Child ; Humans ; COVID-19 ; SARS-CoV-2

Objective: To investigate the predictive value of N-terminal type B natriuretic peptide（NT-proBNP) on the prognosis of elderly hospitalized patients without heart failure（non-heart failure). Method: Elderly patients aged 65 years or older, who were admitted to Beijing Hospital from September 2018 to February 2019, were enrolled in this study. Patients with clinical diagnosis of heart failure or left ventricular ejection fraction（LVEF)<50% were excluded. The patients were divided into 2 groups based on the serum NT-proBNP level: low NT-proBNP group （<125 ng/L) and high NT-proBNP group（≥125 ng/L). Patients were followed up at 3, 6, and 12 months after enrollment, and the major adverse events were recorded. The composite endpoint events included all-cause mortality, readmission or Emergency Department visits. Cardiovascular events include death, readmission or emergency room treatment due to cardiogenic shock, myocardial infarction, angina pectoris, arrhythmia, heart failure or stroke/transient ischemic attack. Results: A total of 600 elderly patients with non-heart failure were included in the analysis. The average age was （74.9±6.5) years, including 304（50.7%) males. The median follow-up time was 344（265, 359) days. One hundred and seventy-eight（29.7%) composite endpoint events were recorded during the follow-up, 19（3.2%) patients died, and 12（2.0%) patients were lost to follow-up. There were 286(47.7%) cases in low NT-proBNP group and 314 cases（52.3%) in high NT-proBNP group. Patients were older, prevalence of atrial fibrillation and myocardial infarction was higher; MMSE scores and ADL scores, albumin and creatinine clearance rate were lower in high NT-proBNP group than in low NT-proBNP group（all P<0.05). At 1-year follow-up, the incidence of composite endpoint events was significantly higher in high NT-proBNP group than in low NT-proBNP group（33.4%（105/314) vs. 24.8%（71/286), P = 0.02). Cardiovascular events were more common in high NT-proBNP group than in low NT-proBNP group（17.5%（55/314) vs. 8.4%（24/286), P = 0.001). Kaplan-Meier survival analysis showed both composite endpoint events（Log-rank P=0.016) and cardiovascular events（Log-rank P=0.001) were higher in high NT-proBNP group than in low NT-proBNP group. All-cause mortality was also significantly higher in highNT-proBNP group than in lowNT-proBNP group（4.8%（15/314) vs. 1.4%（4/286), P = 0.020), and Kaplan-Meier survival analysis demonstrated borderline statistical significance（Log-rank P = 0.052). Cox proportional hazard regression analysis showed that after adjusting for age, sex, creatinine clearance rate, myocardial infarction, and atrial fibrillation, NT-proBNP remained as an independent risk factor for composite endpoint events（HR=1.376，95%CI 1.049-1.806, P=0.021), and cardiovascular events（HR=1.777, 95%CI 1.185-2.664, P=0.005), but not for all-cause mortality（P=0.206). Conclusions: NT-proBNP level at admission has important predictive value on rehospitalization and cardiovascular events for hospitalized elderly non-heart failure patients. NT-proBNP examination is helpful for risk stratification in this patient cohort.
Aged ; Aged, 80 and over ; Biomarkers ; Heart Failure ; Humans ; Male ; Natriuretic Peptide, Brain ; Peptide Fragments ; Prognosis ; Stroke Volume ; Ventricular Function, Left

Objective To determine the relationship between estimated glomerular filtration rate (eGFR) and proteinuria with cardiovascular events in subjects aged 80 years or older.Methods Data for this retrospective prognostic study were drawn from the patient database for routine checkup in Beijing hospital between January 2001 to December 2001.Baseline eGFR and proteinuria were evaluated in 340 subjects [mean age:(85.6 ± 4.0) years].eGFR was calculated using the modified abbreviated MDRD equations based on the Chinese chronic kidney disease patients.The subjects were divided into normal renal function group and reduced renal function group (eGFR ＜ 60 ml · min-1 · 1.73 m-2).The subjects were divided into subjects without proteinuria and subjects with proteinuria group.Cardiovascular events included cardiovascular death,nonfatal myocardial infarction,nonfatal stroke.Results The proportion of reduced renal function was 36.8％ (125/340).The proportion of proteinuria was 10.3％ (35/340).The proportion of reduced renal function or proteinuria was 41.8％ (142/340).Follow-up time was 79 months (40-114 months).Cardiovascular events rate was significantly higher in reduced renal function group than in normal renal function group [37.6％ (47/125)vs.26.2％ (55/210),P ＜0.05] and in proteinuria group than in without proteinuria group [50.0％ (17/34) vs.28.2％ (85/301),P ＜ 0.01].Cox multivariate analysis revealed that both eGFR (HR =0.978,95％ CI:0.961-0.994,P ＜ 0.05) and proteinuria (HR =2.049,95％ CI:1.132-3.709,P ＜ O.05) were independent risk factors for cardiovascular events after adjusting for age,gender,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,uric acid,hypertension,coronary heart disease,diabetes mellitus.Conclusions Reduced eGFR and presence of proteinuria are independent risk factors for cardiovascular event in subjects aged 80 years or older.eGFR and proteinuria can thus be used for cardiovascular event risk stratification in subjects aged 80 years or older.

OBJECTIVETo describe the distribution of plasma high sensitivity C-reactive protein (hsCRP) and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China.

METHODS268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference (WC), blood pressure (BP), hsCRP, plasma lipids, and fasting blood glucose (FBG) were measured.

RESULTSThe median of hsCRP was 0.99 mg/L in the middle-aged group and 1.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level >3.0 mg/L. The prevalence of high hsCRP was 16.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with ln (hsCRP) concentration in the middle-aged group, whereas ln (TG), HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group.

CONCLUSIONHDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.

Adult ; Aged, 80 and over ; Aging ; Asian Continental Ancestry Group ; Biomarkers ; C-Reactive Protein ; metabolism ; China ; Cross-Sectional Studies ; Female ; Humans ; Longevity ; Male ; Middle Aged ; Models, Biological

BACKGROUNDThe term heart failure with normal ejection fraction (HFNEF) is often used to describe the syndrome of heart failure with normal ejection fraction. Based on the previous studies, HFNEF has a significant morbidity and mortality and is associated with a similar prognosis to heart failure with reduced ejection fraction (HFREF). The present study aimed to investigate the clinical characteristics and prognosis of HFNEF in elderly patients.

METHODSConsecutive elderly patients (≥ 60 years old) hospitalized for the first episode of heart failure (HF) in Beijing Hospital from January 2003 to December 2009 were retrospectively recruited. Three hundred and ten patients with HF were eligible for our study. As recently recommended, a cut-off value of 50% was used to distinguish HFNEF (LVEF ≥ 50%) from HFREF (LVEF < 50%). Data were retrospectively obtained from hospital records and databases. Follow-up data were obtained by telephone and from hospital records. For every eligible patient, the clinical characteristics and prognosis were collected and compared between the HFNEF and HFREF groups.

RESULTSPatients with HFNEF accounted for 54.5% of all cases of elderly patients with HF. Compared with HFREF, the elderly patients with HFNEF had a higher proportion of females (62.1% vs. 32.6%, P < 0.001), higher body mass index (BMI) ((24.9 ± 4.7) vs. (23.5 ± 4.0) kg/m(2), P = 0.011), higher systolic blood pressure at admission ((141.5 ± 22.6) vs. (134.3 ± 18.6) mmHg, P = 0.002), but lower hemoglobin levels ((118.3 ± 22.7) vs. (125.8 ± 23.8) g/L, P = 0.005). The incidence of coronary heart disease (43.2% vs. 65.2%, P < 0.001) and myocardial infarction (16.6% vs. 46.1%, P < 0.001) were significantly lower in elderly patients with HFNEF than in those with HFREF (P < 0.001). With a mean follow-up of 33.5 (0.5 - 93) months, 120 patients (38.7%) died, including 94 (30.3%) cardiac deaths. The HFNEF group had fewer deaths than the HFREF group at the end of the first follow-up (46/169 (27.2%) vs. 58/141 (41.1%)) and at the end of the second follow-up (56/169 (33.1%) vs. 64/141 (45.4%)). Kaplan-Meier survival analysis showed a significantly higher survival rate in elderly patients with HFNEF than those with HFREF (P = 0.021 for total mortality and P < 0.001 for cardiac mortality). Multiple Logistic regression analysis showed that LVEF < 50% was an independent risk factor for death in elderly patients with HF.

CONCLUSIONSMore than half of elderly patients with HF have a normal LVEF. The prognosis of the elderly patients with HFNEF is poor, though slightly better than the elderly patients with HFREF.

Aged ; Aged, 80 and over ; Female ; Heart Failure ; pathology ; Humans ; Male ; Middle Aged ; Prognosis ; Stroke Volume ; physiology

OBJECTIVETo explore the relationship between anemia and cognitive function among senior female aged 90 years old and above in longevity regions in China.

METHODS383 senior female in 5 longevity areas from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008 - 2009 were included in the study. The cognitive function was assessed by mini mental state examination (MMSE) scale. All subjects were administered the physical examinations and biochemical testing of blood, including the hemoglobin. The difference of cognitive function between those with and without anemia was analyzed. Logistic regression was used to analyze the relationship between anemia and cognitive function.

RESULTSThe 383 subjects were divided into two groups, 141 in anemia group and 242 in group without anemia. The total score of cognitive function was 9.65 ± 9.32 in anemia group, and 13.06 ± 10.25 in group without anemia (χ(2) = 5.59, P < 0.05). The percentage of cognition impairment was 84.4% (119/141) in anemia group, and 72.3% (175/242) in group without anemia (χ(2) = 8.08, P < 0.05). In the multivariable logistic regressions, after adjustment for age, education, marital status, smoking and alcohol drinking, the risk for cognition impairment in anemia group was about twice of that in group without anemia (OR = 2.016, 95%CI: 1.185 - 3.431, P = 0.010).

CONCLUSIONAnemia increases the risk of cognition impairment among senior female in Chinese longevity areas.

Age Factors ; Aged, 80 and over ; Anemia ; epidemiology ; psychology ; Causality ; China ; epidemiology ; Cognition ; Female ; Humans ; Longevity

OBJECTIVETo explore the level and effect factors of superoxide dismutase (SOD) and malondialchelyche (MDA) of the people aged 90 years old and above in longevity regions in China.

METHODSFrom Xiayi county (Henan province), Zhongxiang county (Hubei province), Mayang county (Hunan province), Foshan county Sanshui district (Guangdong province) and Yongfu county (Guangxi province), the people of hundred-year were selected and numbered. The old people aged 90 - 99 according to the age and sex were appointed by the centenarians' code and 496 people were selected in total. Questionnaire investigation was conducted on nationality, education, nutrition, smoking, alcohol drinking, tea drinking and physical activities.436 blood sampling (4 ml Per sampling) were conducted and the level of triglyceride (TG), SOD, MDA, Ca, Mg, and some microelements were determined. Non-conditional logistic regression analysis was conducted to explore the effect factors of SOD and MDA in plasma.

RESULTSAnalysis showed that the activity of plasma SOD was (31.19 +/- 5.51) U/ml, and the content of MDA was (4.68 +/- 1.98) micromol/L. The SOD level of minority people of 90 years old and over was (27.55 +/- 4.97) U/ml, lower than that of Han nationality ((31.73 +/- 5.39) U/ml; t = 5.85, P < 0.01); the MDA level of minority people of 90 years old and over was (5.58 +/- 1.95) micromol/L, higher than that of Han nationality ((4.54 +/- 1.95) micromol/L; t = -3.94, P < 0.01). logistic regression showed, comparing with the Han nationality, the minority had lower level of SOD (OR = 0.493), and higher level of MDA (OR = 5.412, P < 0.05). Beside nationality, the factors significantly affecting the activity of SOD included the intake frequency of meat, intake frequency of eggs and plasma concentration of Se (OR values were 0.388, 2.260 and 1.906, P < 0.05). The factors significantly affecting the level of MDA included the intake frequency of milk, physical activity and the level of TG (OR values were 0.435, 1.850 and 1.647, P < 0.05).

CONCLUSIONThe level of SOD of the oldest-old people aged 90 years old and over is relatively higher than the younger ones, and the level of MDA is relatively lower in longevity region, China. The effect factors of SOD are nationality, meat intake frequency, eggs intake frequency and the level of Se in plasma. The effect factors of MDA are nationality, milk intake frequency, physical activity and the level of TG in plasma.

Aged, 80 and over ; China ; Female ; Humans ; Longevity ; Male ; Malondialdehyde ; blood ; Plasma ; chemistry ; Superoxide Dismutase ; blood

OBJECTIVETo investigate the levels and differences of plasma selenium, manganese, iron, copper, zinc among oldest elderly in longevity areas in China.

METHODS446 oldest elderly including 208 centenarians, 238 aged 90 and over, who lived in Xiayi county of Henan province (110 persons), Zhongxiang city of Hubei province (111 persons), Mayang county of Hunan province (60 persons), Sanshui district of Guangdong province (113 persons), Yongfu county of Guangxi Zhuang autonomous region (52 persons) in China, were selected. The contents of plasma selenium, manganese, iron, copper, zinc were detected and compared among these elderly who were classified into different genders, different regions and different age groups.

RESULTSIn oldest elderly, the median (inter-quartile range) of content of plasma selenium was 1.44 (0.91) micromol/L, content of manganese was 0.54 (0.94) micromol/L, content of iron was 69.17 (102.85) micromol/L, content of copper was 20.19 (8.73) micromol/L, content of zinc was 31.66 (32.51) micromol/L. Contents of plasma selenium of oldest elderly in Xiayi, Zhongxiang, Mayang, Sanshui, Yongfu region were 1.46 (0.66), 1.30 (0.80), 1.06 (0.51), 2.39 (1.53) and 1.35(0.55) micromol/L; contents of plasma manganese were 0.56 (0.51), 1.40 (1.11), 0.35 (0.71), 0.44 (0.55) and 0.15 (0.21) micromol/L; contents of plasma iron were 86.77 (86.87), 141.42 (101.83), 38.88 (36.28), 31.38 (46.19) and 79.64 (75.34) micromol/L; contents of plasma copper were 22.16 (8.11), 19.46 (9.26), 21.36 (12.38), 18.12 (6.74) and 21.47 (7.85) micromol/L; contents of plasma zinc were 36.85 (26.18), 36.59 (35.94), 39.98 (56.91), 25.05 (24.92) and 16.74 (16.81) micromol/L. Contents of plasma trace elements among oldest elderly in different longevity areas were significantly different (F values were 29.76, 38.75, 47.18, 11.51 and 13.47, P values were all less than 0.05). Contents of plasma trace elements in different gender groups (contents of plasma selenium were 1.38 (0.83) micromol/L in male and 1.45 (0.91) micromol/L in female; contents of plasma manganese were 0.52 (0.95) and 0.54 (0.91) micromol/L; contents of plasma iron were 69.23 (104.06) and 69.11 (101.05) micromol/L; contents of plasma copper were 20.28 (8.72) and 20.06 (8.76) micromol/L; contents of plasma zinc were 28.39 (32.58) and 31.85 (34.26) micromol/L) were not significantly different (t(Se) = -1.82, P = 0.07; t(Mn) = 0.64, P = 0.52; t(Fe) = 0.65, P = 0.52; t(Cu) = -1.90, P = 0.06; t(Zn) = -0.96, P = 0.34). The contents of plasma selenium, iron, copper in centenarians were higher than those aged 90 and over (contents of plasma selenium were 1.63 (0.94) micromol/L and 1.30 (0.82) micromol/L, contents of plasma iron were 112.63 (119.78) and 60.13 (58.43) micromol/L, contents of plasma copper were 21.07 (9.03) and 18.81 (8.86) micromol/L, F value were 41.99, 27.32, 24.45, P values were less than 0.01). Content of plasma manganese in centenarians was lower than those aged 90 and over (0.44 (0.76) and 0.64 (0.93) micromol/L, F = 10.76, P < 0.01). No significant differences were detected in plasma zinc between concentration and those aged 90 and over (31.78 (34.06) and 31.11 (33.85) micromol/L; F = 1.32, P = 0.25).

CONCLUSIONThe concentrations of plasma selenium, manganese, iron, copper and zinc were high in oldest elderly in the longevity areas. The contents of plasma selenium, iron, copper increased with age.

Aged, 80 and over ; China ; Copper ; blood ; Female ; Humans ; Iron ; blood ; Longevity ; Male ; Manganese ; blood ; Plasma ; chemistry ; Selenium ; blood ; Trace Elements ; blood ; Zinc ; blood

OBJECTIVETo describe the epidemiological characteristics of anemia among elderly people aged 80 years old and above in longevity areas in China and to analyze its relevant factors to the health effects.

METHODSThe data used in this study came from the Chinese Longitudinal Healthy Longevity Survey, including all centenarians in 7 longevity areas, as well as randomly selected population aged 40-, 60-, 80- and 90- in the same 7 areas. A total of 1980 subjects enrolled in the study. The data of general information, eating habits and diseases history was collected by questionnaire survey. Hemoglobin, plasma macro and trace elements were gained by biochemical test. Logistic regression was used to analyze the anemia and its relevant factors.

RESULTSThe prevalence of anemia of elderly people aged 40-, 60-, 80-, 90-, 100- were 16.1% (75/465), 19.1% (82/429), 41.1% (141/343), 46.2% (171/370) and 57.1% (213/373) in 7 longevity areas, which kept on a rise with the increasing of age (z = 14.7, P < 0.05). The prevalence of anemia of male aged 100 years old and above was 66.7% (38/57), which was the highest one among all elderly. Plasma Ca (2.96 mmol/L), Fe (58.22 micromol/L), Zn (28.84 micromol/L) and Cu (19.56 micromol/L) of the elderly people aged 90 years old and above in anemia group, and in control group they were 3.30 mmol/L, 78.26 micromol/L, 33.66 micromol/L, 20.62 micromol/L, respectively. The significant differences were observed between the two groups (z values were -2.95, -3.07, -2.23 and -2.16, P < 0.05). The main risk factors related to anemia were age (OR = 1.675, 95%CI: 1.554 - 1.807), followed by frequency of beans and their products intake (OR = 0.545, 95%CI: 0.435 - 0.682), waist circumference (OR = 0.567, 95%CI: 0.456 - 0.705) and frequency of meat intake (OR = 1.608, 95%CI: 1.303 - 1.983).

CONCLUSIONThe anemia status of oldest old people in longevity areas was severe. Higher frequency of beans and their products intake and maintaining well nutritional condition benefit for the prevention of anemia.

Adult ; Aged ; Aged, 80 and over ; Anemia ; epidemiology ; China ; epidemiology ; Diet Surveys ; Female ; Humans ; Longevity ; Male ; Middle Aged ; Nutritional Status ; Prevalence ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo describe chronic diseases and other related health indicators of centenarians, compare these health indicators with other age groups in longevity areas in China.

METHODSResidents who participated in the project of Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2008 - 2009 were selected from 7 Longevity Areas.2029 people aged 40 and over attended the study from March to June, 2009, including 469 aged 40 and over, 436 aged 60 and over, 346 aged 80 and over, 380 aged 90 and over, 398 centenarians. Information, including socio-demographic, were collected by self-designed questionnaire. Calibrated instruments were used by the clinical personnel who had worked over 3 years to manually check subjects' health. Venous blood and urine samples were collected for blood and urine routine test, plasma macro and trace elements test, plasma biological test, using standard methods such as instrument analysis, atomic absorption spectrometry. Data analysis was conducted using descriptive statistical methods.

RESULTSIn the groups aged 40 and over, 60 and over, 80 and over, 90 and over, 100 and over, the body mass index (BMI) were (23.2 +/- 4.6), (22.1 +/- 3.7), (20.2 +/- 3.4), (20.2 +/- 3.9) and (19.1 +/- 5.0) kg/m(2) in males (F = 22.78, P < 0.01) and (23.3 +/- 4.0), (21.6 +/- 3.5), (19.7 +/- 3.9), (19.0 +/- 4.8), (18.4 +/- 3.8) kg/m(2) in females (F = 51.84, P < 0.01); the prevalence of hypertension were 38.3% (80/209), 60.8% (166/273), 63.5% (106/167), 61.8% (68/110), 54.8% (34/62) in males (chi(2) = 34.26, P < 0.01) and 32.3% (84/260), 60.1% (98/163), 69.8% (125/179), 61.5% (166/270), 58.9% (198/336) in females (chi(2) = 78.45, P < 0.01); the prevalence of diabetes were 10.5% (22/209), 12.5% (34/273), 9.0% (15/167), 18.2% (20/110), 12.9% (8/62) in males (chi(2) = 5.92, P = 0.20) and 4.2% (11/260), 15.3% (25/163), 10.1% (18/179), 12.2% (33/270), 7.4% (25/336) in females (chi(2) = 19.25, P < 0.01). In groups aged 40 and over, 90 and over, 100 and over, the superoxide dismutase (SOD) activity were (29.03 +/- 5.79), (30.93 +/- 5.39), (31.63 +/- 5.92) U/ml in males (F = 4.40, P < 0.05) and (28.27 +/- 6.25), (30.86 +/- 5.72), (31.55 +/- 5.25) U/ml in females (F = 13.13, P < 0.05); levels of plasma calcium were (3.63 +/- 1.08), (3.09 +/- 0.91), (3.34 +/- 1.07) mmol/L in males (F = 5.71, P < 0.01) and (3.84 +/- 1.02), (3.19 +/- 1.16), (3.38 +/- 1.16) mmol/L in females (F = 11.61, P < 0.01); levels of selenium were (1.44 +/- 0.86), (1.28 +/- 0.60), (1.75 +/- 0.57)micromol/L in males (F = 3.79, P < 0.05) and (1.44 +/- 0.80), (1.48 +/- 0.81), (1.78 +/- 0.80) micromol/L in females (F = 8.69, P < 0.01); levels of iron were (63.25 +/- 49.05), (71.86 +/- 54.16), (138.36 +/- 77.60) micromol/L in males (F = 22.78, P < 0.01) and (64.86 +/- 57.72), (74.56 +/- 56.93), (106.56 +/- 74.08) micromol/L in females (F = 17.88, P < 0.01); levels of copper were (23.49 +/- 12.85), (17.96 +/- 7.57), (22.33 +/- 6.89) micromol/L in males (F = 5.18, P < 0.01) and (21.52 +/- 10.63), (19.60 +/- 9.57), (22.99 +/- 8.71) micromol/L in females (F = 5.68, P < 0.01); positive rates of high-sensitivity c-reactive protein (hsCRP) were 5.5% (8/146), 24.0% (18/75), 31.3% (10/32) in males (chi(2) = 22.62, P < 0.01) and 9.8% (12/122), 19.6% (40/204), 25.1% (49/195) in females (chi(2) = 11.24, P < 0.01).

CONCLUSIONThe results indicate that the centenarians have lower chronic diseases risks and higher anti-oxidants activity compared with other age groups, and have a high level of nutritional elements compared with those aged 90 and over. However, it is more common for them suffering from inflammation.

Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; China ; epidemiology ; Chronic Disease ; epidemiology ; Diabetes Mellitus ; epidemiology ; Dyslipidemias ; epidemiology ; Feeding Behavior ; Female ; Health Status Indicators ; Humans ; Hypertension ; epidemiology ; Longevity ; Male ; Middle Aged ; Prevalence ; Smoking