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JACC. Heart Failure Sep 2023Age and sex influence treatment and outcomes in patients with heart failure (HF).
BACKGROUND
Age and sex influence treatment and outcomes in patients with heart failure (HF).
OBJECTIVES
The authors examined the associations of age and sex with clinical characteristics, background therapies, outcomes, and response to vericiguat in this post hoc analysis of 5,050 VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) patients with HF and reduced ejection fraction; 1,568 (31%) were ≥75 years of age, of whom 445 (24%) were women.
METHODS
Clinical characteristics were compared across age (<65, 65 to <75, and ≥75 years) and sex. The treatment effect of vericiguat was estimated by age and sex on the primary composite outcome (time to first HF hospitalization or cardiovascular death) using Cox proportional hazards regression.
RESULTS
Compared with younger patients, those ≥75 years of age had more class III and IV symptoms, higher N-terminal pro-B-type natriuretic peptide levels, and worse kidney function but had the lowest use of triple therapy. No sex differences in triple therapy existed by age, but achieving target doses of triple therapy was less likely in older patients. Men ≥75 years of age were more than twice as likely to receive defibrillators and 65% more likely to undergo cardiac resynchronization than women. The primary composite outcome was nominally lower in women than men across all age groups. Vericiguat dosing did not differ between sexes in each age group, and its beneficial effect on the primary endpoint was not modified by age (continuous age, P = 0.169; categorical age, P = 0.189); and sex (3-way interaction; P = 0.847).
CONCLUSIONS
Although elderly women received less intense background HF therapy than men, their prognosis was nominally better. The benefit of vericiguat was independent of age and sex. (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction [HFrEF] [MK-1242-001] [VICTORIA]; NCT02861534).
Topics: Male; Humans; Female; Aged; Heart Failure; Stroke Volume; Prognosis; Ventricular Dysfunction, Left; Cardiotonic Agents
PubMed: 37565973
DOI: 10.1016/j.jchf.2023.06.020 -
Archives of Medical Science : AMS 2023The aim of the study was to examine the burden of uterine fibroids at global, regional and national levels in terms of age and the Socio-demographic Index (SDI).
INTRODUCTION
The aim of the study was to examine the burden of uterine fibroids at global, regional and national levels in terms of age and the Socio-demographic Index (SDI).
MATERIAL AND METHODS
Data were extracted from the GBD 2019 dataset. Estimated annual percentage changes (EAPCs) were calculated to assess the incidence of uterine fibroids, and trends in disability-adjusted life years (DALYs) were examined. All measures examined were stratified by region, country, age and SDI to assess the effects of these variables on the incidence of uterine fibroids.
RESULTS
The global age-standardized incidence rate of uterine fibroids increased from 1990 to 2019, with an EAPC of 0.25 (95% confidence interval (CI): 0.24 to 0.27). In contrast, the global age-standardized DALY rate decreased from 1990 to 2019, with an EAPC of -0.27 (95% CI: -0.31 to -0.23). High and low-middle SDI regions experienced significantly higher age-standardized incidence rates. Moreover, in 2019, low and low-middle SDI regions had significantly higher age-standardized DALY rates due to uterine fibroids than other SDI regions. Regionally, Eastern Europe had the highest age-standardized incidence rate of uterine fibroids in 2019, and Tropical Latin America experienced the greatest increase in age-standardized incidence rates from 1990 to 2019. Nationally, Brazil (EAPC = 1.46; 95% CI: 1.35-1.57) and India (EAPC = 1.09; 95% CI: 0.94-1.25) experienced the most significant increases in age-standardized uterine fibroid incidence. Age-standardized DALY rates increased the most in Tropical Latin America, high-income North America and Oceania.
CONCLUSIONS
Globally, the age-standardized incidence of uterine fibroids has been increasing in recent years. In contrast, age-standardized DALY rates have exhibited a decreasing trend. Eastern Europe, Tropical Latin America, Brazil and India experience the greatest uterine fibroid burden. Globally, women aged 35-39 years and older have an increased risk of uterine fibroids, as reflected in the higher incidence rates among these age groups.
PubMed: 38058724
DOI: 10.5114/aoms/171786 -
Aging Nov 2023Children from old fathers carry an increased risk for autism spectrum (ASD) and other neurodevelopmental disorders, which may at least partially be mediated by paternal...
Children from old fathers carry an increased risk for autism spectrum (ASD) and other neurodevelopmental disorders, which may at least partially be mediated by paternal age effects on the sperm epigenome. The brain enriched guanylate kinase associated (BEGAIN) protein is involved in protein-protein interactions at and transmission across synapses. Since several epigenome-wide methylation screens reported a paternal age effect on sperm methylation, here we confirmed a significant negative correlation between promoter methylation and paternal age, using more sensitive bisulfite pyrosequencing and a larger number of sperm samples. Paternal age-associated hypomethylation was also observed in fetal cord blood (FCB) of male but not of female offspring. There was no comparable maternal age effect on FCB methylation. In addition, we found a significant negative correlation between methylation and chronological age (ranging from 1 to 70 years) in peripheral blood samples of male but not of female donors. hypomethylation was more pronounced in male children, adolescents and adults suffering from ASD compared to controls. Both genetic variation (CC genotype of SNP rs7141087) and epigenetic factors may contribute to promoter hypomethylation. The age- and sex-specific methylation trajectories in the male germ line and somatic tissues, in particular the brain, support a role of this gene in ASD development.
Topics: Adolescent; Aged; Female; Humans; Male; Autistic Disorder; DNA Methylation; Epigenesis, Genetic; Fathers; Semen; Infant; Child, Preschool; Child; Young Adult; Adult; Middle Aged
PubMed: 38019471
DOI: 10.18632/aging.205275 -
Skin Research and Technology : Official... Aug 2023Age-related changes in scalp parameters affect hair quality and scalp condition. However, detailed data on biophysical parameters of the scalp across age groups remain...
BACKGROUND
Age-related changes in scalp parameters affect hair quality and scalp condition. However, detailed data on biophysical parameters of the scalp across age groups remain scarce. We aimed to investigate the differences in scalp parameters between individuals in their 20s and 50s and analyze their sex-specific variations.
MATERIALS AND METHODS
Two hundred participants (160 women and 40 men) were equally divided into 20s and 50s age groups. Biophysical parameters of the scalp, including elasticity, pH, trans-epidermal water loss (TEWL), sebum production, desquamation, firmness, redness, and yellowness, were measured in the vertex, occipital, and temporal regions. Hair density and thickness were measured in the temporal region. The accumulation of advanced glycation end products (AGEs) in the skin was noninvasively measured in a subset of 60 women.
RESULTS
Skin firmness and redness increased with age in women, whereas yellowness increased with age in both sexes. Sebum production and pH levels were significantly lower in the 50s age group than in the 20s age group, particularly in women. TEWL was lower in men in their 50s than in those in their 20s, particularly in the occipital region. A significant reduction in hair density was observed in the 50s age group in both sexes. AGE accumulation in the skin increased with age and was correlated with scalp skin yellowness.
CONCLUSION
Age-related changes in scalp parameters have important implications for hair health and scalp condition. These findings emphasize the importance of considering age and sex when developing hair care strategies.
Topics: Male; Female; Humans; Scalp; Skin; Hair; Epidermis; Biophysics
PubMed: 37632187
DOI: 10.1111/srt.13433 -
Forensic Sciences Research Jun 2023Estimating an individual's age can be relevant in several areas primarily related to the clinical and forensic fields. In the latter, estimation of an individual's... (Review)
Review
Estimating an individual's age can be relevant in several areas primarily related to the clinical and forensic fields. In the latter, estimation of an individual's chronological age from biological material left by the perpetrator at a crime scene may provide helpful information for police investigation. Estimation of age is also beneficial in immigration cases, where age can affect the person's protection status under the law, or in disaster victim identification to narrow the list of potential missing persons. In the last decade, research has focused on establishing new approaches for age prediction in the forensic field. From the first forensic age estimations based on morphological inspections of macroscopic changes in bone and teeth, the focus has shifted to molecular methods for age estimation. These methods allow the use of samples from human biological material that does not contain morphological age features and can, in theory, be investigated in traces containing only small amounts of biological material. Molecular methods involving DNA analyses are the primary choice and estimation of DNA methylation levels at specific sites in the genome is the most promising tool. This review aims to provide an overview of the status of forensic age prediction using molecular methods, with particular focus in DNA methylation. The frequent challenges that impact forensic age prediction model development will be addressed, together with the importance of validation efforts within the forensic community.
PubMed: 37621446
DOI: 10.1093/fsr/owad021 -
Cellular and Molecular Biology... Jun 2023Several factors, including age and polymorphisms in genes such as MTHFR, affect sperm quality. However, the relationship between MTHFR C677T polymorphism and infertility...
Several factors, including age and polymorphisms in genes such as MTHFR, affect sperm quality. However, the relationship between MTHFR C677T polymorphism and infertility remains unclear. Hence, the purpose of this study was to investigate the effects of age and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism on the forward progressive sperm motility and sperm DNA integrity. For this purpose, a total of 845 men were recruited from the hospital's infertility clinic for semen analysis, sperm DNA integrity testing, and MTHFR C677T genotyping. The participants were grouped by age (<30 years, 30-35 years, >35 years) to determine the relationship between age and the progressive motility of sperms (PR%) and sperm DNA integrity. The effect of MTHFR C677T polymorphism on sperm motility and sperm DNA integrity was also analyzed in all the age groups. Results showed that PR% and DNA fragmentation index (DFI) differed significantly among the groups (P<0.001). The correlation analysis showed that age was positively correlated with DFI and negatively correlated with PR%. DFI correlated negatively with PR% (P <0.01). When the age groups were classified based on the C677T genotype, we observed that PR% and DFI did not differ significantly between different genotypes within the same age range (P>0.05). The conclusion was that age exerted a negative effect on sperm motility and sperm DNA integrity. Age correlated positively with DFI and negatively with PR%. MTHFR C677T polymorphism did not affect forward motile sperm count and sperm DNA integrity. Our observations will be useful for fertility guidance and MTHFR genotype interpretation in the clinic for couples of childbearing age.
Topics: Male; Humans; Adult; Sperm Motility; Methylenetetrahydrofolate Reductase (NADPH2); Semen; DNA; Genotype
PubMed: 37605581
DOI: 10.14715/cmb/2023.69.6.17 -
Annals of Medicine Dec 2024The incidence of mortality is considerable after ST-elevation myocardial infarction (STEMI) hospitalization; risk assessment is needed to guide postdischarge management....
BACKGROUND
The incidence of mortality is considerable after ST-elevation myocardial infarction (STEMI) hospitalization; risk assessment is needed to guide postdischarge management. Age shock index (SI) and age modified shock index (MSI) were described as useful prognosis instruments; nevertheless, their predictive effect on short and long-term postdischarge mortality has not yet been sufficiently confirmed.
METHODS
This analysis included 3389 prospective patients enrolled from 2016 to 2018. Endpoints were postdischarge mortality within 30 days and from 30 days to 1 year. Hazard ratios (HRs) were evaluated by Cox proportional-hazards regression. Predictive performances were assessed by area under the curve (AUC), integrated discrimination improvement (IDI), net reclassification improvement (NRI) and decision curve analysis (DCA) and compared with TIMI risk score and GRACE score.
RESULTS
The AUCs were 0.753, 0.746 for age SI and 0.755, 0.755 for age MSI for short- and long-term postdischarge mortality. No significant AUC differences and NRI were observed compared with the classic scores; decreased IDI was observed especially for long-term postdischarge mortality. Multivariate analysis revealed significantly higher short- and long-term postdischarge mortality for patients with high age SI (HR: 5.44 (2.73-10.85), 5.34(3.18-8.96)), high age MSI (HR: 4.17(1.78-9.79), 5.75(3.20-10.31)) compared to counterparts with low indices. DCA observed comparable clinical usefulness for predicting short-term postdischarge mortality. Furthermore, age SI and age MSI were not significantly associated with postdischarge prognosis for patients who received fibrinolysis.
CONCLUSIONS
Age SI and age MSI were valuable instruments to identify high postdischarge mortality with comparable predictive ability compared with the classic scores, especially for events within 30 days after hospitalization.
Topics: Humans; Infant; Prognosis; ST Elevation Myocardial Infarction; Prospective Studies; Aftercare; Retrospective Studies; Patient Discharge; Risk Assessment
PubMed: 38325361
DOI: 10.1080/07853890.2024.2311854 -
Health & Place Sep 2023In this cross-sectional study, we examined the extent to which features of the neighbourhood natural, built, and socio-economic environments were related to cognitive...
In this cross-sectional study, we examined the extent to which features of the neighbourhood natural, built, and socio-economic environments were related to cognitive age in adults (N = 3418, M = 61 years) in Australia. Machine learning estimated an individual's cognitive age from assessments of processing speed, verbal memory, premorbid intelligence. A 'cognitive age gap' was calculated by subtracting chronological age from predicted cognitive age and was used as a marker of cognitive age. Greater parkland availability and higher neighbourhood socio-economic status were associated with a lower cognitive age gap score in confounder- and mediator-adjusted regression models. Cross-sectional design is a limitation. Living in affluent neighbourhoods with access to parks maybe beneficial for cognitive health, although selection mechanisms may contribute to the findings.
Topics: Humans; Aged; Middle Aged; Cross-Sectional Studies; Social Class; Residence Characteristics; Cognition; Neighborhood Characteristics; Environment Design
PubMed: 37451077
DOI: 10.1016/j.healthplace.2023.103077 -
Skin Research and Technology : Official... Jun 2024Many consumers use cosmetic eye products to counteract age-related changes in appearance. Measurements of eyelid shape in Asian women have been reported in the frontal...
BACKGROUND
Many consumers use cosmetic eye products to counteract age-related changes in appearance. Measurements of eyelid shape in Asian women have been reported in the frontal view or 45-degree profile only. The aim of this study was to describe morphological characteristics of the upper eyelid in Japanese and Chinese females from the frontal and profile aspects and examine morphological changes with age.
MATERIALS AND METHODS
Standardized digital photographs of 772 Japanese and 346 Chinese women (15-79 years of age) were acquired in frontal and 90-degree profile aspects. Eleven upper eyelid parameters (e.g., width, length, depth, aperture, and curvature) were measured using image analysis to determine age-related changes and compare by ethnicity.
RESULTS
Eyelid width, area between eyebrow and eyelid, and eyelid curvature were comparable for both ethnicities under age 40, but the aging effect was more pronounced in Chinese subjects. Eyelid height, depth, and upper eyelid aperture angle were also comparable for both ethnicities under age 40, but the aging effect was more evident in Japanese subjects. Upper eyelid incline angle, eye orientation, and upper eyelid protrusion angle changed comparably with age for both ethnicities. No prominent age-related changes were evident for eyelid length or area between eyebrow and eye with the eye closed.
CONCLUSION
Upper eyelid morphology changes with age in Japanese and Chinese females, starting around 40 years of age. Ethnic differences are limited in younger age groups but become more prominent with age. The findings suggest that aging affects some upper eyelid features earlier than others.
Topics: Adolescent; Adult; Aged; Female; Humans; Middle Aged; Young Adult; Aging; Asian People; China; East Asian People; Eyelids; Japan; Photography; Skin Aging
PubMed: 38858846
DOI: 10.1111/srt.13604 -
Journal of the American Heart... Aug 2023Background Aneurysm size is an imperfect risk assessment tool for those with thoracic aortic aneurysm (TAA). Assessing arterial age may help TAA risk stratification, as...
Background Aneurysm size is an imperfect risk assessment tool for those with thoracic aortic aneurysm (TAA). Assessing arterial age may help TAA risk stratification, as it better reflects aortic health. We sought to evaluate arterial age as a predictor of faster TAA growth, independently of chronological age. Methods and Results We examined 137 patients with TAA. Arterial age was estimated according to validated equations, using patients' blood pressure and carotid-femoral pulse wave velocity. Aneurysm growth was determined prospectively from available imaging studies. Multivariable linear regression assessed the association of chronological age and arterial age with TAA growth, and multivariable logistic regression assessed associations of chronological and arterial age with the presence of accelerated aneurysm growth (defined as growth>median in the sample). Mean±SD chronological and arterial ages were 62.2±11.3 and 54.2±24.5 years, respectively. Mean baseline TAA size and follow-up time were 45.9±4.0 mm and 4.5±1.9 years, respectively. Median (interquartile range) TAA growth was 0.31 (0.14-0.52) mm/year. Older arterial age (ß±SE for 1 year: 0.004±0.001, <0.0001) was independently associated with faster TAA growth, while chronological age was not (=0.083). In logistic regression, each 5-year increase in arterial age was associated with a 23% increase in the odds of accelerated TAA growth (95% CI, 1.085-1.394; =0.001). Conclusions Arterial age is independently associated with accelerated aneurysm expansion, while chronological age is not. Our results highlight that a noninvasive and inexpensive assessment of arterial age can potentially be useful for TAA risk stratification and disease monitoring as compared with the current clinical standard (chronological age).
Topics: Humans; Pulse Wave Analysis; Aortic Aneurysm, Thoracic; Arteries; Risk Assessment; Aging
PubMed: 37581401
DOI: 10.1161/JAHA.122.029466