Suchergebnisse

Abstract

Background
Little is known as to how rest-activity rhythms (RAR) are associated with frailty and how this relationship differs by sex. This study examined the relationship between RAR and frailty in a nationally representative sample of US older adults, focusing on the moderating role of sex.


Methods
2,531 participants aged ≥60yrs [Females:55.2%; Frail:5.15% (4.02–6.29); Pre-frail:33.49% (31.29–35.68)] were included using the 2011-2014 National Health and Nutrition Examination Survey. Non-parametric RAR parameters, including inter-daily stability (IS), intra-daily variability (IV), relative amplitude (RA), most active 10-h, and least active 5-h, were estimated from wrist-worn actigraphy data. Frailty status was assessed using a modified version of frailty phenotype (range:0–5): frail (≥3), pre-frail (1–2), and non-frail (0). Multinomial logistic regression models were used to examine the interest of associations, adjusting for potential confounders.


Results
Frail and pre-frail older adults exhibited significantly lower RA, IS, higher IV, and phase delay when compared to non-frail older adults (p's<.05). Particularly, older adults with low RA had significantly greater odds of being frail and pre-frail [aOR(95%CIs); Frailty:5.60(2.61–12.04); Pre-frailty:1.58(1.13–2.20)]. Significant sex-interaction was observed (p<.01), with this association being greater in females than in males [aOR(95%CIs); Females:7.78(2.98–20.30) for frailty, 2.31(1.60–3.32) for pre-frailty; Males:4.48(1.38–14.54) for frailty, 1.12(0.61–2.07) for pre-frailty].


Conclusion
Weakened RAR strength is unfavorably associated with frailty, particularly in females. RAR may be a useful indicator associated with frailty in older adults, but sex-specific differences should be considered. Further longitudinal research is necessary to investigate the bidirectionality of their association.

Purpose To examine the prevalence of cardiovascular diseases (CVD) among breast cancer (BC) survivors. Design Cross-sectional observational study using the data from the National Health and Nutrition Examination Survey (NHANES) 2003–2018. Setting United States (US). Subjects A nationally representative sample of US women with a history of BC. Measures Self-reported CVD status (i.e., coronary artery disease (CAD), heart failure, and stroke) and time of the CVD diagnosis were used to categorize BC survivors into three groups: No CVD, preexisting CVD, and post-acquired CVD after BC diagnosis. Analysis The prevalence of CVD among BC survivors were estimated by demographic characteristics. Complex sampling design of the NHANES was accounted to estimate the population-level prevalence. Results A total of 658 BC survivors were identified, representing 3.01% (≈3.4 million) of the US women aged ≥18 years old. Of those, ≈6% (≈.2 million) had preexisting CVD and ≈11% (≈.4 million) had at least one CVD diagnosed after BC diagnosis, with an average time elapsed ranging from ≈5 years for heart failure to ≈9 years for CAD and stroke. The prevalence of CVD among BC survivors differed by demographic characteristics including age, education, marital status, menopausal, and physical activity levels. Conclusion Our findings suggest that BC survivors are at risk of suffering from CVD and public health strategies for the long-term management of CVD risk factors in this vulnerable population group is recommended.