Publications by authors named "Steffy Jansen"

Purpose: The aim of the present study was to investigate characteristics and outcomes in vaccinated and unvaccinated older patients hospitalized for COVID-19 infection.

Methods: A retrospective multicentre cohort study among patients aged ≥70 years hospitalized for COVID-19 infection.

Results: 263 vaccinated and 82 unvaccinated patients were included.

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Purpose: Viral mutations and improved prevention or treatment options may have changed the association of frailty with mortality throughout the COVID-19 pandemic. We investigated how associations of frailty with in-hospital mortality changed throughout the pandemic in older people hospitalised for COVID-19.

Methods: The COVID-OLD study included COVID-19 patients aged ≥ 70 years hospitalised during the first (early 2020), second (late 2020), third (late 2021) or fourth wave (early 2022).

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Article Synopsis
  • This study investigated the prevalence and risk factors of delirium in hospitalized COVID-19 patients aged 70 and older over three pandemic waves in Dutch hospitals.
  • The research included 2,794 patients, finding a decrease in delirium prevalence from 22.5% in the first wave to 12.7% in the third wave, possibly due to vaccinations and improved treatments.
  • Despite changes in prevalence, pre-existing memory issues remained a consistent risk factor for delirium throughout the waves, while the association of delirium with in-hospital mortality was not significant across any wave.
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Purpose: Older patients with COVID-19 can present with atypical complaints, such as falls or delirium. In other diseases, such an atypical presentation is associated with worse clinical outcomes. However, it is not known whether this extends to COVID-19.

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Objectives: A high incidence of delirium has been reported in older patients with Coronavirus disease 2019 (COVID-19). We aimed to identify determinants of delirium, including the Clinical Frailty Scale, in hospitalized older patients with COVID-19. Furthermore, we aimed to study the association of delirium independent of frailty with in-hospital outcomes in older COVID-19 patients.

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Aging is associated with changes in heart rate (HR), heart rate variability (HRV), and 24-h rhythms in HR. Longevity has been linked to lower resting HR, while a higher resting HR and a decreased HRV were linked to cardiovascular events and increased mortality risk. HR and HRV are often investigated during a short electrocardiogram (ECG) measurement at a hospital.

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Background: In order to provide the best care, the perspective of older COVID-19 patients must be involved in the development of treatment protocols. This study describes the experiences of older adults affected by COVID-19 who recovered in the hospital or at home.

Methods: Qualitative semi-structured interviews were conducted with 23 older adults affected by COVID-19.

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Background: as the coronavirus disease of 2019 (COVID-19) pandemic progressed diagnostics and treatment changed.

Objective: to investigate differences in characteristics, disease presentation and outcomes of older hospitalised COVID-19 patients between the first and second pandemic wave in The Netherlands.

Methods: this was a multicentre retrospective cohort study in 16 hospitals in The Netherlands including patients aged ≥ 70 years, hospitalised for COVID-19 in Spring 2020 (first wave) and Autumn 2020 (second wave).

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Background: During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older patients had an increased risk of hospitalisation and death. Reports on the association of frailty with poor outcome have been conflicting.

Objective: The aim of the present study was to investigate the independent association between frailty and in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands.

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Article Synopsis
  • The study investigates how the hormones GH, TSH, ACTH, and cortisol interact in healthy older adults, stressing the importance of these interrelations rather than viewing them in isolation.
  • Correlation analysis showed that ACTH and cortisol are positively correlated, while cortisol and TSH have a negative correlation, indicating complex hormonal interactions within and between different axes.
  • Findings suggest that hormones can influence one another over time, making it essential for future research to explore the biological significance and potential clinical implications of these relationships.
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Background: It is well known that adiposity is a risk factor for insulin resistance and type 2 diabetes mellitus. In the present study, we aimed to investigate the associations of measures of adiposity with indices of glycemia and of glycemic variability over a 72-h period in non-diabetic older adults.

Methods: This cross-sectional study was conducted in non-diabetic individuals from the Active and Healthy Aging Study ( = 228), Switchbox ( = 116), and the Growing Old Together Study ( = 94).

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Introduction: Middle-aged offspring from long-lived families are thought to have a slower pace of aging, possibly related to HPA-axis function. Here, we investigated the neural and behavioral effects of social stress in offspring compared to their regular aging partners on emotional distraction during working memory (WM).

Methods: 104 middle-aged participants (53 males) consisting of offspring and their partners underwent the Trier Social Stress Test or a control procedure.

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Background: Elevated concentrations of liver enzymes have been associated with an increased risk of developing type 2 diabetes mellitus. However, it remains unclear to which specific aspects of diurnal glucose metabolism these associate most. We aimed to investigate the associations between liver enzyme concentrations and 24 h-glucose trajectories in individuals without diabetes mellitus from three independent cohorts.

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The biological clock, whose function deteriorates with increasing age, determines bodily circadian (i.e. 24h) rhythms, including that of cholesterol metabolism.

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Context: A trade-off between fertility and longevity possibly exists. The association of the male hypothalamic-pituitary-gonadal (HPG) axis with familial longevity has not yet been investigated.

Objective: To study 24-h hormone concentration profiles of the HPG axis in men enriched for familial longevity and controls.

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Reduced growth hormone (GH) signaling has been consistently associated with increased health and lifespan in various mouse models. Here, we assessed GH secretion and its control in relation with human familial longevity. We frequently sampled blood over 24 h in 19 middle-aged offspring of long-living families from the Leiden Longevity Study together with 18 of their partners as controls.

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Background: The rs7903146-T allele in the transcription factor 7-like 2 (TCF7L2) gene has been associated with impaired pancreatic insulin secretion, enhanced liver glucose production, and an increased risk of type 2 diabetes. Nevertheless, the impact of rs7903146 on daily glucose trajectories remains unclear. Continuous glucose monitoring (CGM) can estimate glycemia and glycemic variability based on consecutive glucose measurements collected over several days.

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Article Synopsis
  • Individuals from families with a history of longevity exhibit lower rates of age-related diseases like cardiovascular and metabolic issues, potentially due to a healthier stress response.
  • In a study, male offspring from long-lived families had significantly lower cortisol levels and blood pressure compared to non-offspring when exposed to stress, indicating a better physiological response to stressors.
  • This adaptive response to stress could lead to reduced damage over time, contributing to their lower incidence of stress-related diseases and promoting healthier aging.
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Background: The validity of continuous glucose monitoring (CGM) is well established in diabetic patients. CGM is also increasingly used for research purposes in normo-glycemic individuals, but the CGM validity in such individuals is unknown. We studied the accuracy of CGM measurements in normo-glycemic individuals by comparing CGM-derived versus venous blood-derived glucose levels and measures of glycemia and glycemic variability.

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Subclinical hypothyroidism (SCH), defined as elevated thyroid stimulating hormone (TSH) and normal thyroid hormone levels, and cognitive impairment are both common in older people. While the relation between overt hypothyroidism and cognitive impairment is well established, data on the association between SCH and cognitive impairment are conflicting. This systematic review and meta-analysis was performed to assess available evidence on the association of SCH with cognition in community dwelling, relatively healthy older adults.

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Context: Longevity is associated with changes in circulating levels of thyroid hormone (TH) and/or TSH in animals and humans, but underlying mechanisms remain elusive.

Objective: We explored in 38 offspring of nonagenarian participants from the Leiden Longevity Study, who are enriched for longevity and in their partners, ultradian and circadian rhythmicity of TSH, temporal relationship, and feedback and forward interplay between TSH and TH.

Methods: We collected blood samples every 10 minutes for 24 hours for TSH and TH profiles.

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Article Synopsis
  • The study investigates the HPA-axis, a key stress response system, in relation to familial longevity, comparing 24-hour plasma ACTH and cortisol levels in offspring of long-lived siblings to age-matched controls.
  • Despite observing higher basal ACTH levels in male offspring, other parameters of HPA-axis activity and its regulation showed no significant differences between the two groups.
  • Results indicate that while familial longevity might not correlate with major differences in HPA-axis function at rest, there are minor, sex-specific variations worth further exploration.
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Given the concurrent, escalating epidemic of diabetes mellitus and neurodegenerative diseases, two age-related disorders, we aimed to understand the relation between parameters of glucose metabolism and indices of pathology in the aging brain. From the Leiden Longevity Study, 132 participants (mean age 66 years) underwent a 2-h oral glucose tolerance test to assess glucose tolerance (fasted and area under the curve (AUC) glucose), insulin sensitivity (fasted and AUC insulin and homeostatic model assessment of insulin sensitivity (HOMA-IS)) and insulin secretion (insulinogenic index). 3-T brain MRI was used to detect macro-structural damage (atrophy, white matter hyper-intensities, infarcts and/or micro-bleeds) and magnetization transfer imaging (MTI) to detect loss of micro-structural homogeneity that remains otherwise invisible on conventional MRI.

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Impaired glucose metabolism and type 2 diabetes have been associated with cognitive decline, dementia, and with structural and functional brain features. However, it is unclear whether these associations differ in individuals that differ in familial longevity or age. Here, we investigated the association between parameters of glucose metabolism and microstructural brain integrity in offspring of long-lived families ("offspring") and controls; and age categories thereof.

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Article Synopsis
  • The study investigates whether offspring of long-lived families exhibit lower activity in the HPA axis, indicated by cortisol levels, compared to their partners.
  • Offspring showed significantly lower salivary cortisol levels in both morning and evening measurements compared to partners, suggesting reduced HPA activity.
  • No significant difference in cortisol feedback sensitivity was observed between offspring and partners, indicating that while cortisol secretion is lower, feedback mechanisms are similar.
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