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Article ; Online: Building on a Legacy of Hypertension Research: Charting Our Future Together.

Mensah, George A / Galis, Zorina S / Fine, Lawrence J / Garcia, Melissa E / Levy, Daniel F / Gibbons, Gary H

Hypertension (Dallas, Tex. : 1979)

2016 Volume 69, Issue 1, Page(s) 5–10

MeSH term(s)	Humans ; Hypertension ; Research ; Translational Research, Biomedical
Language	English
Publishing date	2016-11-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	423736-5
ISSN	1524-4563 ; 0194-911X ; 0362-4323
ISSN (online)	1524-4563
ISSN	0194-911X ; 0362-4323
DOI	10.1161/HYPERTENSIONAHA.116.06582
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Article ; Online: Salivary cortisol, brain volumes, and cognition in community-dwelling elderly without dementia.

Geerlings, Mirjam I / Sigurdsson, Sigurdur / Eiriksdottir, Gudny / Garcia, Melissa E / Harris, Tamara B / Gudnason, Vilmundur / Launer, Lenore J

Neurology

2015 Volume 85, Issue 11, Page(s) 976–983

Abstract: Objective: We investigated the associations of morning and evening salivary cortisol levels with regional brain volumes and cognitive functioning in community-dwelling older persons without dementia.: Method: From the Age, Gene/Environment ... ...

Abstract	Objective: We investigated the associations of morning and evening salivary cortisol levels with regional brain volumes and cognitive functioning in community-dwelling older persons without dementia. Method: From the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we included 4,244 persons without dementia (age 76 ± 5 years, 58% women) who had 1.5T brain MRI, assessment of cognitive functioning, and saliva collected at home 45 minutes after awakening and at night. Linear regression analysis was used to estimate the cross-sectional relationship among cortisol levels, brain volumes, and cognitive functioning, adjusting for covariates. Results: Higher evening cortisol was associated with smaller total brain volume (highest vs lowest tertile -16.0 mL; 95% confidence interval -19.7 to -12.2 mL, adjusted for age, sex, education, intracranial volume, smoking, steroid use, white matter lesions, and brain infarcts on MRI). The smaller volumes were observed in all brain regions, but were significantly smaller in gray matter than in white matter regions. Poorer cognitive functioning across all domains was also associated with higher evening cortisol. Higher levels of morning cortisol were associated with slightly greater normal white matter volume and better processing speed and executive functioning, but not with gray matter volume or with memory performance. Conclusions: In older persons, evening and morning cortisol levels may be differentially associated with tissue volume in gray and white matter structures and cognitive function. Understanding these differential associations may aid in developing strategies to reduce the effects of hypothalamic-pituitary-adrenal axis dysfunction on late-life cognitive impairment.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Aging ; Brain/pathology ; Cognition/physiology ; Cognition Disorders/physiopathology ; Cross-Sectional Studies ; Dementia/pathology ; Female ; Humans ; Hydrocortisone/analysis ; Male ; Memory/physiology ; Middle Aged ; Neuropsychological Tests ; Pituitary-Adrenal System/pathology ; Saliva/chemistry ; Saliva/physiology
Chemical Substances	Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2015-09-15
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0000000000001931
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Article ; Online: Olfaction and incident Parkinson disease in US white and black older adults.

Chen, Honglei / Shrestha, Srishti / Huang, Xuemei / Jain, Samay / Guo, Xuguang / Tranah, Gregory J / Garcia, Melissa E / Satterfield, Suzanne / Phillips, Caroline / Harris, Tamara B

Neurology

2017 Volume 89, Issue 14, Page(s) 1441–1447

Abstract: Objective: To investigate olfaction in relation to incident Parkinson disease (PD) in US white and black older adults.: Methods: The study included 1,510 white (mean age 75.6 years) and 952 black (75.4 years) participants of the Health, Aging, and ... ...

Abstract	Objective: To investigate olfaction in relation to incident Parkinson disease (PD) in US white and black older adults. Methods: The study included 1,510 white (mean age 75.6 years) and 952 black (75.4 years) participants of the Health, Aging, and Body Composition study. We evaluated the olfaction of study participants with the Brief Smell Identification Test (BSIT) in 1999-2000. We retrospectively adjudicated PD cases identified through August 31, 2012, using multiple data sources. We used multivariable Cox models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During an average of 9.8 years of follow-up, we identified a total of 42 incident PD cases, including 30 white and 12 black participants. Overall, poor sense of smell, as indicated by a lower BSIT score, was associated with higher risk of PD. Compared with the highest tertile of BSIT (t3), the HR was 1.3 (95% CI 0.5-3.6) for the second tertile (t2) and 4.8 (95% CI 2.0-11.2) for the lowest tertile (t1) ( Conclusions: Poor olfaction predicts PD in short and intermediate terms; the possibility of stronger associations among men and white participants warrants further investigation.
MeSH term(s)	Aged ; Aged, 80 and over ; Animals ; Blacks ; Female ; Humans ; Incidence ; Longitudinal Studies ; Male ; Parkinson Disease/epidemiology ; Parkinson Disease/ethnology ; Parkinson Disease/physiopathology ; Proportional Hazards Models ; Prospective Studies ; Smell/physiology ; United States/epidemiology ; Whites
Language	English
Publishing date	2017-09-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0000000000004382
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Article ; Online: Associations of fat and muscle tissue with cognitive status in older adults: the AGES-Reykjavik Study.

Spauwen, Peggy J J / Murphy, Rachel A / Jónsson, Pálmi V / Sigurdsson, Sigurdur / Garcia, Melissa E / Eiriksdottir, Gudny / van Boxtel, Martin P J / Lopez, Oscar L / Gudnason, Vilmundur / Harris, Tamara B / Launer, Lenore J

Age and ageing

2017 Volume 46, Issue 2, Page(s) 250–257

Abstract: Background/objective: studies on the association of dementia with specific body composition (BC) components are scarce. Our aim was to investigate associations of BC measures with different levels of cognitive function in late-life.: Methods: we ... ...

Abstract	Background/objective: studies on the association of dementia with specific body composition (BC) components are scarce. Our aim was to investigate associations of BC measures with different levels of cognitive function in late-life. Methods: we studied 5,169 participants (mean age 76 years, 42.9% men) in the AGES-Reykjavik Study of whom 485 (9.4%) were diagnosed with mild cognitive impairment (MCI) and 307 (5.9%) with dementia. Visceral fat, abdominal and thigh subcutaneous fat, and thigh muscle were assessed by computed tomography. MCI and dementia were based on clinical assessment and a consensus meeting; those without MCI or dementia were categorised as normal. Multinomial regression models assessed the associations stratified by sex and in additional analyses by midlife body mass index (BMI). Results: among women, there was a decreased likelihood of dementia per SD increase in abdominal subcutaneous fat (OR 0.72; 95% CI: 0.59-0.88), thigh subcutaneous fat (0.81; 0.67-0.98) and thigh muscle (0.63; 0.52-0.76), but not visceral fat, adjusting for demographics, vascular risk factors, stroke and depression. Inverse associations of fat with dementia were attenuated by weight change from midlife and were strongest in women with midlife BMI <25. In men, one SD increase in thigh muscle was associated with a decreased likelihood of dementia (0.75; 0.61-0.92). BC was not associated with MCI in men or women. Conclusion: a higher amount of abdominal and thigh subcutaneous fat were associated with a lower likelihood of dementia in women only, while more thigh muscle was associated with a lower likelihood of dementia in men and women.
MeSH term(s)	Abdominal Fat/diagnostic imaging ; Abdominal Fat/physiopathology ; Adiposity ; Age Factors ; Aged ; Aged, 80 and over ; Body Mass Index ; Cognition ; Cognition Disorders/diagnosis ; Cognition Disorders/epidemiology ; Cognition Disorders/psychology ; Cognitive Aging/psychology ; Cross-Sectional Studies ; Female ; Humans ; Iceland/epidemiology ; Male ; Mental Status and Dementia Tests ; Muscle, Skeletal/diagnostic imaging ; Muscle, Skeletal/physiopathology ; Protective Factors ; Risk Factors ; Sex Factors ; Subcutaneous Fat ; Tomography, X-Ray Computed
Language	English
Publishing date	2017-04-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Intramural ; Research Support, N.I.H., Extramural
ZDB-ID	186788-x
ISSN	1468-2834 ; 0002-0729
ISSN (online)	1468-2834
ISSN	0002-0729
DOI	10.1093/ageing/afw219
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Zs.A 877: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Associations between arterial stiffness, depressive symptoms and cerebral small vessel disease: cross-sectional findings from the AGES-Reykjavik Study.

van Sloten, Thomas T / Mitchell, Gary F / Sigurdsson, Sigurdur / van Buchem, Mark A / Jonsson, Palmi V / Garcia, Melissa E / Harris, Tamara B / Henry, Ronald M A / Levey, Andrew S / Stehouwer, Coen D A / Gudnason, Vilmundur / Launer, Lenore J

Journal of psychiatry & neuroscience : JPN

2015 Volume 41, Issue 3, Page(s) 162–168

Abstract: Background: Arterial stiffness may contribute to depression via cerebral microvascular damage, but evidence for this is scarce. We therefore investigated whether arterial stiffness is associated with depressive symptoms and whether cerebral small vessel ...

Abstract	Background: Arterial stiffness may contribute to depression via cerebral microvascular damage, but evidence for this is scarce. We therefore investigated whether arterial stiffness is associated with depressive symptoms and whether cerebral small vessel disease contributes to this association. Methods: This cross-sectional study included a subset of participants from the AGES-Reykjavik study second examination round, which was conducted from 2007 to 2011. Arterial stiffness (carotid-femoral pulse wave velocity [CFPWV]), depressive symptoms (15-item geriatric depression scale [GDS-15]) and cerebral small vessel disease (MRI) were determined. Manifestations of cerebral small vessel disease included higher white matter hyperintensity volume, subcortical infarcts, cerebral microbleeds, Virchow-Robin spaces and lower total brain parenchyma volume. Results: We included 2058 participants (mean age 79.6 yr; 59.0% women) in our analyses. Higher CFPWV was associated with a higher GDS-15 score, after adjustment for potential confounders (β 0.096, 95% confidence interval [CI] 0.005-0.187). Additional adjustment for white matter hyperintensity volume or subcortical infarcts attenuated the association between CFPWV and the GDS-15 score, which became nonsignificant (p > 0.05). Formal mediation tests showed that the attenuating effects of white matter hyperintensity volume and subcortical infarcts were statistically significant. Virchow-Robin spaces, cerebral microbleeds and cerebral atrophy did not explain the association between CFPWV and depressive symptoms. Limitations: Our study was limited by its cross-sectional design, which precludes any conclusions about causal mediation. Depressive symptoms were assessed by a self-report questionnaire. Conclusion: Greater arterial stiffness is associated with more depressive symptoms; this association is partly accounted for by white matter hyperintensity volume and subcortical infarcts. This study supports the hypothesis that arterial stiffness leads to depression in part via cerebral small vessel disease.
MeSH term(s)	Aged ; Atrophy ; Brain/diagnostic imaging ; Carotid Arteries/physiopathology ; Cerebral Hemorrhage/diagnostic imaging ; Cerebral Hemorrhage/physiopathology ; Cerebral Hemorrhage/psychology ; Cerebral Small Vessel Diseases/diagnostic imaging ; Cerebral Small Vessel Diseases/physiopathology ; Cerebral Small Vessel Diseases/psychology ; Cross-Sectional Studies ; Depression/diagnostic imaging ; Depression/physiopathology ; Female ; Femoral Artery/physiopathology ; Humans ; Magnetic Resonance Imaging ; Male ; Pulse Wave Analysis ; Self Report ; Vascular Stiffness ; White Matter/diagnostic imaging
Language	English
Publishing date	2015-09-15
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural
ZDB-ID	1077443-9
ISSN	1488-2434 ; 1180-4882
ISSN (online)	1488-2434
ISSN	1180-4882
DOI	10.1503/jpn.140334
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Article ; Online: Muscle Quality and Muscle Fat Infiltration in Relation to Incident Mobility Disability and Gait Speed Decline: the Age, Gene/Environment Susceptibility-Reykjavik Study.

Reinders, Ilse / Murphy, Rachel A / Koster, Annemarie / Brouwer, Ingeborg A / Visser, Marjolein / Garcia, Melissa E / Launer, Lenore J / Siggeirsdottir, Kristin / Eiriksdottir, Gudny / Jonsson, Palmi V / Gudnason, Vilmundur / Harris, Tamara B

The journals of gerontology. Series A, Biological sciences and medical sciences

2015 Volume 70, Issue 8, Page(s) 1030–1036

Abstract: Background: Aging is associated with increased risk of reduced mobility. However, data on muscle components in relation to subjective and objective indicators of disability is limited.: Methods: Data were from 2,725 participants (43% men) aged 74.8±4. ...

Abstract	Background: Aging is associated with increased risk of reduced mobility. However, data on muscle components in relation to subjective and objective indicators of disability is limited. Methods: Data were from 2,725 participants (43% men) aged 74.8±4.7 years from the AGES-Reykjavik Study. At baseline, maximal isometric thigh strength (dynamometer chair), and midthigh muscle area and muscle fat infiltration were assessed with computed tomography. Usual 6 m gait speed and mobility disability were assessed at baseline and after 5.2±0.3 years. Incident mobility disability was defined as having much difficulty or unable to walk 500 m or climb-up 10 steps. A decrease of ≥0.1 m/s in gait speed was considered clinically relevant. Results: Greater strength and area were protective for mobility disability risk and gait speed decline. After adjustment for other muscle components, greater strength was independently associated with lower mobility disability risk in women odds ratios (OR) 0.78 (95% CI 0.62, 0.99), and lower decline in gait speed risk among both men OR 0.64 (0.54, 0.76), and women OR 0.72 (0.62, 0.82). Larger muscle area was independently associated with lower mobility disability risk in women OR 0.67 (0.52, 0.87) and lower decline in gait speed risk in men OR 0.74 (0.61, 0.91). Conclusions: Greater muscle strength and area were independently associated with 15-30% decreased risk of mobility disability in women and gait speed decline in men. Among women, greater muscle strength was also associated with lower risk of gait speed decline. Interventions aimed at maintaining muscle strength and area in old age might delay functional decline.
MeSH term(s)	Adipose Tissue/metabolism ; Aged ; Aging/physiology ; Female ; Gait/physiology ; Gene-Environment Interaction ; Humans ; Male ; Mobility Limitation ; Muscle Strength ; Muscle, Skeletal/metabolism
Language	English
Publishing date	2015-08
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/glv016
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Article ; Online: Plasma phospholipid fatty acids and fish-oil consumption in relation to osteoporotic fracture risk in older adults: the Age, Gene/Environment Susceptibility Study.

Harris, Tamara B / Song, Xiaoling / Reinders, Ilse / Lang, Thomas F / Garcia, Melissa E / Siggeirsdottir, Kristin / Sigurdsson, Sigurdur / Gudnason, Vilmundur / Eiriksdottir, Gudny / Sigurdsson, Gunnar / Steingrimsdottir, Laufey / Aspelund, Thor / Brouwer, Ingeborg A / Murphy, Rachel A

The American journal of clinical nutrition

2015 Volume 101, Issue 5, Page(s) 947–955

Abstract: Background: Polyunsaturated fatty acids (PUFAs) may play a role in fracture, but studies have been largely confined to estimates of dietary intake.: Objective: We aimed to examine associations between fatty acids measured in late life and fish-oil ... ...

Abstract	Background: Polyunsaturated fatty acids (PUFAs) may play a role in fracture, but studies have been largely confined to estimates of dietary intake. Objective: We aimed to examine associations between fatty acids measured in late life and fish-oil consumption in early life, midlife, and late life with osteoporotic fracture risk. Design: Osteoporotic fractures were determined from medical records over 5-9 y of follow-up in men and women aged 66-96 y. Data were analyzed from 1438 participants including 898 participants who were randomly selected from the Age, Gene/Environment Susceptibility Study, which is an observational study, and 540 participants with incident fracture. Plasma phospholipid fatty acids were assessed by using gas chromatography. Fish-oil consumption was assessed by using validated questionnaires as never (referent), less than daily, or daily. HRs and 95% CIs adjusted for age, education, height, weight, diabetes, physical activity, and medications were estimated by using Cox regression. Results: In men, the highest tertile of PUFAs, n-3 (ω-3), and eicosapentaenoic acid were associated with decreased fracture risk [HRs (95% CIs): 0.60 (95% CI: 0.41, 0.89), 0.66 (0.45, 0.95), and 0.59 (0.41, 0.86), respectively]. In women, PUFAs tended to be inversely associated with fracture risk (P-trend = 0.06), but tertiles 2 and 3 were not independently associated with risk. Tertile 2 of n-6 and arachidonic acid was associated with fracture risk in women [HRs (95% CIs): 1.43 (1.10, 1.85) and 1.42 (1.09, 1.85), respectively]. Daily fish-oil consumption in late life was associated with lower fracture risk in men (HR: 0.64; 95% CI: 0.45, 0.91). Daily fish-oil consumption in midlife was associated with lower fracture risk in women (HR: 0.75; 95% CI: 0.58, 0.98). Conclusions: Greater PUFA concentrations may be associated with lower osteoporotic fracture risk in older adults, particularly in men. Critical time periods for n-3 fatty acid consumption may differ by sex.
MeSH term(s)	Aged ; Aged, 80 and over ; Arachidonic Acid/blood ; Eicosapentaenoic Acid/blood ; Fatty Acids, Omega-3/blood ; Fatty Acids, Omega-6/blood ; Female ; Fish Oils/administration & dosage ; Follow-Up Studies ; Humans ; Male ; Osteoporotic Fractures/blood ; Osteoporotic Fractures/prevention & control ; Phospholipids/blood ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Surveys and Questionnaires
Chemical Substances	Fatty Acids, Omega-3 ; Fatty Acids, Omega-6 ; Fish Oils ; Phospholipids ; Arachidonic Acid (27YG812J1I) ; Eicosapentaenoic Acid (AAN7QOV9EA)
Language	English
Publishing date	2015-03-18
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.3945/ajcn.114.087502
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Article ; Online: Higher Plasma Phospholipid n-3 PUFAs, but Lower n-6 PUFAs, Are Associated with Lower Pulse Wave Velocity among Older Adults.

Reinders, Ilse / Murphy, Rachel A / Song, Xiaoling / Mitchell, Gary F / Visser, Marjolein / Cotch, Mary Frances / Garcia, Melissa E / Launer, Lenore J / Eiriksdottir, Gudny / Gudnason, Vilmundur / Harris, Tamara B / Brouwer, Ingeborg A

The Journal of nutrition

2015 Volume 145, Issue 10, Page(s) 2317–2324

Abstract: Background: Higher intake of polyunsaturated fatty acids (PUFAs) and higher circulating PUFAs are associated with lower cardiovascular disease (CVD) risk. The positive influence of PUFAs might be via lowering arterial stiffness, resulting in a better ... ...

Abstract	Background: Higher intake of polyunsaturated fatty acids (PUFAs) and higher circulating PUFAs are associated with lower cardiovascular disease (CVD) risk. The positive influence of PUFAs might be via lowering arterial stiffness, resulting in a better CVD risk profile; however, studies investigating circulating PUFAs in relation to arterial stiffness in a general population are limited. Objective: We investigated the associations of plasma phospholipid n-3 (ω-3) and n-6 PUFAs and fish oil intake with arterial stiffness. Methods: We used data from a subgroup of the Age, Gene/Environment Susceptibility-Reykjavik (AGES-Reykjavik) Study (n = 501, 75.0 ± 4.96 y, 46% men), a population-based study of community-dwelling older adults. Plasma phospholipid PUFAs were measured by GC at baseline, and fish oil intake was assessed at 3 time points: early life (ages 14-19 y), midlife (ages 40-50 y), and late life (ages 66-96 y, AGES-Reykjavik baseline) with the use of a validated food-frequency questionnaire. Arterial stiffness was determined as carotid-femoral pulse wave velocity (cf-PWV) with the use of an electrocardiogram after a mean follow-up of 5.2 ± 0.3 y. Regression coefficients (95% CIs), adjusted for demographics, follow-up time, risk factors, cholesterol, triglycerides, and serum vitamin D, were calculated by linear regression per SD increment in PUFAs. Results: Plasma total n-3 PUFAs, eicosapentaenoic acid, and docosahexaenoic acid were associated with lower cf-PWV [β (95% CI): -0.036 (-0.064, -0.008); -0.031 (-0.059, -0.003); -0.036 (-0.064, -0.009), respectively]. In contrast, plasma total n-6 PUFAs and linoleic acid were associated with higher cf-PWV [0.035 (0.009, 0.061) and 0.034 (0.008, 0.059)]. Regular fish oil consumption at early-, mid-, and late-life was not associated with cf-PWV. Conclusions: Our results show a positive association between plasma n-6 PUFAs and arterial stiffness, and suggest that higher concentrations of plasma long-chain n-3 PUFAs are associated with less arterial stiffness and therein may be one of the mechanisms underlying the association between plasma n-3 PUFAs and lower CVD risk.
MeSH term(s)	Adolescent ; Aged ; Biomarkers/blood ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control ; Case-Control Studies ; Cohort Studies ; Dietary Supplements/adverse effects ; Elder Nutritional Physiological Phenomena ; Fatty Acids, Omega-3/adverse effects ; Fatty Acids, Omega-3/blood ; Fatty Acids, Omega-3/therapeutic use ; Fatty Acids, Omega-6/adverse effects ; Fatty Acids, Omega-6/blood ; Fatty Acids, Omega-6/therapeutic use ; Female ; Fish Oils/adverse effects ; Fish Oils/therapeutic use ; Follow-Up Studies ; Humans ; Iceland/epidemiology ; Male ; Phospholipids/blood ; Prospective Studies ; Pulse Wave Analysis ; Risk Factors ; Vascular Stiffness
Chemical Substances	Biomarkers ; Fatty Acids, Omega-3 ; Fatty Acids, Omega-6 ; Fish Oils ; Phospholipids
Language	English
Publishing date	2015-08-26
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	218373-0
ISSN	1541-6100 ; 0022-3166
ISSN (online)	1541-6100
ISSN	0022-3166
DOI	10.3945/jn.115.212282
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Article ; Online: Atrial Fibrillation and Declining Physical Performance in Older Adults: The Health, Aging, and Body Composition Study.

Magnani, Jared W / Wang, Na / Benjamin, Emelia J / Garcia, Melissa E / Bauer, Douglas C / Butler, Javed / Ellinor, Patrick T / Kritchevsky, Stephen / Marcus, Gregory M / Newman, Anne / Phillips, Caroline L / Sasai, Hiroyuki / Satterfield, Suzanne / Sullivan, Lisa M / Harris, Tamara B

Circulation. Arrhythmia and electrophysiology

2016 Volume 9, Issue 5, Page(s) e003525

Abstract: Background: Age is the foremost risk factor for atrial fibrillation (AF), and AF has a rising prevalence in older adults. How AF may contribute to decline in physical performance in older adults has had limited investigation. We examined the ... ...

Abstract	Background: Age is the foremost risk factor for atrial fibrillation (AF), and AF has a rising prevalence in older adults. How AF may contribute to decline in physical performance in older adults has had limited investigation. We examined the associations of incident AF and 4-year interval declines in physical performance at ages 70, 74, 78, and 82 years in the Health, Aging, and Body Composition (Health ABC) Study. Methods and results: Health ABC is a prospective cohort of community-dwelling older adults (n=3075). The study conducted serial assessments of physical performance with the Health ABC physical performance battery (scored 0-4), grip strength, 2-minute walk distance, and 400-m walking time. Incident AF was identified from the Center for Medicare and Medicaid Services and related to 4-year interval decline in physical performance. After exclusions, the analysis included 2753 Health ABC participants (52% women, 41% black race). Participants with AF had a significantly greater 4-year physical performance battery decline than those without AF at age 70, 74, 78, and 82, with mean estimated decline ranging from -0.08 to -0.10 U (95% confidence interval, -0.18 to -0.01; P<0.05 for all estimates) after multivariable adjustment. Grip strength, walk distance, and walk time similarly showed significantly greater declines at each 4-year age interval in participants with AF. Conclusions: In community-based cohort older adults, incident AF was associated with increased risk of decline in physical performance. Further research is essential to identify mechanisms and preventive strategies for how AF may contribute toward declining physical performance in older adults.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Aging ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/rehabilitation ; Body Composition ; Disability Evaluation ; Electrocardiography ; Female ; Follow-Up Studies ; Health Status ; Humans ; Male ; Motor Activity/physiology ; Prevalence ; Prospective Studies ; Risk Assessment/methods ; Risk Factors ; Time Factors ; United States/epidemiology
Language	English
Publishing date	2016-04-06
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2426129-4
ISSN	1941-3084 ; 1941-3149
ISSN (online)	1941-3084
ISSN	1941-3149
DOI	10.1161/CIRCEP.115.003525
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Adipose tissue, muscle, and function: potential mediators of associations between body weight and mortality in older adults with type 2 diabetes.

Murphy, Rachel A / Reinders, Ilse / Garcia, Melissa E / Eiriksdottir, Gudny / Launer, Lenore J / Benediktsson, Rafn / Gudnason, Vilmundur / Jonsson, Palmi V / Harris, Tamara B

Diabetes care

2014 Volume 37, Issue 12, Page(s) 3213–3219

Abstract: Objective: Studies in type 2 diabetes report both increased mortality for normal weight and no evidence of an obesity paradox. We aimed to examine whether adipose tissue, muscle size, and physical function, which are known to vary by weight, mediate ... ...

Abstract	Objective: Studies in type 2 diabetes report both increased mortality for normal weight and no evidence of an obesity paradox. We aimed to examine whether adipose tissue, muscle size, and physical function, which are known to vary by weight, mediate associations between BMI and mortality. Research design and methods: The AGES-Reykjavik cohort comprised participants aged 66-96 years with diabetes defined by fasting glucose, medications, or self-report. BMI was determined from measured height and weight and classified as normal (18.5-24.9 kg/m(2), n = 117), overweight (25.0-29.9 kg/m(2), n = 293, referent group) or obese (≥30.0 kg/m(2), n = 227). Thigh muscle area and intermuscular, visceral, and subcutaneous adipose tissues were assessed with computed tomography. Function was assessed from gait speed and knee extensor strength. Hazard ratios (HRs) and 95% CIs were estimated by Cox proportional hazards regression adjusted for demographics and diabetes-related risk factors. Results: The median follow-up was 6.66 years, and there were 85, 59, and 44 deaths among normal weight, overweight, and obese participants, respectively. There was no mortality risk for obese participants and an increased risk among normal weight compared with overweight participants (HR 1.72 [95% CI 1.12-2.64]). Associations remained with adjustment for adipose tissues and knee extensor strength; however, mortality risk for normal weight was attenuated following adjustment for thigh muscle (HR 1.36 [95% CI 0.87-2.11]) and gait speed (HR 1.44 [95% CI 0.91-2.27]). Linear regression confirmed with bootstrapping indicated that thigh muscle size mediated 46% of the relationship between normal weight and mortality. Conclusions: Normal weight participants had elevated mortality risk compared with overweight participants. This paradoxical association was mediated in part by muscle size.
MeSH term(s)	Adipose Tissue/pathology ; Aged ; Aged, 80 and over ; Aging/physiology ; Body Composition ; Body Weight/physiology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/metabolism ; Diabetes Mellitus, Type 2/mortality ; Female ; Humans ; Male ; Motor Activity ; Muscle, Skeletal/pathology ; Obesity/complications ; Obesity/metabolism ; Obesity/mortality ; Overweight/complications ; Overweight/metabolism ; Overweight/mortality ; Risk Factors
Language	English
Publishing date	2014-10-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/dc14-0293
Database	MEDical Literature Analysis and Retrieval System OnLINE

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