independent predictor of all-cause mortality, underscoring the importance of promoting physical activity to maintain a healthful level of CRF in Korean geriatric population.

scholarly journals Association between Estimated Cardiorespiratory Fitness and All-cause Mortality in Underweight Older Adults

2020 ◽  
Vol 29 (2) ◽  
pp. 146-153
Author(s):  
Inhwan Lee ◽  
Byungroh Kim
Keyword(s):  
Older Adults ◽  
Cardiorespiratory Fitness ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
National Database ◽  
Cox Regression Analysis ◽  
All Cause Mortality ◽  
Study Participants

PURPOSE: This study investigated the association between estimated cardiorespiratory fitness (eCRF) and all-cause mortality in underweight older adults.METHODS: Data from the 2006 Korean longitudinal study of aging (KLoSA) involving 348 study participants aged 60 years and older (58.0% women) was analyzed in this study. CRF was estimated with sex- and age-specific algorithms developed by the fitness registry and the importance of exercise national database (FRIEND). Participants were classified into lowest 25% (Q1), lower 25% (Q2), middle 25% (Q3), and highest 25% (Q4) on the basis of individual eCRF distributions. Cox proportional hazards regression was used to calculate hazard ratio (HR) and 95% confidence interval (CI) according to eCRF levels.RESULTS: During 7.8±3.2-year follow-up period, a total of 175 deaths occurred from all causes. Cox regression analysis showed that HR of all-cause mortality was 0.686 (95% CI, 0.474-0.991, <i>p</i>=.045) for Q2, 0.382 (95% CI, 0.253-0.575, <i>p</i><.001) for Q3, and 0.248 (95% CI, 0.155-0.397, <i>p</i><.001) for Q4 compared to Q1 as reference (HR=1). The HR of Q4 for all-cause mortality remained significant even after adjustments for covariates, including age and marital status.CONCLUSIONS: The current findings suggest that high eCRF is associated with a decreased risk of all-cause mortality in underweight older adults.

scholarly journals Glycated Hemoglobin and All-Cause and Cause-Specific Mortality Among Adults With and Without Diabetes

2019 ◽  
Vol 104 (8) ◽  
pp. 3345-3354 ◽  
Author(s):  
Fu-Rong Li ◽  
Xi-Ru Zhang ◽  
Wen-Fang Zhong ◽  
Zhi-Hao Li ◽  
Xiang Gao ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Hba1c Level ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Community Based ◽  
Hazard Ratios ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
History Of

Abstract Context The patterns of associations between glycated Hb (HbA1c) and mortality are still unclear. Objective To explore the extent to which ranges of HbA1c levels are associated with the risk of mortality among participants with and without diabetes. Design, Setting, and Patients This was a nationwide, community-based prospective cohort study. Included were 15,869 participants (median age 64 years) of the Health and Retirement Study, with available HbA1c data and without a history of cancer. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for mortality. Results A total of 2133 participants died during a median follow-up of 5.8 years. In participants with diabetes, those with an HbA1c level of 6.5% were at the lowest risk of all-cause mortality. When HbA1c level was &lt;5.6% or &gt;7.4%, the increased all-cause mortality risk became statistically significant as compared with an HbA1c level of 6.5%. As for participants without diabetes, those with an HbA1c level of 5.4% were at the lowest risk of all-cause mortality. When the HbA1c level was &lt;5.0%, the increased all-cause mortality risk became statistically significant as compared with an HbA1c level of 5.4%. However, we did not observe a statistically significant elevated risk of all-cause mortality above an HbA1c level of 5.4%. Conclusions A U-shaped and reverse J-shaped association for all-cause mortality was found among participants with and without diabetes. The corresponding optimal ranges for overall survival are predicted to be 5.6% and 7.4% and 5.0% and 6.5%, respectively.

scholarly journals Physical activity combined with sedentary behaviour in the risk of mortality in older adults

2021 ◽  
Vol 55 ◽  
pp. 60
Author(s):  
Lucas Lima Galvão ◽  
Rizia Rocha Silva ◽  
Sheilla Tribess ◽  
Douglas Assis Teles Santos ◽  
Jair Sindra Virtuoso Junior
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sedentary Behaviour ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Risk Of Mortality ◽  
Long Time ◽  
Activity Questionnaire

OBJECTIVE To examine the effects of physical activity (PA) and sedentary behaviour (SB), in isolation and combination, on all-cause mortality in older adults. METHODS Prospective, population-based cohort study. The data were collected from first wave in 2015 and the follow-up continued until 2020. The sample consisted of 332 older adult people aged ≥ 60 years-old, out of which 59 died. The level of PA and SB was assessed by the International Physical Activity Questionnaire (IPAQ). The older adults were divided into PA categorized as sufficiently active and insufficiently active and into high and low SB. We built four combinations of PA and SB. Also, we used the Cox proportional hazards regression with a 95% confidence interval with hazard ratio estimate so as to verify the mortality risks between PA, SB, and the combinations of PA and SB. RESULTS Insufficiently active individuals had higher risks of mortality compared to sufficiently active people. We observed no associations between SB and mortality separately; however, when evaluated in a combined way, insufficiently active individuals and with a high SB time had a higher chance of mortality compared to active individuals with a low SB time. CONCLUSION Our isolated analyses demonstrate that complying with PA recommendations reduces the risk of mortality; however, no association was found between the time of PA exposure with the time of SB. When analysing the combination, being physically inactive and with a long time of SB showed higher mortality rates, with SB being an enhancer of this risk. The results of this study show the interdependence of SB for PA performed at moderate to vigorous intensity. The understanding of this interrelation must be considered in the formulation of public health guidelines.

scholarly journals Association between Estimated Cardiorespiratory Fitness and All-cause Mortality in Underweight Older Adults

2020 ◽  
Vol 29 (2) ◽  
pp. 146-153
Author(s):  
Inhwan Lee ◽  
Byungroh Kim
Keyword(s):  
Older Adults ◽  
Cardiorespiratory Fitness ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
National Database ◽  
Cox Regression Analysis ◽  
All Cause Mortality ◽  
Study Participants

PURPOSE: This study investigated the association between estimated cardiorespiratory fitness (eCRF) and all-cause mortality in underweight older adults.METHODS: Data from the 2006 Korean longitudinal study of aging (KLoSA) involving 348 study participants aged 60 years and older (58.0% women) was analyzed in this study. CRF was estimated with sex- and age-specific algorithms developed by the fitness registry and the importance of exercise national database (FRIEND). Participants were classified into lowest 25% (Q1), lower 25% (Q2), middle 25% (Q3), and highest 25% (Q4) on the basis of individual eCRF distributions. Cox proportional hazards regression was used to calculate hazard ratio (HR) and 95% confidence interval (CI) according to eCRF levels.RESULTS: During 7.8±3.2-year follow-up period, a total of 175 deaths occurred from all causes. Cox regression analysis showed that HR of all-cause mortality was 0.686 (95% CI, 0.474-0.991, <i>p</i>=.045) for Q2, 0.382 (95% CI, 0.253-0.575, <i>p</i><.001) for Q3, and 0.248 (95% CI, 0.155-0.397, <i>p</i><.001) for Q4 compared to Q1 as reference (HR=1). The HR of Q4 for all-cause mortality remained significant even after adjustments for covariates, including age and marital status.CONCLUSIONS: The current findings suggest that high eCRF is associated with a decreased risk of all-cause mortality in underweight older adults.

Claudication, in contrast to angina pectoris, independently predicts mortality risk in the general population

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 105-113 ◽  
Author(s):  
G. Kieback ◽  
Lorbeer ◽  
Wallaschofski ◽  
Ittermann ◽  
Völzke ◽  
...  
Keyword(s):  
Angina Pectoris ◽  
Mortality Rate ◽  
Cardiovascular Mortality ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
All Cause Mortality ◽  
Study Population

Background: The aim of our analyses was to investigate whether claudication and angina pectoris, each defined and based on the answer to a single question, are predictive of future mortality. Probands and methods: The study population consisted of 3995 subjects selected from the population-based Study of Health In Pomerania (SHIP). Kaplan-Meier analysis and multivariable Cox proportional hazards regression analysis were used to analyze the association of angina pectoris and claudication with all-cause and cardiovascular mortality adjusted for major cardiovascular risk factors. Results: At baseline, 417 individuals had symptoms of angina pectoris, and 323 had symptoms of claudication. During a median follow-up of 8.5 years, 277 individuals died. Individuals with claudication had a higher fully-adjusted all-cause mortality rate (Hazard Ratio (HR) 1.79; 95 % CI 1.34, 2.39, p < 0.001) and a higher sex- and age-adjusted cardiovascular mortality rate (HR 1.76; 95 % CI 1.03, 2.99, p = 0.038) compared to subjects without claudication. In contrast, subjects with angina pectoris had neither an elevated fully-adjusted all-cause mortality rate (HR 1.15; 95 % CI 0.82, 1.61, p = 0.413) nor sex- and age-adjusted cardiovascular mortality rate (HR 0.71; 95 % CI 0.34, 1.48, p = 0.363) compared to those without this symptom. Conclusions: Claudication, in contrast to angina pectoris, is a strong, independent predictor of all-cause mortality.

Co-existence of social isolation and homebound status increase the risk of all-cause mortality

2018 ◽  
Vol 31 (5) ◽  
pp. 703-711 ◽  
Author(s):  
Ryota Sakurai ◽  
Masashi Yasunaga ◽  
Mariko Nishi ◽  
Taro Fukaya ◽  
Masami Hasebe ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Proportional Hazards ◽  
Later Life ◽  
Cox Proportional Hazards ◽  
Face To Face ◽  
All Cause Mortality ◽  
Socially Isolated ◽  
The Impact

ABSTRACTBackground:Social isolation and homebound statuses are possible risk factors for increased mortality among older adults. However, no study has addressed the impact of accumulation of these two factors on mortality. The aim of this study was to examine whether such accumulation increased the risk of all-cause mortality.Methods:The analyzed sample was drawn from a mail survey of 1,023 older adults without instrumental activities of daily living disability. Participants were classified into four groups according to the frequency of both face-to-face and non-face-to-face interactions with others (social isolation and non-social isolation) and the frequency of going outdoors (homebound and non-homebound). Social isolation and homebound statuses were defined as having a social interaction less than once a week and going outdoors either every few days or less, respectively. All-cause mortality information during a six-year follow-up was obtained.Results:In total, 78 (7.6%) participants were both socially isolated and homebound. During the follow-up period, 65 participants died, with an overall mortality rate of 10.6 per 1000 person-years. Cox proportional hazards regression analyses demonstrated that older adults who were socially isolated and homebound showed a significantly higher risk of subsequent all-cause mortality compared with healthy adults who were neither socially isolated nor homebound, independent of potential covariates (aHR, 2.19; 95% CI: 1.04–4.63).Conclusion:Our results suggest that the co-existence of social isolation and homebound statuses may synergistically increase risk of mortality. Both active and socially integrated lifestyle in later life might play a major role in maintaining a healthy status.

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