Reply to: Older People's Loneliness in Clinical Work - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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Older People's Loneliness in Clinical Work - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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Alcohol Consumption and Functional Limitations in Older Men: Does Muscle Strength Mediate Them? - American Geriatric Society

OBJECTIVES

To evaluate the dose‐response relationships between alcohol consumption and functional limitations in older European men, and explore the role of muscle strength as a mediator of these relationships.

DESIGN

Cross‐sectional study of older men participating in the Survey of Health, Aging and Retirement in Europe (SHARE).

SETTING

Urban and rural households in 17 European countries and Israel.

PARTICIPANTS

A total of 17 870 men aged 65 years and older from the SHARE (Wave 6, 2015) were included in this study.

MEASUREMENTS

Outcome variables were functional limitations: mobility limitation, arm function limitation, and fine motor limitation. Main exposure variable was alcohol consumption. Mediating factor was grip strength. Basic demographics, life habits, and health status were considered as potential confounders. Dose‐response analyses with restricted cubic splines and the Karlson/Holm/Breen method were conducted.

RESULTS

A total of 17 870 participants were included in this study. Dose‐response analyses revealed that moderate alcohol consumption was related to the lower odds of reporting mobility limitation (≤35 units/wk) and arm function limitation (≤41 units/wk), with a minimum odds ratio (OR) occurring at 10 units/week drinks for mobility limitation (OR = .71; 95% confidence interval [CI] = .62‐.81) and arm function limitation (OR = .66; 95% CI = .59‐.75). The odds of reporting the fine motor limitation monotonically increased with alcohol consumption when alcohol consumption was beyond 15 units/week. No significant mediating effect of grip strength on the relationships between alcohol consumption and mobility limitation and arm function limitation was found.

CONCLUSION

Moderate alcohol consumption has a protective role in mobility and arm function limitation in older European men. Grip strength is not the main mediator of these associations, suggesting that the protective effect is independent of muscle strength. Alcohol consumption is associated with higher odds of reporting fine motor limitation in older European men.

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Physical Activity and Risk of Postoperative Delirium - American Geriatric Society

BACKGROUND/OBJECTIVE

Regular physical activity (PA) has been associated with improved cognitive function, but its effect on postoperative delirium (POD) has not been established. Our objectives were to determine the effect of baseline PA on the incidence of POD in older patients undergoing elective orthopedic surgery and to determine whether these effects were independent of cognitive reserve. We hypothesize that PA protects against POD by bolstering physiologic reserve needed to withstand the stressors of surgery.

DESIGN

Secondary analysis of a prospective, single‐center, cohort study.

SETTING

Urban academic hospital.

PARTICIPANTS

A total of 132 nondemented, English‐speaking adults older than 60 years undergoing elective orthopedic surgery.

MEASUREMENTS

Subjects were screened for POD and delirium severity using the Confusion Assessment Method and the Memorial Delirium Assessment Scale. Baseline cognitive activities and PAs were assessed with a validated Leisure Activity Scale. Regular PA was categorized as 6 to 7 days per week. The association of regular PA with incidence of POD was assessed using multivariable logistic regression, adjusting for age, sex, Charlson Comorbidity Index, cognitive reserve, and cognitive function. Linear regression was used to assess the association of delirium severity with regular PA.

RESULTS

Of 132 patients, 41 (31.1%) developed POD. Regular PA was associated with a 74% lower odds of developing POD (odds ratio [OR] = 0.26; 95% confidence interval [CI] = 0.08‐0.82). There was no significant interaction between PA and cognitive reserve (P = .70). Of 85 women, 25 (29.4%), and of 47 men, 16 (34.0%) developed POD. In stratified analysis, women who engaged in regular PA had dramatically lower odds of POD (OR = 0.08; 95% CI = 0.01‐0.63) compared with men (OR = 0.93; 95% CI = 0.18‐4.97).

CONCLUSIONS

Regular PA is associated with decreased incidence of POD, especially among women. Future studies should address the basis of sex differences in PA benefits on delirium.

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Pro-caspase-3 protects cells from polymyxin B-induced cytotoxicity by preventing ROS accumulation - Journal of Antibiotics

The Journal of Antibiotics, Published online: 02 August 2019; doi:10.1038/s41429-019-0216-6

Pro-caspase-3 protects cells from polymyxin B-induced cytotoxicity by preventing ROS accumulation

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Binge Drinking Among Older Adults in the United States, 2015 to 2017 - American Geriatric Society

OBJECTIVES

Binge drinking is a risk factor for a range of harms. This study estimates the national prevalence of binge drinking and adds to our understanding of correlates of binge drinking among older adults in the United States.

DESIGN

Cross‐sectional analysis.

SETTING/PARTICIPANTS

A total of 10 927 adults, aged 65 years or older, from the 2015 to 2017 administrations of the US National Survey on Drug Use and Health.

MEASUREMENTS

We estimated the prevalence of past‐month binge alcohol use (five or more drinks on the same occasion for men and four or more drinks on the same occasion for women). Characteristics of past‐month binge drinkers, including demographics, substance use, serious mental illness, mental health treatment utilization, chronic disease, and emergency department (ED) use, were compared to participants who reported past‐month alcohol use without binge drinking. Comparisons were made using χ² tests. We then used multivariable generalized linear models using Poisson and log link to examine the association between covariates and binge drinking among all past‐month alcohol users aged 65 years or older.

RESULTS

Of 10 927 respondents, 10.6% (95% CI = 9.9%‐11.2%) were estimated to be current binge drinkers. Binge drinkers were more likely to be male, have a higher prevalence of current tobacco and/or cannabis use, and have a lower prevalence of two or more chronic diseases compared to nonbinge drinkers. In multivariable analysis, among past‐month alcohol users, the prevalence of binge drinking was higher among non‐Hispanic African Americans than whites (adjusted prevalence ratio [aPR] = 1.44; 95% CI = 1.16‐1.80), tobacco users (aPR = 1.52; 95% CI = 1.33‐1.74), cannabis users (aPR = 1.41; 95% CI = 1.11‐1.80), and those who visited the ED in the past year (aPR = 1.16; 95% CI = 1.00‐1.33).

CONCLUSION

Over a tenth of older adults in the United States are estimated to be current binge drinkers. Results confirm the importance of screening for binge drinking behaviors among older adults to minimize harms.

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Heterologous production of coryneazolicin in Escherichia coli - Journal of Antibiotics

The Journal of Antibiotics, Published online: 31 July 2019; doi:10.1038/s41429-019-0212-x

Heterologous production of coryneazolicin in Escherichia coli

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