Vitamin B12 and folate and the risk of anemia in old age: the Leiden 85-Plus Study.

Background: Screening for deficiencies in vitamin B(12) and folate is advocated to prevent anemia in very elderly individuals. However, the effects of vitamin B(12) and folate deficiency on the development of anemia in old age have not yet been established.

Methods: The current study is embedded in the Leiden 85-Plus Study, a population-based prospective study of subjects aged 85 years.

The additional value of routine electrocardiograms in cardiovascular risk management of older people.

Objective: To evaluate whether routinely performed ECGs in older people from the general population have added value for cardiovascular risk management beyond the information that is already available from their medical records.

Design: Observational, prospective cohort study.

Setting: General population.

Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality.

Background: Data on the association between subclinical thyroid dysfunction and coronary heart disease (CHD) and mortality are conflicting.

Purpose: To summarize prospective evidence about the relationship between subclinical thyroid dysfunction and CHD and mortality.

Data Sources: MEDLINE (1950 to January 2008) without language restrictions and reference lists of retrieved articles were searched.

The clinically meaningful change in physical performance scores in an elderly cohort.

Background And Aims: The aim of this study was to assess annual changes in the continuous summary physical performance score (CSPPS) and the quartile summary physical performance (QSPPS) score, evaluate how these changes relate to self-reported changes in physical function and to examine clinically meaningful changes in CSPPS and QSPPS.

Methods: This was a longitudinal study of an elderly cohort of men and women (age>65) reporting at least two domains of disability from 5 centers in the US and Europe. Subjects completed assessments of mobility, ability to perform activities of daily living (ADLs), and the physical component of the SF-36 at both baseline and at 1- year, as well as a self-report of change in function over the year.

High innate production capacity of tumor necrosis factor-alpha and decline of handgrip strength in old age.

Increased signaling of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) elicits apoptosis of skeletal muscle cells in various animal models. Within a population-based prospective follow up study of elderly people aged 85 years we show that a high innate production capacity of TNF-alpha precedes a steeper decline in muscle strength over time.

The routine electrocardiogram for cardiovascular risk stratification in old age: the Leiden 85-plus study.

Objectives: To explore the prognostic value of signs of prior myocardial infarction (MI) and atrial fibrillation (AF) on routine electrocardiograms (ECGs) at the age of 85 with respect to mortality and changes in functional status.

Design: Observational, prospective cohort study with complete 6-year follow-up.

Setting: General population.

Inflammation and interleukin-1 signaling network contribute to depressive symptoms but not cognitive decline in old age.

The association between inflammation and neuropsychiatric symptoms in old age is generally accepted but poorly understood. The purpose of this study was to examine whether inflammation precedes depressive symptoms and cognitive decline in old age, and to identify specific inflammatory pathways herein. We measured serum C-reactive protein (CRP) and lipopolysaccharide-induced production of Interleukin (IL)-1beta, IL-6, Tumor Necrosis Factor (TNF)-alpha, IL-1 receptor antagonist (ra), and IL-10 levels in 85-year-old participants free from neuropsychiatric symptoms at baseline (n=267).

Prospective study of the effect of blood pressure on renal function in old age: the Leiden 85-Plus Study.

High BP is associated with decline of renal function. Whether this is true for very old people largely is unknown. Therefore, this study assessed the effect of BP on creatinine clearance over time in very old participants.

Randomised controlled trial of unsolicited occupational therapy in community-dwelling elderly people: the LOTIS trial.

Objective: The objective of this trial, the Leiden 85-Plus Occupational Therapy Intervention Study (LOTIS), was to assess whether unsolicited occupational therapy, as compared to no therapy, can decelerate the increase in disability in high-risk elderly people.

Design: This was a randomised controlled trial with 2-y follow-up.

Setting: The study took place in the municipality of Leiden in the Netherlands.

Assistive devices and community-based services among 85-year-old community-dwelling elderly in The Netherlands: ownership, use, and need for intervention.

Objective: To assess the home-situation of the oldest old regarding the ownership, use, and need for intervention of assistive devices and community-based services.

Methods: A research nurse and an occupational therapist, who evaluated the current situation regarding ownership and use of assistive devices, visited a representative group of 147 Dutch community-dwelling 85-year-olds in their own homes. Furthermore, the occupational therapist assessed whether an intervention was indicated.

In a population-based prospective study, no association between high blood pressure and mortality after age 85 years.

Objective: To study the impact of a history of hypertension and current blood pressure on mortality in the oldest old.

Design: An observational population-based cohort study.

Setting: Community city of Leiden, The Netherlands.

Natural history of depression in the oldest old: population-based prospective study.

Background: Despite its negative consequences, little is known about the natural history of depression in the oldest old.

Aims: To study the incidence, course and predictors of depression in the general population of the oldest old.

Method: The Leiden 85-plus Study is a prospective population-based study of 500 people from their 85th to their 89th birthdays.

Markers of autonomic tone on a standard ECG are predictive of mortality in old age.

Background: To investigate markers of autonomic tone on a standard electrocardiogram in relation to mortality in old age.

Methods: A total of 599 inhabitants of Leiden, the Netherlands, were enrolled in a population-based follow-up study at their 85th birthday. Electrocardiograms (ECGs) were taken on entry and annually thereafter.

Telomere length in white blood cells is not associated with morbidity or mortality in the oldest old: a population-based study.

Cross-sectional studies have repeatedly suggested peripheral blood monocyte telomere length as a biomarker of aging. To test this suggestion in a large population-based follow-up study of the oldest old, we measured telomere length at baseline in 598 participants of the Leiden 85-plus Study (mean age at baseline 89.8 years).

Homocysteine, vitamin B-12, and folic acid and the risk of cognitive decline in old age: the Leiden 85-Plus study.

Background: High concentrations of homocysteine and low concentrations of vitamin B-12 and folic acid are frequently observed in subjects with dementia.

Objective: We assessed whether serum concentrations of homocysteine, vitamin B-12, or folic acid predict cognitive decline in old age.

Design: This was a prospective, population-based, longitudinal study of 599 subjects (Leiden 85-Plus Study, Netherlands).

Sensory impairment and cognitive functioning in oldest-old subjects: the Leiden 85+ Study.

Objective: Because studies on the association of sensory impairment (both hearing and visual impairment) and cognitive functioning in elderly persons yielded conflicting results, the authors explored this association within the Leiden 85+ Study.

Methods: Within this population-based study of 459 participants aged 85+ years, hearing impairment was measured by audiometry and visual impairment by a visual acuity chart, both under standardized conditions. The Mini-Mental State Exam (MMSE) assessed global cognitive functioning.

Evaluation of continuous summary physical performance scores (CSPPS) in an elderly cohort.

Background And Aims: Physical performance is an important predictor of quality of life among the elderly. A valid and sensitive measure of physical performance is needed in order to evaluate possible interventions. The aim of this study was to examine the validity and reliability of the Continuous Summary Physical Performance Score (CSPPS) and its relationship to the Quartile Summary Physical Performance Score (QSPPS).

Association between chronic diseases and disability in elderly subjects with low and high income: the Leiden 85-plus Study.

Background: Disability in activities of daily living (ADL) might be more prevalent among elderly with low income due to higher prevalence of chronic diseases and impairments, as well as stronger associations of these factors with ADL-disability.

Methods: In the Leiden 85-plus Study, we defined disability as being unable to perform one or more basic ADL activities. Presence of chronic diseases was obtained from medical records, impairments were assessed with performance-tests.

Late-onset dementia: structural brain damage and total cerebral blood flow.

Purpose: To prospectively compare indicators of structural brain damage and total cerebral blood flow in patients with late-onset dementia, subjects of the same age with optimal cognitive function, and young subjects.

Materials And Methods: The institutional ethics committee approved the studies, and all participants (or their guardians) gave informed consent. The test group included 17 patients older than 75 years (four men, 13 women; median age, 83 years) and with a diagnosis of dementia according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

Seasonal mood variation in the elderly: the Leiden 85-plus study.

Background: The influence of seasonal changes on mood and behaviour is called seasonality. The prevalence of seasonality in elderly subjects is unknown.

Aim: To investigate the seasonality pattern in mood and behaviour at old age.

In an observational study elderly patients had an increased risk of falling due to home hazards.

Objective: The objective of this study was to explore the relationship between home hazards and the incidence of falls in the oldest old population.

Study Design And Setting: The Leiden 85-plus Study is a population-based study of all 85-year-old inhabitants of Leiden in the birth-cohort 1912-1914. Participants and general practitioners were interviewed at baseline and annually there after.

Meta-analysis of nonsteroidal antiinflammatory drug use and risk of dementia.

The authors performed a systematic review to summarize the epidemiologic evidence on the association between use of nonsteroidal antiinflammatory drugs (NSAIDs) and the risk of dementia. A total of 25 case-control and cohort studies that reported an odds ratio/relative risk were included. Study-specific log relative risks were weighted by the inverse of their variances to obtain pooled relative risks and 95% confidence intervals.

Is depression in old age fatal only when people feel lonely?

Objective: The impact of depression and perceived loneliness in the oldest old is largely unknown. The authors studied the relationship between the presence of depressive symptoms and all-cause mortality in old age, especially the potential distorting effect of perceived loneliness.

Method: Within a prospective population-based study of 85-year-olds, the 15-item Geriatric Depression Scale and the Loneliness Scale were annually applied in all 476 participants with a Mini-Mental State Examination score of 18 points or more.

Thyroid status, disability and cognitive function, and survival in old age.

Context: Despite the equivocal outcomes of randomized controlled trials, general clinical opinion favors screening and treatment of elderly individuals with subclinical thyroid disorders.

Objectives: To determine whether subclinical thyroid dysfunction should be treated in old age and the long-term impact of thyroid dysfunction on performance and survival in old age.

Design, Setting, And Participants: A prospective, observational, population-based follow-up study within the Leiden 85-Plus Study of 87% of a 2-year birth cohort (1912-1914) in the municipality of Leiden, the Netherlands.