Background-The ability of older persons to function independently is dependent largely on the maintenance of sufficient aerobic capacity and strength to perform daily activities. Although peak aerobic capacity is widely recognized to decline with age, its rate of decline has been estimated primarily from cross-sectional studies that may provide misleading, overly optimistic estimates of aging changes. Methods and Results-To determine longitudinal rate of change in aerobic capacity and the influence of age, gender, and physical activity on these changes, we performed serial measurements of peak treadmill oxygen consumption (peak V O 2 ) in 375 women and 435 men ages 21 to 87 years from the Baltimore Longitudinal Study of Aging, a community-dwelling cohort free of clinical heart disease, over a median follow-up period of 7.9 years. A linear mixed-effects regression model was used to calculate the predicted longitudinal 10-year rate of change in peak V O 2 , expressed in milliliters per minute, for each age decade from the 20s through the 70s after adjustment for self-reported leisure-time physical activity. A longitudinal decline in peak V O 2 was observed in each of the 6 age decades in both sexes; however, the rate of decline accelerated from 3% to 6% per 10 years in the 20s and 30s to Ͼ20% per 10 years in the 70s and beyond. The rate of decline for each decade was larger in men than in women from the 40s onward. Similar longitudinal rates of decline prevailed when peak V O 2 was indexed per kilogram of body weight or per kilogram of fat-free mass and in all quartiles of self-reported leisure-time physical activity. When the components of peak V O 2 were examined, the rate of longitudinal decline of the oxygen pulse (ie, the O 2 utilization per heart beat) mirrored that of peak V O 2 , whereas the longitudinal rate of heart rate decline averaged only 4% to 6% per 10 years, and accelerated only minimally with age. Conclusions-The longitudinal rate of decline in peak V O 2 in healthy adults is not constant across the age span in healthy persons, as assumed by cross-sectional studies, but accelerates markedly with each successive age decade, especially in men, regardless of physical activity habits. The accelerated rate of decline of peak aerobic capacity has substantial implications with regard to functional independence and quality of life, not only in healthy older persons, but particularly when disease-related deficits are superimposed. (Circulation. 2005;112:674-682.)

A positive and significant association between UA and several inflammatory markers was found in a large population-based sample of older persons and in a sub-sample of participants with normal UA. Accordingly, the prevalence of abnormally high levels of C-reactive protein and IL-6 increased significantly across UA quintiles.

Background Findings from several studies suggested an association between oral health and several health outcomes including cardiovascular disease, aspiration pneumonia, malnutrition, poor quality of life, and mortality. Using data from the Baltimore Longitudinal Study of Aging (BLSA), we tested the hypothesis that number of teeth is indicative of mortality risk independent of other confounders. Methods Dentists conducted a standardized oral examination that included tooth count, tooth with coronal and cervical caries count, and gingival and periodontal index. Blood tests used in the analysis included fasting glucose, oral glucose tolerance test, serum low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol, triglycerides, and white blood cell counts. Physical activity, skin fold thickness, body mass index and chronic diseases were also evaluated. Results Of the 500 BLSA participants evaluated, 198 died an average of 130 (±75) months postdental evaluation, and 302 survivors were followed for a mean of 185 (±90) months. Based on multivariate Cox regression models, being edentulous or having than 20 teeth was independently associated with mortality. Conclusion The results of this study support the notion that number of teeth is a significant and independent risk indicator for early mortality. These findings suggest that the improvement of oral health may have a positive impact on general health and may delay mortality.

Fatores socioambientais associados à ocorrência de quedas em idososSocial and environmental factors associated with the occurrence of falls in the elderly

Abstract

Postmenopausal women taking HRT have a smaller increase in systolic blood pressure over time than those not taking HRT. This difference is intensified at older ages.

No abstract

OBJETIVO: Idosos usam a rede pública ou privada de atendimento de saúde de acordo com a sua situação econômica, social, demográfica e epidemiológica. Analisar como esses fatores influenciam a escolha do local de atendimento e comparar o impacto das rendas individual e familiar do idoso nessa decisão são os objetivos do estudo. MÉTODOS: Foram utilizados dados de um estudo realizado pelo Conselho Estadual do Idoso do Rio Grande do Sul, em 1995, com 7.920 idosos, com idade acima de 60 anos. A coleta de dados foi feito mediante questionário que incluía questões sobre influência do gênero, idade, escolaridade, renda individual e familiar, tamanho da família, participação na renda familiar e auto-avaliação da saúde do idoso. As chances de uso da rede privada de atendimento de saúde foi medida pela regressão logística. RESULTADOS: No acesso à rede privada de atendimento a renda familiar do idoso teve um impacto muito mais expressivo do que a individual. Com um aumento na renda familiar em um salário mínimo, as chances do idoso utilizar a rede privada aumentam 20% contra um acréscimo de apenas 7% no mesmo aumento na renda individual. Também influenciaram positivamente: gênero feminino, idade, escolaridade e tamanho menor da família. CONCLUSÕES: As decisões sobre onde o idoso recebe cuidados de saúde dependem das necessidades e recursos da família e não somente da situação individual do idoso. Conseqüentemente, a saúde do idoso de família de renda baixa recebe prioridade menor e é desproporcionalmente prejudicada pelo pouco recurso familiar e deficiências do sistema público de atendimento.