Management of the Acutely Ill and Medically Complex Older Patient

Wells, Chris; Townsend, Martha A.

doi:10.1016/b978-0-323-60912-8.00014-2

Cited by 5 publications

(3 citation statements)

References 92 publications

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“…However, cognition was associated with an average nightly sleep duration of <6 or >9 hours (compared to 6-9 hours) in only midlife patients, and with higher systolic blood pressure, lower diastolic blood pressure, and less mentally-active sedentary behaviour in only later-life patients. The blood pressure associations in later-life are consistent with known increases in systolic and decreases in diastolic blood pressure with age, which in turn increase pulse pressure (Wells & Townsend, 2019)and predict cognitive impairment in middle aged and older people (Sha, Cheng, & Yan, 2018). Indeed, high systolic blood pressure and low diastolic blood pressure are recognised as risk factors for dementia in late-life (>65 years) (Forte, Pascalis, Favieri, & Casagrande, 2020;Ou et al, 2020).…”

Section: Discussionsupporting

confidence: 73%

Relative Associations of Behavioural and Physiological Risks for Cardiometabolic Disease with Cognition in Bipolar Disorder: Findings from the UK Biobank

Ringin,

Dunstan,

Meyer

et al. 2023

Preprint

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Background: Cardiometabolic disease risk factors are disproportionately prevalent in bipolar disorder (BD) and are associated with cognitive impairment. It is, however, unknown which health risk factors for cardiometabolic disease are relevant to cognition in BD. This study aimed to identify the cardiometabolic disease risk factors that are the most important correlates of cognitive impairment in BD; and to examine whether the nature of the relationships vary between mid and later life.Methods: Data from the UK Biobank were available for 966 participants with BD. Individual cardiometabolic disease risk factors were initially regressed onto a global cognition score in separate models for the following risk factor domains; 1) health risk behaviours (physical activity, sedentary behaviour, smoking, sleep) and 2) physiological risk factors, stratified into 2a) anthropometric and clinical risk (handgrip strength, body composition, blood pressure), and 2b) cardiometabolic disease risk biomarkers (CRP, lipid profile). A final combined multivariate regression model for global cognition was then fitted, including only the predictor variables that were significantly associated with cognition in the previous models.Results: In the final combined model, lower mentally-active and higher passive sedentary behaviour, higher levels of physical activity, inadequate sleep duration, higher systolic and lower diastolic blood pressure, and lower handgrip strength were associated with worse global cognition. Conclusions: Health risk behaviours, as well as blood pressure and muscular strength, are associated with cognitive function in BD, whereas other traditional physiological cardiometabolic disease risk factors are not.

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Section: Discussionsupporting

confidence: 73%

Relative Associations of Behavioural and Physiological Risks for Cardiometabolic Disease with Cognition in Bipolar Disorder: Findings from the UK Biobank

Ringin,

Dunstan,

Meyer

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…However, global cognition was associated with an average nightly sleep duration of <6 or >9 h (compared to 6-9 h) in only midlife patients, and with higher systolic blood pressure, lower diastolic blood pressure, and less mentally active sedentary behavior in only later-life patients. The blood pressure associations in later-life are consistent with known increases in systolic and decrease in diastolic blood pressure with age, which in turn increase pulse pressure (Wells & Townsend, 2019) and predict cognitive impairment in middle aged and older people (Sha, Cheng, & Yan, 2018). Indeed, high systolic blood pressure and low diastolic blood pressure are recognized as risk factors for dementia in late-life (>65 years) (Forte, De Pascalis, Favieri, & Casagrande, 2020;Ou et al, 2020).…”

Section: Discussionsupporting

confidence: 72%

Relative associations of behavioral and physiological risks for cardiometabolic disease with cognition in bipolar disorder during mid and later-life: findings from the UK biobank

Ringin,

Dunstan,

Meyer

et al. 2024

Psychol. Med.

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Background Cardiometabolic disease risk factors are disproportionately prevalent in bipolar disorder (BD) and are associated with cognitive impairment. It is, however, unknown which health risk factors for cardiometabolic disease are relevant to cognition in BD. This study aimed to identify the cardiometabolic disease risk factors that are the most important correlates of cognitive impairment in BD; and to examine whether the nature of the relationships vary between mid and later life. Methods Data from the UK Biobank were available for 966 participants with BD, aged between 40 and 69 years. Individual cardiometabolic disease risk factors were initially regressed onto a global cognition score in separate models for the following risk factor domains; (1) health risk behaviors (physical activity, sedentary behavior, smoking, and sleep) and (2) physiological risk factors, stratified into (2a) anthropometric and clinical risk (handgrip strength, body composition, and blood pressure), and (2b) cardiometabolic disease risk biomarkers (CRP, lipid profile, and HbA1c). A final combined multivariate regression model for global cognition was then fitted, including only the predictor variables that were significantly associated with cognition in the previous models. Results In the final combined model, lower mentally active and higher passive sedentary behavior, higher levels of physical activity, inadequate sleep duration, higher systolic and lower diastolic blood pressure, and lower handgrip strength were associated with worse global cognition. Conclusions Health risk behaviors, as well as blood pressure and muscular strength, are associated with cognitive function in BD, whereas other traditional physiological cardiometabolic disease risk factors are not.

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“…However, in their supplementary material, it seems heart rate falls as eudaemonia rises in both men and women (Ikeda et al, 2020: Table S3). Wells and Townsend (2020) note that there are three aspects of pulse that are potentially related to cardiovascular function. These are rate, regularity and quality.…”

Section: 3: the Association Between Pulse And Wellbeingmentioning

confidence: 99%

Taking the Pulse of Nations: a Biometric Measure of Well-being

Blanchflower¹,

Bryson²

2021

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A growing literature identifies associations between subjective and biometric indicators of wellbeing. These associations, together with the ability of subjective wellbeing (SWB) metrics to predict health and behavioral outcomes, have spawned increasing interest in SWB as an important concept in its own right. However, some social scientists continue to question the usefulness of SWB metrics. We contribute to this literature in three ways. First, we introduce a biometric measure of wellbeing -pulse -which has been largely overlooked. Using nationally representative data on 165,000 individuals from the Health Survey for England (HSE) and Scottish Health Surveys (SHeS) we show that its correlates are similar in a number of ways to those for SWB, and that it is highly correlated with SWB metrics, as well as self-assessed health. Second, we examine the determinants of pulse rates in mid-life (age 42) among the 9,000 members of the National Child Development Study (NCDS), a birth cohort born in a single week in 1958 in Britain. Third, we track the impact of pulse measured in mid-life (age 42) on health and labor market outcomes at age 50 in 2008 and age 55 in 2013. The probability of working at age 55 is negatively impacted by pulse rate a decade earlier. The pulse rate has an impact over and above chronic pain measured at age 42. General health at 55 is lower the higher the pulse rate at age 42, while those with higher pulse rates at 42 also express lower life satisfaction and more pessimism about the future at age 50. Taken together, these results suggest social scientists can learn a great deal by adding pulse rates to the metrics they use when evaluating people's wellbeing.

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Management of the Acutely Ill and Medically Complex Older Patient

Cited by 5 publications

References 92 publications

Relative Associations of Behavioural and Physiological Risks for Cardiometabolic Disease with Cognition in Bipolar Disorder: Findings from the UK Biobank

Relative Associations of Behavioural and Physiological Risks for Cardiometabolic Disease with Cognition in Bipolar Disorder: Findings from the UK Biobank

Relative associations of behavioral and physiological risks for cardiometabolic disease with cognition in bipolar disorder during mid and later-life: findings from the UK biobank

Taking the Pulse of Nations: a Biometric Measure of Well-being

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