RISK OF CARDIOVASCULAR DISEASE MORBIDITY AND MORTALITY IN FRAIL AND PRE-FRAIL OLDER ADULTS:RESULTS FROM A META-ANALYSIS AND EXPLORATORY META-REGRESSION ANALYSIS

Frailty is common and associated with poorer outcomes in the elderly, but its role as potential cardiovascular disease (CVD) risk factor requires clarification. We thus aimed to meta-analytically evaluate the evidence of frailty and pre-frailty as risk factors for CVD. Two reviewers selected all studies comparing data about CVD prevalence or incidence rates between frail/pre-frail vs. robust. The association between frailty status and CVD in cross-sectional studies was explored by calculating and pooling crude and adjusted odds ratios (ORs)+/- 95% confidence intervals (CIs); the data from longitudinal studies were pooled using the adjusted hazard ratios (HRs). Eighteen cohorts with a total …

Effect of acetyl-l-carnitine in the treatment of diabetic peripheral neuropathy : A systematic review and meta-analysis

Background/aim: Deficiency of acetyl-L-carnitine (ALC) and L-carnitine (LC) appears to play a role in peripheral diabetic neuropathy, although the evidence in humans is still limited. We conducted a systematic review and meta-analysis investigating the effect of ALC on pain and electromyographic parameters in people with diabetic neuropathy. Methods: A literature search in major databases, without language restriction, was undertaken. Eligible studies were randomized controlled trials (RCTs) or pre-and post-test studies. The effect of ALC supplementation on pain perception and electromyographic parameters in patients with diabetic neuropathy was compared vs. a control group (RCTs). The effe…

Paradoxes in the old age – reverse epidemiology

Retirement as a predictor of physical functioning trajectories among older businessmen

Abstract Background Associations between retirement characteristics and consequent physical functioning (PF) are poorly understood, particularly in higher socioeconomic groups, where postponing retirement has had both positive and negative implications for PF. Methods Multiple assessments of PF, the first of which at the mean age of 73.3 years, were performed on 1709 men who were retired business executives and managers, using the RAND-36/SF-36 instrument, between 2000 and 2010. Questionnaire data on retirement age and type of pension was gathered in 2000. Five distinct PF trajectories were created using latent growth mixture modelling. Mortality- and covariate-adjusted multinomial regressi…

An Expert Opinion From the European Society of Hypertension–European Union Geriatric Medicine Society Working Group on the Management of Hypertension in Very Old, Frail Subjects

Two years after the publication of the 2013 guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC),1 the ESH and the European Union Geriatric Medicine Society have created a common working group to examine the management of hypertensive subjects aged >80 years. The general term hypertension in the elderly is not sufficiently accurate because it mixes younger old patients (60–70 years) with the oldest old. Our group believes that the management of hypertension in individuals aged ≥80 years should be specifically addressed. Although arbitrary, this cutoff value identifies a population that is expanding …

Working hours and sleep duration in midlife as determinants of health-related quality of life among older businessmen

Background long working hours and short sleep duration are associated with a range of adverse health consequences. However, the combined effect of these two exposures on health-related quality of life (HRQoL) has not been investigated. Methods we studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3,490). Data on clinical variables, self-rated health (SRH), working hours and sleep duration in 1974, and RAND-36 (SF-36) HRQoL survey in the year 2000 were available for 1,527 men. Follow-up time was 26 years. By combining working hours and sleep duration, four categories were formed: (i) normal work (≤50 hours/week) and normal sleep (>47 hours/week);…

What Makes a 97-Year-Old Man Cycle 5,000 km a Year?

<b><i>Background:</i></b> The nature versus nurture debate is one of the oldest issues in the study of longevity, health and successful aging. <b><i>Objective:</i></b> We present a 97-year-old man (I.K.) as an example of the effects of habitual exercise on the aging process. <b><i>Methods:</i></b> Extensive assessments included medical examinations, interviews, musculoskeletal structure, performance characteristics, cognitive function and gut microbiota composition. <b><i>Results:</i></b> I.K. suffers from iatrogenic hypogonadism, prostate cancer, hypothyroidism and a history of deep popliteal th…

Additional file 1 of Retirement as a predictor of physical functioning trajectories among older businessmen

Additional file 1: Supplementary Table 1. Model Fit Statistics, Group Sizes and Average Latent Class Probabilities for Most Likely Class Membership. Figures. Reproduced with permission from [15]. Supplementary Fig. 1. Individual observations belonging to each of the five identified physical functioning trajectories. Reproduced with permission from [15].

Associations of vacation time with lifestyle, long-term mortality and health-related quality of life in old age: The Helsinki Businessmen Study

Abstract Introduction There are few longitudinal studies of relationships between vacation and later health outcomes. We studied these during a 26-year follow-up of the Helsinki Businessmen Study. Methods In 1974, at mean age of 47 years, 2741 members of a cohort of executives and businessmen born 1919–1934 were clinically examined and reported their annual vacation time (dichotomized >21 [n = 2001] vs. ≤21 days [n = 740]), self-rated health (SRH) and perceived physical fitness using a five-step scale. In old age in 2000 (mean age 73 years), the survivors filled in the RAND-36/SF-36 health-related quality of life (HRQoL) questionnaire. Mortality between 1974 and 2000 was retrieved from nati…

Retirement age and type as predictors of frailty : a retrospective cohort study of older businessmen

ObjectivesTo study the association between retirement characteristics and frailty in a homogenous population of former business executives.DesignCross-sectional cohort study using data from the Helsinki Businessmen Study.SettingHelsinki, Finland.Participants1324 Caucasian men, born in 1919–1934, who had worked as business executives and managers and of whom 95.9% had retired by the year 2000. Questions on age at and type of retirement, lifestyle and chronic conditions were embedded in questionnaires.Primary and secondary outcome measuresFrailty assessed according to a modified phenotype definition at mean age 73.3 years.ResultsMean age at retirement was 61.3 years (SD 4.3) and 37.1% had ret…

Associations of overweight and metabolic health with successful aging: 32-year follow-up of the Helsinki Businessmen Study

Background & aims: Prognostic significance of metabolically healthy overweight and obesity (MHO) is under debate. However the relationship between MHO and health-related quality of life (HRQoL) is less studied. We compared successful aging (longevity plus HRQoL) in men with MHO, metabolically healthy normal weight (MHN) and metabolically unhealthy overweight and obesity (MUO). Methods: In the Helsinki Businessmen Study longitudinal cohort, consisting of men born 1919 to 1934. In 1985/86, overweight (BMI >= 25 kg/m(2)) and metabolic health were determined in 1309 men (median age 60 years). HRQoL was assessed using RAND-36/SF-36 in 2000 and 2007, and all-cause mortality retrieved from registe…

Midlife Cardiovascular Status and Old Age Physical Functioning Trajectories in Older Businessmen

Objectives The associations between cardiovascular disease (CVD) risk and later physical functioning have been observed, but only a few studies with follow-up into old age are available. We investigated the association between cardiovascular status in midlife and physical functioning trajectories in old age. Design Prospective cohort study. Setting Helsinki Businessmen Study. Participants We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3490). Measurements Three CVD status groups were formed based on clinical measurements carried out in 1974: signs of CVD (diagnosed clinically or with changes in ECG, chronic disease present or used medicati…