An observational prospective cohort study to explore predictors of safety in over 75-year-old elderly colorectal cancer
Ontology highlight
ABSTRACT:
DISEASE(S): Colorectal Cancer
PROVIDER: 2696765 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:BackgroundFrailty captures the age-related declines in health leading to increased vulnerability, including falls which are commonplace in older women. The relationship between frailty and falls is complex, with one leading to the other in a vicious cycle.AimsThis study addresses the gap in understanding how patterns of frailty and falls propensity interact, particularly in those who have not yet entered the falls-frailty cycle.MethodsThe Osteoporosis Risk Assessment cohort consists of 1044 community-dwelling women aged 75, with 10 years of follow-up. Investigations were performed and a frailty index constructed at baseline, 5 and 10 years. Falls were self-reported for each previous 12 months. Analysis was two-directional, firstly based on frailty status and second, based on falls status. Recurrent falls was the primary outcome.ResultsBaseline frailty was a significant predictor of recurrent falls after 5 and 10 years [(OR 2.55 (1.62-3.99); 3.04 (1.63-5.67)]. Among women who had no history of falls at age 75, frailty was a stronger predictor of falls at 5 years [OR 3.06 (1.59-5.89)] than among women who had previously fallen.DiscussionFrailty is significantly associated with recurrent falls and most pronounced in those who are frail but have not yet fallen.ConclusionsThis suggests that frailty should be an integral part of falls-risk assessment to improve identification of those at risk of becoming fallers.
| S-EPMC7591409 | biostudies-literature
Project description:Rapid response teams (RRTs) attend severely ill general ward patients whose average 30-day mortality is near 30%. A major part of RRT patients are over 75 years old, but there are no studies on the characteristics and outcome of this geriatric RRT population. We compared the characteristics and outcome of geriatric RRT sub-population with the RRT patients <75 years old. We further investigated, whether the accumulation of risk factors (RFs) for mortality among the general RRT population predicts a tenuous outcome among the geriatric sub-population.Prospective three-year observational cohort study of adult RRT patients in Tampere University Hospital, Finland. After identifying independent RFs for 30-day mortality among RRT patients with multivariate logistic regression, we further studied the impact of the accumulation of these RFs among geriatric RRT patients who had no limitations of medical treatment.A total of 1372 patients were reviewed 1722 times. Geriatric patients (n = 449, 33%), when compared to non-geriatric patients, had higher 30-day (33% vs. 21%, respectively; p < 0.001) and one-year (54% vs. 35%, respectively; p < 0.001) mortality rates. Among the general RRT population, positive RRT criteria as measured by RRT during the review, high comorbidity index, age ≥ 75 years, non-elective hospital admission, medical reason for admission and afferent limb failure were identified as independent RFs for 30-day mortality and classified as feasible to obtain during a routine RRT review. The observed rates of these RFs among the geriatric RRT patients substantially affected their 30-day mortality (e.g. no RFs: 5.3%; one RF: 14%; two RFs: 27%; three RFs: 38%; four RFs: 52%; five RFs: 38%).One-third of patients reviewed by RRT were ≥75 years old, and age statistics were comparable to previous RRT studies suggesting that this is the case globally. Outcome of geriatric RRT patients is poorer as compared with RRT patients <75 years. However, the outcome is substantially affected by the accruement (or lack) of RFs generally increasing the mortality of RRT patients. Considering these factors during a geriatric RRT review may aid with the decision to either escalate or de-escalate care.
| S-EPMC5544988 | biostudies-other
Project description: Not available
| S-EPMC6607023 | biostudies-literature
Project description: Not available
| S-EPMC6839949 | biostudies-literature
Project description:BackgroundLeft atrial appendage closure (LAAC) is an established therapy for patients with atrial fibrillation (AF); however, there is a limited understanding of LAAC in elderly patients (≥75 years old). We conducted a meta-analysis to investigate the procedural complications and long-term outcomes after LAAC in the elderly versus the non-elderly.MethodsWe screened PubMed, EMBASE, Cochrane Library, and Web of Science. Procedural endpoints of interest included successful implantation LAAC rates, in-hospital mortality, major bleeding events, pericardial effusion/tamponade, stroke, and vascular access complications related to LAAC. Long-term outcomes included all-cause mortality, major bleeding events, and stroke/transient ischemic attack (TIA) during follow-up.ResultsFinally, 12 studies were included in the analysis; these included a total of 25,094 people in the elderly group and 36,035 people in the non-elderly group. The successful implantation LAAC rates did not differ between the groups, while the elderly patients experienced more periprocedural mortality (OR 2.62; 95% CI 1.79-3.83, p < 0.01; I2 = 0%), pericardial effusion/tamponade (OR 1.39; 95% CI: 1.06-1.82, p < 0.01; I2 = 0%), major bleeding events (OR 1.32; 95% CI 1.17-1.48, p < 0.01; I2 = 0%), and vascular access complications (OR 1.34; 95% CI 1.16-1.55, p < 0.01; I2 = 0%) than the non-elderly patients. The long-term stroke/TIA rates did not differ between the elderly and the non-elderly at least one year after follow-up.ConclusionsEven though successful implantation LAAC rates are similar, elderly patients have a significantly higher incidence of periprocedural mortality, major bleeding events, vascular access complications, and pericardial effusion/tamponade after LAAC than non-elderly patients. The stroke/TIA rates did not differ between both groups after at least one-year follow-up.
| S-EPMC9777302 | biostudies-literature
Project description:BackgroundCross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design.MethodsThis prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures.ResultsAt baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs - but higher dental care use - than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures.ConclusionsIt was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants).
| S-EPMC8418734 | biostudies-literature
Project description:BackgroundWe aimed to evaluate the current status of first-line treatment options for prostate cancer in patients aged ≥75 years in Korea.Materials and methodsThe study included 873 patients diagnosed with biopsy-proven prostate cancer at 5 institutions in Korea from January 2009 to December 2018. Inclusion criteria were aged ≥75 years at diagnosis, prostate biopsy with ≥12 cores, and follow-up period ≥1 year. Clinical data were retrospectively collected from electronic medical records.ResultsPrimary treatment for prostate cancer in patients aged ≥75 years included androgen deprivation therapy (ADT) (n = 614), radical prostatectomy (RP) (n = 114), and radiation therapy (n = 62). Among patients with RP, nine patients received ADT before RP. The RP group was younger with better Eastern Cooperative Oncology Group Performance Status (ECOG PS), lower initial prostate-specific antigen (PSA), Gleason score (GS), max percent positive cores, less positive cores, and less advanced clinical Tumor Node Metastasis (TNM) stage compared with the ADT group. Multivariate analysis showed that age, ECOG PS, and PSA were independent prognostic factors for RP. When the ADT group was classified by therapeutic regimens, the most common therapeutic regimen was maximal androgen blockade (MAB) (n = 571), and leuprolide + bicalutamide (n = 330) was the most common MAB regimen. Multivariate analysis for secondary treatment showed that age, ECOG PS, GS, and clinical N1 or M1 stage were independent predictive factors. Enzalutamide was the most preferred treatment for tertiary treatment.ConclusionIn patients with prostate cancer aged ≥75 years, the most common treatment option was MAB, and the leuprolide + bicalutamide was the most common MAB regimen. Age, ECOG PS, and PSA are the useful indicators of surgical treatment, which increased during the study period. Younger patients with high GS and advanced clinical stage were more likely to undergo secondary treatment.
| S-EPMC9995689 | biostudies-literature
Project description:BACKGROUND: little is known about the prevalence of at-risk drinking in older adults. OBJECTIVE: to compare rates of at-risk drinking in 75-year-olds examined in 1976-77 and in 2005-06. DESIGN: cross-sectional survey. SETTING: two samples representative of the general population in Gothenburg, Sweden. PARTICIPANTS: 75-year-olds born in 1901-02 (n = 303) and in 1930 (n = 753). METHODS: participants took part in a multidisciplinary study on health and ageing. Protocols regarding alcohol consumption were identical for both cohorts. Total weekly alcohol intake was estimated and at-risk drinking was defined as ?100 g alcohol/week. RESULTS: the proportion abstaining differed significantly between birth cohorts (18% in 1976-77 versus 9% in 2005, P < 0.001). Frequencies of drinking beer and liquor were similar in the two cohorts for men, but were lower for women in the later-born cohort. Proportions drinking wine were higher in the later-born cohort for both sexes. Total weekly alcohol intake was higher for both men and women. At-risk drinking was observed in 19.3% of the men in the earlier-born cohort, and in 27.4% in the later-born cohort (P = 0.117). Corresponding figures for women were 0.6 and 10.4% (P < 0.001). At-risk drinking was significantly associated with birth cohort in women (OR: 13.77, CI: 1.82-104.0, P = 0.011) and the occupational group in men (OR: 1.60, CI: 1.13-2.26, P = 0.008). CONCLUSIONS: alcohol consumption in 75-year-olds has changed markedly, especially in women. Studies need to be carried out in varied settings in order to evaluate the clinical and public health implications of changing trends in alcohol consumption.
| S-EPMC3927771 | biostudies-other
Project description:Exceptionally preserved organic remains are known throughout the vertebrate fossil record, and recently, evidence has emerged that such soft tissue might contain original components. We examined samples from eight Cretaceous dinosaur bones using nano-analytical techniques; the bones are not exceptionally preserved and show no external indication of soft tissue. In one sample, we observe structures consistent with endogenous collagen fibre remains displaying ? 67 nm banding, indicating the possible preservation of the original quaternary structure. Using ToF-SIMS, we identify amino-acid fragments typical of collagen fibrils. Furthermore, we observe structures consistent with putative erythrocyte remains that exhibit mass spectra similar to emu whole blood. Using advanced material characterization approaches, we find that these putative biological structures can be well preserved over geological timescales, and their preservation is more common than previously thought. The preservation of protein over geological timescales offers the opportunity to investigate relationships, physiology and behaviour of long extinct animals.
| S-EPMC4468865 | biostudies-other
Project description:IntroductionHigh-resolution peripheral quantitative computed tomography (HR-pQCT) is a powerful tool that has revolutionized 3D longitudinal assessment of bone microarchitecture. However, cortical porosity, a common characteristic of cortical bone loss, is still often determined by static evaluation of overall porosity at one timepoint. Therefore, we sought to 1) describe a technique to evaluate individual cortical pore dynamics in aging females over one year using HR-pQCT imaging and 2) determine whether formation and expansion of pores would exceed contraction and infilling of pores.MethodsHR-pQCT (60.7 μm resolution) images were acquired one year apart at the distal tibia and distal radius in seven female volunteers (60-72 years of age). Baseline and one-year images were registered at each bone site and a custom software was used to quantify dynamic activity of individual cortical pores using the following categories: developed, infilled, expanded, contracted, and static.ResultsOver the one-year period, cortical pores actively developed, contracted, expanded, and infilled. More pores expanded and developed vs. infilled or contracted leading to increased pore area in both tibial and radial sites (p = 0.0034 and p = 0.0474, respectively). Closed pores in the tibia, those that were not connected to the endosteal or periosteal surfaces, were the most dynamic of any pores type (open/closed) at either bone site.ConclusionThis study demonstrates an approach to longitudinally track individual cortical pore activity in tibial and radial sites. These data expand conventional parameters for assessing cortical porosity and show increased porosity in one year of aging is caused by newly developed pores and expansion of existing pores.
| S-EPMC9634666 | biostudies-literature