Sources of folate and serum folate levels in older adults

This study examined dietary folate intake in 173 older adults. A subsample (n=128) also provided data about folic acid from vitamin/mineral supplements and serum folate. Subjects were community-dwelling men and women 60 years of age and older. Overall, this sample had healthful dietary patterns with adequate dietary folate. Mean dietary intake converted to dietary folate equivalents (DFE) was 464 microg DFE/day. However, 20% (n=36) had inadequate and 2% (n=3) had high dietary DFE (>1,000 microg DFE/day). A subsample (n=128) completed a dietary supplement questionnaire and biochemical assessment of folate. Adding folic acid from vitamin/mineral supplements to dietary folate (total DFE), intake increased to 766 microg DFE/day; 13% (n=16) had inadequate, 75% (n=95) had adequate, and 13% (n=13) had high total DFE. No subject with low total DFE reported supplement use, but 94% (n=39) with high total DFE intake did so. In the subsample, all subjects had acceptable serum folate levels (mean serum folate=28.0+/-13.8 ng/mL [63.5+/-31.3 nmol/L]). In conclusion, vitamin/mineral supplements should be included in nutrition assessment of older adults. Older adults may be at risk for inadequate folate intake if their energy intake is low, they do not take a vitamin/mineral supplement, or are not consuming fortified cereals. However, older adults may be at risk for excess folic acid intake if they consume both a supplement and fortified cereals.     

Factors affecting leukocyte count in healthy adults

The relationships between white blood cell (WBC) count, smoking, and other health variables were determined among 35,000 apparently healthy men and women. The effect of smoking on the WBC count was greater than that of all other variables. The leukocyte level and the variance in WBC count values increased with increased smoking intensity. The relationship between smoking intensity and leukocyte level is expressed quantitatively by the following regression equation: WBC (10(3)/mm3) = 7.1 + 0.05(SM), where SM has seven values according to the smoking level. Multiple regression analysis with additional variables other than smoking did not much improve the predictive value of the equation. The effect of smoking on WBC count could be only partially explained by an inflammatory process, e.g., chronic bronchitis. Relationships of statistical significance (but mostly with r values of less than 0.10) were found between WBC count and the following variables: hemoglobin, heart rate, weight (or Quetelet index), cholesterol, uric acid, creatinine, sex, ethnic origin, systolic blood pressure, height, blood sugar, and diastolic blood pressure. The normal WBC count range for smokers differs from that of nonsmokers and is shifted to the right according to the smoking level. This may have both a diagnostic and prognostic significance in different clinical settings.     

老年直肠癌患者预后的影响因素分析

[目的]探讨影响老年直肠癌患者预后的危险因素,为改善老年直肠癌患者预后提供参考依据。[方法]选择2007年1月-2012年1月我院收治的124例老年直肠癌患者作为研究对象,通过SPSS 17.0软件分析患者生存率及预后影响因素。[结果]124例患者1年、3年、5年生存率分别为91.13%、54.03%、23.39%,中位生存时间为41个月;Ⅰ期+Ⅱ期患者3年生存率最高,为85.71%,复发患者3年生存率最低,为11.54%;COX回归分析结果显示,TNM分期、远处转移、复发、分化程度对患者预后有显著影响(P<0.05)。[结论]TNM分期、远处转移、分化程度、复发是老年直肠癌患者独立危险因素,可作为患者预后重要评估指标。     

Factors affecting bone density in young adults.

A 14-y follow-up of 581 children who took part in a randomized controlled trial of the effect of a milk supplement on growth of children was conducted to investigate the supplement's effect on adult bone mineral content (BMC) and density (BMD). BMC and BMD of the nondominant forearm were measured by single-photon absorptiometry in 371 subjects (64%) aged 20-23 y, at a proximal site (shaft of radius and ulna) and at a distal site near the wrist. BMCs and BMDs tended to be higher in the intervention group (NS). Cross-sectionally, BMD was positively associated with body weight (P less than 0.01) in both sexes; inversely associated with alcohol consumption (P less than 0.05), and positively with manual occupation (NS) in men; positively associated with current intakes of calcium (P less than 0.05), vitamin D (P less than 0.01), and sports activity during adolescence (P less than 0.01), and inversely with parity (NS) in women. In multiple linear-regression analysis body weight and sports activity during adolescence were stronger determinants of female BMD than was diet.     

Factors affecting attitudes toward care of elderly mothers

OBJECTIVE: In this study, we aimed to examine the factors that affect people's attitudes toward parental care. Previous qualitative studies present several factors that affect the decision of adult children of whether to take care of elderly parents or send them to a nursing home when they become fragile and need daily help. In the present study, we included affection, filial obligation, sekentei (i.e., wanting to keep an appearance of taking care), and other factors presented in previous studies. METHODS: In May 2001, we mailed a questionnaire to females in their 30s who live in an agricultural area of K. City, Saitama Prefecture in Japan. We asked the respondents whether they would take care of their mothers or mothers-in-law, or send the mothers to a nursing home when the mothers need 24-hour care in the near future. RESULTS: Logistic regression analysis revealed that filial obligation and sekentei affected attitude toward care in the case of a mother while affection did in the case of a mother-in-law. DISCUSSION: These results suggest that women who do not have intimate feelings towards their mothers-in-law may choose not be a caregiver. On the other hand, women may take care of their mothers, whatever feelings they have because of the blood-relation. Also it may be that in such a small agricultural area, sekentei affects people's conduct, even if it is a private matter, such as caring an elderly mother.     

Factors affecting the uptake of vaccination by the elderly in Western society

ObjectiveTo present the results of a literature review on factors related to vaccine uptake by elderly persons.MethodsA systematic literature search was performed using Medline, Embase, and SciSearch to collect all publications available on factors related to vaccine uptake from 1966 until October 2012 for West European and North American societies. In total, 1001 articles were identified and 60 were included in the review.ResultsWe identified six main themes that influence the willingness to be vaccinated: 1) attitudes and beliefs regarding vaccination in general including positive and negative attitudes and beliefs; 2) perceived risk and severity including knowledge, perceived susceptibility and severity and personal experience; 3) vaccine characteristics including side-effects, effectiveness, content of the vaccine and knowledge; 4) advice and information including influence of the healthcare worker and relatives and the information source and format; 5) general health-related behavior including previous vaccinations, visiting GP or senior center and other preventive behaviors; and 6) accessibility and affordability including logistics, combinations of vaccines and costs.ConclusionThe most important factors related to vaccine uptake are people's attitudes and beliefs regarding vaccination (especially their negative attitudes), recommendations of healthcare workers, side effects and effectiveness of the vaccine, and perceived susceptibility.     

Factors affecting death at home in bedridden elderly people

To examine factors which affect death at home in bedridden elderly people, relatives of bedridden elderly people, in three areas of Japan, who had died, were interviewed, and demographic, medical, social and familial factors were compared between 136 persons who died at home and 132 persons who died in the hospital. 1) In all three geographical areas, significantly more subjects who died at home had physicians who made home visits than in those who died at hospital (p less than 0.01). 2) The mean age at death was significantly higher in the elderly people who died at home than in those who died in the hospital in all three areas (p less than 0.01). 3) The results of multiple logistic regression analysis indicated that physician's home visits and death age were significantly related independently to death at home. This relation was independent of confounding factors such as residential area, disease type, or use of social services.     

血清同型半胱氨酸、叶酸浓度水平与老年阿尔茨海默病发病的相关性研究

目的研究血清同型半胱氨酸(Hcy)、叶酸浓度水平与老年阿尔茨海默病(AD)发病的相关性,以期为临床防治提供指导。方法将2016年5月-2018年10月于本院接受诊治的92例老年阿尔茨海默病患者作为研究组,另选择同期于本院健康体检者80例为对照组。选择高效液相法对2组人员的血清Hcy表达水平进行测定,并应用化学发光法对血清叶酸水平进行检测;分析血清Hcy、叶酸与AD患者认知功能、生活质量的相关性。结果研究组患者的血清Hcy水平高于对照组,但血清叶酸水平、MMSE评分均低于对照组,差异有统计学意义(P<0.05);研究组患者的血清Hcy过高表达检出率、叶酸过低表达检出率均高于对照组,差异有统计学意义(P<0.05);AD过高Hcy组患者的血清叶酸水平显著低于AD正常Hcy组,差异有统计学意义(P<0.05);经Spearman相关性分析发现,血清叶酸和认知功能、生活质量显示为正相关(r=0.328、r=0.339,P<0.05),而血清Hcy和认知功能、生活质量显示为负相关(r=-0.517、r=-0.502,P<0.05)。结论血清同型半胱氨酸过高表达和老年阿尔茨海默病发病存在直接相关性,即高Hcy血症可能是引发AD的独立危险因素;而人体缺乏叶酸能导致血清Hcy表达升高,故认为叶酸的缺乏可能是引发AD的间接危险因素。     

Factors affecting the adoption of exercise behavior among sedentary older adults

This research examines factors affecting the adoption of regularexercise by sedentary older adults and describes changes infitness indicatiors among sedentary, community-living well elderlywho volunteered to take part in a 10-week free exercise program.High attenders could be differentiated from low attenders onthe basis of exercise expectations at baseline. Both high andlow attenders experienced reducation in systolic blood pressureand gains in flexibility, but only high attenders experiencedreducation in diastolic blood rpressure and weight and increasedcardiovascular endurance. Knowledge of the number of days andminutes one should exercise, commitment to exercise and benefitsexperienced from exercise explained 34% of the variance whenregressed on the Exercise Behavior Index.     

影响老年颅内动脉瘤患者手术预后的因素

目的 探讨影响老年颅内动脉瘤患者手术预后的因素.方法 回顾性分析30例手术治疗的老年颅内动脉瘤患者的临床资料.对可能的影响因素和手术结果进行单因素和多因素分析.结果 将患者按年龄(以70岁为界)、Hunt-Hess分级、动脉瘤部位(分为前循环和后循环)、动脉瘤大小(以直径1.5 cm为界)、是否合并高血压、手术时机(以72 h为界)分组后经单因素和多因素分析发现,患者Hunt-Hess分级、动脉瘤部位、手术时机与预后相关(P值分别为0.007、0.019、0.007),年龄、高血压、动脉瘤大小与预后无关(P值分别为0.502、0.697、0.500).结论 老年颅内动脉瘤患者的手术预后受多种因素影响,年龄不是颅内动脉瘤手术的禁忌证,宜早期手术.     

Factors affecting the frequency of health enhancing behaviors by the elderly.

The authors examined the frequency of health-enhancing behaviors practiced by the elderly living in community settings, with emphasis on the impact of disease and disability on the frequency of those practices. Data were collected through personal interviews with a probability sample of 667 respondents in a 4-county region of northeastern New York. Almost all respondents said they engaged in at least one health-enhancing practice on a regular basis. The most commonly reported behaviors involved dietary practices. Results of the analysis support the importance of differentiating among health-enhancing behaviors that are undertaken as primary levels of prevention, in contrast to those undertaken as secondary or tertiary levels of prevention.     

Factors affecting regional variations in hospitalization expenditures of elderly residents in Japan

Aim

The aim of this study was to examine the possible effects of healthcare resource factors, socioeconomic factors, and sociodemographic factors on variations in hospitalization expenditures of elderly patients in Japan at different levels of urbanization.

Subject and methods

A secondary analysis was conducted using data obtained from a regional health care cost report and the Portal Site of Official Statistics of Japan. The regional unit of analysis used was the secondary medical care area. We divided these areas into three groups based on their levels of urbanization (low, middle, and high urbanization), indicated by their respective population densities of inhabitable areas. Multiple linear regression models were used to analyze the candidate factors affecting per capita hospitalization expenditures of elderly residents.

Results

The significance and magnitude of associations were observed to vary according to different levels of urbanization. Our findings showed that medical resource factors and sociodemographic factors were more influential in areas of low urbanization, whereas the number of hospital beds and socioeconomic factors appeared more influential in high urbanization areas.

Conclusion

Policies designed to contain healthcare expenditures should take regional characteristics and levels of urbanization into account in order to support the development and implementation of region-specific improvements that ensure affordable healthcare for the elderly.     

Associations of different serum folate forms with indices of nonalcoholic fatty liver disease and advanced fibrosis

ObjectiveWe aim to examine the associations of different serum folate forms (total folate, 5-methyltetrahydrofolate [5-mTHF] and unmetabolized folic acid [UMFA]), with the prevalence of nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis.MethodsThis cross-sectional analysis was conducted in 6610 participants aged ≥ 18 years from the 2011–2018 National Health and Nutrition Examination Survey (NHANES) database. NAFLD was defined as a United States fatty liver index (USFLI) ≥ 30. Advanced fibrosis was defined as a Fibrosis-4 score (FIB-4) > 3.25, a NAFLD Fibrosis Score (NFS) > 0.676, and a Hepamet Fibrosis Score (HFS) ≥ 0.47, respectively.ResultsThe prevalence of NAFLD was 34.5%. Overall, serum total folate and 5-mTHF were inversely associated with the prevalence of NAFLD (both P for trend across quartiles <0.001). A similar trend was found for advanced fibrosis based on NFS and HFS (both P for trend across quartiles <0.05). However, a higher concentration of UMFA was significantly related to a higher prevalence of NAFLD (P for trend across quartiles =0.004). A similar relation was found for advanced fibrosis based on NFS (P for trend across quartiles =0.024).ConclusionsHigher concentrations of serum total folate and 5-mTHF were associated with a lower prevalence of NAFLD and advanced fibrosis, while a higher concentration of UMFA was related to a higher prevalence of NAFLD.     

Factors affecting commencement and cessation of betel quid chewing behaviour in Malaysian adults

Background  

Betel quid chewing is a common habit widely practiced in Southern Asian populations. However, variations are seen in the content of a betel quid across the different countries. Factors associated with commencement and cessation of this habit has been numerously studied. Unfortunately, data on Malaysian population is non-existent. This study aims to determine the factors associated with the inception and also cessation of betel quid chewing behaviour among Malaysian adults.     

Chronic cigarette smoking is associated with diminished folate status, altered folate form distribution, and increased genetic damage in the buccal mucosa of healthy adults

BACKGROUND: Smoking causes genetic damage in buccal cells and increases the risk of oral cancer. Because folate is instrumental in DNA synthesis and repair, it is a determinant of genetic stability and therefore might attenuate the genotoxic effects of smoking. OBJECTIVE: Our aim was to compare the presence of folate metabolites and select indicators of genetic damage in the mouths of chronic smokers and nonsmokers. DESIGN: Dietary, biochemical, and molecular correlates of folate status were measured in healthy smoker (n = 35) and nonsmoker (n = 21) groups of comparable age, sex, and body mass indexes. RESULTS: After correction for dietary intake, the smokers displayed lower plasma, erythrocyte, and buccal mucosal cell (BMC) folate (20%, 32%, and 50% lower, respectively; P < 0.05) and lower plasma vitamin B-12 and pyridoxal 5-phosphate (P < 0.05) than did nonsmokers. Folate in the BMCs of smokers comprised significantly greater proportions of pteroylmonoglutamate, formyltetrahydrofolate, and 5,10-methenyltetrahyrofolate than did folate in the BMCs of nonsmokers. Although the degree of genomic methylation and uracil incorporation in the buccal cells of the 2 groups were not significantly different, the BMC micronucleus index, a cytologic indicator of genetic damage, in the smokers was 2-fold that of the nonsmokers (9.57 compared with 4.44 micronuclei/1000 cells; P < 0.0001). Neither systemic nor oral folate status was an independent predictor of micronuclei. CONCLUSIONS: Chronic smoking is associated with a lower systemic status of several B vitamins, reduced oral folate, and changes in folate form distribution in the mouth. However, the cytologic damage that is evident in the mouths of smokers does not correlate with oral folate status.