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Anthropometric measurements from a cross-sectional survey of community dwelling subjects aged over 90 years of age
Abstract
To measure anthropometric variables of weight, height, body mass index (BMI) and triceps skin fold thickness (TSF) and produce local percentiles for > 90 y old subjects. To assess prevalence of conventional measures of under nutrition (BMI at or below 18.5 kg/m2) or over nutrition (BMI values > 30 kg/m2) in this age group.
Community cross-sectional study.
Belfast, Northern Ireland.
238 subjects > 90 y of age who were apparently well, mentally competent and recruited from all areas of Belfast.
Mean weight was significantly heavier in male 63.9 (s.d. 9.1) kg compared to female subjects 54.4 (s.d. 11.9) kg (P < 0.0001). Men were significantly taller than women with mean height of 162 (s.d. 5.9) cm compared to 150 (s.d. 6.7) cm in women (P < 0.0001). Increasing age was associated with a fall in weight (P = 0.06 female; P = 0.09 male) and in height for women (P = 0.04). Mean BMI was 24.3 (s.d. 3.0) kg/m2 for men and 24.6 (s.d. 5.4) kg/m2 for women with no sex or age differential. 10% of females had values for BMI < 18.5 kg/m2. 11% of female and 2% of male subjects had BMI values > 30 kg/m2. TSF values were 11.7 (s.d. 4.1) mm in male and 12.3 (s.d. 4.5) mm in female subjects with no age or sex-related difference.
Local percentiles for anthropometric variables are presented for subjects > 90 y. Both BMI and TSF show no sex or age-related difference. Ten percent of females have BMI values consistent with either under nutrition or over nutrition.
... Although a number of other authors have attempted to produce reference data for the elderly (McEvoy & James, 1982;Frisancho, 1984;Chumlea et al. 1986;Latin et al. 1987;Falciglia et al. 1988;Lehmann et al. 1991), the measurements used were collected approximately 20 years ago and are probably not appropriate to define the current nutritional status of the Irish population. The recently published Northern Irish data of Rea et al. (1997) apply only to those aged over 90 years. In addition, a recent study estimating the prevalence of undernutrition on admission to hospital in Dublin, Republic of Ireland, highlighted that the anthropometric reference data currently available in the UK and Republic of Ireland are inadequate to accurately determine nutritional status (Corish et al. 2000). ...
... Reported height in the elderly is thought to reflect height at a younger age and has been shown to result in over-estimation of height (Haboubi et al. 1990). Standing height is still the most widely collected and quoted statistic for height measurement in the elderly (Van Staveren et al. 1995;World Health Organization, 1995;Rea et al. 1997;Finch et al. 1998) and was used and measured by standard methods in the present study. The mean height recorded in the present survey was identical to that of free-living participants in the British National Diet and Nutrition Survey of people aged 65 years and over (Finch et al. 1998) (1·70 m in both Irish and British males; 1·56 m in both Irish and British females). ...
... The Northern Irish study of elderly aged over 90 years reported that no male subjects, but 10 % of females had a BMI below 18·5 kg/m 2 . Undernutrition in the elderly is recognised as a risk factor for medical, mental and functional decline, and needs to be recognised and treated (Rea et al. 1997;Morley, 1998) but has never been adequately defined. In light of the low prevalence of a BMI below 20 kg/m 2 , particularly in males, it may be more appropriate to replace a threshold BMI value of 20 kg/m 2 with an assessment of the extent and rate of weight change when determining which elderly are at nutritional risk. ...
Anthropometric screening has been recommended for the detection of undernutrition as it is simple, inexpensive and non-invasive. However, a recent study estimating the prevalence of undernutrition on admission to hospital in Dublin, Republic of Ireland, highlighted that the anthropometric reference data currently available in the UK and Republic of Ireland are inadequate to accurately determine nutritional status. In order to provide current anthropometric data, we carried out a cross-sectional study of 874 free-living, apparently healthy Irish-born elderly individuals aged over 65 years. Height, weight, triceps skinfold thickness, mid-arm and calf circumference were measured, values for BMI, mid-arm muscle circumference and arm muscle area were calculated and smoothed centile data derived for each variable. One-third of these elderly individuals had a BMI between 20-25 kg/m2, approximately two-thirds (68.5 % of males and 61 % of females) were classified as overweight or obese, almost one-fifth having a BMI over 30 kg/m2 (17 % of men and 20 % of women). Very few were underweight, only 3 % having a BMI below 20 kg/m2. Height, weight, BMI and muscle reserves decreased with increasing age. The reduction in muscle size was associated with lower handgrip strength. Fat reserves declined with age in females only. Just over half of elderly Irish women reported participating in active leisure of 20 min duration four or more times/week, although 13 % reported having no involvement in active leisure. These data for the Irish elderly extend the data generated from a recent countrywide survey of Irish adults aged 18-64 years, thus providing suitable reference standards for nutritional assessment of elderly Irish individuals.
... The results of our study provided useful information, even if preliminary, on the anthropometric characteristics of elderly people living in urban Bangladesh. The pattern of gender differences in anthropometric characteristics of the elderly, as observed in this study, was similar to patterns reported from the other developed (de Groot et al, 1996; Lehmann and Bassey, 1996; Rea et al, 1997 ) and developing countries (Strickland and Ulijaszek, 1993; Chilima and Ismail, 1998; Suzana et al, 2002). In our study, most of the measurements indicated increasingly poorer nutritional status with increasing age. ...
... Kyphosis (abnormal spinal curvature) also causes reduced height because of osteoporotic compression fractures , degenerative disease, or slippage of one vertebra forward on another (Chumlea and Baumgartner, 1989; Shatenstein et al, 2001). Moreover, severe osteoporosis due to hormonal disorders, vitamin D deficiency, or congenital phosphatemia that causes bowing of the leg bones may further add to the problem (Haboubi et al, 1990; Rea et al, 1997; Jitapunkul and Benchajarconwong, 1998). Most of the declines in weight are reported to be due to lower water content with advancing age (Rico et al, 1993). ...
... However, that was not observed among healthy, active Chinese elderly in Hong Kong, probably because of their higher body fat and protein stores, and less energy expenditure (Woo et al, 1998Woo et al, , 2001). That women are significantly more overweight with increasing age more often than men has also been reported (Rea et al, 1997). Probably, this small fraction of elderly women is genetically more capable of retaining nutrients and/or posses better metabolic efficiency (Woo et al, 1993; Rea et al, 1997). ...
There is a lack of evidence-based information to assist health policy makers in preparing for appropriate health, nutrition, and social-support guidelines for the elderly in Bangladesh. We examined selected indicators of the nutritional status of elderly people attending the Dhaka Hospital of ICDDR,B, Dhaka, Bangladesh. The population constituted of 1,196 individuals (718 men and 478 women), aged 60 to 106 years, who attended the hospital between 1 January 1993 and 31 December 2003. Patients were recruited from a hospital-based systematic sampling, regardless of age and gender, that presented to the facility. Men were heavier, and taller than women were (p < 0.001 for both comparisons). Using MUAC cut-off of < 22 cm for females and < 23 cm for males, at least 50% of the elderly were peripherally wasted (malnourished). Among all the study population, 40% had a BMI within the optimal range (18.5-24.9 kg/m(2)). Using the chronic energy deficiency (CED) classification, at least half of elderly (> or= 60 year) women were chronic energy deficient (BMI < 18.5). A significantly higher proportion of elderly women (7%) compared to men (2%) were overweight (BMI > or = 25, p < 0.001). Among the elderly ( > or = 60 year), males and females from a higher socioeconomic status (SES) had significantly higher BMI (p < 0.001, p = 0.001, respectively) and MUAC values (p < 0.001, p < 0.001, respectively) than their less well-off SES counterparts. We consider that, although our data were not valid for assessing the country situation, they are still useful as baseline information for longitudinal studies and for highlighting the need for studies in other geographical locations and in other population groups.
... Ethical permission was given by The Queen's University of Belfast Ethics Committee. Measurements A trained research nurse (A.M.) saw all the subjects at home on at least two visits, took medical history, anthropometric measurements and blood samples, as previously described (Rea et al. 1997). Height measurements were not included for subjects recruited early into the study, nor for subjects with severe kyphosis, where it was impossible for the research nurse to make a convenient or reliable measurement, thus BMI was not available for the total group. ...
... Debate continues as to which anthropometric markers track best with cardiovascular risk and/or outcomes and whether they are applicable in very elderly people (Molarius et al. 2000), where changes in body composition (Harris et al. 2000 ) and osteoporosis make interpretation of anthropometry more challenging (Seidell and Visscher 2000). BMI is a less good measure of body composition in older women, where osteoporosis significantly reduces height and increases BMI measures inappropriately, especially in the 'oldest old' (Rea et al. 1997). In the BELFAST study, it was noteworthy that, although increases in weight significantly associated across the tertiles of blood pressure, the trend for BMI did not achieve significance. ...
Hypertension is a key risk factor for stroke, cardiovascular disease and dementia. Although the link between weight, sodium
and hypertension is established in younger people, little is known about their inter-relationship in people beyond 80years
of age. Associations between blood pressure, anthropometric indices and sodium were investigated in 495 apparently healthy,
community-living participants (age 90, SD4.8; range 80–106), from the cross-sectional Belfast Elderly Longitudinal Free-living
Aging STudy (BELFAST) study. In age-sex-adjusted logistic regression models, blood pressure ≥140/90mmHg significantly associated
with body mass index (BMI) [odds ratio (OR) = 1.28/ kg/m2], with weight (OR = 1.22/kg) approaching significance (P = 0.07). In further age-sex-adjusted models, blood pressure above the 120/80mmHg normotensive reference value significantly
associated with BMI (OR = 1.44/kg/m2), weight (OR = 1.36/kg), skin-fold-thickness (OR = 1.33/mm) and serum sodium (OR = 1.37mmol/l). In BELFAST participants
over 80years old, blood pressure ≥140/90mmHg is associated with BMI, in apparently similar ways to younger groups.
... Subjects were a randomly recruited but consecutive group of 38 elderly subjects, enlisted as part of a longitudinal study of ageing—Belfast Elderly Longitudinal Free-Living Aging Study (BELFAST); (Rea et al. 1997Rea et al. , 2009). This study was parallel to but part of the ongoing main BELFAST study. ...
... The numbers of older subjects involved in this study could have reduced the overall statistical power. Recruitment was slow because subjects were elderly with a mean age of 85 years, were community living and relatively few could meet both the 'elite' criteria of the BELFAST (Rea et al. 1997Rea et al. , 2009) and the exacting demands of the Senieur protocol for immune-gerontological studies (Ligthart et al. 1984). The subject group enrolled from within the ongoing BELFAST study was also subject to time constraints imposed by the completion of a master's research project (Armstrong et al. 2001). ...
Hypertension, a key risk factor for stroke, cardiovascular disease and dementia, is associated with chronic vascular inflammation, and although poorly understood, putative mechanisms include pro-inflammatory responses induced by mechanical stretching, with cytokine release and associated up-regulated expression of adhesion molecules. Because blood pressure increases with age, we measured baseline and tumour necrosis alpha (TNF-α)-stimulated CD11b/CD18 adhesion molecule expression on leucocytes to assess any association between the two. In 38 subjects (mean age 85 years), consecutively enrolled from Belfast Elderly Longitudinal Free-Living Aging Study (BELFAST), baseline and TNF-α-stimulated CD11b/CD18 expression on separated monocytes and neutrophils increased with systolic blood pressure >120 mmHg (p = 0.05) and for lymphocytes, with diastolic blood pressure >80 mmHg (p < 0.05).These findings show increased potential stickiness of intravascular cells with increasing blood pressure which is accentuated by TNF-α, and suggest mechanistic reasons why better hypertension control is important.
... cm compared to 150(6.7) cm with P <0.0001 [14]. Kevai, K and Tanuj, K pointed out some errors researchers make pertaining the use of anthropometry in identification of individuals [6]. ...
This research is unlike many others in that the concept of the nested design is applied in the medical science as against the trend in the agricultural and social sciences. In this research, we consider a three-stage (2 × 5 × 2) nested design with the factors being Hospital Centre, Days of the week and Ailments such that the days of the week are nested within the centres and the ailments are nested within the days. The replications represent the weight of twelve (12) patients selected randomly for each day in each centre which brings the total number of replications to 240. This work being largely an illustration uses simulated data. Analyses of variance (ANOVA) for the sum of squares across all factors and within replicates were investigated for significance. Results obtained reveal that the days and ailments are significant factors in the experiment at 5% significant level.
... Consequently, different anthropometric indicators are used at different life stages to evaluate nutritional status. Some international studies in the older than 60 years old of the population have investigated body composition changes (Seidell and Visscher, 2000;de Groot et al., 1991;Rea et al., 1997;. WHO has assembled international anthropometric data for health assessment, nutrition, and well-being emphasizing the significance of phenotypic impact of aging, senility, and associated diseases. ...
Anthropometry (derived from the Greek Anthropos: human, and metron: measure) refers to the systematic collection, and measurement of the physical characteristics of the human body, primarily body weight, body size, and shape. Anthropometric values are closely related to genetic factors, environmental characteristics, social, and cultural conditions, lifestyle, functional status, and health. Anthropometric measurements can be used to assess risk of malnutrition, obesity, muscle wasting, increased fat mass, and maldistribution of adipose tissue. Potential modifiable factors include circumferences, skinfolds, and body weight. While are height, and the bone diameters are non-modifiable. Kinanthropometry is the study of size, shape, proportionality, composition, biological maturation, and body function, in order to understand the process of growth, exercise, sports performance, and nutrition. Aging of the population, which is associated with increased risk of chronic disease, and disability, is one of the most important demographic changes facing many countries. Anthropometric indicators are simple, portable, non-invasive, inexpensive, and easily applied measurements that can be readily applied in geriatric populations to guide preventative measures, and medical interventions in older adults.
... Body composition changes among individuals aged more the 60 years have been previously studied. [8][9][10][11] In ideal conditions, body mass increases during adulthood and decreases progressively with old age at a rate of approximately 1 kg per decade. The mean weight and height are both greater in men than women and both gradually decrease as age advances in the two sexes. ...
Background: The study of the interrelations between body mass index (BMI) and body composition measures is of much interest in health sciences.
... Anthropometric measures were stated in almost every physiological study. In addition, comprehensive European anthropometric studies [35][36][37][38][39][40][41][42][43][44][45][46] were used, and coverage was dense for the age range of 30-100 years. ...
Background:
Because of the vulnerability and frailty of elderly adults, clinical drug development has traditionally been biased towards young and middle-aged adults. Recent efforts have begun to incorporate data from paediatric investigations. Nevertheless, the elderly often remain underrepresented in clinical trials, even though persons aged 65 years and older receive the majority of drug prescriptions. Consequently, a knowledge gap exists with regard to pharmacokinetic (PK) and pharmacodynamic (PD) responses in elderly subjects, leaving the safety and efficacy of medicines for this population unclear.
Objectives:
The goal of this study was to extend a physiologically based pharmacokinetic (PBPK) model for adults to encompass the full course of healthy aging through to the age of 100 years, to support dose selection and improve pharmacotherapy for the elderly age group.
Methods:
For parameterization of the PBPK model for healthy aging individuals, the literature was scanned for anthropometric and physiological data, which were consolidated and incorporated into the PBPK software PK-Sim(®). Age-related changes that occur from 65 to 100 years of age were the main focus of this work. For a sound and continuous description of an aging human, data on anatomical and physiological changes ranging from early adulthood to old age were included. The capability of the PBPK approach to predict distribution and elimination of drugs was verified using the test compounds morphine and furosemide, administered intravenously. Both are cleared by a single elimination pathway. PK parameters for the two compounds in younger adults and elderly individuals were obtained from the literature. Matching virtual populations-with regard to age, sex, anthropometric measures and dosage-were generated. Profiles of plasma drug concentrations over time, volume of distribution at steady state (V ss) values and elimination half-life (t ½) values from the literature were compared with those predicted by PBPK simulations for both younger adults and the elderly.
Results:
For most organs, the age-dependent information gathered in the extensive literature analysis was dense. In contrast, with respect to blood flow, the literature study produced only sparse data for several tissues, and in these cases, linear regression was required to capture the entire elderly age range. On the basis of age-informed physiology, the predicted PK profiles described age-associated trends well. The root mean squared prediction error for the prediction of plasma concentrations of furosemide and morphine in the elderly were improved by 32 and 49 %, respectively, by use of age-informed physiology. The majority of the individual V ss and t ½ values for the two model compounds, furosemide and morphine, were well predicted in the elderly population, except for long furosemide half-lifes.
Conclusion:
The results of this study support the feasibility of using a knowledge-driven PBPK aging model that includes the elderly to predict PK alterations throughout the entire course of aging, and thus to optimize drug therapy in elderly individuals. These results indicate that pharmacotherapy and safety-related control of geriatric drug therapy regimens may be greatly facilitated by the information gained from PBPK predictions.
... The pattern of sex differences in anthropometric characteristics of the elderly, as observed in this study, was similar to patterns reported from the other developed [29,30] and developing countries [31,32,33,34]. ...
Body composition is a good indicator of an individual's health and physical status. In addition to total body fat, fat distribution is a major risk factor for cardio-vascular diseases and insulin resistance/diabetes in elderly. There are a limited number of studies focused on the body composition of elderly populations in Turkey. The primary objective of this study is to evaluate body composition in the Turkish elderly living in nursing homes. The sample included a total of 164 adults (91 females and 73 males), aged 65 years and over, living in Ankara nursing homes. According to the standard anthropometric protocols weight, height, skinfold thicknesses, and arm circumference were taken, and the body mass index (BMI), fat mass, fat free mass and arm fat area were calculated. The study results showed that males were significantly heavier and taller, whereas BMI were higher in females. The comparison of arm fat area between sexes showed that females have significantly (p<0.001) greater values. Total body fat (kg) was higher in females and decreases with age for both sexes, where this decline is greater in elderly females. In conclusion, the body composition of elderly can provide information on the general health status, and support clinicians to understand more in their treatment progress.
... Elderly and very elderly subjects enlisted into the Belfast Elderly Longitudinal Free-living Ageing STudy (BELFAST) study gave written consent, were apparently well, lived independently in the community, were mentally competent [86] and met the criteria for inclusion in immuno-gerontological studies using the Senieur protocol [27,87]. Elderly subjects had a range of anthropometric measurements together with blood sampling carried out by a research nurse who visited at home as previously described [88,89]. Not all subjects provided adequate sample material for DNA separation, NK cell phenotyping and the full range of cytokines analyses. ...
Natural Killer Cells (NK) play an important role in detection and elimination of virus-infected, damaged or cancer cells. NK cell function is guided by expression of Killer Immunoglobulin-like Receptors (KIRs) and contributed to by the cytokine milieu. KIR molecules are grouped on NK cells into stimulatory and inhibitory KIR haplotypes A and B, through which NKs sense and tolerate HLA self-antigens or up-regulate the NK-cytotoxic response to cells with altered HLA self-antigens, damaged by viruses or tumours. We have previously described increased numbers of NK and NK-related subsets in association with sIL-2R cytokine serum levels in BELFAST octo/nonagenarians. We hypothesised that changes in KIR A and B haplotype gene frequencies could explain the increased cytokine profiles and NK compartments previously described in Belfast Elderly Longitudinal Free-living Aging STudy (BELFAST) octo/nonagenarians, who show evidence of ageing well.
In the BELFAST study, 24% of octo/nonagenarians carried the KIR A haplotype and 76% KIR B haplotype with no differences for KIR A haplogroup frequency between male or female subjects (23% v 24%; p=0.88) or for KIR B haplogroup (77% v 76%; p=0.99). Octo/nonagenarian KIR A haplotype carriers showed increased NK numbers and percentage compared to Group B KIR subjects (p=0.003; p=0.016 respectively). There were no KIR A/ B haplogroup-associated changes for related CD57+CD8 (high or low) subsets. Using logistic regression, KIR B carriers were predicted to have higher IL-12 cytokine levels compared to KIR A carriers by about 3% (OR 1.03, confidence limits CI 0.99--1.09; p=0.027) and 14% higher levels for TGF-beta (active), a cytokine with an anti-inflammatory role, (OR 1.14, confidence limits CI 0.99--1.09; p=0.002).
In this observational study, BELFAST octo/nonagenarians carrying KIR A haplotype showed higher NK cell numbers and percentage compared to KIR B carriers. Conversely, KIR B haplotype carriers, with genes encoding for activating KIRs, showed a tendency for higher serum pro-inflammatory cytokines compared to KIR A carriers. While the findings in this study should be considered exploratory they may serve to stimulate debate about the immune signatures of those who appear to age slowly and who represent a model for good quality survivor-hood.
... The reference data in current use in the UK and Republic of Ireland were derived from measurements made in the early 1970s of healthy Caucasian Americans (Bishop et al. 1981;Frisancho, 1981) while reference data derived from subjects in South Wales in the UK, published in 1984, are frequently used for de®ning the nutritional status of those aged 65 years or more (Burr & Phillips, 1984). Considerable geographical variation in anthropometric variables has been observed (Bishop et al. 1981;Frisancho, 1981;Burr & Phillips, 1984;Delarue et al. 1994;Launer & Harris, 1996;Bannerman et al. 1997;Rea et al. 1997). Whereas for survey purposes, the use of standard data allow the rates of obesity and underweight to be estimated in different areas of the world and for secular changes to be monitored, for clinical purposes, reference to local, healthy population data may be more appropriate. ...
Protein±energy undernutrition, or the possibility of its development, has been documented to occur frequently in patients on admission to hospital. Deterioration in nutritional status is known to occur in hospital. In a prospective study of 594 sequential hospital admissions, we aimed to assess the prevalence of undernutrition among patients on admission to two acute teaching hospitals in Dublin, Republic of Ireland using the widely-accepted anthropometric criteria applied in a large study from Dundee, Scotland, UK (McWhirter & Pennington, 1994) and to determine changes in nutritional status in hospital. The mean prevalence of undernutrition (11 %) was considerably lower than was reported from Dundee (40 %). Unintentional weight loss before admission and functional impairment on admission occurred to a similar extent in both centres. Weight loss in hospital occurred in the same proportion of patients, but less frequently among those undernourished on admission to hospital, in Dublin compared with Dundee. The patients found to be undernourished on admission in this study had a mortality rate in hospital (6×5 %) over three times that of the adequately nourished group (2 %). The magnitude of the difference in prevalence of undernutrition between the two centres cannot be explained by ethnicity, case-mix or age distribution. With the secular increase in BMI in the population, the thresholds for classifying patients as undernourished or at risk of nutritional deterioration may need to be reviewed. For clinical use, recent weight loss and functional status may be more appropriate variables to use in the evaluation of nutritional status on admission to hospital.
... Longitudinal studies are required to determine the magnitude of changes in anthropometric measures with ageing, but cross-sectional data have often been used, even though they might be affected by secular trend or cohort effect. Longitudinal and cross-sectional studies have, however, reported similar results on the effect of ageing on anthropometric and nutritional characteristics (Rea et al. 1997;Sorkin et al. 1999). ...
In clinical practice and epidemiological surveys, anthropometric measurements represent an important component of nutritional assessment in the elderly. The anthropometric standards derived from adult populations may not be appropriate for the elderly because of body composition changes occurring during ageing. Specific anthropometric reference data for the elderly are necessary. In the present study we investigated anthropometric characteristics and their relationship to gender and age in a cross-sectional sample of 3356 subjects, randomly selected from an elderly Italian population. In both sexes, weight and height significantly decreased with age while knee height did not. The BMI was significantly higher in women than in men (27·6 SD 5·7 V. 26·4 sd 3·7; P<0·001) and it was lower in the oldest than in the youngest subjects (P<0·05) of both genders. The 75th year of age was a turning point for BMI as for other anthropometric measurements. According to BMI values, the prevalence of malnutrition was lower than 5 % in both genders, whereas obesity was shown to have a higher prevalence in women than in men (28 % v. 16 %; P<0·001). Waist circumference and waist : hip ratio values were higher for the youngest men than for the oldest men (P<0·05), whereas in women the waist : hip ratio values were higher in the oldest women, suggesting that visceral redistribution in old age predominantly affects females. In conclusion, in the elderly the oldest subjects showed a thinner body frame than the youngest of both genders, and there was a more marked fat redistribution in women.
... Although various methods to estimate height in the elderly have been developed, their validity remains uncertain. Standing height (stature) is still the most widely used statistic for height measurement in the elderly (Van Staveren et al., 1995;Rea et al., 1997;Finch et al., 1998) and was measured by a standard method in the present study. Table 5 shows that the subjects in the older groups had lower mean statures. ...
Anthropometric data of the elderly have become an immediate need for ergonomic design of health care and living products even in a developing country like China. The first aim of this survey was to collect anthropometric data of the Chinese elderly (aged over 65) living in the Beijing area. 58 females (age range 65.0-80.7, mean 71.2, SD 4.1) and 50 males (age range 65.2-85.1, mean 71.5, SID 4.4) took part in the survey. A total of 47 anthropometric dimensions and three items of functional strength were measured. Mean values, standard deviations, coefficients of variation, and percentiles for each parameter were estimated. It was found that in most dimensions there were no significant differences between the age groups of 65-69 and 70-74 or between the age groups of 70-74 and 75+. Male and female elderly had no significant differences in the body dimensions around the hip area. Comparison between Chinese (Beijing) and Japanese elderly shows that Chinese (Beijing) elderly are larger in the dimensions of the body trunk, and Japanese elderly are larger in the dimensions of the head and extremities. The conclusions are based on a limited number of subjects in the Beijing area, and the in-depth reasons for the above findings remain a subject for further study. Relevance to industry The continuous growth of the number of aged people has created a big market of health care and living products for the elderly. Anthropometric data are essential to the ergonomic design of these products. However, available anthropometric data for aged people are quite limited. This study fills part of this gap by supplying anthropometric data of the Chinese elderly. (c) 2007 Elsevier B.V. All rights reserved.
... Female in-patients are at a markedly increased (by more than 3-fold) risk for undernutrition when compared to men (Castel et al., 2006). These findings are in contrast with previous publications reporting similar prevalence rates in elderly men and women (Perissinotto et al., 2002;Rea et al., 1997) or higher rates in men (Ritchie et al., 1997). ...
Nutrition exerts a life-long impact on human health, and the interaction between nutrition and health has been known for centuries. The recent literature has suggested that nutrition could differently influence the health of male and female individuals. Until the last decade of the 20th century, research on women has been neglected, and the results obtained in men have been directly translated to women in both the medicine and nutrition fields. Consequently, most modern guidelines are based on studies predominantly conducted on men. However, there are many sex-gender differences that are the result of multifactorial inputs, including gene repertoires, sex steroid hormones, and environmental factors (e.g., food components). The effects of these different inputs in male and female physiology will be different in different periods of ontogenetic development as well as during pregnancy and the ovarian cycle in females, which are also age dependent. As a result, different strategies have evolved to maintain male and female body homeostasis, which, in turn, implies that there are important differences in the bioavailability, metabolism, distribution, and elimination of foods and beverages in males and females. This article will review some of these differences underlying the impact of food components on the risk of developing diseases from a sex-gender perspective.
... Subjects willing to enrol, were community-living, mobile, and mentally competent (> 26/30), [3] and gave written Ethical Consent, Queens University Belfast. Briefly, subjects gave blood samples for DNA and other laboratory variables, responded to nutrition, life style and medical history questionnaires and had Blood Pressure and anthropometric measurements taken [2,4]. ...
Nonagenarians are the fastest growing sector of populations across Western European and the developed world. They are some of the oldest members of our societies and survivors of their generation and may help us understand how to age not only longer, but better.
The Belfast Longevity Group enlisted the help of 500 community-living, mobile, mentally competent, 'elite' nonagenarians, as part of an ongoing study of ageing. We assessed some immunological, cardiovascular, nutritional and genetic factors and some aspects of their interaction in this group of 'oldest old'.
Here we present some of the evidence related to genetic and nutritional factors which seem to be important for good quality ageing in nonagenarians from the Belfast Elderly Longitudinal Free-living Ageing STudy (BELFAST).
... Mean body mass index (BMI) was 25.7 with females having non-signficantly higher BMI compared to males; higher BMI in aged females being related to reduction in height due to osteoporosis viz a viz weight in the BMI calculation. Values for weight and height were lower than those for BELFAST nonagenarians [13]. ...
Centenarians are reservoirs of genetic and environmental information to successful ageing and local centenarian groups may help us to understand some of these secrets. The current centenarian cohort in Belfast survived the 1970s epidemic of death from coronary heart disease in Northern Ireland, where cardiovascular mortality was almost highest in the world. These centenarians provided an opportunity to assess biological and genetic factors important in cardiovascular risk and ageing. Methods: Thirty-five (27 female, 8 male) centenarians, participants of the Belfast Elderly Longitudinal Free-living Ageing STudy (BELFAST), were community-living and of good cognition at enrollment.
Centenarians showed median Body Mass Index (BMI) at 25.7, systolic blood pressure 140 mmHg and diastolic blood pressure 90 mmHg respectively, and fasting glucose of 5.54 mmol/l with no sex-related difference. Lipoproteins showed median cholesterol 5.3, High Density Lipoprotein (HDL) 1.10 and Low Density Lipoprotein (LDL) 3.47 micromol/l respectively. Centenarian smokers showed no different blood pressure or lipid measurements compared with non-smokers. Malondialdehyde, a measure of lipid peroxidation, was low at 1.19, and measures of antioxidant status showed variable results. Male centenarians did not carry any of the vascular risk genotypes studied-Apolipoprotein E (ApoE), Angiotensin-Converting Enzyme (ACE) and Methylenetetrafolatedehydrogenase reductase (MTFHR), though this was not true for female centenarians.
This small local study shows, apart from age, that Belfast centenarians carry a reasonably optimized risk profile with respect to cardiovascular disease. There is also some evidence suggesting that vascular risk factors and genotypes may be tolerated differently between the male and female centenarians. Maintaining an optimized cardiovascular risk profile seems likely to improve the chance of becoming a centenarian, especially for males.
... About 30% of circulating IL-6 is said to be derived from adipose tissue , and so body adiposity may modulate the association between IL-6 genetic variability and the risk for disease, such as diabetes, with the genetic effect being more evident in leaner subjects (Illig et al., 2004). Across the metaanalysis studies, we have no consistent documentation about weight or body mass index to relate measures of adiposity with IL-6 levels, though women, throughout life, do have a lower lean and higher fat mass compared to men (Zamboni et al., 2003), though not apparently in very old age (Rea et al., 1997). On the other hand IL-6 values are influenced by life-long antigenic load (Moutsopoulos and Madianos, 2006) and this is likely to have both local and geographical determinants. ...
Several studies have assessed changes in frequency of -174 interleukin (IL)-6 single nucleotide polymorphism (SNP) with age. If IL-6 tracks with disability and age-related diseases, then there should be reduction, in the oldest old, of the frequency of homozygous GG subjects, who produce higher IL-6 levels. However, discordant results have been obtained. To explore the relationship between this polymorphism and longevity, we analyzed individual data on long-living subjects and controls from eight case-control studies conducted in Europeans, using meta-analysis. There was no significant difference in the IL-6 genotype between the oldest old and controls (Odds Ratio [OR]=0.96; 95% C.I.: 0.77-1.20; p=0.71), but there was significant between-study heterogeneity (I2=55.5%). In a subgroup analyses when male centenarians from the three Italian studies were included, the frequency of the IL-6 -174 GG genotype was significantly lower than the other genotypes (OR=0.49; 95% C.I.: 0.31-0.80; p=0.004), with no evidence of heterogeneity (I2=0%). Our data supports a negative association between the GG genotype of IL-6 SNP and longevity in Italian centenarians, with males who carry the genotype being two times less likely to reach extreme old age compared with subjects carrying CC or CG genotypes. These findings were not replicated in other European groups suggesting a possible interaction between genetics, sex and environment in reaching longevity.
... It is important to assess the nutritional status of older people because of its role in ensuring a better quality of life and its association with functional ability (Galanos et al, 1994; Manandhar et al, 1997a). The accurate nutritional assessment of older people is hindered by age related alterations in body comparison (Mitchell & Lipschitz, 1982) and this is further compounded by the lack of suitable standards (Jelliffe & Jelliffe, 1989 ). Anthropometric measurements provide an indirect assessment of body composition (Whitehead & Finucane, 1997) and are easy and economical to carry out (Whitehead & Finucane, 1997; Rea et al, 1997) since minimal equipment is required. They are valuable in predicting mortality (Friedman et al, 1985), in determining changes in nutritional status over time and also in monitoring the effectiveness of nutritional interventions (Chumlea, 1991). ...
Older people are becoming an increasingly important proportion of the populations of developing countries, yet little information exists on their nutritional status or social conditions.
To assess the nutritional status of older people in rural Malawi.
Cross-sectional study.
Lilongwe, Malawi.
A total of 296 respondents (97 males and 199 females) aged from 55-94 y were studied.
Selected anthropometric measurements were taken by trained personnel. Among kyphotic respondents, height was estimated from armspan using regression equations derived from the non-kyphotic respondents. Body mass index (BMI) and corrected arm muscle area (CAMA) were computed using standard equations.
The mean age of the respondents was 63.3 y and 68.9 y among females and males, respectively. Kyphosis was seen in 17.3% of all subjects and oedema in 4.1%. Nearly 90% of the subjects were involved in agricultural activities. Men were heavier and taller than women but women had larger MUACs and triceps skinfolds than males. The mean BMIs in kg/m2 (+/- s.d.) were as follows: 19.7 (2.6) for men and 20.3 (3.0) for women. The prevalence of undernutrition, defined as BMI< 18.5 kg/m2, was 36.1% among males and 27.0% among females. In contrast, using MUAC (cut-offs 23 cm for males and 22 cm for females), 20.4% of the men and only 10% of the women were classified as malnourished.
The study demonstrated for the first time that undernutrition is a significant problem among older people in rural Malawi. It highlights the need to incorporate older people into existing and future nutrition and health programmes.
... General Practitioners in the Greater Belfast area (500,000 inhabitants) were invited to allow access to names of elderly subjects who were in good health for their age and who lived in the community (Belfast Elderly Longitudinal Free-living Aging STudy; BELFAST) (Rea et al., 1997a). One hundred and seventeen older subjects were randomly enlisted, in two age groups-77 subjects aged 70 -85 years [34 male, mean age 78.5 (standard deviation SD 4.5) years; 43 female, mean age 77.6 (SD 5.2) years], 40 subjects aged Ͼ85 years [18 male, mean age 91 (SD 1.7) years; 22 female, mean age 90.2 (SD 3.4) years]. ...
Aging is associated with changes in lymphocyte subsets and unexplained HLA-DR upregulation on T-lymphocytes. We further investigated this activation, by measuring early (CD69), middle (CD25), and late (HLA-DR) T-lymphocyte activation markers on CD3+ lymphocytes, across subjects (20-100 years) together with serum tumor necrosis factor (TNF-alpha), interferon-gamma (IFN-gamma), and soluble interleukin-2 receptor (sIL-2R). HLA-DR was present as a CD3+ HLA-DR+ subset that constituted 8% of total lymphocytes, increased twofold with age and included CD4+, CD8+, and CD45RA+ phenotypes. HLA-DR was also expressed on a CD8+ CD57+ subset. The CD3+ CD25+ subset constituted 13% of lymphocytes, fell with age but was weakly associated with the CD3+ HLA-DR+ subset especially in older subjects. A small 3-5% CD3+ CD69+ subsets showed no age effect. Serum sIL-2R, TNF-alpha, but not IFN-gamma, were associated with CD3+ HLA-DR+ lymphocytes, TNF-alpha with CD8+ CD57+ count and sIL-2R and IFN-gamma with the CD3+ CD25+/CD3+ CD4+ ratio. The study confirms age-related upregulation of HLA-DR on CD3+ lymphocytes, shows some evidence for associated upregulation of CD25 on CD3+ cells in older subjects, and links serum TNF-alpha, IFN-gamma, and sIL2-R to T-lymphocyte activation.
... Total homocysteine (free plus protein-bound) was assayed by high performance liquid chromatogra- phy [29] , serum folate and vitamin B12 measured simultaneously by Simul TRAC-S radio assay (ICN Biomedicals, Germany), MTHFR genotyping by Frosst [10] and GFR estimation by Cockcroft and Gault formula [30]. Anthropometric measurements [31] used upper arm muscle circumference (UMAC) and triceps skinfold thickness (TSF) to derive an estimate of lean body mass (AMC) [32]. The 24 h dietary recall for 74 subjects, was analysed by Compeat Data Analysis. ...
This cross-sectional study assessed relationships between plasma homocysteine, 'thermolabile' methylenetetrahydrofolatereductase (MTHFR) genotype, B vitamin status and measures of renal function in elderly (70-89 years) and nonagenarian (90+ years) subjects, with the hypothesis that octo/nonagenarian subjects who remain healthy into old age as defined by 'Senieur' status might show reduced genetic or environmental risk factors usually associated with hyperhomocysteinaemia. Plasma homocysteine was 9.1 micromol/l (geometric mean [GM]) for all elderly subjects. Intriguingly, homocysteine was significantly lower in 90+ (GM; 8.2 micromol/l) compared to 70-89-year-old subjects (GM; 9.8 micromol/l) despite significantly lower glomerular filtration rate (GFR) and serum B12 in nonagenarian subjects and comparable MTHFR thermolabile (TT) genotype frequency, folate and B6 status to 70-89-year-olds. For all elderly subjects, the odds ratio and 95% confidence intervals for plasma homocysteine being in the highest versus lowest quartile was 4.27 (2.04-8.92) for age <90 compared >90 years, 3.4 (1.5-7.8) for serum folate <10.7 compared >10.7nmol/l, 3.0 (0.9-10.2) for creatinine >140 compared <140 umol/l and 2.1 (1.0-4.4) for male sex. This study shows that plasma homocysteine does not invariably increase with age. Compared to similarly enlisted 70-89-year-olds, apparently well, mentally alert, community-living 90+ year olds approximating 'Senieur' status, show lower homocysteine, which is unexplained by renal function, TT genotype and B vitamin status, suggesting that lower homocysteine may be associated with survival.
... The redistribution of body fat with age renders skinfold thickness measurements less valid in the elderly compared with younger persons (Taren & Schler, 1990). Although there have been attempts to derive anthropometric tables of normal values (Burr & Phillips, 1984;Chumlea et al. 1986;Falciglia et al. 1988;Rea et al. 1997), there is as yet no universally accepted`gold standard' measurements for the elderly population. This may well be impossible, because population reference norms differ between countries, both for young and elderly populations and make accurate comparisons impossible (World Health Organization, 1995;Launer & Harris, 1996). ...
Impaired nutritional status has been frequently reported in surveys estimating its prevalence amongst patients in hospital. While there is no doubt that protein-energy undernutrition has serious implications for health, recovery from illness or surgery and hospital costs, lack of nationally or internationally accepted cut-off points and guidelines for most nutrition-related variables make nutritional assessment difficult and proper comparisons between studies impossible. In reviewing published work in which the prevalence of undernutrition has been assessed, it can be seen that each study defined undernutrition, or nutritional risk, using different methodology. This present review aims to highlight the problems which arise when deciphering these studies, and the resulting difficulty in determining the true prevalence of undernutrition and nutritional risk, amongst both general and specific groups of hospital in-patients. It is widely agreed that routine hospital practices can further adversely affect the nutritional status of sick patients in hospital. How this occurs, and the potential effects of impaired nutritional status on clinical outcome are examined. The methods currently available to assess nutritional status are evaluated in the knowledge that such assessments are difficult in clinical practice. The review concludes by proposing that if we want the medical and nursing professions to consider the nutritional status of hospital patients seriously, definitions of undernutrition and nutritional risk, and cut-off values for the nutritional variables measured must be agreed to allow evidence-based practice. Outcome measures which allow clear comparisons between groups and treatments must be used in studies assessing the effects of nutritional interventions.
... The reference data in current use in the UK and Republic of Ireland were derived from measurements made in the early 1970s of healthy Caucasian Americans (Bishop et al. 1981; Frisancho, 1981) while reference data derived from subjects in South Wales in the UK, published in 1984, are frequently used for de®ning the nutritional status of those aged 65 years or more (Burr & Phillips, 1984). Considerable geographical variation in anthropometric variables has been observed (Bishop et al. 1981; Frisancho, 1981; Burr & Phillips, 1984; Delarue et al. 1994; Launer & Harris, 1996; Bannerman et al. 1997; Rea et al. 1997). Whereas for survey purposes, the use of standard data allow the rates of obesity and underweight to be estimated in different areas of the world and for secular changes to be monitored, for clinical purposes, reference to local, healthy population data may be more appropriate. ...
Protein-energy undernutrition, or the possibility of its development, has been documented to occur frequently in patients on admission to hospital. Deterioration in nutritional status is known to occur in hospital. In a prospective study of 594 sequential hospital admissions, we aimed to assess the prevalence of undernutrition among patients on admission to two acute teaching hospitals in Dublin, Republic of Ireland using the widely-accepted anthropometric criteria applied in a large study from Dundee, Scotland, UK (McWhirter & Pennington, 1994) and to determine changes in nutritional status in hospital. The mean prevalence of undernutrition (11 %) was considerably lower than was reported from Dundee (40 %). Unintentional weight loss before admission and functional impairment on admission occurred to a similar extent in both centres. Weight loss in hospital occurred in the same proportion of patients, but less frequently among those undernourished on admission to hospital, in Dublin compared with Dundee. The patients found to be undernourished on admission in this study had a mortality rate in hospital (6.5 %) over three times that of the adequately nourished group (2 %). The magnitude of the difference in prevalence of undernutrition between the two centres cannot be explained by ethnicity, case-mix or age distribution. With the secular increase in BMI in the population, the thresholds for classifying patients as undernourished or at risk of nutritional deterioration may need to be reviewed. For clinical use, recent weight loss and functional status may be more appropriate variables to use in the evaluation of nutritional status on admission to hospital.
... 15 Weight change, assessed as % initial weight, is a potential predictor of proteinenergy malnutrition and subsequent mor-tality. [15][16][17][18][28][29][30] A 4 to 5% annual weight loss is considered clinically significant, increasing mortality especially in 'involuntary weight losers'. 8 In hospitalized patients, risk of undernutrition has classically been judged as low when current weight is 85-95% of usual weight, moderate if current weight is 75-84% of usual weight, and severe if it falls below 75%. ...
Nutritional risk and its predictors were assessed by evaluating longitudinal changes in body weight using data collected from elderly community-dwelling and institutionalized Canadians who participated in both phases of the Canadian Study of Health and Aging, CSHA (n = 10,263). Change in body weight (% initial weight) was examined over a 5-year interval in 584 community and 237 institutionalized participants, and its predictors tested in multiple and logistic regression analyses. Average weight at CSHA-2 was 97% of initial weight at CSHA-1. Values were lower in those over 90 years and the demented. Increasing frailty in a 7-point scale (beta = -1.23, p = 0.04) predicted weight loss in institutional participants, as did difficulty in eating unaided (beta = 4.24, p < 0.001) and reported loss of interest in life (beta = 2.22, p < 0.001) among community subjects. Some 16% in institutions and 9% in the community were at moderate/severe nutritional risk, disproportionately represented by the oldest subjects and the demented. These analyses support the importance of assessing dietary intakes, anthropometrics, well-being and environmental predictors of aging in the elderly.
... Longitudinal studies are required to determine the magnitude of changes in anthropometric measures with ageing, but cross-sectional data have often been used, even though they might be affected by secular trend or cohort effect. Longitudinal and cross-sectional studies have, however, reported similar results on the effect of ageing on anthropometric and nutritional characteristics (Rea et al. 1997; Sorkin et al. 1999). The principal aims of the present study were: (1) to provide distribution values for anthropometric characteristics based on a large cross-sectional sample randomly drawn from an elderly Italian population; (2) to quantify the prevalence of obesity and underweight conditions among the elderly in Italy; (3) to describe the age and gender differences of anthropometric characteristics in the elderly. ...
In clinical practice and epidemiological surveys, anthropometric measurements represent an important component of nutritional assessment in the elderly. The anthropometric standards derived from adult populations may not be appropriate for the elderly because of body composition changes occurring during ageing. Specific anthropometric reference data for the elderly are necessary. In the present study we investigated anthropometric characteristics and their relationship to gender and age in a cross-sectional sample of 3,356 subjects, randomly selected from an elderly Italian population. In both sexes, weight and height significantly decreased with age while knee height did not. The BMI was significantly higher in women than in men (27.6 SD 5.7 v. 26.4 SD 3.7; P<0.001) and it was lower in the oldest than in the youngest subjects (P<0.05) of both genders. The 75th year of age was a turning point for BMI as for other anthropometric measurements. According to BMI values, the prevalence of malnutrition was lower than 5 % in both genders, whereas obesity was shown to have a higher prevalence in women than in men (28% v. 16%; P<0.001). Waist circumference and waist: hip ratio values were higher for the youngest men than for the oldest men (P<0.05), whereas in women the waist: hip ratio values were higher in the oldest women, suggesting that visceral redistribution in old age predominantly affects females. In conclusion, in the elderly the oldest subjects showed a thinner body frame than the youngest of both genders, and there was a more marked fat redistribution in women.
... Consequently, different anthropometric indicators are used at different life stages to evaluate the nutritional status. Some international studies in the older than 60 years population have investigated body composition changes7891011 However there are no national Mexican references. Information on differences in body composition according to age and gender is also limited. ...
Anthropometric evaluation is an essential feature of geriatric nutritional evaluation for determining malnutrition, being overweight, obesity, muscular mass loss, fat mass gain and adipose tissue redistribution. Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly. We evaluated anthropometric measurements and nutritional status as they relate to age and gender in healthy elderly people.
The study analyzed data from the national survey "Health needs and health service use by older-than-60-year-old beneficiaries of the Mexican Institute of Social Security (IMSS)". The present study included only individuals who reported no chronic disease in the last 20 years and had no hospital admission in the two months prior to the survey. Anthropometric measurements included weight, height, body mass index (BMI), body circumference (arm, waist, hip and calf), waist to hip ratio (WHR), elbow amplitude and knee-heel length.
Application of the inclusion criteria resulted in a study population elderly of 1,968, representing 12.2% of the original number in the national survey in urban areas beneficiaries of the IMSS. The study population comprised 870 women and 1,098 men, with a mean age of 68.6 years. The average weights were 62.7 kg for women and 70.3 kg for men (p < 0.05), and the mean heights were 1.52 m for women and 1.63 m for men (p < 0.05). Age related changes in anthropometric values were identified. BMI values indicated that 62.3% of the population was overweight, and 73.6% of women and 16.5% of men had high fat tissue distribution.
Our findings suggest that applying the BMI thresholds that identify being overweight in the general adult population may lead to an overestimation in the number of overweight elderly Similar problems appear to exist when assessing waist circumference and WHR values. Prospective studies are required to determine the associations between health and BMI, waist circumference and WHR in the elderly.
Significance
In the present study we investigated the epigenetic pattern of genes involved in the regulation of glucocorticoid receptor signaling in two African populations of heavily traumatized individuals. The strongest link between regional methylation and posttraumatic stress disorder (PTSD) risk and symptoms was observed for NTRK2 , which has been shown to play an important role in memory formation. NTRK2 methylation was not related to trauma load, suggesting that methylation differences preexisted the trauma. Furthermore, NTRK2 methylation was found to be related to memory and memory-related brain activity in healthy nontraumatized individuals. The present findings suggest that epigenetic modifications of NTRK2 are involved in memory modulation in health, and in influencing risk and symptoms of PTSD in case of traumatic experiences.
Background
Aging is characterized by anatomical, physiological, and biological changes that can impact drug kinetics. The elderly are often excluded from clinical trials and knowledge about drug kinetics and drug–drug interaction magnitudes is sparse. Physiologically based pharmacokinetic modeling can overcome this clinical limitation but detailed descriptions of the population characteristics are essential to adequately inform models.
Objective
The objective of this study was to develop and verify a population database for aging Caucasians considering anatomical, physiological, and biological system parameters required to inform a physiologically based pharmacokinetic model that included population variability.
Methods
A structured literature search was performed to analyze age-dependent changes of system parameters. All collated data were carefully analyzed, and descriptive mathematical equations were derived.
Results
A total of 362 studies were found of which 318 studies were included in the analysis as they reported rich data for anthropometric parameters and specific organs (e.g., liver). Continuous functions could be derived for most system parameters describing a Caucasian population from 20 to 99 years of age with variability. Areas with sparse data were identified such as tissue composition, but knowledge gaps were filled with plausible qualified assumptions. The developed population was implemented in Matlab® and estimated system parameters from 1000 virtual individuals were in accordance with independent observed data showing the robustness of the developed population.
Conclusions
The developed repository for aging subjects provides a singular specific source for key system parameters needed for physiologically based pharmacokinetic modeling and can in turn be used to investigate drug kinetics and drug–drug interaction magnitudes in the elderly.
Hydrogen peroxide is the final electron acceptor for the biosynthesis of thyroid hormone catalyzed by thyroperoxidase at the apical surface of thyrocytes. Pig and human thyroid plasma membrane contain a Ca(2+)-dependent NAD(P)H oxidase that generates H(2)O(2) by transferring electrons from NAD(P)H to molecular oxygen. We purified from pig thyroid plasma membrane a flavoprotein which constitutes the main, if not the sole, component of the thyroid NAD(P)H oxidase. Microsequences permitted the cloning of porcine and human full-length cDNAs encoding, respectively, 1207- and 1210-amino acid proteins with a predicted molecular mass of 138 kDa (p138(Tox)). Human and porcine p138(Tox) have 86.7% identity. The strongest similarity was to a predicted polypeptide encoded by a Caenorhabditis cDNA and with rbohA, a protein involved in the Arabidopsis NADPH oxidase. p138(Tox) shows also similarity to the p65(Mox) and to the gp91(Phox) in their C-terminal region and have consensus sequences for FAD- and NADPH-binding sites. Compared with gp91(Phox), p138(Tox) shows an extended N-terminal containing two EF-hand motifs that may account for its calcium-dependent activity, whereas three of four sequences implicated in the interaction of gp91(Phox) with the p47(Phox) cytosolic factor are absent in p138(Tox). The expression of porcine p138(Tox) mRNA analyzed by Northern blot is specific of thyroid tissue and induced by cyclic AMP showing that p138(Tox) is a differentiation marker of thyrocytes. The gene of human p138(Tox) has been localized on chromosome 15q15.
Older-adult community programs are significant partners in the identification of need and delivery of health care for seniors. At present there is no systematic screening for nutritional risk in Ontario, and the interest and resources of community programs to screen is unknown. From three Ontario organizational membership lists, 200 programs were randomly selected; 136 key informants completed and returned the survey. A diverse sample of programs was included. Most were providing some form of nutrition programming, with the most common being meal provision. Two thirds (67.7%) were collecting some form of nutrition information: 56.4 per cent had an assessment questionnaire with nutrition information, and 21.8 per cent had clients subjectively assess their own nutritional risk. Most providers were interested in the nutritional health of their clients, and over half were interested in formally screening for nutritional risk. Barriers to screening were also identified. It is clear that nutrition is an area of priority for community programs and that nutrition screening is desired. Barriers to ethical screening need to be addressed prior to implementation of a systematic screening program.
The present study compares results of direct numerical simulations of thermal convection within a rectangular geometry with Rayleigh-Benard convection in thin fluid layers and cylindrical geometries. It is shown that boundary layer thicknesses show similar tendencies in the rectangular geometry and a thin fluid layer, but the quasi two-dimensional geometry of the container delays the onset of convection significantly. Analysis of the thermal dissipation rates indicates that there are three distinct regimes, of the small scale contribution grows rap-idly as Rayleigh number is increasing, whereas the large scale contribution remains almost constant.
ResumenLa implicación mundial en la mejora de la salud del ser humano ha permitido hoy entre otros hechos, elevar tanto la esperanza como la calidad de vida. Los individuos con edad superior de 65 años forman un grupo cada vez más numeroso. En nuestro entorno éstos constituyen el 20% de la población.Una de las preocupaciones sanitarias para esta población, es la valoración y la resolución de la malnutrición, hoy considerada como uno de los grandes síndromes geriátricos, Sin existir un gold standard que permita esta valoración, el Mini Nutritional Assessment (MNA) parece ser un instrumento que ha demostrado tener una gran aceptación en la comunidad científica por ser sencillo de aplicar, por no requerir exámenes de laboratorio y a pesar de ello tener una adecuada correlación con los marcadores bioquímicos del estado nutricional.Basándonos en estos antecedentes, nosotros nos propusimos realizar un estudio que permitiera 1) Valorar el estado nutricional mediante la escala MNA de los usuarios de centros asistenciales de la ciudad de Lleida; 2) Establecer los factores que pueden estar asociados a riesgo de malnutrición o malnutrición establecida en dicha población y 3) Evaluar la utilidad clínica de la escala MNA como herramienta de cribado nutricional en los centros estudiados.Para ello se diseñó un estudio de prevalencia sobre una muestra representativa de la población mayor procedente de distintos niveles asistenciales: centros sociosanitarios, hospital de agudos, residencia asistida y centro de atención primaria. En total fueron evaluados 398 sujetos, 46,2% hombres y 53,8% mujeres, con una media de edad de 77 años.1) Según las categorías del MNA, observamos que el 22,6% de individuos estaban malnutridos, el 35,4% estaban en riesgo de malnutrición y el 42% estaban bien nutridos. La mayor prevalencia de malnutrición recayó en los centros sociosanitarios (larga y media estancia) y en el servicio de medicina interna del hospital de agudos seguidos por la residencia asistida y el servicio de cirugía del hospital de agudos. No se detectaron individuos malnutridos en el centro de atención primaria aunque si se observaron con riesgo de malnutrición. Todo ello confirma que a medida que aumenta el nivel de atención, el estado nutricional se deteriora. Así mismo pudimos comprobar que a medida que avanza la edad, las personas mayores tienen mayor riesgo de malnutrición o están mas mal nutridas.2) Después de introducir en la regresión logística todos los factores que estaban asociados al estado nutricional insatisfactorio observamos que la perdida de peso, el vivir sin pareja, la discapacidad funcional, el deterioro cognitivo, el encontrarse subjetivamente solo, la patología pulmonar, los antecedentes de enfermedades del corazón y la presencia de vómitos, fueron los únicos factores independientes asociados a riesgo de malnutrición o malnutrición establecida.3) Para finalizar, se confirma la considerable utilidad clínica de la escala MNA en su versión completa para la valoración nutricional de nuestra población mayor. Se confirma también la utilidad de la versión corta, aunque se necesitan en este sentido más estudios de investigación que refuercen esta hipótesis. El MNA es una herramienta práctica, rápida, sencilla y no invasiva que puede ser fácilmente administrada por cualquier profesional de la salud y que puede ayudar a entender y comparar diferentes grupos asistenciales desde la perspectiva nutricional.
Determine basic anthropometry for elderly participants in a Venezuelan community and compare results for subgroups with different health status.
Standardized anthropometric, nutritional, neurological, neuropsychiatric, and cardiovascular assessments generated data on weight, height, and body mass index (BMI) by sex and age for the total sample, for normative groups without health problems that might impact anthropometry, and for reference groups with no major health problems. Centile curves of anthropometric measurements versus age are determined for women and men in the normative group.
Mean weight and height are significantly different between sexes, but not BMI. All three parameters show gradual declines with age. The mean 90% central interval for BMI in the normative and reference groups is 20-29 kg/m(2).
The anthropometric data for healthy elderly Venezuelans can be used in monitoring anthropometric changes and disease risk analysis for this population and possibly for other Latin American populations.
Although a sizeable portion of India's population (13%, over 110 million) is elderly (aged > 55 years) very little information exists on their levels of adiposity and central body fat distribution.
The present study seeks to investigate age and sex variations in adiposity and central fat distribution among urban elderly Bengalee men and women.
A cross-sectional study of 410 (210 men and 200 women) elderly (> 55 years) urban Bengalee Hindu individuals resident in Calcutta, India, was undertaken utilizing various measures of adiposity and central fat distribution.
There existed significant sex differences in various anthropometric variables and indices. Age had significant negative association with most variables and indices in both sexes. In general, the associations were much stronger in men. Regression analysis demonstrated that age had significant negative effect on height, sitting height (SH), weight, body mass index (BMI), minimum waist (MWC), maximum hip (MHC) and mid upper arm (MUAC) circumferences and triceps skinfold (TSF), in both sexes. Age also had significant negative impact on conicity index (CI) in men.
The present investigation revealed that there is a significant inverse age trend in adiposity among urban elderly Bengalee Hindus. Moreover, there existed sex differences in the effect of age on various anthropometric measures.
The Disabled-1 (Dab1) gene encodes a key regulator of Reelin signaling. Reelin is a large glycoprotein secreted by neurons of the developing brain, particularly Cajal-Retzius cells. The DAB1 protein docks to the intracellular part of the Reelin very low density lipoprotein receptor and apoE receptor type 2 and becomes tyrosine-phosphorylated following binding of Reelin to cortical neurons. In mice, mutations of Dab1 and Reelin generate identical phenotypes. In humans, Reelin mutations are associated with brain malformations and mental retardation; mutations in DAB1 have not been identified. Here, we define the organization of Dab1, which is similar in human and mouse. The Dab1 gene spreads over 1100 kb of genomic DNA and is composed of 14 exons encoding the major protein form, some alternative internal exons, and multiple 5'-exons. Alternative polyadenylation and splicing events generate DAB1 isoforms. Several 5'-untranslated regions (UTRs) correspond to different promoters. Two 5'-UTRs (1A and 1B) are predominantly used in the developing brain. 5'-UTR 1B is composed of 10 small exons spread over 800 kb. With a genomic length of 1.1 Mbp for a coding region of 5.5 kb, Dab1 provides a rare example of genomic complexity, which will impede the identification of human mutations.
In the present cross-sectional study we examined 332 (171 men and 161 women) elderly (60 years and above) urban Bengalee Hindu resident in south Calcutta, India. Individuals were selected by random sampling procedure using local voter's registration list. Skin folds measures were used to compute body composition measures among them. There existed significant sex differences in various anthropometric body composition measures. Age had significant (p < 0.001) negative association with all anthropometric body composition measures namely percentage of body fat (PBF), fat mass (FM), arm muscle circumference (AMC), arm muscle area (AMA) and arm fat area (AFA) in both sexes. Fat free mass (FFM) in contrast had negative but not significant age impact. Regression analyses demonstrated that age had explained substantial amount of variance of PBF (men = 32%; women = 18.2%), FM (men = 18.2%; women = 12.8%), AMC (men = 23.4%; women = 19.2%), AMA (men = 22.2%; women = 10.2%) and AFA (men = 34%; women = 31%) in both sexes. Two-way ANOVA revealed age-sex interaction only had significant effect on FFM. The present investigation vindicated that there is a significant inverse age trends in anthropometric body composition measures among the Bengalee Hindus. Moreover, there existed sexual dimorphism in the effect of age on various anthropometric body composition measures.
Most of the anthropometric standards are derived from adult populations but not from older subjects, so their use to evaluate the nutritional status in the elderly may not be the most appropriate. In this sense, the anthropometric characteristics and their relationship to sex and age in a cross-sectional sample of 809 Venezuelan subjects (370 males and 439 females), aged 60 to 102 years old, randomly selected from a elderly institution-alised population were studied. The results indicate that anthropometric variables show different degrees and signs of sexual dimorphism. Males presented higher stature, weight, waist and calf circumferences and higher bone diameters, while females have higher hip and thigh perimeters, and bigger trunk and extremities skinfolds. Independently of the changes observed in these variables with age, the difference spread between the sexes tends to stay and even to increase with age in the height and weight, in hip perimeter and in thigh and calf skinfolds; while, on the contrary, they attenuate in waist perimeter and in triceps, subescapular and suprailiac skinfolds. Males and females appear to be more similar for these variables in the advanced ages. In general, these results could be used as reference elements for similar researches in Venezuela, due to the low number of studies developed in the country in older populations
To evaluate gender differences in nutritional risk of older people admitted to an acute-care general medical department, and identify gender-specific risk factors.
Cross-sectional study.
Internal Medicine Department in an acute care, university-affiliated hospital in southern Israel.
204 cognitively intact patients aged 65 and over, admitted during a 12-month period to a general medical department. Measures of outcome: Evaluation included demographic and clinical data consisting of the sum of medical conditions and of prescribed medications, evaluation of nutritional status, cognitive status, depression assessment and functional ability. Statistical analyses were conducted to evaluate the gender specific risk factors for under-nutrition.
32.5% of the men and 48.1% of the women admitted to an internal medicine department were at risk for under-nutrition. Those at nutritional risk had a higher rate of depression, lower cognitive and physical ability, poorer reported health status and more diagnosed diseases. Nutritional risk for men was associated with higher depression score, longer hospitalization, and poor appetite. For women, nutritional risk was associated with lower functional status and more diagnosed diseases. In a multivariate analysis, being a female increased the risk of under-nutrition by 3.3 fold.
Risk of under-nutrition is prevalent among older in-patients and is gender-related. Female inpatients are at markedly increased risk for under-nutrition. The mechanism of the gender discrepancy in factors related to nutritional deterioration is complex and poorly understood.
We compared anthropometric data (height, weight and body mass index) from 19 geographically and ethnically varied samples
of community-dwelling elderly people. Participants were stratified into three age groups, 60–69, 70–79 and 80 years or older.
We present age-group-specific means and standard deviations for height, weight and body mass index (BMI, weight/height2) and the prevalence of underweight (BMI < 20) and overweight (BMI ⩾ 30).
Across studies there are large differences in the prevalence of overweight and underweight, but in all studies mean height
and BMI decreased with age. In general, mean BMI among 70–79-year-old women is greater than that for men of a similar age,
and the Mediterranean samples are heavier for height than samples from Western Europe, Asia, Africa and the United States.
The comparisons suggest that the sensitivity and specificity of a fixed cut-off for underweight and overweight are likely
to differ by sex, age, and geographic location in samples of older persons.
We evaluated the association between nutritional status and cognitive functioning in 260 noninstitutionalized men and women older than 60 years who had no known physical illnesses and were receiving no medications. Nutritional status was evaluated by three-day food records and also by biochemical determination of blood levels of specific nutrients. Cognitive status was evaluated by the Halstead-Reitan Categories Test (a nonverbal test of abstract thinking ability) and by the Wechsler Memory Test. Subjects with low blood levels of vitamins C or B12 scored worse on both tests. Subjects with low levels of riboflavin or folic acid scored worse on the categories test. These differences remained significant after controlling for age, gender, level of income, and amount of education. "Subclinical" malnutrition may play a small role in the depression of cognitive function detectable in some elderly individuals, or depressed cognitive function may result in reduced nutrient intake.
We compared anthropometric indices in samples of elderly people aged 65 years and over living in two French areas. The samples were divided into four age-groups (65-69, 70-74, 75-79 and over 80 years). We observed interregional differences in women aged 65-69 years and in men aged 65-74 years. Weight and anthropometric variables related to body fat percentage and to muscle mass showed a decline with age as already reported by others. We established anthropometric percentile values according to sex in pooled subjects when no integrated difference was found. The 50th percentile of arm circumference, muscle arm circumference and triceps skinfold was higher, and the 50th percentile of body mass index was lower than the one reported for the same indices from an elderly Welsh population. Our results show that an interregional difference in anthropometric indices exists in the elderly. The differences which are observed between our results and those reported from a British population emphasize the importance of establishing local values for the elderly population.
Objective: Assess longitudinal changes in height, body weight, triceps skinfold thickness and circumferences in elderly Europeans. Design: Longitudinal study including baseline measurements taken in 1988/1989 which were repeated in 1993. Setting: Baseline and follow-up data were collected in nine European research towns: Hamme/Belgium (H/F), Roskilde/Denmark (R/DK), Haguenau/France (H/F), Remans/France (R/F), Padua/Italy (P/I), Culemborg/the Netherlands (C/NL), Vila Franca de Xira/Portugal (V/P), Betanzos/Spain (B/E), Yverdon/Switzerland (Y/CH). Single 1993 measurements were carried out in 4 towns: Coimbra/Portugal (C/P), Marki/Poland (M/PL), Ballymoney-Limavady-Portstewart/Northern Ireland/UK (BLP/NI/UK), Mansfield/Connecticut/USA (M/CT/USA). Subjects: Using standardized methodologies data were collected from a random stratified sample of elderly men and women born between 1913 and 1918 including a total of 1242 subjects in 1993. Results: At most sites stature had decreased by 1-2 cm. Median weight changed by -1.5 kg to -3.5 kg in only three towns. An increase of at least 5 kg of body weight had taken place in 9% of men and 6% of women whereas 16% of both men and women had lost at least 5 kg of their baseline weight. Serial changes in triceps skinfold thickness, arm circumference and waist-to-hip ratio were small. Conclusions: Height declined with age. Median changes in other anthropometric characteristics of interest were small. These changes resulted from both considerable gains and losses of body weight in a significant proportion of the SENECA populations.
The vitamin C status of 186 elderly subjects living at home and institutionalised in hospital, residential accommodation and sheltered dwelling was studied. Subjects from hospital and home receiving multivitamin supplements regularly were grouped separately. Ascorbic acid deficiency (plasma ascorbic acid less than or equal to 0.3 mg/100 ml) was noted in 47.2, 39.0, 46.2 and 47.4 per cent subjects of home, hospital, residential accommodation and sheltered dwelling, respectively. All subjects receiving multi-vitamin had plasma ascorbic acid (PAA) levels greater than or equal to 0.3 mg/100 ml. The mean levels of PAA appeared higher in females than males and the percentage incidence of low vitamin C status was higher in males than females in the majority of the groups. Leucocyte ascorbic acid (LAA) levels were measured in only 26 subjects of residential accommodation and of these 38.5 per cent had low LAA levels (less than 15 microgram/10(8) cells). The biochemical vitamin C deficiency was not accompanied by any recognised clinical manifestation.
Corrected arm muscle area (CAMA), triceps skin-fold thickness (TSF) and body mass index (BMI) were measured in a community sample of 758 people who were then followed for 40-46 months. Percentile values were calculated for each sex in 5-year age groups. The relative risk of death of those in the upper and lower percentiles was compared with those between the 10th and 90th percentiles, controlling for age and sex. Subjects below the 5th percentile for CAMA, TSF and BMI and between the 5th and 10th percentile for CAMA had a significantly increased risk of death. There was no increased risk of death in those subjects above the 90th percentile in any measurement. In the logistic regression model, both low CAMA and low TSF were associated with a significantly increased risk of subsequent mortality. Poor nutritional state shown by low muscle bulk and fat stores was an important predictor of mortality, but obesity had no adverse effect on survival.
Ten years' follow-up of mortality of 1.7 million persons aged 15 years or more with measured body weight and height demonstrates a consistent correlation between body mass index and mortality. The risk function is an asymmetrical U-function. This shape makes the determination of an optimum very uncertain. The two tails in the distribution of the body mass index show marked differences as to the causes of death: the lower tail is characterized by tuberculosis, lung cancer, obstructive lung diseases, and the upper tail by cerebrovascular and cardiovascular diseases, diabetes and (for males) colon cancer.
1. Skinfold thicknesses at four sites – biceps, triceps, subscapular and supra-iliac – and total body density (by underwater weighing) were measured on 209 males and 272 females aged from 16 to 72 years. The fat content varied from 5 to 50% of body-weight in the men and from 10 to 61% in the women.
2. When the results were plotted it was found necessary to use the logarithm of skinfold measurements in order to achieve a linear relationship with body density.
3. Linear regression equations were calculated for the estimation of body density, and hence body fat, using single skinfolds and all possible sums of two or more skinfolds. Separate equations for the different age-groupings are given. A table is derived where percentage body fat can be read off corresponding to differing values for the total of the four standard skinfolds. This table is subdivided for sex and for age.
4. The possible reasons for the altered position of the regression lines with sex and age, and the validation of the use of body density measurements, are discussed.
For children between the ages of one and five years, the ratio weight/height1.6 is independent of age but correlates with the nutritional status. This ratio can be used as a nutritional index when the age of the child is not accurately known.
The study includes measurements of height, weight, triceps skinfold, subscapular skinfold, upper arm circumference, and elbow breadth of a cross-sectional multiracial sample of 21,752 subjects aged 25 to 74 yr derived from the data sets of the first and second National Health and Nutrition Examination Surveys (NHANES I and NHANES II). Based on these data, percentiles of weight, skinfolds, and bone-free upper arm muscle area by height, sex, and frame size were established for all races combined in two groups: adults aged 25 to 54 yr and the elderly aged 55 to 74 yr. These new standards can be used to differentiate those who are at risk of being obese and undernourished. It is recommended that assessment of anthropometric nutritional status and health status of contemporary adult and elderly populations be made with reference to the present standards in conjunction with age correction factors.
Anthropometric indices are presented for representative samples of elderly people in South Wales, based on over 1500 subjects seen during community surveys. Body mass index declined with age after 70 years in both men and women. Estimates of fat and muscle volume based on upper arm measurements also showed a decline with age, which was particularly steep for triceps skinfold thickness in women. These indices are in general similar to results that have been reported from other surveys within the UK; they suggest that Welsh old people have less fat and muscle than elderly Americans.
Anthropometric measurements (weight, skinfold thickness at triceps, subscapular and dorsum of the hand and circumference of upper arm and abdomen) of 126 aged subjects, studied in four groups, are reported. The relationship of any of these anthropometric parameters with energy intake was not significant in the majority of the groups. Abdominal circumference was the only measurement which showed a significant correlation with body weight in the males and females of the four groups. The use of abdominal circumference as an indicator of nutritional status needs further study.
To study whether individual Human Leucocyte Antigens (HLA) at the HLA 1 or 11 loci or the phenotypic combination A1B8Cw7DR3 were associated with longevity.
Direct comparison of the > 90-year-old subjects with a control group.
Northern Ireland population with little migratory mobility.
The > 90-year-old group (79 females, 38 males) was compared with a control group consisting of 150 unrelated blood donors (81 females, 69 males).
Human Leucocyte Antigen (HLA) Class 1 typing was carried out on 117 nonagenarians (mean age 93.7 years) and 150 younger controls (mean age 33.7 years) using conventional serological methods; HLA DR typing was carried out on 102 of the 117 > 90-year-old subjects, together with the 150 control subjects, and performed using restriction fragment length polymorphisms. The frequency of the phenotypic combination A1B8Cw7DR3 was measured in both groups.
There were no significant differences in the HLA antigen frequencies between the very elderly groups and the younger subjects at the A, B, C, and DR loci. The phenotypic combination A1B8Cw7DR3 was significantly increased (X3) in nonagenarian men compared with young men but not between elderly women and young women. There was a trend for increased representation of this phenotype in elderly men compared with women of the same age.
The frequency of the supratype A1B8Cw7DR3 was significantly increased in very elderly men but not in elderly women. Since this phenotypic combination has been associated with immune surveillance and/or hyperactivity in Caucasians, there is the suggestion that it could influence longevity through immune mechanisms but that sex differences may exist in its influence and expression.
To determine if there is a relationship between body mass index and the ability to perform the usual activities of living in a sample of community-dwelling elderly.
Secondary data analysis of The National Health and Nutrition Examination Survey-I Epidemiologic Follow-up Study (1982-1984). Follow-up home interview of a population-based sample originally interviewed between 1971 and 1975 in the National Health and Nutrition Examination Survey-I (NHANES-I).
Survivors of the original NHANES-I cohort who were 65 years of age or older and who were living at home at the time of the second interview (n = 3061). Excluded were those who could not be found, refused participation, or were institutionalized (n = 220), and those without complete height and weight data (n = 194).
Functional status as measured by a 26-item battery.
Bivariate analysis revealed a greater risk for functional impairment for subjects with a low body mass index or a high body mass index. The greater the extreme of body mass index (either higher or lower), the greater the risk for functional impairment. Logistic regression analysis indicated that both high and low body mass index continued to be significantly related to functional status when 22 other potential confounders were included in the model.
The body mass index is related to the functional capabilities of community-dwelling elderly. The inclusion of this simple measurement in the comprehensive assessment of community-dwelling elderly is supported.
The primary objective was to confirm the results of a prior study that demonstrated a strong independent correlation between the severity of protein-energy undernutrition and the risk of subsequent morbidity in a population of elderly rehabilitation patients. A second objective was to determine whether inadequate in-hospital nutrient intake is a co-contributor to the risk of subsequent morbidity.
Cohort study.
Geriatric Rehabilitation Unit (GRU) of a Veterans Administration hospital.
Three hundred fifty randomly selected admissions to the GRU, of whom 99% were male, and 75% were white. The average age of the study patients was 76 years.
At admission, each patient completed a comprehensive medical, functional, neuro-psychological, socio-economic, and nutritional assessment. While remaining in the hospital, each subject was monitored on a daily basis for the development of complications. Complete calorie counts were obtained at least every other day, and the average pre-complication daily nutrient intake was expressed as a percent of predicted requirements as determined using the Harris-Benedict equation.
Of the 96 variables evaluated, the strongest predictor of subsequent complications was the Katz Index of ADL score, followed by serum albumin, usual weight percent, number of prescription medications, presence of renal disease, individual income, the presence of decubiti, dysphagia, and mid-arm muscle circumference. When all nine of these variables were included in the logistic regression analysis, the final model had a sensitivity of 70%, a specificity of 71%, and an overall predictive accuracy of 71%. When tested using the data from the previous study, the model differentiated the patients who developed a complication from those who had not a sensitivity of 76.7, a specificity of 76.1, and an overall predictive accuracy of 76.3. There was no difference in the pre-complication average daily nutrient intake between the complication and the no-complication groups (79% vs 75% of predicted requirements, P > 0.2).
Protein-energy undernutrition appears to be a strong independent risk factor for in-hospital morbidity. However, in-hospital nutrient intake may not be a significant determinant of risk.
This study is part of a transcultural investigation under the auspices of the International Union of Nutritional Sciences, where dietary habits are studied with similar methodology in different populations throughout the world. The present paper describes and evaluates the intake of energy and nutrients, and food habits in an urban elderly population in Sweden, in relation to existing standards. The study population comprised 66 males and 122 females, aged 70 years and over (average 78 years) living in the city of Gothenburg. Energy intake was on average 11.5 MJ in males and 9.9 MJ in females. Nutrient intakes were on average above recommendations, and neither intake nor food choice seemed to change much with increasing age. A validation by a 4-day record and 24-hour urinary nitrogen determination was performed in a subsample, and indicated a probable systematic overestimation of at least 10% for protein consumed. The data from this study support the view that people 70 years of age and older in Sweden are generally healthy, active and have good food habits. This population, however, was not a representative sample. They were all living in a well defined area, with a stable social situation, and belonged generally to middle class. With this background the nutrient data seem reasonable. As long as elderly people stay healthy and do not have other serious risk factors, they seem to keep good food habits and nutritional status up into their eighties and nineties.
(1) To assess changes in body weight longitudinally over 4 years in a representative group of men and women aged over 65 years, living in their own homes. (2) To assess whether initial weight (or weight in proportion to skeletal size) was associated with health 4 years later. (3) To assess whether any changes found in body weight were associated with changes in physical or mental health. (4) To compare the cross-sectional age-related changes in weight found in the initial survey with the longitudinal changes found over 4 years.
A large randomised age-stratified survey using a structured questionnaire and measurements of body weight and demispan (for skeletal size), with a 4-year follow-up.
The survey was conducted in the respondents' own homes.
958 subjects age over 65 years, who were recruited from the Nottingham general practitioners' lists, took part in the initial survey; 629 of these subjects completed the second survey 4 years later.
(1) The mean 4-year change in body weight was a small but significant loss; in women (n = 385) it was 1.56kg (P <0.001, 95% CI 1.02-2.10) and in men (n = 244) 0.85kg (P = 0.010, 95% CI 0.21-1.49). (2) Initial weight did not predict mortality, new morbidity nor health 4 years later. (3) There were no robust associations between weight change ans either absolute measures of physical health or changes in these measures. (4) The longitudinal change in weight was similar to that predicted by the cross-sectional data.
(1) Ageing, in old age, is associated with loss of body weight, but with a large intra-individual variation. (2) Neither initial body weight nor the change, was associated with mortality or morbidity over 4 years in a large representative sample of old people living in their own homes in a food-rich country.
In this study, the changes in some of the cellular components of the immune system and the activity of the cytokine interleukin 2, important for immune activation and lymphocyte proliferation, were measured in a large cross-sectional study of all age groups including octogenarian and nonagenarian subjects. In 206 apparently well community-living subjects, the absolute lymphocyte count and T and B cell numbers fell a little in old and very old subjects. Within the T cell compartment, helper/inducer CD4+ T cells, together with their subsets identified as 'naive' (CD4+/CD45RA+) and 'memory' (CD4+/CD45RO+) cells, also showed a decline with increased age. The suppressor/cytotoxic CD8+ subset showed no age-related change. The levels of the cytokine interleukin 2 were very low in octogenarian and nonagenarian subjects, while the soluble interleukin 2 receptor levels increased with increasing age. The interleukin 2 levels were associated with number and percentage of the 'memory' (CD4+/CD45RO+) subset of T cells which mediates the host response to previously met antigens. Since the interleukin 2 values were very low in the oldest groups and were associated with a reduced 'memory' (CD4+/CD45RO+) compartment, this suggests a possible mechanism of why the very elderly subject is more susceptible to morbidity and mortality from infectious or other agents.
Triceps skinfold (TSF) and midarm circumference (MAC) were measured and the arm muscle circumference (AMC) calculated in 1860 healthy persons aged between 20 and 101 years and because the distribution of our findings was not Gaussian we have used the 5th and 10th percentiles instead of standard deviation to define limits between severe and moderate malnutrition and between moderate malnutrition and normal. One-way variance analysis showed significant increases in TSF in women from the 3rd (mean 18.3 mm) to the 6th (mean 23.6 mm) decades (p<0.05 - 0.001). No variation was seen in the 6th and 7th decades but thereafter decreases occurred to the 10th (mean 14.4 mm) decade (p<0.05 - 0.001). In men, TSF showed no variation from the 3rd (mean 10.8 mm) to the 9th (mean 10.6 mm) decades but in the 10th (mean 9.4 mm) decade it decreased significantly (p<0.05). In women, AMC increased from the 3rd (mean 21.1 cm) to the 6th (mean 22.1 cm) decades (p<0.05 - 0.001). No variation was seen from the 6th to 8th decades, but thereafter decreases occurred to the 10th (mean 20.2 cm) decade (p<0.05 - 0.001). In men no variation was seen in AMC from the 3rd (mean 26.2 cm) to the 7th (mean 25.9 cm) decades, but decreases were shown to the 10th (mean 23.0 cm) decade (p<0.001). Using these values in 112 surgical patients, 26 per cent showed signs of malnutrition in their fat stores and 6 per cent in muscle. The wide variation in anthropometric measurements between different age groups precludes the use of a mean reference value covering all ages in the assessment of malnutrition.
Measurements of body weight and skeletal size have been made, as part of a demographically representative survey, in 532 women and 358 men aged over 65 years living in their own homes. Body weight was assessed using calibrated portable scales. Skeletal size was measured as half body span (demispan) using a steel tape stretched from the sternal notch to the finger roots. Age had a weak but significant negative association with both body weight and demispan. After controlling for demispan, age still accounted for a significant decline in weight (in kg per decade) of 2.5 in men and 3.5 in women. Weight, demispan and indices of weight-for-skeletal-size have been presented as percentiles for men and women separately.
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