Publications by authors named "Leo Westbury"

We investigated associations between 'healthy dietary pattern' scores, at ages 36, 43, 53 and 60-64 years, and body composition at age 60-64 among participants from the MRC National Survey of Health and Development (NSHD). Principal component analyses of dietary data (food diaries) at age 60-64 were used to calculate diet scores (healthy dietary pattern scores) at each age. Higher scores indicated healthier diets (higher consumption of fruit, vegetables and wholegrain bread).

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Aims: We examined whether admission risk increases at a certain threshold of number of systems medicated or whether any increase confers greater admission risk in either sex in a community-dwelling cohort of older persons in Hertfordshire. This study uses a longitudinal retrospective study design.

Methods: Data from 2997 men and women (aged 59-73 at baseline) were analyzed.

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Aim: To examine the relationship between level of morbidity burden and long-term risk of fractures, falls, and joint replacements in the community-dwelling participants of the Hertfordshire Cohort Study.

Methods: Data were analyzed from 2997 individuals (age 59-73 at baseline). Outcomes (fractures, falls, and lower limb joint replacements) were identified using ICD-10 and OPCS-4 codes from Hospital Episode Statistics data, available from baseline (1998-2004) until December 2018.

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Introduction: HIV infection and its treatment compromises skeletal development (growth and maturation). Skeletal maturity is assessed as bone age (BA) on hand and wrist radiographs. BA younger than chronological age (CA) indicates delayed development.

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Background: Low grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited.

Aim: We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.

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Aims: The 2021 European Society of Cardiology prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding initiation of prevention. We aimed to update and systematically recalibrate the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model to four European risk regions for the estimation of lifetime CVD risk for apparently healthy individuals.

Methods And Results: The updated LIFE-CVD (i.

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Aim: To consider how self-reported physical function measures relate to adverse clinical outcomes measured over 20 years of follow-up in a community-dwelling cohort (aged 59-73 at baseline) as compared with hand grip strength, a well-validated predictor of adverse events.

Background: Recent evidence has emphasized the significant association of physical activity, physical performance, and muscle strength with hospital admissions in older people. However, physical performance tests require staff availability, training, specialized equipment, and space to perform them, often not feasible or realistic in the context of a busy clinical setting.

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Article Synopsis
  • This study investigates the links between grip strength and bone mineral density (BMD) with overall and specific causes of mortality in a UK population over 20 years.
  • Data from 909 participants, aged around 64 years, revealed that lower grip strength significantly increases the risk of all-cause and cardiovascular mortality, while BMD showed no association with mortality risk.
  • The findings suggest that grip strength may be a more relevant indicator of mortality risk than BMD, possibly due to better awareness and management of low BMD in the studied group.
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Background: Poor self-rated health (SRH) has been shown to predict adverse health outcomes among older people, however these associations have traditionally only been considered at one point in the lifecourse, usually midlife or later. Here we examined lifecourse correlates of SRH in early, mid and later life, relating these to subsequent risk of mortality in a community-dwelling cohort.

Methods: 2989 men and women from the Hertfordshire Cohort Study (HCS) were included in this study.

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Registry studies have suggested associations between relationship status and fracture risk. We considered associations between relationship status and incident fracture in the Hertfordshire Cohort Study, comprising community-dwelling older adults, and explored associations between socioeconomic and lifestyle factors with relationship status. 2997 participants completed a baseline questionnaire (1998-2004) and clinic visit.

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Background: Social isolation and loneliness are prevalent among older adults. This study investigated factors influencing worsening social isolation and loneliness in community-dwelling older adults during the COVID-19 pandemic, focusing on musculoskeletal conditions, falls, and fractures.

Methods: We studied 153 participants from the Hertfordshire Cohort Study.

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This study explores the relationship between musculoskeletal conditions of ageing and life-space mobility (LSM) in 1110 community-dwelling older adults from the Hertfordshire Cohort Study. LSM is a novel measure which captures ability to mobilise within the home, locally and more widely. Among men, older age, care receipt, not driving a car, lower wellbeing, and reduced physical function were associated with lower LSM, while in women only driving status and physical function were associated with LSM.

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Small noncoding RNAs (sncRNAs) are implicated in age-associated pathologies, including sarcopenia and insulin resistance (IR). As potential circulating biomarkers, most studies have focussed on microRNAs (miRNAs), one class of sncRNA. This study characterized the wider circulating sncRNA transcriptome of older individuals and associations with sarcopenia and IR.

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Background: Muscle weakness is associated with adverse clinical outcomes including disability and mortality. We report demographic, anthropometric and lifestyle correlates of grip strength in UK and Japanese population-based cohorts.

Aim: To report prevalence of low grip strength according to 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and 2019 Asian Working Group for Sarcopenia (AWGS 2019) thresholds and to consider correlates of grip strength in Eastern and Western populations.

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Background: While ageing is associated with increased insulin resistance (IR), the molecular mechanisms underlying increased IR in the muscle, the primary organ for glucose clearance, have yet to be elucidated in older individuals. As epigenetic processes are suggested to contribute to the development of ageing-associated diseases, we investigated whether differential DNA methylation was associated with IR in human primary muscle stem cells (myoblasts) from community-dwelling older individuals.

Methods: We measured DNA methylation (Infinium HumanMethylationEPIC BeadChip) in myoblast cultures from vastus lateralis biopsies (119 males/females, mean age 78.

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Background: Demographic changes worldwide are leading to pressures on health services, with hospital admissions representing an important contributor. Here, we report admission types experienced by older people and examine baseline risk factors for subsequent admission/death, from the community-based Hertfordshire Cohort Study.

Methods: 2997 participants (1418 women) completed a baseline questionnaire and clinic visit to characterize their health.

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Article Synopsis
  • * The study analyzed data from 359 participants aged 71-80, finding that observer-derived K&L scores were better at predicting pain and function compared to minimum joint space measurements and osteophyte assessments, while ML-derived scores for women were comparable to expert scores.
  • * The researchers suggest that using ML alongside expert evaluation for K&L scoring could enhance accuracy and efficiency in diagnosing knee OA.
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Background: Amongst healthy older people, a number of correlates of impaired skeletal muscle mass and function have been defined. Although the prevalence of obesity is increasing markedly in this age group, information is sparse about the particular impacts of obesity on ageing skeletal muscle or the molecular mechanisms that underlie this and associated disease risk.

Methods: Here, we examined genome-wide transcriptional changes using RNA sequencing in muscle biopsies from 40 older community-dwelling men from the Hertfordshire Sarcopenia Study with regard to obesity (body mass index [BMI] >30 kg/m , n = 7), overweight (BMI 25-30, n = 19), normal weight (BMI < 25, n = 14), and per cent and total fat mass.

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Introduction: Adequate nutrition is important for health in later life. Older adults are especially vulnerable to adverse outcomes following infection by COVID-19 and have commonly spent a disproportionate time within their own homes to reduce risk of infection. There are concerns that advice to shield may have led to malnutrition as older adults may modify daily routines including usual shopping habits.

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Background: The 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and the Sarcopenia Definitions and Outcomes Consortium (SDOC) have recently proposed sarcopenia definitions. However, comparisons of the performance of these approaches in terms of thresholds employed, concordance in individuals and prediction of important health-related outcomes such as death are limited. We addressed this in a large multinational assembly of cohort studies that included information on lean mass, muscle strength, physical performance and health outcomes.

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Background: Traditional analysis of High Resolution peripheral Quantitative Computed Tomography (HR-pQCT) images results in a multitude of cortical and trabecular parameters which would be potentially cumbersome to interpret for clinicians compared to user-friendly tools utilising clinical parameters. A computer vision approach (by which the entire scan is 'read' by a computer algorithm) to ascertain fracture risk, would be far simpler. We therefore investigated whether a computer vision and machine learning technique could improve upon selected clinical parameters in assessing fracture risk.

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Background: Self-perceived risk of fracture (SPR) is associated with fracture independent of FRAX calculated risk. To understand this better we considered whether lifestyle factors not included in the FRAX algorithm and psychosocial factors (social isolation, self-efficacy, or mental health status) explain the relationship between SPR and fracture.

Methods: We studied 146 UK community-dwelling older adults from the Hertfordshire Cohort Study.

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Article Synopsis
  • The study investigated how osteoarthritis and other musculoskeletal conditions affect the self-care abilities and care access for older adults living independently.
  • It involved data from 443 older adults around 75 years, finding that significant percentages had osteoarthritis, osteoporosis, sarcopenia, or frailty.
  • Results showed that osteoarthritis and frailty were linked to difficulties in self-care and increased need for home care, indicating the need for better management of osteoarthritis to support independent living in older adults.
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Purpose: The age-related loss of skeletal muscle mass and strength is associated with adverse health outcomes. However, to date, peripheral quantitative computed tomography (pQCT)-derived muscle density has been little studied. We used a well characterised cohort of older adults to identify lifestyle and anthropometric determinants of pQCT-derived muscle density measured 11 years later, and to report relationships between pQCT-derived muscle density with history of falls and prevalent fractures.

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