A Comparison of Objective Physical Performance Tests and Future Mortality in the Elderly People.
Background: Physical performance is an important predictor of mortality, but little is known on the comparative prognostic utility of different objective physical performance tests in community-dwelling older adults. We compared the prognostic usefulness of several objective physical performance tests on mortality, adjusting our analyses for potential confounders. Methods: Among 3,099 older community-dwelling participants included in the Progetto Veneto Anziani study, 2,096 were followed for a mean of 4.4 years. Physical performance tests measured were Short Physical Performance Battery (SPPB), 4-meter gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute…
Frailty Is Associated with an Increased Risk of Incident Type 2 Diabetes in the Elderly
Objective To investigate whether frailty is associated with an increased risk of incident type 2 diabetes mellitus (T2DM) in a prospective cohort of community-dwelling older people. Design Longitudinal study, mean follow-up of 4.4 years. Setting Progetto Veneto Anziani (Pro.V.A.) study that involved older community-dwellers. Participants 1754 men and women older than 65 years without T2DM at baseline. Measurements Frailty status was defined according to Fried criteria and categorized as frailty (≥3 criteria), prefrailty (1-2 criteria), or no frailty (0 criterion). Incident T2DM was defined as fasting plasma glucose (FPG) ≥7.0 mmol/L, or glycosylated hemoglobin ≥6.5%, the use of glucose-lowe…
Serum 25-Hydroxyvitamin D and Orthostatic Hypotension in Old People
Interest in the association between serum 25-hydroxyvitamin D (25OHD) and blood pressure has increased because recent research showed a close relationship between them, but there is still little information on the possible association between 25OHD and orthostatic hypotension. The aim of this study was to explore the relationship of 25OHD levels with any presence of orthostatic hypotension in a large group of older people. This study was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian population–based cohort study involving people aged >65 years. In this cross-sectional work, we considered 2640 (1081 men and 1559 women) with a mean age of 73.8±6.8 years. Orthostatic hypotensi…
Serum 25-hydroxyvitamin d and the onset of late-life depressive mood in older men and women: the Pro.V.A. study.
Depression is a debilitating chronic condition, and its diagnosis and treatment in elderly people are often challenging. Because depressive mood seems to follow a seasonal pattern, peaking in summer and winter (1), it has recently been suggested that, through its action on the hypothalamus (which is involved in mood regulation), vitamin D might account for the link between seasonal changes in photoperiod and seasonal mood swings (2). Acting as a neurosteroid hormone, vitamin D may regulate human and animal neurotransmission, neuroprotection, and neuroimmunomodulation (3), and nuclear vitamin D receptors have been located in the human cortex and hippocampus (4). Although an association betwe…
Serum dehydroepiandrosterone sulfate and osteoarthritis in older people: the Pro.V.A. study.
Although osteoarthritis (OA) and low levels of dehydroepiandrosterone sulfate (DHEAS) are common in the elderly, no studies on human beings are available concerning the possible relationship between them. We aimed to examine the relationship between DHEAS levels and any presence of OA in a cohort of community-dwelling older subjects. This study was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study on people over 65 years old. In this cross-sectional work, we considered 2050 individuals with a mean age of 74.2 ± 7.1 years (818 M and 1232 F), and with a complete set of information on OA and DHEAS levels. OA was defined using a standardized algorithm inve…
Bone regeneration in the stem cell era: safe play for the patient?
The past decade has seen outstanding scientific progress in the field of stem cell (SC) research and clinical application. SCs are convenient both technically and biologically: they are easy to find and to culture and they can differentiate in virtually all tissues and even in whole organs. Induced pluripotent stem cells (iPSs) are a type of pluripotent SC generated in vitro directly from mature cells through the introduction of key transcription factors. The use of iPSs, however tantalizing, poses serious safety concerns because of their genomic instability. Recently, it has been suggested that the main mechanism of SC action relies on paracrine signals. Therefore, the secretome would be p…
Vitamin D deficiency and leisure time activities in the elderly: are all pastimes the same?
Background Optimal vitamin D status is important for overall health and well-being, particularly in the elderly. Although vitamin D synthesis in the skin declines with age, exposure to sunlight still seems to help older-aged adults to achieve adequate serum 25-hydroxyvitamin D (25OHD) levels. Elderly people would therefore benefit from outdoor leisure activities, but the effects of different types of pastime on serum 25OHD levels have yet to be thoroughly investigated. Aims To assess the association of different pastimes with 25OHD deficiency in elderly subjects. Methods A sample of 2,349 community-dwelling elderly individuals (1,389 females and 960 males) enrolled in the Progetto Veneto An…
Results of an Observational Cohort Study of Hyperuricemia as a Predictor of Poor Physical Performance in the Elderly
Objective: Hyperuricemia is frequent in older people and associated with several medical conditions. The relationship between hyperuricemia and physical performance is limited. We aimed to investigate the association between hyperuricemia and physical performance over a 4.4-year followup in the elderly. Methods: A total of 1,904 community-dwelling older participants were followed for a mean of 4.4 years. Hyperuricemia at baseline was defined using serum uric acid concentrations ≥6 and ≥7 mg/dl for women and men, respectively. Objective physical performance tests measured included the Short Physical Performance Battery (SPPB), 4-meter gait speed, chair-stands time, leg extension and flexion,…
Low Hemoglobin Levels and the Onset of Cognitive Impairment in Older People: The PRO.V.A. Study
Low hemoglobin (Hb) levels are attracting interest as a risk factor for cognitive impairment, but with contrasting evidence emerging from the current literature. The aim of our work was to investigate the relationship between baseline serum Hb levels and the incidence of cognitive impairment in older people over a follow-up of 4.4 years. Our study considered a sample of 1227 elderly subjects cognitively intact at baseline, enrolled under the Progetto Veneto Anziani (Pro.V.A.) among 3099 screened subjects. For all participants, we measured serum Hb levels on blood samples; incident cognitive impairment was defined as a Mini Mental State Examination (MMSE) score <24 and confirmed by geriat…
Hypovitaminosis D predicts the onset of orthostatic hypotension in older adults
A number of small cross sectional studies have demonstrated that hypovitaminosis D (represented by low 25 hydroxyvitamin D (25OHD) levels) is associated with orthostatic hypotension (OH). We investigated if hypovitaminosis D is associated with the onset of OH in older adults over a follow-up of 4.4 years. 25OHD was categorized using sex-specific quartiles; OH was defined as a drop of ≤20 mm Hg in systolic or ≤10 mm Hg in diastolic blood pressure <3 minutes of standing. Among 1308 elderly without OH at baseline, using an adjusted logistic regression analysis and taking those with higher baseline serum 25OHD as reference, there was a significant increase in the onset of OH in those with lo…
Orthostatic Changes in Blood Pressure and Cognitive Status in the Elderly: The Progetto Veneto Anziani Study.
We studied a cohort of 1408 older subjects to explore whether postural changes in blood pressure (BP; defined as orthostatic hypo- or hypertension) can predict the onset of cognitive deterioration. Orthostatic hypotension was defined as a drop of 20 mm Hg in systolic or 10 mm Hg in diastolic BP and orthostatic hypertension as a rise of 20 mm Hg in systolic BP. Orthostatic BP values were grouped into quintiles for secondary analyses. Two cognitive assessments were considered: (1) cognitive impairment, that is, Mini-Mental State Examination scores ≤24/30, and (2) cognitive decline (CD), that is, a 3-point decrease in Mini-Mental State Examination score from the baseline to the follow-up. At t…
What physical performance measures predict incident cognitive decline among intact older adults? A 4.4 year follow up study
Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2 years, 59.5% females). Physical performance measures included the Short Physical Performance Battery …
Low Hemoglobin Levels and Risk of Developing Depression in the Elderly: Results From the Prospective PRO.V.A. Study.
OBJECTIVE Low hemoglobin negatively affects health in the elderly, but research about the association with risk for depression is limited. We investigated the association between baseline hemoglobin concentrations and incident depression in a cohort of nondepressed elderly individuals. METHODS As part of the Northern Italian Progetto Veneto Anziani (PRO.V.A.) study, randomly drawn, community-dwelling subjects aged ≥ 65 years underwent prospective clinical and laboratory assessments between October 1995 and December 2002. The association between baseline hemoglobin and depression was assessed with adjusted Cox regression analyses. Baseline serum hemoglobin concentrations were further categor…
High serum uric acid levels increase the risk of metabolic syndrome in elderly women: The PRO.V.A study
Background and aims: Serum uric acid (SUA) is the end-product of purine metabolism in humans, and its levels often increase in subjects with metabolic syndrome (MetS). Despite several studies demonstrating a relationship between increased SUA levels and the prevalence of MetS, prospective data on SUA as a predictor of the incidence of MetS in the elderly are limited. Our aim was to conduct a prospective study on the association between SUA concentrations and the onset of MetS in an elderly Italian cohort. Methods and results: This is a cohort study (Progetto Veneto Anziani Pro.V.A.) involving community-dwelling subjects aged ≥65 years and followed up for a mean 4.4 years. We included 1128 p…
Hyperuricemia, cardiovascular profile, and comorbidity in older men and women: The Pro.V.A. Study
Hyperuricemia (HU) is growing worldwide and associates with several medical conditions in the elderly. However, data about older people and possible gender differences are sparse. The aim of this study was to compare HU prevalence rates and association with relevant medical disorders in elderly subjects of both sexes. Pro.V.A. is a survey of 3099 individuals aged 65+, focusing on chronic diseases and disability. Uric acid (UA) levels were dichotomized using 6.0 mg/dL (females) and 7.0 mg/dL (males), and multivariate logistic regression models were used to estimate odds ratios (ORs) between HU and single comorbidity. HU prevalence was 21.5% in females and 15.8% in males. HU was associated wi…
Serum 25-Hydroxyvitamin D and Osteoarthritis in Older People: The Progetto Veneto Anziani Study.
Recent work has shown that low 25-hydroxyvitamin D (25OHD) levels are associated with the presence of osteoarthritis (OA), but these studies focused on radiographical changes of OA, investigated only one joint, and did not consider the association with OA-related pain. In this study, we aimed to examine the relationship between 25OHD levels and any presence of OA and pain in a cohort of older people. This study was part of the Progetto Veneto Anziani (Pro.V.A), a population-based cohort study in older people. In this cross-sectional work, we considered 2756 subjects (1102 males and 1654 females) with a mean age of 74.2 ± 7.1 years. OA and OA-related pain were defined using a standardized al…
Factors Influencing Transitions Between Frailty States in Elderly Adults: The Progetto Veneto Anziani Longitudinal Study.
Objectives: To investigate frailty state transitions in a cohort of older Italian adults to identify factors exacerbating or improving frailty conditions. Design: Population-based longitudinal study with mean follow-up of 4.4 years. Setting: Community. Participants: Individuals enrolled in the Progetto Veneto Anziani (Pro.V.A.) (N = 2,925; n = 1,179 male, n = 1,746 female; mean age 74.4 ± 7.3). Measurements: Frailty was identified at baseline and follow-up based on the presence of at least three Fried criteria; prefrailty was defined as the presence of one or two Fried criteria. Anthropometric, socioeconomic, and clinical characteristics were assessed at baseline in a personal interview and…
Poor Physical Performance Predicts Future Onset of Depression in Elderly People: Progetto Veneto Anziani Longitudinal Study.
Abstract Background. Reduced physical performance is predictive of deleterious outcomes in older adults. Data considering objective physical performance and incident depression are sparse. Objective. The objective of this study was to investigate during a 4-year study whether objective physical performance can predict incident depression among older adults who do not have depression at the baseline. Design. This was a longitudinal study. Methods. From 3,099 older people initially enrolled in the Progetto Veneto Anziani study, 970 participants without depression at the baseline were included (mean age = 72.5 years; 54.6% women). Physical performance measures included the Short Physical Perfo…
Serum 25-Hydroxyvitamin D and Incidence of Diabetes in Elderly People: The PRO.V.A. Study
Context: Increasing research has shown that low levels of serum 25-hydroxyvitamin (25OHD) predict the onset of diabetes, but no research is available on this issue in elderly people. Objective: Our objective was to examine whether low serum levels of 25OHD are associated with a higher risk of incident type 2 diabetes over a lengthy follow-up in a representative group of elderly people. Design and Setting: This was a population-based cohort study as part of the Progetto Veneto Anziani (Pro.V.A.) Study over a follow-up of 4.4 years in the general community. Participants: Participants included 2227 participants (1728 with follow-up visits and 499 died during the follow-up) over 65 years of ag…
Pain increases the risk of developing frailty in older adults with osteoarthritis
OBJECTIVE.: While osteoarthritis (OA)-related pain increases the risk of physical inactivity, disability, and falls, less is known about whether pain increases the risk of frailty. We investigated if people with OA reporting pain are more likely to develop frailty than people with OA without pain. DESIGN.: Population-based prospective cohort study with a follow-up of 4.4 years. SETTING.: Community. SUBJECTS.: The subjects were 1,775 older men and women with osteoarthritis, enrolled in the Progetto Veneto Anziani. METHODS.: Pain was ascertained according to medical records, symptoms/signs, and use of analgesics. Participants were considered frail if they met three out of five criteria of Fri…