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04/2013 journal articles

ASSESSING SERUM CONCENTRATIONS OF 25-HYDROXY-VITAMIN D IN NORTH-WESTERN ITALY

M. Basile, L. Ciardi, I. Crespi, E. Saliva, G. Bellomo, M.Vidali

J Frailty Aging 2013;2(4):174-178

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Objectives: Backgound: Most of the published studies on vitamin D levels in Italy have been performed in specific age- or disease- subgroups. Few data are available on the status of vitamin D in the adult general population. Objective: We report on vitamin D levels of a large sample of adults from North-Western Italy. Association with age, sex, and season is also evaluated. Participants: 13,110 cases (24% men, 76% women; median age 67 [interquartile range, IQR, 56-77] years old) were collected in the North-Eastern of Piedmont (Italy). Measurements: 25-OH-vitamin D levels were measured by chemiluminescent immunoassay. Results: Median total vitamin D level was 19.9 ng/ml (IQR 11.2-28.8 ng/ml) with up to 3,592 (27.4%) and 10,185 (77.7%) subjects respectively below 12 and 30 ng/ml. Vitamin D levels were significantly higher in women than in men (20.5 vs 18.1 ng/ml; p<0.001), in summer than in winter (21.4 vs 18.5 ng/ml; p<0.001), and in individuals aged ≤45years or 46-64 years than in those older than 65 years (20.3 and 21.3 vs 18.8 ng/ml). The lowest mean vitamin D levels were reported during the winter season by men aged ≥65 years (14.7 ng/ml) and 46-64 years (16.8 ng/ml). Multivariate analysis confirmed that age (p<0.001), sex (p=0.002), season (p<0.001) and their interaction (p=0.03) were independently associated to vitamin D concentrations. Conclusions: This study clearly shows that the majority of adult Italian population, living in a sunny and highly urbanized area of North-Western Italy, have an important deficiency in vitamin D. However, these data must be interpreted with caution if considering the lack of standardization of vitamin D assays.

CITATION:
M. Basile ; L. Ciardi ; I. Crespi ; E. Saliva ; G. Bellomo ; M. Vidali (2013): ASSESSING SERUM CONCENTRATIONS OF 25-HYDROXY-VITAMIN D IN NORTH-WESTERN ITALY. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.25

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KLOTHO, FGF21 AND FGF23: NOVEL PATHWAYS TO MUSCULOSKELETAL HEALTH?

B. Bartali, R.D. Semba, A.B. Araujo

J Frailty Aging 2013;2(4):179-183

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Bone mineral density, muscle mass and physical function reach their peak between the second and fourth decade of life and then decline steadily with aging. The crucial question is: what factors contribute to or modulate this decline? The aim of this mini-review is to propose a theoretical framework for the potential role of emerging biomarkers such as klotho, fibroblast growth factors (FGF)21 and FGF23 on musculoskeletal health, with a particular focus on decline in muscle mass and function, and calls for future research to examine this proposed link. The identification of new physiological mechanisms underlying these declines may open a potentially important avenue for the development of novel intervention strategies aimed at preventing or reducing their potentially detrimental consequences.

CITATION:
B. Bartali ; R.D. Semba ; A.B. Araujo (2013): Klotho, FGF21 and FGF23: Novel Pathways to Musculoskeletal Health?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.26

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PROFILE OF THE HEALTH AND NUTRITIONAL STATUS OF OLDER ADULTS IN MEXICO. 2012 NATIONAL HEALTH AND NUTRITION SURVEY

T. Shamah Levy, L. Cuevas Nasu, M.C. Morales Ruan, V. Mundo Rosas, I. Méndez Gómez-Humarán, S. Villalpando Hernández

J Frailty Aging 2013;2(4):184-191

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Background: The health and nutritional conditions of older adults in Mexico are heterogeneous. The prevalence of chronic noncommunicable diseases is elevated with disparities in functionality and socioeconomic inequities. Objectives: To obtain updated information of the health and nutritional profile of older adults in Mexico in a national representative sample. Methods: Information was obtained from 6,687 60 years and older adults from the 2012 National Health and Nutrition Survey (ENSANUT 2012). An index defining the status of "healthy adult" was constructed taking into account the variables of independence in performing activities of daily living (ADL), based on the development by Katz, instrumental ADL, no chronic diseases, nonsmoker and no active use of alcohol. Tables of frequencies and proportions were constructed and expanded to describe the general characteristics and nutritional status of the adult Mexican population. A logistic regression model was used to study changes in the probability of being classified as a healthy adult with respect to different variables of interest. Probabilities using the delta method were estimated to establish 95% confidence intervals. Results: In this study 12.2% of the older adults, were classified as healthy. The logistic regression model adjusted for the variables included in the study shows that the interaction of age and gender is significant (P = 0.068), where the probability of healthy adult status decreases in women with ageing and remains stable for men. Also, living in the southern region of the country significantly decreases the probability of healthy adult status (P = 0.001). Gender of the older adult was not significant. Conclusions: In Mexico, the health conditions of older adults are deficient. Public policies need to be generated that are directed at this population group and will translate into self-care actions in the early stages of life so as to guarantee a healthy future.

CITATION:
T. Shamah Levy ; L. Cuevas Nasu ; M.C. Morales Ruan ; V. Mundo Rosas ; I. Méndez Gómez-Humarán ; S. Villalpando Hernández (2013): Profile of the health and nutritional status of older adults in Mexico - 2012 National Health and Nutrition Survey. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.27

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VALIDITY OF THREE-DIMENSIONAL PHOTONIC SCANNING TECHNIQUE FOR ESTIMATING PERCENT BODY FAT

K. Shitara, H. Kanehisa, T. Fukunaga, T. Yanai, Y. Kawakami

J Frailty Aging 2013;2(4):192-197

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Background: Three-dimensional photonic scanning (3DPS) was recently developed to measure dimensions of a human body surface. Objective: The purpose of this study was to explore the validity of body volume measured by 3DPS for estimating the percent body fat (%fat). Design, setting, participants, and measurement: The body volumes were determined by 3DPS in 52 women. The body volume was corrected for residual lung volume. The %fat was estimated from body density and compared with the corresponding reference value determined by the dual-energy x-ray absorptiometry (DXA). Results: No significant difference was found for the mean values of %fat obtained by 3DPS (22.2 ± 7.6%) and DXA (23.5 ± 4.9%). The root mean square error of %fat between 3DPS and reference technique was 6.0%. For each body segment, there was a significant positive correlation between 3DPS- and DXA-values, although the corresponding value for the head was slightly larger in 3DPS than in DXA. Residual lung volume was negatively correlated with the estimated error in %fat. Conclusions: The body volume determined with 3DPS is potentially useful for estimating %fat. A possible strategy for enhancing the measurement accuracy of %fat might be to refine the protocol for preparing the subject’s hair prior to scanning and to improve the accuracy in the measurement of residual lung volume.

CITATION:
K. Shitara ; H. Kanehisa ; T. Fukunaga ; T. Yanai ; Y. Kawakami (2013): Validity of three-dimensional photonic scanning technique for estimating percent body fat. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.28

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ARE HEALTH INSURANCE ITEM ALLOCATIONS IN THE AMERICAN COMMUNITY SURVEY MISSING COMPLETELY AT RANDOM?

C. Siordia

J Frailty Aging 2013;2(4):198-204

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Background: Item allocation (the assignment of plausible values to missing or illogical responses in survey studies) is at times necessary in the production of complete data sets. In the American Community Survey (ACS), missing responses to health insurance coverage questions are allocated. Objectives: Because allocation rates may vary as a function of compositional characteristics, this project investigates how seven different health insurance coverage items vary in their degree of allocation along basic demographic variables. Methods: Data from the ACS 2010 1-year Public Use Microdata Sample file are used in a logistic regression model and to calculate allocations rates. Results: The findings reveal that: males; people aged 65 and older; those who speak English “very well” or “well”; US citizens; those out-of-poverty; and all racial/ethnic minority groups have higher odds of experiencing a health insurance item allocation relative to their counterparts. Conclusions: Since health insurance coverage allocations vary by demographic characteristics, further research is needed to investigate their mechanisms of missingness and how these may have implications for frailty related research.

CITATION:
C. Siordia (2013): Are Health Insurance Item Allocations in the American Community Survey Missing Completely at Random?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.29

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GERIATRIC SYNDROMES IN OLDER SURGICAL PATIENTS: A LITERATURE REVIEW

P. J. McRae, A.M. Mudge, N.M. Peel, P.J. Walker

J Frailty Aging 2013;2(4):205-210

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With the ageing of the population, surgical wards are caring for an increased proportion of older patients. Geriatric syndromes are common in older hospitalised medical and hip fracture patients and are important predictors of poor outcomes in these groups, however the extent of presenting and hospital acquired geriatric syndromes in other older inpatients is less clear. This systematic literature review aimed to identify the proportion of patients aged 60 or older, cared for in usual-care surgical wards, who presented with and/or developed geriatric syndromes. Observational studies in English were identified through searches in CINAHL and Medline databases from 1985-2012. Studies of hip fracture patients and those requiring surgical intensive care (eg cardiac surgery) were excluded. The review included 25 studies. The majority of studies reported on the incidence of post-operative delirium, which ranged from 2% to 51% and varied with the type of surgery. The prevalence of depression at pre-admission screening varied from 9% to 29%. No studies reported on functional decline. Estimates of falls, malnutrition, pressure ulcers and urinary incontinence were limited by the small number of studies. These findings indicate the need for further studies to improve the understanding of geriatric syndromes in older surgical patients in usual-care wards.

CITATION:
P. J. McRae ; A.M. Mudge ; N.M. Peel ; P.J. Walker (2013): Geriatric Syndromes in Older Surgical Patients: A Literature Review . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.30

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FISH OILS AND THEIR POTENTIAL IN THE TREATMENT OF SARCOPENIA

S.R. Gray, M. Da Boit

J Frailty Aging 2013;2(4):211-216

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We are living in an “ageing society” meaning that there will be an increase in the incidence of age related health problems. One issue consistently observed in ageing is for muscle mass and strength to be reduced, a condition termed sarcopenia. The consequences of these changes are numerous and include a reduction in quality of life and an increased risk of falls. The mechanisms underlying sarcopenia remain to be elucidated but include an anabolic resistance to both nutrients and exercise and so the search for strategies to overcome this resistance is of great importance. There are several nutritional strategies purported to be useful in the treatment of sarcopenia and in recent years the n-3 PUFAs found in fish oil have been of increasing interest. This review will discuss the main nutritional interventions used in the treatment of sarcopenia with a focus on fish oils.

CITATION:
S.R. Gray ; M. Da Boit (2013): Fish oils and their potential in the treatment of sarcopenia. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.31

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LETTER TO THE EDITOR : ARE PRESCRIBING INDICATORS ESSENTIALLY REPRESENTING THE FRAIL OLDER POPULATION?

A. Poudel, R.E. Hubbard, L. Nissen, C. Mitchell

J Frailty Aging 2013;2(4):217

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CITATION:
A. Poudel ; R.E. Hubbard ; L. Nissen ; C. Mitchell (2013): LETTER TO THE EDITOR: ARE PRESCRIBING INDICATORS ESSENTIALLY REPRESENTING THE FRAIL OLDER POPULATION?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.32

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