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Zhu Y.,Rugao Peoples Hospital | Liu Z.,Fudan University | Wang Y.,Rugao Peoples Hospital | Wang Z.,Rugao Peoples Hospital | And 6 more authors.
Archives of Gerontology and Geriatrics | Year: 2016

Background: The objective of this study is to examine the agreement between two commonly used frailty measurements (frailty index and phenotype) and their associations with falls and overnight hospitalizations in a community-based population. Methods: Data was collected from 1663 elderly adults (aged 70-84 years) from the aging arm of the Rugao Longevity and Ageing study, a two-arm cohort conducted in Rugao, China. Items concerning the frailty index and phenotype, falls and overnight hospitalizations were collected. Results: The Kappa agreement examining three levels of these two frailty measurements was 0.310 (95% CI: 0.277-0.343) according to the frailty index cut-off developed by Hoover et al. Both frailty measurements were significantly associated with falls and overnight hospitalizations. For instance, compared with the frailty index defined non-frail participants, their pre-frail and frail counterparts had significantly increased risks for falls, with odds ratios (ORs) of 1.69 (95% CI: 1.17-2.43) and 2.87 (95% CI: 1.93-4.28), respectively. When the two frailty measurements were simultaneously included in the models, significant associations were also observed. More importantly, a sub-analysis in participants who were categorized as robust by frailty phenotype revealed that frail participants (frailty index > 0.21) still had increased risks for falls (OR = 2.35, 95% CI: 1.24-4.46) and overnight hospitalizations (OR = 2.56, 95% CI: 1.05-6.23) compared with their non-frail counterparts. Conclusions: Common characteristics and complementarity existed in the frailty index and phenotype in the elderly Chinese population. Additional consideration of the frailty index when applying frailty phenotype should be undertaken. The findings provide preliminary but crucial clues for future studies on frailty. © 2016 Elsevier Ireland Ltd.

Zhu Y.,Longevity Research Institute of Rugao | Liu Z.,Fudan University | Wang Y.,Longevity Research Institute of Rugao | Wang Z.,Longevity Research Institute of Rugao | And 5 more authors.
Archives of Gerontology and Geriatrics | Year: 2016

Background: C-reactive protein (CRP), an important inflammatory biomarker, has been linked to various diseases (e.g., cardiovascular disease). Here, we aimed to investigate the associations of high sensitivity C-reactive protein (hsCRP) with frailty and overnight hospital admission in an elderly Chinese population. Methods: We used cross-sectional data from 1478 participants (aged 70-84 years) who were randomly recruited from 31 villages in Jiang'an township, Rugao city, China. Frailty status was defined using a modified frailty phenotype. The number of overnight hospital admissions was ascertained. Results: The sample mean age was 75.3 years, and 53.0% of participants were female (n = 784). The mean level of hsCRP was 3.6 mg/L. From the low (hsCRP ≤ 1.00 mg/L) to high hsCRP (hsCRP ≥ 3.0 mg/L) group, the proportion of overnight hospital admission increased linearly (8.7%, 10.6%, vs. 15.5%; P for trend = 0.007). For frailty, the age- and sex-adjusted odds ratios (ORs) were 1.21 (95% CI: 0.89, 1.64) for participants in the intermediate hsCRP group and 1.49 (95% CI: 1.05, 2.09) for participants in the high hsCRP group compared with those in the low hsCRP group. For overnight hospital admission, the corresponding ORs were 1.26 (95% CI: 0.72, 2.19) and 1.94 (95% CI: 1.08, 3.48), respectively. After adjustment for other covariates, the significance of these associations remained. Conclusions: Elevated levels of hsCRP were associated with increased risks of frailty and overnight hospital admission among elderly individuals in Rugao. More public health concerns about inflammation and subsequent outcomes are needed to improve the quality of life in elderly populations. © 2015 Elsevier Ireland Ltd.

Liu Z.,Fudan University | Zhong G.,Capital Medical University | Li S.,Capital Medical University | Deng W.,Fudan University | And 4 more authors.
Age | Year: 2015

Both activities of daily living (ADL) and some blood biomarkers (such as albumin) have been associated with mortality in very elderly people, but scarce data is available on the predictive performance of them in isolation or in combination, which is important for clinicians in decision making. Here, based on prospective mortality data over a 6-year follow-up period from 433 long-lived individuals (LLIs) aged 95+ years in the Rugao longevity cohort, we aimed to evaluate Cox proportional hazard ratios (HRs) and discriminative power (ROC curve) of 14 biomarkers and ADL for all-cause mortality. We found that six biomarkers (total triglyceride, albumin, low-density lipoprotein cholesterol, platelet count, lymphocyte count, and neutrophil count) were associated with mortality with a p < .10 in the univariate model. Significant associations of albumin and neutrophil count with mortality were observed when they were simultaneously included in a multivariate model, with HRs of 0.97 (95 % CI 0.94, 0.99; p = .005) and 1.09 (95 % CI 1.00, 1.18; p = .043). With respect to ADL, the corresponding HR was 1.10 (95 % CI 1.07, 1.14; p < .001). Low albumin (<40 g/L) combined with ADL dependent had a significantly increased mortality risk (HR = 2.19; 95 % CI 1.63, 2.95). Albumin and ADL separately showed good discriminative accuracies (area under the curve [AUC] = 0.68 and 0.66, respectively), and their combination had an increased predictive utility (AUC = 0.73). In conclusion, both albumin and ADL are efficient predictors of all-cause mortality in long-lived populations and their combination further increases discriminative power. The preliminary findings, if validated and translated, would help clinicians to identify the elderly people at varying mortality risk. © 2015, American Aging Association.

Liu Z.,Fudan University | Wu D.,Fudan University | Wu D.,Shanghai JiaoTong University | Huang J.,Fudan University | And 6 more authors.
Archives of Gerontology and Geriatrics | Year: 2016

Background: Sensory impairment affects an increasing number of elderly adults, with a negative psychological impact. Our objective was to examine the associations of visual and hearing impairment with subjective well-being (SWB), an important psychological concept defined by life satisfaction [LS], positive affect [PA], negative affect [NA], and affect balance [AB] among long-lived individuals (LLIs) over 95 years of age. Methods: Data on 442 LLIs from the Rugao longevity cohort, a population-based study in Rugao, China, were analyzed. Graded classifications of visual and hearing impairment (none, mild, moderate, and severe) were constructed from self-reported items. Bivariate correlation and multiple regression analysis were performed to test the associations. Results: Approximately 66.1% and 87.3% of the subjects reported varying degrees of visual and hearing impairment. Following the degree of vision impairment, LS, PA, and AB decreased linearly, whereas NA increased linearly (all p for trend<0.05). Vision was significantly related to LS (. r=. 0.238, p<. 0.001), PA (. r=. 0.142, p<. 0.01), NA (. r=. -0.157, p<. 0.001), and AB (. r=. 0.206, p<. 0.001). After adjustment for multiple variables including functional ability, an important factor of SWB, the associations of vision impairment with LS, NA, and AB, while diminished, still existed. Conclusions: Visual impairment, but not hearing impairment, was independently associated with low SWB among LLIs, and functional ability may play a mediating role in the observed relationship. The findings indicate that rehabilitation targeted for those with reduced vision and functioning in long-lived populations may be important for promoting well-being and quality of life. © 2015 Elsevier Ireland Ltd.

Liu Z.,Fudan University | Wang Y.,Rugao Peoples Hospital | Huang J.,Fudan University | Chu X.,Rugao Peoples Hospital | And 8 more authors.
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2015

Background. Several blood biomarkers have been linked to functional disability, a health problem in general populations. However, there are limited data for evaluating the potential association of biomarkers with functional disability in an extremely longevous (95+) population. Methods. We used data from 420 extremely longevous individuals from the Rugao longevity cohort, a population-based association study conducted in Rugao, a longevity town in China. Functional disability was assessed by the Katz Index of Independence in activities of daily living. Blood biomarkers, including serum lipid, lipoprotein cholesterol, serum albumin, and lymphocyte count, were correlated with activities of daily living. Results. Among extremely longevous women, following the degree of functional disability, serum albumin and lymphocyte count decreased significantly (all p for trend <. 001). In a univariate model, serum albumin (β = -0.279, p <. 001), lymphocyte count (β = -0.187, p <. 001), and neutrophil count (β = 0.140, p =. 012) were found to be significantly associated with activities of daily living in women. After adjustment for other covariates, the significance remained. Notably, multivariate regression analysis revealed independent effects of all the three biomarkers on activities of daily living (β = -0.242, -0.185, and 0.143, all p <. 05). We did not observe any association in men. Conclusions. We found significant associations between serum albumin, lymphocyte count, and neutrophil count and physical disability even after adjustment for potential confounders in extremely longevous women, which call for further study. The findings provide preliminary but crucial clues for future studies specifically aimed at exploring the longitudinal relationships of interest before proceeding with interventions. © 2014 © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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