The metabolic syndrome is common after liver transplant being present in approximately half of recipients. It has been associated with adverse outcomes such as progression of hepatitis C and major vascular events. As ...The metabolic syndrome is common after liver transplant being present in approximately half of recipients. It has been associated with adverse outcomes such as progression of hepatitis C and major vascular events. As the United States population ages and the rate of obesity increases, prevention of the metabolic syndrome in the post-transplant population deserves special consideration. Currently, the metabolic syndrome after transplant appears at least two times more common than observed rates in the general population. Specific guidelines for patients after transplant does not exist, therefore prevention rests upon knowledge of risk factors and the presence of modifiable elements. The current article will focus on risk factors for the development of the metabolic syndrome after transplant, will highlight potentially modifiable factors and propose potential areas for intervention. As in the non-transplant population, behavioral choices might have a major role. Opportunities exist in this regard for health prevention studies incorporating lifestyle changes. Other factors such as the need for immunosuppression, and the changing characteristics of wait listed patients are not modifiable, but are important to know in order to identify persons at higher risk. Although immunosuppression after transplant is unavoidable, the contribution of different agents to the development of components of the metabolic syndrome is also discussed. Ultimately, an increased risk of the metabolic syndrome after transplant is likely unavoidable, however, there are many opportunities to reduce the prevalence.展开更多
Objectives:To describe the characteristics and relationships of social isolation and health promoting behaviors of Chinese older adults with different health statuses.Methods:Totally 485 older adults were recruited.Th...Objectives:To describe the characteristics and relationships of social isolation and health promoting behaviors of Chinese older adults with different health statuses.Methods:Totally 485 older adults were recruited.They were divided into three groups based on their health status:healthy group(n=72),group with one disease(n=183)and group with multimorbidity(n=230).Lubben Social Network Scale-6 and Health-Promoting Lifestyle Profile II were used to measure their social isolation and health-promoting behaviors,respectively.Results:Among the aged with one disease or multimorbidity,30.6%(56/183)and 31.7%(73/230)were socially isolated,respectively,based on the score of the Lubben Social Network Scale-6.The three groups differed significantly in health-promoting behaviors and scores on several subscales.The group with multimorbidity exhibited more social isolation and fewer health-promoting behaviors than other groups.Social isolation was among the factors adversely affecting health-promoting behaviors in older adults.Conclusions:Health care providers should help older adults with multimorbidity preserve the remaining abilities to improve health-promoting behaviors.Meanwhile,it is important to support healthy older adults to increase self-responsibility to achieve healthy aging.展开更多
AIM: To clarify the relationship between age, menopause, and nonalcoholic fatty liver disease (NAFLD) in women. METHODS: We conducted a follow-up study on non-alcoholic fatty liver disease by using abdominal ultrasono...AIM: To clarify the relationship between age, menopause, and nonalcoholic fatty liver disease (NAFLD) in women. METHODS: We conducted a follow-up study on non-alcoholic fatty liver disease by using abdominal ultrasonography, and investigated the relationship of age and menopause with the development of NAFLD in women. We followed 1829 women and 2572 men (response rate, 86%) selected in 2001 to represent the non-institutionalized adult population of Gifu, Japan. Data collected included self-reported medical history, lifestyle factors, and menopausal status. The postmenopausal state was defined as beginning 1 year after the cessation of menses. We diagnosed NAFLD with the aid of abdominal ultrasonography by using diagnostic criteria describedRESULTS: The prevalence of NAFLD in women increases with age, but does not alter with age in men. Furthermore, the prevalence of NAFLD in premenopausal women (6%) was lower than that in men (24%) and in postmenopausal women (15%). The associations of the postmenopausal state and hormone replacement therapy with NAFLD were statistically significant in a univariate logistic regression model. At the follow-up examination, 67 women (5%) were newly diagnosed with NAFLD. The incidence of NAFLD was 3.5% (28/802) in premenopausal women, 7.5% (4/53) in menopausal women, 6.1% (24/392) in postmenopausal women, and 5.3% (11/206) in women receiving hormone replacement therapy. The weight gain in premenopausal women was equal to that in postmenopausal women. Metabolic syndrome and weight gain were independent risk factors for NAFLD in pre-and postmenopausal women, but age was an independent risk factor in premenopausal women only. CONCLUSION: Aging is a risk factor for NAFLD in premenopausal women, independent of weight gain or influence of metabolic syndrome.展开更多
The aging of the population is, currently, a major phenomenon, drawing the attention of a number of investigators. The significant increase of life expectancies over the past few decades, in addition to social and eco...The aging of the population is, currently, a major phenomenon, drawing the attention of a number of investigators. The significant increase of life expectancies over the past few decades, in addition to social and economic consequences, has lead to a major change in the morbidity and mortality profile of elders. Heart failure （HF） is a condition in which the heart can not pump enough blood to meet the body＇s needs. HF is predominantly a disorder of the elderly with rates increasing exponentially. The prevalence of HF approximately doubles with each decade of life. As people live longer, the occurrence of HF rises, as well as other conditions that complicate its treatment. Impaired heart function implies a reduced duration of survival. Fortunately, many factors that can prevent HF and improve outcome are known and can be applied at any stage. This review emphasizes the importance of factors inherent in aging itself, focusing on heart disease, particularly as a disease of aging, can help critically refine management of this acute and chronic disease, as well as foster preventive strategies to reduce the incidence of this common malady.展开更多
Diverticular disease(DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK.This high prevalence ranks it as one of the most common bowel disorders in we...Diverticular disease(DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK.This high prevalence ranks it as one of the most common bowel disorders in western nations.The majority of patients remain asymptomatic but there are associated life-threatening co-morbidities, which, given the large numbers of people with DD, translates into a considerable number of deaths per annum.Despite this public health burden, relatively little seems to be known about either the mechanisms of development or causality.In the 1970s, a model of DD formulated the concept that diverticula occur as a consequence of pressureinduced damage to the colon wall amongst those with a low intake of dietary fiber.In this review, we have examined the evidence regarding the influence of ageing, diet, inflammation and genetics on DD development.We argue that the evidence supporting the barotrauma hypothesis is largely anecdotal.We have also identified several gaps in the knowledge base which need to be filled before we can complete a model for the etiology of diverticular disease.展开更多
We are currently faced with an aging population, which is rapidly growing worldwide. Two thirds of cancer occurs in the over 65-year age group. Societal conceptions from the past have created ageist stereotypes; old a...We are currently faced with an aging population, which is rapidly growing worldwide. Two thirds of cancer occurs in the over 65-year age group. Societal conceptions from the past have created ageist stereotypes; old age is associated with frailty and the elderly are perceived to be destined for deterioration and loss of independence. Cancer within the elderly is also subject to these stereotypes, with elderly cancer patients considered by some not as likely to recover as younger patients with cancer. We summarise and review the current concerns regarding elderly management and treatments utilised for the management of oncological disease in the elderly, and discuss the impact of under-treatment within this population.展开更多
Immunosenescence is described as a decline in the normal functioning of the immune system associated with physiologic ageing.Immunosenescence contributes to reduced efficacy to vaccination and increased susceptibility...Immunosenescence is described as a decline in the normal functioning of the immune system associated with physiologic ageing.Immunosenescence contributes to reduced efficacy to vaccination and increased susceptibility to infectious diseases in the elderly.Extensive studies of laboratory animal models of ageing or donor lymphocyte analysis have identified changes in immunity caused by the ageing process.Most of these studies have identified phenotypic and functional changes in innate and adaptive immunity.However,it is unclear which of these defects are critical for impaired immune defense against infection.This review describes the changes that occur in innate and adaptive immunity with ageing and some age-related viral diseases where defects in a key component of immunity contribute to the high mortality rate in mouse models of ageing.展开更多
China is facing challenges of the increasing incidence of some chronic diseases. However, the share of government spending on health in total kept fairing during the economic transition and the cost of health care has...China is facing challenges of the increasing incidence of some chronic diseases. However, the share of government spending on health in total kept fairing during the economic transition and the cost of health care has been rising dramatically. Using the data at the provincial level, I find that income and population aging are significant determinants of increasing health expenditure. Time dummies contribute more than 40% in the growth of health expenditure and nearly one-third in the growth rate of health expenditure, which implies that technological and institutional changes are also very important drivers in China. In the future, the rising of health expenditure is a necessary response to income growth and population aging; but there is still plenty of room to cut the cost through reforming the health care sector.展开更多
文摘The metabolic syndrome is common after liver transplant being present in approximately half of recipients. It has been associated with adverse outcomes such as progression of hepatitis C and major vascular events. As the United States population ages and the rate of obesity increases, prevention of the metabolic syndrome in the post-transplant population deserves special consideration. Currently, the metabolic syndrome after transplant appears at least two times more common than observed rates in the general population. Specific guidelines for patients after transplant does not exist, therefore prevention rests upon knowledge of risk factors and the presence of modifiable elements. The current article will focus on risk factors for the development of the metabolic syndrome after transplant, will highlight potentially modifiable factors and propose potential areas for intervention. As in the non-transplant population, behavioral choices might have a major role. Opportunities exist in this regard for health prevention studies incorporating lifestyle changes. Other factors such as the need for immunosuppression, and the changing characteristics of wait listed patients are not modifiable, but are important to know in order to identify persons at higher risk. Although immunosuppression after transplant is unavoidable, the contribution of different agents to the development of components of the metabolic syndrome is also discussed. Ultimately, an increased risk of the metabolic syndrome after transplant is likely unavoidable, however, there are many opportunities to reduce the prevalence.
文摘Objectives:To describe the characteristics and relationships of social isolation and health promoting behaviors of Chinese older adults with different health statuses.Methods:Totally 485 older adults were recruited.They were divided into three groups based on their health status:healthy group(n=72),group with one disease(n=183)and group with multimorbidity(n=230).Lubben Social Network Scale-6 and Health-Promoting Lifestyle Profile II were used to measure their social isolation and health-promoting behaviors,respectively.Results:Among the aged with one disease or multimorbidity,30.6%(56/183)and 31.7%(73/230)were socially isolated,respectively,based on the score of the Lubben Social Network Scale-6.The three groups differed significantly in health-promoting behaviors and scores on several subscales.The group with multimorbidity exhibited more social isolation and fewer health-promoting behaviors than other groups.Social isolation was among the factors adversely affecting health-promoting behaviors in older adults.Conclusions:Health care providers should help older adults with multimorbidity preserve the remaining abilities to improve health-promoting behaviors.Meanwhile,it is important to support healthy older adults to increase self-responsibility to achieve healthy aging.
基金Supported by Young Scientists (B) (23790791) from Japan Society for the Promotion of Science
文摘AIM: To clarify the relationship between age, menopause, and nonalcoholic fatty liver disease (NAFLD) in women. METHODS: We conducted a follow-up study on non-alcoholic fatty liver disease by using abdominal ultrasonography, and investigated the relationship of age and menopause with the development of NAFLD in women. We followed 1829 women and 2572 men (response rate, 86%) selected in 2001 to represent the non-institutionalized adult population of Gifu, Japan. Data collected included self-reported medical history, lifestyle factors, and menopausal status. The postmenopausal state was defined as beginning 1 year after the cessation of menses. We diagnosed NAFLD with the aid of abdominal ultrasonography by using diagnostic criteria describedRESULTS: The prevalence of NAFLD in women increases with age, but does not alter with age in men. Furthermore, the prevalence of NAFLD in premenopausal women (6%) was lower than that in men (24%) and in postmenopausal women (15%). The associations of the postmenopausal state and hormone replacement therapy with NAFLD were statistically significant in a univariate logistic regression model. At the follow-up examination, 67 women (5%) were newly diagnosed with NAFLD. The incidence of NAFLD was 3.5% (28/802) in premenopausal women, 7.5% (4/53) in menopausal women, 6.1% (24/392) in postmenopausal women, and 5.3% (11/206) in women receiving hormone replacement therapy. The weight gain in premenopausal women was equal to that in postmenopausal women. Metabolic syndrome and weight gain were independent risk factors for NAFLD in pre-and postmenopausal women, but age was an independent risk factor in premenopausal women only. CONCLUSION: Aging is a risk factor for NAFLD in premenopausal women, independent of weight gain or influence of metabolic syndrome.
文摘The aging of the population is, currently, a major phenomenon, drawing the attention of a number of investigators. The significant increase of life expectancies over the past few decades, in addition to social and economic consequences, has lead to a major change in the morbidity and mortality profile of elders. Heart failure （HF） is a condition in which the heart can not pump enough blood to meet the body＇s needs. HF is predominantly a disorder of the elderly with rates increasing exponentially. The prevalence of HF approximately doubles with each decade of life. As people live longer, the occurrence of HF rises, as well as other conditions that complicate its treatment. Impaired heart function implies a reduced duration of survival. Fortunately, many factors that can prevent HF and improve outcome are known and can be applied at any stage. This review emphasizes the importance of factors inherent in aging itself, focusing on heart disease, particularly as a disease of aging, can help critically refine management of this acute and chronic disease, as well as foster preventive strategies to reduce the incidence of this common malady.
基金Supported by Food Standards Agency, N12105Northumbria Colorectal Research Funds
文摘Diverticular disease(DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK.This high prevalence ranks it as one of the most common bowel disorders in western nations.The majority of patients remain asymptomatic but there are associated life-threatening co-morbidities, which, given the large numbers of people with DD, translates into a considerable number of deaths per annum.Despite this public health burden, relatively little seems to be known about either the mechanisms of development or causality.In the 1970s, a model of DD formulated the concept that diverticula occur as a consequence of pressureinduced damage to the colon wall amongst those with a low intake of dietary fiber.In this review, we have examined the evidence regarding the influence of ageing, diet, inflammation and genetics on DD development.We argue that the evidence supporting the barotrauma hypothesis is largely anecdotal.We have also identified several gaps in the knowledge base which need to be filled before we can complete a model for the etiology of diverticular disease.
文摘We are currently faced with an aging population, which is rapidly growing worldwide. Two thirds of cancer occurs in the over 65-year age group. Societal conceptions from the past have created ageist stereotypes; old age is associated with frailty and the elderly are perceived to be destined for deterioration and loss of independence. Cancer within the elderly is also subject to these stereotypes, with elderly cancer patients considered by some not as likely to recover as younger patients with cancer. We summarise and review the current concerns regarding elderly management and treatments utilised for the management of oncological disease in the elderly, and discuss the impact of under-treatment within this population.
文摘Immunosenescence is described as a decline in the normal functioning of the immune system associated with physiologic ageing.Immunosenescence contributes to reduced efficacy to vaccination and increased susceptibility to infectious diseases in the elderly.Extensive studies of laboratory animal models of ageing or donor lymphocyte analysis have identified changes in immunity caused by the ageing process.Most of these studies have identified phenotypic and functional changes in innate and adaptive immunity.However,it is unclear which of these defects are critical for impaired immune defense against infection.This review describes the changes that occur in innate and adaptive immunity with ageing and some age-related viral diseases where defects in a key component of immunity contribute to the high mortality rate in mouse models of ageing.
基金The author is grateful for financial support from the National Science Foundation of China（70573024, 70973027 ）
文摘China is facing challenges of the increasing incidence of some chronic diseases. However, the share of government spending on health in total kept fairing during the economic transition and the cost of health care has been rising dramatically. Using the data at the provincial level, I find that income and population aging are significant determinants of increasing health expenditure. Time dummies contribute more than 40% in the growth of health expenditure and nearly one-third in the growth rate of health expenditure, which implies that technological and institutional changes are also very important drivers in China. In the future, the rising of health expenditure is a necessary response to income growth and population aging; but there is still plenty of room to cut the cost through reforming the health care sector.
