Suchergebnisse

Two thirds of adults aged 60 and older agreed or strongly agreed with shielding. Interestingly, a higher percentage of those most affected by policy, the over 70s, agreed with it. Whether people lived alone or with others does not appear to influence their level of agreement with shielding. On average, those who agreed or agreed strongly with shielding were more concerned about the virus. These findings suggest widespread support for the governments? decision to ask the over 70s to remain at home and limit their interactions for long periods of time. The level of agreement with shielding was also related to the ease with which older adults understood government guidance on the pandemic. This clearly illustrates the importance of clear communication of these policies and suggests that older adults are willing to adhere to guidelines when they understand the reasoning behind them. Future TILDA research will enable to ascertain whether this agreement was consistent during the entire period the restrictions were in place or if they changes over the course of the pandemic.

PUBLISHED ; Background: syncope is an important, but underestimated clinical problem in older persons. It is often overlooked in clinical practice or mistaken for falls. Atrial fibrillation (AF) is the most common cardiac arrhythmia, but little evidence exists regarding the association between AF, falls and syncope in the general population. Methods: cross-sectional analyses within a population sample of people aged 50+, taken from The Irish Longitudinal Study on Ageing. Ten-minute electrocardiogram recordings (n = 4,885) were analysed to detect AF. Syncope (self-reported faints or blackouts) and falls in the past year, co-morbidities, health measures and medications were gathered through computer-aided personal interviews. Multivariable logistic regression was performed to study associations between AF, falls and syncope. Results: mean age was 62 years (range: 50?91), 54% were female. Prevalence of AF was 3%, increasing to 8% in participants aged 75+. Of participants, 5% (n = 223) reported syncope and 20% (n = 972) reported falls. After adjustment for confounders, AF was significantly associated with faints and blackouts (odds ratio (OR) 2.0 [95% confidence interval (CI) 1.0?3.9]). After stratification by age category, we found that this association was strongest and only significant in participants aged 50?64 years (OR 4.4 [1.5?12.6]). Stratified for age group, AF was significantly associated with falls in participants aged 65?74 years (OR 2.0 [1.0?4.1]). Conclusions: adults aged 50+ with self-reported syncope and adults aged 65?74 years with falls are twice as likely to have AF at physical examination. These associations are independent of stroke, cardiovascular and psychotropic drugs and other confounders. Further longitudinal studies are needed to explore this association and potential causality further. ; Financial support was provided by Irish Life plc, the Irish Government and the Atlantic Philanthropies. The sponsors played no part in the design, methods, subject recruitment, data collection, analysis and preparation of this paper. There is no conflict of interest in this regard.

PUBLISHED ; Objectives This study aims to examine the extent to which statins are used by adults at high risk of cardiovascular disease (CVD) compared to European clinical guidelines. The high-risk groups examined are those with (1) known CVD, (2) known diabetes and (3) a high or very high risk (?5%) of CVD mortality based on Systematic COronary Risk Evaluation (SCORE). Design This study is cross-sectional in design using data from the first wave (2009?2011) of The Irish Longitudinal Study on Ageing (TILDA). Setting and participants The sample (n=3372) is representative of community living adults aged 50?64?years in Ireland. Results Statins were used by 68.6% (95% CI 61.5% to 75.8%) of those with known CVD, 57.4% (95% CI 49.1% to 65.7%) of those with known diabetes and by 19.7% (95% CI 13.0% to 26.3%) of adults with a SCORE risk ?5%. Over a third (38.5%, 95% CI 31.0% to 46.0%) of those with known CVD, 46.8% (95% CI 38.4% to 55.1%) of those with known diabetes and 85.2% (95% CI 79.3% to 91.1%) of those with a SCORE risk ?5% were at or above the low-density lipoprotein cholesterol (LDL-C) target of 2.5?mmol/L specified in the 2007 European guidelines. Conclusions Despite strong evidence and clinical guidelines recommending the use of statins for secondary prevention, a gap exists between guidelines and practice in this cohort. It is also of concern that a low proportion of adults with a SCORE risk ?5% were taking statins. A policy response that strengthens secondary prevention, and improves risk assessment and shared decision-making in the primary prevention of CVD is required. ; This work was supported by the Irish Health Research Board Interdisciplinary Capacity Enhancement Award [grant number: ICE/2012/7]. TILDA is funded by the Irish Government (Department of Health), Atlantic Philanthropies and Irish Life. The funders had no involvement in the analysis or preparation of this paper.

PUBLISHED ; For single gait tasks, associations have been reported between gait speed and cognitive domains. However, few studies have evaluated if this association is altered in dual gait tasks given gait speed changes with complexity and nature of task. We evaluated relative contributions of specific elements of cognitive function (including sustained attention and processing speed) to dual task gait speed in a nationally representative population of community-dwelling adults over 50 years. METHODS: Gait speed was obtained using the GaitRite walkway during three gait tasks: single, cognitive (alternate letters), and motor (carrying a filled glass). Linear regression models, adjusted for covariates, were constructed to predict the relative contributions of seven neuropsychological tests to gait speed differences and to investigate gait task effects. RESULTS: The mean age and gait speed of the population (n = 4,431, 55% women) was 62.4 years (SD = 8.2) and 135.85 cm/s (SD = 20.20, single task), respectively. Poorer processing speed, short-term memory, and sustained attention were major cognitive contributors to slower gait speed for all gait tasks. Both dual gait tasks were robust to covariate adjustment and had a significant additional executive function element not found for the single gait task. CONCLUSIONS: For community-dwelling older adults processing speed, short-term memory and sustained attention were independently associated with gait speed for all gait tasks. Dual gait tasks were found to highlight specific executive function elements. This result forms a baseline value for dual task gait speed. ; Supported by Atlantic Philanthropies, Irish Government, Irish Life Plc., Trinity Centre for Bioengineering, and Trinity College, Dublin.

PUBLISHED ; Background: Older adults are the most at-risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and among the most affected by measures put in place to prevent the spread of the virus. While the full effect of the public health measures, such as social distancing and wearing masks in public spaces, implemented since March 2020 are not yet known, it is expected that they will have a severely damaging effect on physical and psychological wellbeing. The Irish Longitudinal Study on Ageing (TILDA) has been researching the lives of older adults in Ireland since 2008 with data collection conducted at two-year intervals. With an established research infrastructure, TILDA was ideally placed to examine the effect of the coronavirus disease 2019 (COVID-19) pandemic on older adults. The aim of this study is to document the lives of older adults during the COVID-19 pandemic to understand the effect of the pandemic and public health responses on their wellbeing. Methods: Data was collected from TILDA participants via self-completion-questionnaire (SCQ). The SCQ contains ten sections that capture information on many aspects of people's lives during the pandemic including, changes in behaviour and social interactions, physical and psychological wellbeing indicators, healthcare utilisation, and exposure to SARS-CoV-2. Ethical approval was granted by the National Research Ethics Committee (NREC). Conclusions: Research findings will be shared in a variety of formats including research reports and briefs, presentations, and academic papers. Data will be archived in the Irish Social Science Data Archive (ISSDA) and the Inter-university Consortium for Political and Social Research (ICPSR). As well as documenting the impact of the COVID-19 pandemic on older adults, findings from this study will provide important information to policy-makers as we respond to the damage caused by the COVID-19 pandemic.

PUBLISHED ; How did the study come about? Ireland shares with other developed countries the prospect of rapid and sustained population ageing. The age distribution of the Irish population is undergoing a dramatic change at present and this trend is predicted to continue into the future.1 People are living longer, and older persons represent a larger proportion of the population. In Ireland, the proportion of the population aged 565 years has remained steady at 11% for the past 40 years. However, it is projected that this proportion will rise to 14% by 2021 and to 19% by 2031.2 The greatest increase will be in the oldest old, aged 480 years, which is expected to more than treble by 2036.2 This change in the demographic profile of the Irish population poses a major public health challenge. ; The Atlantic Philanthropies (research grant to the Irish Longitudinal Study of Ageing); Irish Life plc and the Irish Government (grant to the Irish Longitudinal Study of Ageing); Paul Beeson Career Development Award in Aging Research (with support from a grant to The American Federation for Aging Research from The Atlantic Philanthropies) (to P.K.).

Abstract

Background
Although type 2 diabetes mellitus (T2DM) is an established risk factor for cognitive impairment, the underlying mechanisms remain poorly explored. One potential mechanism may be through effects of T2DM on cerebral perfusion. The current study hypothesized that T2DM is associated with altered peripheral and central hemodynamic responses to orthostasis, which may in turn be associated with cognitive impairment in T2DM.


Methods
A novel use of function-on-scalar regression, which allows the entire hemodynamic response curve to be modeled, was employed to assess the association between T2DM and hemodynamic responses to orthostasis. Logistic regression was used to assess the relationship between tissue saturation index (TSI), T2DM, and cognitive impairment. All analyses used cross-sectional data from Wave 3 of The Irish Longitudinal Study on Ageing (TILDA).


Results
Of 2 984 older adults (aged 64.3 ± 8.0; 55% female), 189 (6.3%) had T2DM. T2DM was associated with many features that are indicative of autonomic dysfunction including a blunted peak heart rate and lower diastolic blood pressure. T2DM was associated with reduced TSI and also with greater odds of impaired performance on the Montreal Cognitive Assessment (odds ratio [OR]: 1.62; confidence interval [CI: 1.07, 2.56]; p = .019). Greater TSI was associated with lower odds of impaired performance (OR: 0.90, CI [0.81–0.99]; p = .047).


Conclusions
T2DM was associated with impaired peripheral and cerebral hemodynamic responses to active stand. Both T2DM and reduced cerebral perfusion were associated with impaired cognitive performance. Altered cerebral perfusion may represent an important mechanism linking T2DM and adverse brain health outcomes in older adults.

The European population is ageing rapidly: its median age is the highest in the world. The topic of ageing has received significant attention in recent years, as is evident in the multiple international reports on ageing published during the last five years and the existence of at least eight active working groups on ageing at the EU level. The SAPEA Working Group on Transforming the Future of Ageing aims to provide a scientific perspective to address the question of what policies at the EU level could support the member states in their response to the current and future opportunities and challenges posed by ageing. In this project, SAPEA assembled a large multi-disciplinary working group, with world-leading expertise in the biomedical, human, social and engineering sciences. The Federation of European Academies of Medicine network led the project. The resulting report reflects not only the outstanding knowledge of the experts, but also their exemplary commitment to the voluntary task of collaborating in an interdisciplinary way and bringing the best and latest scientific knowledge into evidence-based policymaking. The report aims to make a unique contribution from a broad public health standpoint to a complex topic in a way that complements other related resources, thereby providing evidence-based science advice for the highest policy level in Europe. In particular, the working group has made a conscious effort not to duplicate the same aspects of ageing covered in existing reports. Likewise, by adopting a multi-disciplinary approach in the present report, the working group has distinguished itself from other EU ageing-related initiatives. These include the European Innovative partnership for Active and Healthy Ageing, Horizon 2020 projects in response to identified societal challenges posed by ageing, and the EU health programme managed by DG Santé focusing on healthy ageing, as well as existing networks funded by the EU, such as Innovation, Futurage, Mopact, Nestpar, and SHARE . The choice of topics covered in this report, or excluded, is based upon the expressed interest of policymakers throughout the scoping process, e.g. health, social affairs, employment, and technology. SAPEA is an integral part of the European Commission's Scientific Advice Mechanism (SAM). This Evidence Review Report is presented to the European Group of Chief Scientific Advisors, informing their Scientific Opinion which will be published later in 2019. Both this report and the Scientific Opinion are delivered directly to the College of Commissioners, and will be used for planning and policymaking. By such means, the best available science, distilled and analysed by the leading experts in Europe, should have a direct and tangible impact on decisions taken by the European Commission which influences the lives of some 500 million people across our continent.

The European population is ageing rapidly: its median age is the highest in the world. The topic of ageing has received significant attention in recent years, as is evident in the multiple international reports on ageing published during the last five years and the existence of at least eight active working groups on ageing at the EU level. The SAPEA Working Group on Transforming the Future of Ageing aims to provide a scientific perspective to address the question of what policies at the EU level could support the member states in their response to the current and future opportunities and challenges posed by ageing. In this project, SAPEA assembled a large multi-disciplinary working group, with world-leading expertise in the biomedical, human, social and engineering sciences. The Federation of European Academies of Medicine network led the project. The resulting report reflects not only the outstanding knowledge of the experts, but also their exemplary commitment to the voluntary task of collaborating in an interdisciplinary way and bringing the best and latest scientific knowledge into evidence-based policymaking. The report aims to make a unique contribution from a broad public health standpoint to a complex topic in a way that complements other related resources, thereby providing evidence-based science advice for the highest policy level in Europe. In particular, the working group has made a conscious effort not to duplicate the same aspects of ageing covered in existing reports. Likewise, by adopting a multi-disciplinary approach in the present report, the working group has distinguished itself from other EU ageing-related initiatives. These include the European Innovative partnership for Active and Healthy Ageing, Horizon 2020 projects in response to identified societal challenges posed by ageing, and the EU health programme managed by DG Santé focusing on healthy ageing, as well as existing networks funded by the EU, such as Innovation, Futurage, Mopact, Nestpar, and SHARE . The choice of topics covered in this report, or excluded, is based upon the expressed interest of policymakers throughout the scoping process, e.g. health, social affairs, employment, and technology. SAPEA is an integral part of the European Commission's Scientific Advice Mechanism (SAM). This Evidence Review Report is presented to the European Group of Chief Scientific Advisors, informing their Scientific Opinion which will be published later in 2019. Both this report and the Scientific Opinion are delivered directly to the College of Commissioners, and will be used for planning and policymaking. By such means, the best available science, distilled and analysed by the leading experts in Europe, should have a direct and tangible impact on decisions taken by the European Commission which influences the lives of some 500 million people across our continent.

The European population is ageing rapidly: its median age is the highest in the world. The topic of ageing has received significant attention in recent years, as is evident in the multiple international reports on ageing published during the last five years and the existence of at least eight active working groups on ageing at the EU level. The SAPEA Working Group on Transforming the Future of Ageing aims to provide a scientific perspective to address the question of what policies at the EU level could support the member states in their response to the current and future opportunities and challenges posed by ageing. In this project, SAPEA assembled a large multi-disciplinary working group, with world-leading expertise in the biomedical, human, social and engineering sciences. The Federation of European Academies of Medicine network led the project. The resulting report reflects not only the outstanding knowledge of the experts, but also their exemplary commitment to the voluntary task of collaborating in an interdisciplinary way and bringing the best and latest scientific knowledge into evidence-based policymaking. The report aims to make a unique contribution from a broad public health standpoint to a complex topic in a way that complements other related resources, thereby providing evidence-based science advice for the highest policy level in Europe. In particular, the working group has made a conscious effort not to duplicate the same aspects of ageing covered in existing reports. Likewise, by adopting a multi-disciplinary approach in the present report, the working group has distinguished itself from other EU ageing-related initiatives. These include the European Innovative partnership for Active and Healthy Ageing, Horizon 2020 projects in response to identified societal challenges posed by ageing, and the EU health programme managed by DG Santé focusing on healthy ageing, as well as existing networks funded by the EU, such as Innovation, Futurage, Mopact, Nestpar, and SHARE . The choice of topics covered in this report, or excluded, is based upon the expressed interest of policymakers throughout the scoping process, e.g. health, social affairs, employment, and technology. SAPEA is an integral part of the European Commission's Scientific Advice Mechanism (SAM). This Evidence Review Report is presented to the European Group of Chief Scientific Advisors, informing their Scientific Opinion which will be published later in 2019. Both this report and the Scientific Opinion are delivered directly to the College of Commissioners, and will be used for planning and policymaking. By such means, the best available science, distilled and analysed by the leading experts in Europe, should have a direct and tangible impact on decisions taken by the European Commission which influences the lives of some 500 million people across our continent.

The European population is ageing rapidly: its median age is the highest in the world. The topic of ageing has received significant attention in recent years, as is evident in the multiple international reports on ageing published during the last five years and the existence of at least eight active working groups on ageing at the EU level. The SAPEA Working Group on Transforming the Future of Ageing aims to provide a scientific perspective to address the question of what policies at the EU level could support the member states in their response to the current and future opportunities and challenges posed by ageing. In this project, SAPEA assembled a large multi-disciplinary working group, with world-leading expertise in the biomedical, human, social and engineering sciences. The Federation of European Academies of Medicine network led the project. The resulting report reflects not only the outstanding knowledge of the experts, but also their exemplary commitment to the voluntary task of collaborating in an interdisciplinary way and bringing the best and latest scientific knowledge into evidence-based policymaking. The report aims to make a unique contribution from a broad public health standpoint to a complex topic in a way that complements other related resources, thereby providing evidence-based science advice for the highest policy level in Europe. In particular, the working group has made a conscious effort not to duplicate the same aspects of ageing covered in existing reports. Likewise, by adopting a multi-disciplinary approach in the present report, the working group has distinguished itself from other EU ageing-related initiatives. These include the European Innovative partnership for Active and Healthy Ageing, Horizon 2020 projects in response to identified societal challenges posed by ageing, and the EU health programme managed by DG Santé focusing on healthy ageing, as well as existing networks funded by the EU, such as Innovation, Futurage, Mopact, Nestpar, and SHARE . The choice of topics covered in this report, or excluded, is based upon the expressed interest of policymakers throughout the scoping process, e.g. health, social affairs, employment, and technology. SAPEA is an integral part of the European Commission's Scientific Advice Mechanism (SAM). This Evidence Review Report is presented to the European Group of Chief Scientific Advisors, informing their Scientific Opinion which will be published later in 2019. Both this report and the Scientific Opinion are delivered directly to the College of Commissioners, and will be used for planning and policymaking. By such means, the best available science, distilled and analysed by the leading experts in Europe, should have a direct and tangible impact on decisions taken by the European Commission which influences the lives of some 500 million people across our continent.