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Cardiff, United Kingdom

Gallacher J.,Center for Health science Research | Bayer A.,University of Cardiff | Lowe G.,Royal Infirmary | Fish M.,Center for Health science Research | And 6 more authors.
Arteriosclerosis, Thrombosis, and Vascular Biology | Year: 2010

Objective-Hemostasis and inflammation have been implicated in dementia. This study investigates the role of specific hemostatic and inflammatory pathways with incident vascular and nonvascular dementia. Methods and Results-This was a prospective study of a population sample of men aged 65 to 84 years, with baseline assessment of hemostatic and inflammatory factors and cognition measured 17 years later. The sample included 865 men (59 had dementia and 112 had cognitive impairment, not dementia), free of vascular disease at baseline and for whom hemostatic and inflammatory marker data were available and cognitive status was known. A total of 15 hemostatic and 6 inflammatory markers were assessed. Factor analysis was used to identify hemostatic subsystems. The National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurologie criteria were used to identify vascular dementia. By using standardized (z) scores for hemostatic and inflammatory markers, and after adjustment for age and risk factors, vascular dementia was associated with fibrinogen (hazard ratio [HR], 1.68; 95% confidence interval [CI], 1.02-2.76), factor VIII (HR, 1.79; 95% CI, 1.09-3.00), and plasminogen activator inhibitor 1 (HR, 3.13; 95% CI, 1.73-5.70). For vascular dementia, the HR risk from high levels of all three hemostatic variables (fibrinogen, factor VIII, and plasminogen activator inhibitor 1) was 2.97 (P<0.001). Inflammatory factors were not associated with vascular dementia. Conclusion-The associations of these hemostatic markers with vascular dementia may implicate clot formation as the primary mechanism and are consistent with a microinfarct model of vascular dementia. © 2010 American Heart Association, Inc.

Birnie K.,University of Bristol | Martin R.M.,University of Bristol | Gallacher J.,Center for Health science Research | Bayer A.,Center for Health science Research | And 3 more authors.
Journal of Epidemiology and Community Health | Year: 2011

Background: Socio-economic influences over a lifetime impact on health and may contribute to poor physical functioning in old age. Methods: The authors examined the impact of both childhood and adulthood socio-economic factors on locomotor function at 63-86 years (measured with the get up and go timed walk and flamingo balance test) in the UK-based Boyd Orr (n=405) and Caerphilly (n=1196) prospective cohorts. Results: There was a marked reduction in walking speed and balance time with increasing age. Each year of age was associated with a 1.7% slower walk time and a 14% increased odds of poor balance. Participants who moved from a low socio-economic position in childhood to a high socio-economic position in adulthood had 3% slower walking times (95% CI -2% to 8%) than people with a high socio-economic position in both periods. Participants who moved from a high socio-economic position in childhood to a low adulthood socio-economic position had 5% slower walking times (95% CI -2% to 12%). Participants with a low socio-economic position in both periods had 10% slower walking times (95% CI 5% to 16%; p for trend <0.001). In Boyd Orr, low socio-economic position in childhood was associated with poor balance in old age (OR per worsening category=1.26; 95% CI 1.01 to 1.57; p=0.043), as was socio-economic position in adulthood (OR=1.71; 95% CI 1.20 to 2.45; p=0.003). Similar associations were not observed in Caerphilly. Conclusion: Accumulating socio-economic disadvantage from childhood to adulthood is associated with slower walking time in old age, with mixed results for balance ability.

Khan S.,Center for Health science Research | Doi S.A.R,Australian National University | Memon M.A.,Center for Health science Research
Applied Mathematics and Information Sciences | Year: 2016

In the age of evidence based decision making through a systematic review of the literature, statistical meta-analysis has beenextensively used to synthesise published summary data on a particular topic of interest from a number of independent studies in order tomake credible and scienti?cally valid conclusions. The main objective is to estimate the common effect size as a pooled statistic for anyselected outcome variables from the relevant data. There are several issues concerning the quality and type of the published summarystatistics and inherent heterogeneity among the estimates of the effect size across the studies. This paper covers several estimators of thecommon effect size and some of their major impacts in meta-analysis through redistribution of weights to the individual studies. Someexamples from recent literature on cancer research studies are used to illustrate the alternative estimators and discuss their usefulnessin analysing data from randomised controlled trials in medicine. © 2016 NSP Natural Sciences Publishing Cor.

Gil A.W.O.,University of Northern Parana | Gil A.W.O.,Center for Health science Research | Oliveira M.R.,University of Northern Parana | Oliveira M.R.,Center for Health science Research | And 7 more authors.
Revista Brasileira de Fisioterapia | Year: 2011

Background: Clinical and laboratory methods have been developed to assess the different dimensions of postural control with the aim to increase the clinical relevance of decisions about balance deficit. Objectives: The purpose of this study was to correlate the force platform measurements with two functional tests used to evaluate balance in elderly. Methods: A total of 124 physically independent elderly volunteers participated in this study. Subjects performed the following three tests: 1) a traditional functional balance test, named the one-leg standing test, which measures the time in seconds at this position; 2) a functionalagility/dynamic balance test, which quantifies the total time in seconds that a subject canstand up from a chair and move as quickly as possible around two cones; and 3) an unipodal balance test on a force platform. Results: The one-leg standing test yielded a mean of 12 seconds (SD=9 s), while the mean time observed in the functional agility/dynamic balance test was 26 seconds (SD=6 s). The correlations between the balance parameters of force platform and two functional tests varied between -0.28 and 0.20, which shows a weak association between them. Conclusions: Our results support the idea that these functional tests do not necessarily furnish the same information regarding balance mechanisms as the force platform. This study contributes to the evaluation of balance in elderly and suggests that functional tests should be used with caution especially in regards to the purposes of the research and when conducting clinical assessments of the elderly. © Revista Brasileira de Fisioterapia.

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