Objectives: To determine the association between fatigue and survival over 10 years in a population of older community-dwelling primary care patients.
Design: Prospective cohort study.
Setting: Medicare health maintenance organization and Veterans Affairs primary care programs.
Participants: Older primary care patients (N=492).
Measurements: Fatigue, operationalized as feeling tired most of the time, was assessed at baseline. Mortality was ascertained from the National Death Index. Covariates included demographics, comorbidity, cognitive function, depressive symptoms, body mass index, self-rated health, functional status, and gait speed.
Results: Mortality rates at 10 years were 59% (123/210) for older adults with fatigue, versus 38% (106/282) for those without fatigue (P<.001). After adjustment for multiple potential confounders, participants who were tired at baseline had a greater risk of death than those who were not (hazard ratio=1.44, 95% confidence interval=1.08-1.93).
Conclusion: A single simple question "Do you feel tired most of the time?" identifies older adults with a higher risk of mortality. Further research is needed to identify and characterize the underlying mechanisms of fatigue, to develop and test specific treatments, and to determine whether improvement leads to decreased morbidity and mortality.
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http://dx.doi.org/10.1111/j.1532-5415.2008.01957.x | DOI Listing |
Sports Med Open
January 2025
Institute of Primary Care, University of Zurich, Zurich, Switzerland.
Background: Marathon training and running have many beneficial effects on human health and physical fitness; however, they also pose risks. To date, no comprehensive review regarding both the benefits and risks of marathon running on different organ systems has been published.
Main Body: The aim of this review was to provide a comprehensive review of the benefits and risks of marathon training and racing on different organ systems.
J Gen Intern Med
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Research and Development Unit, Hammersmith and Fulham Primary Care Network, London, UK.
J Gen Intern Med
January 2025
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Background: Active surveillance (AS) is the guideline-recommended treatment for low-risk prostate cancer and involves routine provider visits, lab tests, imaging, and prostate biopsies. Despite good uptake, adherence to AS, in terms of receiving recommended follow-up testing and remaining on AS in the absence of evidence of cancer progression, remains challenging.
Objective: We sought to better understand urologist, primary care providers (PCPs), and patient experiences with AS care delivery to identify opportunities to improve adherence.
Mol Biol Rep
January 2025
Department of Pharmacology, School of Health Sciences, Central University of Punjab, Bathinda, 151401, India.
Background: Multiple sclerosis (MS) is a chronic autoimmune condition that damages the myelin sheath of neurons in the central nervous system, resulting in compromised nerve transmission and motor impairment. The astrocytopathy is considered one of the prominent etiological factor in the pathophysiology of demyelination in MS. The expression level of ceramide synthase-2 (CS-2) is yet to be established in the pathophysiology of astrocytopathy although the derailed ceramide biosynthetic pathways is well demonstrated in the pathophysiology of demyelination.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Pharmacy, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam.
Evidence of antihypertensive drug-related problems (aDRP) is limited in Asian ambulatory care. To better detect aDRP without causing alert fatigue, we investigated whether adding more antihypertensive agents was associated with increasing aDRP risk and factors associated with physician acceptance of aDRP correction. We conducted a cross-sectional study targeting ambulatory prescriptions of Vietnamese patients with hypertension who either received standard therapy (using two or fewer medications, SdT) or standard plus add-on therapy (using more than two medications, SdT + add-on).
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