Cohort Profile: The Longitudinal Aging Study Amsterdam
01 Aug 2011-International Journal of Epidemiology (Oxford University Press)-Vol. 40, Iss: 4, pp 868-876
TL;DR: The Longitudinal Aging Study Amsterdam (LASA) was initiated by the Dutch Ministry of Welfare, Health and Culture (currently Ministry of Health, Welfare and Sports) in 1991 to inform the ministry’s policy and monitor functioning and well-being of older Dutch people.
Abstract: The Longitudinal Aging Study Amsterdam (LASA) was initiated by the Dutch Ministry of Welfare, Health and Culture (currently Ministry of Health, Welfare and Sports). By the end of the 1980s, ministry officials recognized that ageing would be a major demographic driving force, shaping the need for health care in the Dutch population in the near future. Therefore, they became increasingly interested in the process of ageing and ageing-related determinants of health-care use, and wanted to develop policies for older people in The Netherlands who were in need of extra care and support. Maintaining independent functioning, quality of life and participation of older people were recognized to be major challenges for Dutch society. Multi-disciplinary and longitudinal scientific research was considered to be needed to inform the ministry’s policy and monitor functioning and well-being of older Dutch people, leading to the start of the LASA study in 1991. The study was designed by researchers from the VU University and VU University Medical Center in Amsterdam, in a close collaboration between social and biomedical scientists. This collaboration ensured a thoroughly multi-disciplinary approach fitting the scope of the intended focus of LASA.
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Technical University of Madrid1, Carlos III Health Institute2, Ghent University3, University of Zaragoza4, University of Copenhagen5, University of Tromsø6, Harokopio University7, Robert Koch Institute8, Medical Research Council9, Medical University of Graz10, VU University Amsterdam11, University of Iceland12, National Institutes of Health13, University of Helsinki14, Loyola University Chicago15, University College Cork16
TL;DR: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective, and what direction these strategies take will depend on European policy.
830 citations
Additional excerpts
...75 LASA (158) (33) Weighted Deming — 22....
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...Longitudinal Aging Study Amsterdam (Netherlands) (33) 13....
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Medical University of Graz1, University of Tromsø2, Synlab Group3, Heidelberg University4, University of Ulm5, Charité6, University of Bern7, National Institutes of Health8, RMIT University9, VU University Amsterdam10, Utrecht University11, Aarhus University Hospital12, Robert Koch Institute13, VU University Medical Center14, Loyola University Medical Center15, University College Cork16
TL;DR: An association between low 25(OH)D and increased risk of all-cause mortality is observed and it is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths.
Abstract: Background
Vitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D) concentrations and used aggregate data instead of individual participant data (IPD). We therefore performed an IPD meta-analysis on the association between standardized serum 25(OH)D and mortality.
Methods
In a European consortium of eight prospective studies, including seven general population cohorts, we used the Vitamin D Standardization Program (VDSP) protocols to standardize 25(OH)D data. Meta-analyses using a one step procedure on IPD were performed to study associations of 25(OH)D with all-cause mortality as the primary outcome, and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488.
Findings
We analysed 26916 study participants (median age 61.6 years, 58% females) with a median 25(OH)D concentration of 53.8 nmol/L. During a median follow-up time of 10.5 years, 6802 persons died. Compared to participants with 25(OH)D concentrations of 75 to 99.99 nmol/L, the adjusted hazard ratios (with 95% confidence interval) for mortality in the 25(OH)D groups with 40 to 49.99, 30 to 39.99, and <30 nmol/L were 1.15 (1.00–1.29), 1.33 (1.16–1.51), and 1.67 (1.44–1.89), respectively. We observed similar results for cardiovascular mortality, but there was no significant linear association between 25(OH)D and cancer mortality. There was also no significantly increased mortality risk at high 25(OH)D levels up to 125 nmol/L.
Interpretation
In the first IPD meta-analysis using standardized measurements of 25(OH)D we observed an association between low 25(OH)D and increased risk of all-cause mortality. It is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths.
283 citations
Brigham and Women's Hospital1, Beth Israel Deaconess Medical Center2, University of Florida3, California Pacific Medical Center4, United States Department of Agriculture5, University of Maryland, Baltimore6, University of Pittsburgh7, University of Southampton8, Ohio University9, The Catholic University of America10, Public Health Research Institute11, Novartis12, The Chinese University of Hong Kong13, University of Alberta14, Washington University in St. Louis15, Johns Hopkins University16, National Institutes of Health17, Boston University18, Georgia Southern University19
TL;DR: The Sarcopenia Definition and Outcomes Consortium crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population‐based studies.
Abstract: Objectives To develop an evidence-based definition of sarcopenia that can facilitate identification of older adults at risk for clinically relevant outcomes (eg, self-reported mobility limitation, falls, fractures, and mortality), the Sarcopenia Definition and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population-based studies. Methods Thirteen position statements related to the putative components of a sarcopenia definition, informed by the SDOC analyses and literature synthesis, were reviewed by an independent international expert panel (panel) iteratively and voted on by the panel during the Sarcopenia Position Statement Conference. Four position statements related to grip strength, three to lean mass derived from dual-energy x-ray absorptiometry (DXA), and four to gait speed; two were summary statements. Results The SDOC analyses identified grip strength, either absolute or scaled to measures of body size, as an important discriminator of slowness. Both low grip strength and low usual gait speed independently predicted falls, self-reported mobility limitation, hip fractures, and mortality in community-dwelling older adults. Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size. Conclusion The panel agreed that both weakness defined by low grip strength and slowness defined by low usual gait speed should be included in the definition of sarcopenia. These position statements offer a rational basis for an evidence-based definition of sarcopenia. The analyses that informed these position statements are summarized in this article and discussed in accompanying articles in this issue of the journal. J Am Geriatr Soc 68:1410-1418, 2020.
270 citations
Additional excerpts
...The SDOC team assembled eight observational studies that included 18 831 community-dwelling older adults (13 683 men and 5148 women), eight carefully characterized clinical populations (randomized trials and additional cohort studies of patients with hip fracture and human immunodeficiency virus [HIV]), and two nationally representative population-based cohorts (the Health and Retirement Survey [HRS], with 7370 subjects [3170 men and 4200 women]; and the National Health and Aging Trends Survey [NHATS], with 5614 subjects [2460 men and 3154 women]).(19-33) Among 18 831 community-dwelling older adults in the eight observational studies, 3143 (17%) had self-reported mobility limitation defined as any difficulty walking two to three blocks or climbing 10 steps....
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TL;DR: In this article, the authors investigated the associations of sarcopenia as defined by European Working Group on Sarcopenia in Older People (EWGSOP) and Foundation for the National Institutes of Health (FNIH) Sarc Openia Project, and their underlying components, with the incidence of recurrent falling and fractures.
Abstract: Background: The aim was to investigate the associations of sarcopenia as defined by European Working Group on Sarcopenia in Older People (EWGSOP) and Foundation for the National Institutes of Health (FNIH) Sarcopenia Project, and their underlying components, with the incidence of recurrent falling and fractures. Methods: In 498 older men and women (mean age = 75.2 [SD = 6.4]) from the Longitudinal Aging Study Amsterdam (LASA), the sarcopenia components lean mass (DXA), handgrip strength (handheld dynamometer), and gait speed were measured. Data on falls (3-year follow-up) and fractures (10-year follow-up) were collected. Cox regression analyses were performed, adjusting for age, sex, and total body fat. Results: Recurrent falling occurred in 130 persons and 60 persons experienced a fracture during follow-up. Participants who were identified as sarcopenic based on the FNIH definitions had a more than 2-fold increased risk to become a recurrent faller. There was no association between sarcopenia based on the EWGSOP definition and incidence of recurrent falling. When the sarcopenia components were examined individually, only a low grip strength was associated with incidence of recurrent falling, independent of a low lean mass or a slow gait speed. Sarcopenia according to both definitions was not associated with incident fractures, which may be caused by low statistical power. Conclusion: Sarcopenia according to the FNIH definitions, but not according to the EWGSOP definition was associated with recurrent falling. When examining the individual components, only a low grip strength was independently associated with recurrent falling. No associations between sarcopenia with incidence of fractures were found.
261 citations
Cites methods from "Cohort Profile: The Longitudinal Ag..."
...In brief, a sample of older men and women (aged 55–85 years), stratified by age and sex, was drawn from the population registries of 11 municipalities in three areas of The Netherlands....
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...Data for this study were collected in the context of the Longitudinal Aging Study Amsterdam (LASA), an ongoing interdisciplinary cohort study on predictors and consequences of changes in autonomy and well-being in the aging population in The Netherlands (21,22)....
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...Study Sample Data for this study were collected in the context of the Longitudinal Aging Study Amsterdam (LASA), an ongoing interdisciplinary cohort study on predictors and consequences of changes in autonomy and well-being in the aging population in The Netherlands (21,22)....
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TL;DR: The increased cardiovascular risk found is equivalent to the effect of traditional cardiovascular risk factors, suggesting that long-term elevated cortisol may be an important cardiovascular risk factor.
Abstract: Background: Stress is associated with an increased incidence of cardiovascular disease. The impact of chronic stress on cardiovascular risk has been studied by measuring cortisol in serum and saliva, which are measurements of only 1 time point. These studies yielded inconclusive results. The measurement of cortisol in scalp hair is a novel method that provides the opportunity to measure long-term cortisol exposure. Our aim was to study whether long-term cortisol levels, measured in scalp hair, are associated with cardiovascular diseases. Methods: A group of 283 community-dwelling elderly participants were randomly selected from a large population-based cohort study (median age, 75 y; range, 65-85 y). Cortisol was measured in 3-cm hair segments, corresponding roughly with a period of 3 months. Self-reported data concerning coronary heart disease, stroke, peripheral arterial disease, diabetes mellitus, and other chronic noncardiovascular diseases were collected. Results: Hair cortisol levels were significantly lower in women than in men (21.0 vs 26.3 pg/mg hair; P < .001). High hair cortisol levels were associated with an increased cardiovascular risk (odds ratio, 2.7; P = .01) and an increased risk of type 2 diabetes mellitus (odds ratio, 3.2; P = .04). There were no associations between hair cortisol levels and noncardiovascular diseases. Conclusions: Elevated long-term cortisol levels are associated with a history of cardiovascular disease. The increased cardiovascular risk we found is equivalent to the effect of traditional cardiovascular risk factors, suggesting that long-term elevated cortisol may be an important cardiovascular risk factor. Copyright
181 citations
Cites methods from "Cohort Profile: The Longitudinal Ag..."
...Detailed information concerning data collection and sampling have been described previously (24, 25)....
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TL;DR: Although the majority of U.S. health care expenditures for the treatment of osteoporotic fractures were for white women, one‐fourth of the total was borne by other population subgroups.
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TL;DR: The results of this prospective, population-based study show that lower 25-OHD and higher PTH levels increase the risk of sarcopenia in older men and women.
Abstract: The age-related change in hormone concentrations has been hypothesized to play a role in the loss of muscle mass and muscle strength with aging, also called sarcopenia. The aim of this prospective study was to investigate whether low serum 25-hydroxyvitamin D (25-OHD) and high serum PTH concentration were associated with sarcopenia. In men and women aged 65 yr and older, participants of the Longitudinal Aging Study Amsterdam, grip strength (n = 1008) and appendicular skeletal muscle mass (n = 331, using dual-energy x-ray absorptiometry) were measured in 1995-1996 and after a 3-yr follow-up. Sarcopenia was defined as the lowest sex-specific 15th percentile of the cohort, translating into a loss of grip strength greater than 40% or a loss of muscle mass greater than 3%. After adjustment for physical activity level, season of data collection, serum creatinine concentration, chronic disease, smoking, and body mass index, persons with low ( 50 nmol/liter) levels. High PTH levels (>or=4.0 pmol/liter) were associated with an increased risk of sarcopenia, compared with low PTH (<3.0 pmol/liter): odds ratio = 1.71 (1.07-2.73) based on grip strength, odds ratio = 2.35 (1.05-5.28) based on muscle mass. The associations were similar in men and women. The results of this prospective, population-based study show that lower 25-OHD and higher PTH levels increase the risk of sarcopenia in older men and women.
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TL;DR: The 2006 Second International Working Meeting on Frailty and Aging as mentioned in this paper discussed the distinction between frailty and aging, its relationship with chronic disease, and the critical domains in its operational definition.
Abstract: Clinicians and researchers have shown increasing interest in frailty. Yet, there is still considerable uncertainty regarding the concept and its definition. In this article, we present perspectives on key issues and controversies discussed by scientists from 13 different countries, representing a diverse range of disciplines, at the 2006 Second International Working Meeting on Frailty and Aging. The following fundamental questions are discussed: What is the distinction, if any, between frailty and aging? What is its relationship with chronic disease? Is frailty a syndrome or a series of age-related impairments that predict adverse outcomes? What are the critical domains in its operational definition? Is frailty a useful concept? The implications of different models and approaches are examined. Although consensus has yet to be attained, work accomplished to date has opened exciting new horizons. The article concludes with suggested directions for future research.
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