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Effects of physicochemical characteristics of feed ingredients on DE and ME and apparent total tract digestibility (ATTD) of GE, DM, and nutrients were determined in growing pigs using ingredients with different ratios between insoluble dietary fiber (IDF) and soluble dietary fiber (SDF). Eighty growing barrows (BW: 48.41 ± 1.50 kg) were allotted to a randomized complete block design with 10 diets and eight replicate pigs per diet. Dietary treatments included a corn-based diet, a wheat-based diet, a corn–soybean meal (SBM) diet, and seven diets based on a mixture of the corn–SBM diet and canola meal, distillers dried grains with solubles (DDGS), corn germ meal (CGM), copra expellers, sugar beet pulp (SBP), synthetic cellulose, or pectin. Values for the ATTD of DM and nutrients were also compared with the in vitro digestibility of GE, DM, and nutrients. Results indicated that the ATTD of GE was greater (P < 0.05) in wheat than in canola meal, DDGS, CGM, copra expellers, SBP, and synthetic cellulose, but not different from corn, SBM, or pectin. SBM had greater (P < 0.05) DE and ME (DM basis) compared with all other ingredients. The concentration of ME (DM basis) was greater (P < 0.05) in wheat than in canola meal, DDGS, CGM, copra expellers, SBP, synthetic cellulose, and pectin, but not different from corn. Stronger correlations between total dietary fiber (TDF) and DE and ME than between ADF or NDF and DE and ME were observed, indicating that TDF can be used to more accurately predict DE and ME than values for NDF or ADF. The DE, ME, and the ATTD of DM in ingredients were positively correlated (P < 0.05) with in vitro ATTD of DM, indicating that the in vitro procedure may be used to estimate DE and ME in feed ingredients. Swelling and water-binding capacity were positively correlated (P < 0.05) with the ATTD of IDF, TDF, nonstarch polysaccharides (NSP), and insoluble NSP, and viscosity was positively correlated (P < 0.05) with the ATTD of NDF, IDF, and insoluble NSP, indicating that some physical characteristics may influence digestibility of fiber. However, physical characteristics of feed ingredients were not correlated with the concentration of DE and ME, which indicates that these parameters do not influence in vivo energy digestibility in feed ingredients. It is concluded that the DE and ME in feed ingredients may be predicted from some chemical constituents and from in vitro digestibility of DM, but not from physical characteristics. [ABSTRACT FROM AUTHOR]

Effects of inclusion rate of fiber-rich ingredients on apparent ileal digestibility (AID) and apparent total tract digestibility (ATTD) of GE and on the concentration of DE and ME in mixed diets fed to growing pigs were determined. The hypothesis was that increasing the inclusion rate of fiber decreases digestibility of GE, and thus, the contribution of DE and ME from hindgut fermentation because greater concentrations may reduce the ability of microbes to ferment fiber. Twenty ileal-cannulated pigs (BW: 30.64 ± 2.09 kg) were allotted to a replicated 10 × 4 incomplete Latin Square design with 10 diets and four 26-d periods. There were 2 pigs per diet in each period for a total of 8 replications per diet. A basal diet based on corn and soybean meal (SBM) and a corn-SBM diet with 30% corn starch were formulated. Six additional diets were formulated by replacing 15% or 30% corn starch by 15% or 30% corn germ meal, sugar beet pulp, or wheat middlings, and 2 diets were formulated by including 15% or 30% canola meal in a diet containing corn, SBM, and 30% corn starch. Effects of adding 15% or 30% of each fiber source to experimental diets were analyzed using orthogonal contrasts and t-tests were used to compare inclusion rates within each ingredient. The AID and ATTD of GE and concentration of DE and ME in diets decreased (P < 0.05) with the addition of 15% or 30% canola meal, corn germ meal, sugar beet pulp, or wheat middlings compared with the corn starch diet. However, inclusion rate did not affect the calculated DE and ME or AID and ATTD of GE in any of the ingredients indicating that concentration of DE and ME in ingredients was independent of inclusion rate and utilization of energy from test ingredients was equally efficient between diets with 15% and 30% inclusion. Increased inclusion of fiber in the diet did not influence transit time in the small intestine, but reduced the time of first appearance of digesta in the feces indicating that transit time was reduced in the hindgut of pigs fed high-fiber diets. However, this had no impact on DE and ME or ATTD of GE in test ingredients. In conclusion, fiber reduced the DE and ME in the diet. However, inclusion rate of fiber-rich ingredients in diets did not affect calculated values for DE and ME in feed ingredients indicating that microbial capacity for fermentation of fiber in pigs is not overwhelmed by inclusion of 30% high-fiber ingredients in the diets. [ABSTRACT FROM AUTHOR]

An experiment was conducted to quantify nutrient and fiber fractions of feed ingredients and to determine in vitro apparent ileal digestibility (IVAID) and in vitro apparent total tract digestibility (IVATTD) of DM and OM in each ingredient. Ten ingredients that vary in fiber concentration and composition were used: corn, wheat, soybean meal (SBM), canola meal, distillers dried grains with solubles (DDGS), corn germ meal, copra expellers, sugar beet pulp (SBP), synthetic cellulose (SF), and pectin. Correlations between chemical and physical characteristics of ingredients and IVAID and IVATTD of DM and OM were determined. The physical characteristics measured included bulk density, water-binding capacity (WBC), swelling, and viscosity. The analyzed GE was compared with values for GE calculated from all energy-contributing components. Results indicated that the analyzed chemical composition of most ingredients added to 100% or greater, except for DDGS, SBP, and SF, where nutrients added to only 94.29%, 88.90%, and 96.09%, respectively. The difference between the sum of the calculated GE of the analyzed components and the analyzed GE of the ingredients ranged from -2.25 MJ/kg in DDGS to 1.74 MJ/kg in pectin. No correlation was observed between swelling, WBC, or viscosity and IVAID or IVATTD of DM or OM. The concentration of insoluble dietary fiber (IDF) and total dietary fiber (TDF) was negatively correlated (P < 0.05) with IVAID and IVATTD of DM and OM. There was a tendency for NDF (r = -0.60) and ADF (r = -0.61) to be negatively correlated (P < 0.10) with IVAID of DM. However, no correlation was observed between the concentration of CP, GE, acid-hydrolyzed ether extract, lignin, or soluble dietary fiber and IVAID and IVATTD of DM and OM. The stronger correlations between IDF, TDF, and insoluble non-starch polysaccharides and IVAID and IVATTD of DM and OM than between ADF and NDF and IVAID and IVATTD of DM and OM indicate that the concentration of TDF in feed ingredients is a better predictor of the digestibility of DM and OM than values for NDF and ADF. In conclusion, the calculated GE of some feed ingredients was in agreement with the analyzed GE, which gives confidence that energy-contributing components were accounted for, but for DDGS and SBP, it was not possible to account for all analyzed GE. Concentrations of IDF and TDF, but not the physical characteristics of feed ingredients, may be used to estimate IVAID and IVATTD of DM and OM in feed ingredients. [ABSTRACT FROM AUTHOR]

An experiment was conducted to determine the apparent ileal digestibility (AID) and the standardized ileal digestibility (SID) of CP and AA in 4 sources of processed soybean products, in conventional dehulled soybean meal (SBM-CV), in conventional 00-rapeseed expellers (RSE), and in a fermented coproduct mixture (FCM) that contained rapeseed meal, wheat, soy molasses, and potato peel fed to weanling pigs. The 4 processed soybean products included 2 sources of enzyme-treated soybean meal (ESBM-1 and ESBM-2), extruded soybean meal, and soy protein concentrate (SPC). Twenty-seven weanling barrows (9.29 ± 0.58 kg initial BW) were surgically equipped with a T-cannula in the distal ileum. Pigs were randomly allotted to three 9 × 5 Youden squares with 9 pigs and five 7-d periods in each square. Seven cornstarch-based diets were prepared using each of the protein sources as the sole source of CP and AA. A N-free diet was prepared to calculate basal endogenous losses of CP and AA, and this diet was fed to 2 groups of pigs, which resulted in a total of 9 dietary treatments. Results indicate that the SID of CP was greater (P < 0.05) in ESBM-1 than in SPC, RSE, or FCM. The SID of Arg, His, Ile, Leu, Met, and Phe were greater (P < 0.05) in ESBM-1 than in SPC, and the SID of Lys was greater (P < 0.05) in SBM-CV than in ESBM-2. The SID of Thr, Trp, Val, and total indispensable AA were not different among the soybean products, but the SID of total dispensable AA in ESBM-1 was greater (P < 0.05) than in SPC. Therefore, the SID of total AA was greater (P < 0.05) in ESBM-1 than in SPC, but no other differences were observed among soybean meal (SBM) products. The SID of most AA in RSE and the SID of all AA in FCM were less (P < 0.05) than in all the SBM products, but the SID of all AA in RSE were greater (P < 0.05) than in FCM. Results of this research indicate that although processing of SBM results in increased concentration of CP, processing may also reduce the digestibility of AA, which is likely due to heat damage during processing. There are, however, differences among processed soy products, with some products having greater SID of AA than others. Results also indicate that fermentation of a mixture of rapeseed meal, wheat, and relatively low quality coproducts does not result in SID values that are similar to those of unfermented 00-rapeseed expellers or soybean products. [ABSTRACT FROM AUTHOR]

Background: previously, frailty indices were constructed using mostly subjective health measures. The reporting error in this type of measure can have implications on the robustness of frailty findings. Objective: to examine whether frailty assessment differs when we construct frailty indices using solely self-reported or test-based health measures. Design: secondary analysis of data from The Irish LongituDinal study on Ageing (TILDA). Subjects and methods: 4,961 Irish residents (mean age: 61.9 ± 8.4; 54.2% women) over the age of 50 years who underwent a health assessment were included in this analysis. We constructed three frailty indices using 33 self-reported health measures (SRFI), 33 test-based health measures (TBFI) and all 66 measures combined (CFI). The 2-year follow-up outcomes examined were all-cause mortality, disability, hospitalisation and falls. Results: all three indices had a right-skewed distribution, an upper limit to frailty, a non-linear increase with age, and had a dose--response relationship with adverse outcomes. Levels of frailty were lower when self-reported items were used (SRFI: 0.12 ± 0.09; TBFI: 0.17 ± 0.15; CFI: 0.14 ± 0.13). Men had slightly higher frailty index scores than women when test-based measures were used (men: 0.17 ± 0.09; women: 0.16 ± 0.10). CFI had the strongest prediction for risk of adverse outcomes (ROC: 0.64-0.81), and age was not a significant predictor when it was included in the regression model. Conclusions: except for sex differences, characteristics of frailty are similar regardless of whether self-reported or test-based measures are used exclusively to construct a frailty index. Where available, self-reported and test-based measures should be combined when trying to identify levels of frailty. [ABSTRACT FROM AUTHOR]

Background: previously, frailty indices were constructed using mostly subjective health measures. The reporting error in this type of measure can have implications on the robustness of frailty findings. Objective: to examine whether frailty assessment differs when we construct frailty indices using solely self-reported or test-based health measures. Design: secondary analysis of data from The Irish LongituDinal study on Ageing (TILDA). Subjects and methods: 4,961 Irish residents (mean age: 61.9 ± 8.4; 54.2% women) over the age of 50 years who underwent a health assessment were included in this analysis. We constructed three frailty indices using 33 self-reported health measures (SRFI), 33 test-based health measures (TBFI) and all 66 measures combined (CFI). The 2-year follow-up outcomes examined were all-cause mortality, disability, hospitalisation and falls. Results: all three indices had a right-skewed distribution, an upper limit to frailty, a non-linear increase with age, and had a dose--response relationship with adverse outcomes. Levels of frailty were lower when self-reported items were used (SRFI: 0.12 ± 0.09; TBFI: 0.17 ± 0.15; CFI: 0.14 ± 0.13). Men had slightly higher frailty index scores than women when test-based measures were used (men: 0.17 ± 0.09; women: 0.16 ± 0.10). CFI had the strongest prediction for risk of adverse outcomes (ROC: 0.64-0.81), and age was not a significant predictor when it was included in the regression model. Conclusions: except for sex differences, characteristics of frailty are similar regardless of whether self-reported or test-based measures are used exclusively to construct a frailty index. Where available, self-reported and test-based measures should be combined when trying to identify levels of frailty. [ABSTRACT FROM AUTHOR]

An experiment was conducted to test the hypothesis that an increased inclusion rate of fiber decreases the contribution of DE and ME from hindgut fermentation. Twenty ileal-cannulated pigs (BW: 30.64 ± 2.09 kg) were allotted to a replicated 10 × 4 incomplete Latin Square design with 10 diets and 4 26-d periods. A basal diet based on corn and soybean meal (SBM) and a corn-SBM diet with 30% corn starch were formulated. Six additional diets were formulated by replacing 15 or 30% corn starch by 15 or 30% corn germ meal (CGM), sugar beet pulp (SBP), or wheat middlings (WM), and 2 diets were formulated by including 15 or 30% canola meal (CM) in a diet containing corn, SBM, and 30% corn starch. Effects of adding 15 or 30% of each fiber source to the corn starch diet were analyzed using orthogonal polynomial contrasts. Two-independent-sample t-tests were used to compare inclusion rates within each ingredient. Results indicated that concentration of ME (kcal/kg) linearly decreased (P < 0.001) from 3,420 kcal/kg in the corn starch diet to 3,348 and 3,305, 3,290 and 3,221, 3,316 and 3,125 and 3,310 and 3,213 kcal/kg as 15 or 30% CM, CGM, SBP, or WM was added to the diet. However, inclusion rate did not affect DE and ME of the ingredients (Table 1). This indicates that DE and ME in ingredients were independent of inclusion rates and utilization of energy from test ingredients was equally efficient in diets with 30% inclusion compared with diets with 15% inclusion. In conclusion, fiber had a negative effect on DE and ME in the diet, but inclusion rate does not affect calculated values for DE and ME in feed ingredients with relatively high concentration of fiber indicating that the microbial capacity for fermentation of fiber in pigs is not overwhelmed by inclusion of 30% high-fiber ingredients in the diets. Table 1. Concentration of DE and ME in canola meal, corn germ meal, sugar beet pulp, and wheat middlings Item, kcal/kg DM Inclusion rate SEM P-value 15% 30% Digestible Energy Canola meal 3,257 3,517 198 0.218 Corn germ meal 3,254 3,314 165 0.722 Sugar beet pulp 3,027 2,839 197 0.357 Wheat middlings 3,181 3,319 198 0.495 Metabolizable Energy Canola meal 3,235 3,377 167 0.410 Corn germ meal 3,024 3,290 182 0.165 Sugar beet pulp 3,032 2,729 190 0.136 Wheat middlings 3,197 3,244 198 0.817 [ABSTRACT FROM AUTHOR]

Eighteen Holstein cows (6 ruminally cannulated) were used in the first 60 days of lactation to evaluate the effect of the replacement of corn grain (CG) by crude glycerol (CGly) on organic matter intake (OMI), pasture degradability and milk yield (MY). Cows were blocked [by parity (3.17±1.42), body condition score (3.0±0.3), expected caving date], and assigned randomly to two treatments (T). T1= partially mixed diet (PMR) containing sorghum silage (SS) plus concentrate (CG, wheat grain, soybean expeller, minerals and vitamins) and T2= PMR containing SS plus concentrate where CGly -76.5% glycerol, ALUR Uruguay-replacing the CG. Both groups received PMR in individual feeders and grazed during afternoon in a temperate pasture with herbage allowance-above the ground level-60 kg DM.cow-1.day-1. Chemical composition of PMR (OM, CP, NDF, and EE in g/kgDM) respectively was for T1 [934, 117, 317, and 5] and [927, 106, 297 and 46] for T2. OMI and the ruminal degradation kinetics of DM of pasture were measured in situ in two periods. PMR intake (OMI-PMR) was measured individually as the difference between the amounts offered and refused. OMI-forage was determined with chromium oxide (Cr2O3) and indigestible acid detergent fiber as external and internal marker respectively. In situ data was fitted to nonlinear model D(t)=a+b(1-e-ct), where D= disappearance of DM, (a) soluble fraction, (b) degradable fraction, and (c) degradation rate. MY was Individual measured daily. Intake, degradability parameters, and MY were analyzed with a mixed model whit repeated measures. The model included fixed effects: T, period/week, interaction T*period and cow as a random effect. The statistical analyzes were performed with SAS (2010), data are expressed as lsmeans (s.e) and were considered to differ when P < 0.05. Treatment or interaction did not affect Total organic matter intake, OMI-PMR or OMI-f and was [23.6(1.4), 12.7(0.5) and 10.9 (1.0)] kgOM.d-1 for T1 and [20.8(1.3), 10.9(0.5) and 9.8 (0.9)] kg OM.d-1 for T2 respectively. The parameters "a", "b" "c" of pasture were not affected by T, period or interactions and averaged 20(3.1) g/kgDM 602 (3.6) g/kgDM, 0.04(0.007) h-1. Milk yields was not affected by treatment (30.6(1.0) kg.día-1) or interaction T*week of lactation (WOL) but as expected it was affected for WOL. The absence of negative effects related to the use of CGly in substitution of CG in these conditions allows its use up to 10% DMI for dairy cows without altering the efficiency of the milk production process. [ABSTRACT FROM AUTHOR]

The objective was to determine the apparent ileal digestibility (AID), apparent hindgut disappearance (AHD), and the apparent total tract digestibility (ATTD) of DM, energy, and nutrients by growing pigs fed mixed diets containing increasing concentrations of dietary fiber. Twenty ileal-cannulated pigs (BW: 30.64 ± 2.09 kg) were allotted to a replicated 10 × 4 incomplete Latin Square design with 10 diets and 4 26-d periods. A basal diet based on corn and soybean meal (SBM) and a corn-SBM diet with 30% corn starch were formulated. Six diets were formulated by replacing 15 or 30% corn starch by 15 or 30% corn germ meal (CGM), sugar beet pulp (SBP), or wheat middlings (WM). Two additional diets were formulated by including 15 or 30% canola meal (CM) in a diet containing corn, SBM, and 30% corn starch. Effects of adding 15 or 30% of each fiber source to the corn starch diet were analyzed using orthogonal polynomial contrasts. Results indicated a linear reduction (P < 0.001) of AID of DM from 76.8% in the corn starch diet to 73.7 and 65.6%, 65.9 and 56.0%, 61.4 and 48.6%, and 66.1 and 62.1% in diets containing 15 and 30% CM, CGM, SBP, or WP. The ATTD of DM linearly decreased (P < 0.05) from 93.6% in the corn starch diet to 90.3 and 87.7%, 89.7 and 86.2, 90.7 and 86.8%, and 89.5 and 85.7% as CM, CGM, SBP, or WM were included by 15 or 30% in the diets. The AID of CP was linearly reduced (P < 0.05) by the inclusion of 15 and 30% CM (76.8 and 70.1%), CGM (73.6 and 66.6%), SBP (74.6 and 70.0%), and WM (74.9 and 71.0%) compared with the corn starch diet (79.6%). The ATTD of CP was also reduced (Linear, P < 0.05) with increasing inclusion of test ingredients in the diet. The AHD of DM linearly increased (P < 0.05) from 16.6% in the corn starch diet to 16.5 and 22.2%; 24.0 and 30.1%, 29.2 and 38.1%, and 23.3 and 21.3% as CM, CGM, SBP, or WM were included by 15 or 30% in the diets. In conclusion, increasing concentrations of fiber in the diet may result in increased hindgut fermentation of some nutrients but this may also reduce AID and ATTD of DM and CP. [ABSTRACT FROM AUTHOR]

The primary objective of this experiment was to test the hypothesis that concentrations of soluble (SDF), insoluble (IDF), and total dietary fiber (TDF) in feed ingredients used in diets for pigs and poultry analyzed using Method AOAC 2011.25 are greater than values determined using Method AOAC 991.43. A second objective was to determine the variation that may exist among 3 laboratories using the 2 methods with the AnkomTDF Dietary Fiber Analyzer (Ankom Technology, Macedon, NY). The 3 laboratories were the Ministry of Agriculture Feed Industry Center (MAFIC) at China Agricultural University, Trouw Nutrition, and Hans H. Stein Monogastric Nutrition Laboratory at University of Illinois at Urbana-Champaign (UIUC). All laboratories analyzed SDF and IDF in feed ingredients in duplicate or triplicate using both methods AOAC 991.43 and 2011.25 with the AnkomTDF Dietary Fiber Analyzer. The 9 test ingredients were wheat, soybean meal, rapeseed meal, sugar beet pulp, peas, horse beans, native pea starch, and 2 samples of corn; 1 from Europe and 1 from China. All ingredient samples, with the exception of Chinese corn, were procured by Trouw Nutrition, ground to pass through a 0.5 mm screen, subsampled, and sent to MAFIC and UIUC. Data were analyzed using SDF, IDF, and TDF as response variables, replication as random effect, and method and location as fixed effects over all ingredients and within each ingredient. When averaged among 9 different ingredients, results indicated that SDF, IDF, and TDF values were not different with either method or at any laboratory. However, the concentration of IDF in corn, wheat, peas, and sugar beet pulp determined using Method AOAC 991.43 was greater (P < 0.05) compared with 2011.25. Soluble dietary fiber determined using Method AOAC 2011.25 was greater (P < 0.05) in corn, rapeseed meal, soybean meal, and sugar beet pulp compared with 991.43. There was no difference in TDF determined with either method, except for wheat having greater (P < 0.05) TDF when determined using Method AOAC 991.43. Interlaboratory variation for SDF, IDF, and TDF was 0.38, 0.87, 1.20, respectively, with Method AOAC 991.43 and 0.40, 0.93, and 1.27, respectively, with 2011.25. Therefore, values determined with the AnkomTDF Analyzer are repeatable among laboratories and can be used in feed formulation worldwide. In conclusion, it is recommended that Method AOAC 991.43 be used to determine SDF, IDF, and TDF in feed ingredients and diets for pigs and poultry. [ABSTRACT FROM AUTHOR]

An experiment was conducted to determine the standardized ileal digestibility (SID) of AAby pigs in 6 sources of meat and bone meal (MBM). Eighteen ileal-cannulated barrows (initial BW: 69.3 ± 4.4 kg) were randomly allotted to a replicated 4x9 incomplete Latin square design with 4 periods and 9 diets, therefore, a total of 8 replications per diet. One diet included 33% soybean meal (SBM) as the sole source of AA and 6 diets contained 1 source of MBM included at 9% and SBM included at 22% as the only AA containing ingredients. A N-free diet was used to determine basal endogenous losses of AA. The last diet was unrelated to the experiment. The SID of AA was calculated using the direct procedure for the SBM diet. The difference procedure was used to calculate the SID of AA for all sources of MBM. The SID of Lys was greater (P < 0.05) in MBM 4 than in MBM 2, MBM 3, and MBM 6, but not different from MBM 1 and MBM 5. The SID of Met was greater (P < 0.05) in MBM 1 and MBM 4 than in MBM 3 and MBM 6, but not different from MBM 2 and MBM 5. The SID of Thr was greater (P < 0.05) in MBM 1 than in MBM 2, MBM 3, and MBM 6, but not different from MBM 4 and MBM 5. The SID of Trp was the least (P < 0.05) in MBM 3 among MBM sources. In conclusion, the SID of indispensable AA varies widely among MBM sources. [ABSTRACT FROM AUTHOR]

Introduction: Recent literature suggests that impaired systolic blood pressure (SBP) recovery after standing predicts mortality1. Orthostatic heart rate (HR) signals have received less attention. We studied the association between beat-to-beat orthostatic hemodynamic variables in TILDA wave 1 (2010) and incident mortality in wave 2 (2012).Methods: Of the 8175 participants aged 50 and over in the first wave of TILDA, 5037 (62%) had a Health Centre (HC) assessment (active stand testing with Finometer® was only available in HC). Good quality active stand data was available in 4468 participants. Receiver operating characteristic curves explored univariate associations between orthostatic hemodynamic variables (baseline, nadir and recovery until 110 seconds post-stand) and mortality. Multivariate analyses were based on binary logistic regression.Results: 233 subjects (3%) had died at wave 2. Amongst those who had died, 53 (23%) had had aFinometer® active stand in Wave 1. Compared to the 4415 who had not died and had active stand data, the 53 who had died had no statistically significant differences in orthostatic SBP variables or DBP variables. However, those who had died had a higher baseline HR (mean of 69 vs. 65 bpm)and a higher mean orthostatic HR, especially between 30-60 seconds post-stand (mean of 79 vs. 73 bpm). Adjusted for age, sex, baseline HR, cardiovascular comorbidity and antihypertensives (including beta-blockers), the mean HR between 30-60 seconds post-stand was an independent predictor of mortality (OR = 1.05, 95% CI: 1.01–1.10, P = 0.012), together with age (OR = 1.05, 95% CI: 1.02-1.09, P = 0.001) and female sex (OR = 0.55, 95% CI: 0.31-0.97, P = 0.038).Conclusions: Although the small number of mortality events could have led to underpower for blood pressure variables, higher orthostatic HR was independently associated with mortality and could be a novel (and perhaps more sensitive) risk signal. [ABSTRACT FROM AUTHOR]

Introduction: Falls are common among older adults and are associated with injury, hospitalisation and mortality (Rubenstein Age & Aging 2006 35-S2,ii37). Obesity is associated with many recognised risk factors for falls in the elderly and recent research indicates that obesity may itself be an independent risk factor for falls (Himes & Reynolds J AM Geriatr Soc 2012 60,124). The aim of this analysis was to investigate obesity as a risk factor for incident falls in community dwelling older adults after a 2 year follow up.Methods: 4701 community dwelling adults aged 50+ from the Irish Longitudinal Study on Aging (TILDA) had their baseline height and weight measured during a comprehensive health assessment. Obesity was defined as having a Body Mass Index (BMI) ≥30 kg.m2. After a 2 year follow up participants were asked if they had experienced any falls since the previous interview, and if so how many falls were sustained. Logistic regression was used to assess the relationship between baseline obesity and incident falls. Covariates studied include baseline demographics, history of chronic and cardiovascular disease, physical disability, previous falls, gait speed, self-rated vision, chronic pain, cognitive function, mental health and medication use.Results: Mean (SD) age of participants at baseline was 61.0 years (8.8) and 55.6% were female. 32.9% of the sample was classified as obese at baseline. 12.5% of obese participants reported one fall during follow up compared to 13.9% of non-obese participants. A further 11.2% of obese participants reported 2 or more falls compared to 7% of non-obese participants. Adjusting for several covariates, baseline obesity was independently associated with reporting 2 or more falls after a 2-year follow up (Odds Ratio = 1.31, p = 0.023).Conclusion: Obesity is associated with recurrent falls in community dwelling older adults over a two year follow up period. [ABSTRACT FROM AUTHOR]

Introduction: Recent literature suggests that impaired systolic blood pressure (SBP) recovery after standing predicts mortality1. Orthostatic heart rate (HR) signals have received less attention. We studied the association between beat-to-beat orthostatic hemodynamic variables in TILDA wave 1 (2010) and incident mortality in wave 2 (2012).Methods: Of the 8175 participants aged 50 and over in the first wave of TILDA, 5037 (62%) had a Health Centre (HC) assessment (active stand testing with Finometer® was only available in HC). Good quality active stand data was available in 4468 participants. Receiver operating characteristic curves explored univariate associations between orthostatic hemodynamic variables (baseline, nadir and recovery until 110 seconds post-stand) and mortality. Multivariate analyses were based on binary logistic regression.Results: 233 subjects (3%) had died at wave 2. Amongst those who had died, 53 (23%) had had aFinometer® active stand in Wave 1. Compared to the 4415 who had not died and had active stand data, the 53 who had died had no statistically significant differences in orthostatic SBP variables or DBP variables. However, those who had died had a higher baseline HR (mean of 69 vs. 65 bpm)and a higher mean orthostatic HR, especially between 30-60 seconds post-stand (mean of 79 vs. 73 bpm). Adjusted for age, sex, baseline HR, cardiovascular comorbidity and antihypertensives (including beta-blockers), the mean HR between 30-60 seconds post-stand was an independent predictor of mortality (OR = 1.05, 95% CI: 1.01–1.10, P = 0.012), together with age (OR = 1.05, 95% CI: 1.02-1.09, P = 0.001) and female sex (OR = 0.55, 95% CI: 0.31-0.97, P = 0.038).Conclusions: Although the small number of mortality events could have led to underpower for blood pressure variables, higher orthostatic HR was independently associated with mortality and could be a novel (and perhaps more sensitive) risk signal. [ABSTRACT FROM PUBLISHER]

Introduction: Falls are common among older adults and are associated with injury, hospitalisation and mortality (Rubenstein Age & Aging 2006 35-S2,ii37). Obesity is associated with many recognised risk factors for falls in the elderly and recent research indicates that obesity may itself be an independent risk factor for falls (Himes & Reynolds J AM Geriatr Soc 2012 60,124). The aim of this analysis was to investigate obesity as a risk factor for incident falls in community dwelling older adults after a 2 year follow up.Methods: 4701 community dwelling adults aged 50+ from the Irish Longitudinal Study on Aging (TILDA) had their baseline height and weight measured during a comprehensive health assessment. Obesity was defined as having a Body Mass Index (BMI) ≥30 kg.m2. After a 2 year follow up participants were asked if they had experienced any falls since the previous interview, and if so how many falls were sustained. Logistic regression was used to assess the relationship between baseline obesity and incident falls. Covariates studied include baseline demographics, history of chronic and cardiovascular disease, physical disability, previous falls, gait speed, self-rated vision, chronic pain, cognitive function, mental health and medication use.Results: Mean (SD) age of participants at baseline was 61.0 years (8.8) and 55.6% were female. 32.9% of the sample was classified as obese at baseline. 12.5% of obese participants reported one fall during follow up compared to 13.9% of non-obese participants. A further 11.2% of obese participants reported 2 or more falls compared to 7% of non-obese participants. Adjusting for several covariates, baseline obesity was independently associated with reporting 2 or more falls after a 2-year follow up (Odds Ratio = 1.31, p = 0.023).Conclusion: Obesity is associated with recurrent falls in community dwelling older adults over a two year follow up period. [ABSTRACT FROM PUBLISHER]

Introduction Patients with hip fracture and depression are less likely to recover. This review aimed to identify prognostic factors of depression up to one year after hip fracture surgery in adults. Secondary aims were to determine whether identified factors are modifiable or non-modifiable and describe proposed underlying mechanisms for their association with depression. Methods We searched MEDLINE, Embase, PsychInfo, CINAHL and Web of Science Core Collection databases for published studies as well as grey literature. We did not impose any date, geographical, or language limitations. Two reviewers independently screened studies against predefined eligibility criteria to identify relevant papers. We included observational studies investigating prognostic factors of depression up to one year after surgery in adults surgically managed for non-pathological hip fracture. Two reviewers independently extracted data (Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies, adapted for use with prognostic factors studies Checklist) and completed quality appraisal (using Quality in Prognosis Studies tool). Results 3,402 studies were identified; 2,915 studies were excluded leaving 13 studies included in this review. 3,769 patients were included across all studies with a mean age ranging from 76.21–81.82 years. A total of 39 prognostic factors were investigated and most studies failed to identify a primary prognostic factor of interest. Most of these factors were patient factors with only a few being process or structure factors. Conclusion Various potential prognostic factors of depression after hip fracture were identified however, Methodological quality and heterogeneity between studies limited the certainty of which prognostic factors were the strongest. High-quality research investigating prognostic factors using the same study design, Methodology and measurements is warranted to allow for comparisons of the predictive power of factors. As well as future research into the underlying mechanisms of prognostic factors. [ABSTRACT FROM AUTHOR]

Aim: Homeostatic blood pressure responses to standing play a pivotal role in identifying individuals at risk of syncope and unexplained falls. Here we examine the relationship between beat-to-beat orthostatic blood pressure responses and falls in a nationally representative population sample.Methods: Participants were recruited from The Irish Longitudinal Study on Ageing, a nationally representative cohort study of Irish adults aged 50+. Beat-to-beat blood pressure records were analysed among those who underwent an active stand test. Individuals were identified as having orthostatic hypotension (OH), if on standing they demonstrated sustained blood pressure drops of ≥20/10mmHg below resting values at 10 second intervals. Relationships with a history of falls were assessed by logistic regression adjusting for age, gender, education, comorbidities and medications.Results: A sample of N = 4490 older adults was considered. The prevalence of OH is 6.9% (95% CI: 5.9–7.8) being higher in women (8.2% (95% CI: 6.8–9.5) vs. 5.6% (95% CI: 5.9–7.8)) and increases with age to 18.9% (95% CI: 6.21–31.60) in older men. Impaired recovery at 40 seconds, affecting 24.5% (95% CI: 18.9–30.0) of the sample, is associated with an increased odds of having a history of falls OR: 1.57 (95% CI:1.2–2.0); p < 0.001).Conclusions: Using beat-to-beat approaches sustained blood pressure drops at 40 seconds are associated with increased odds of having a falls history. When considering health outcomes in older adults, the time course of blood pressure responses to standing are paramount with impaired recovery at 40 seconds independently associated with falls. [ABSTRACT FROM AUTHOR]

Aim: Homeostatic blood pressure responses to standing play a pivotal role in identifying individuals at risk of syncope and unexplained falls. Here we examine the relationship between beat-to-beat orthostatic blood pressure responses and falls in a nationally representative population sample.Methods: Participants were recruited from The Irish Longitudinal Study on Ageing, a nationally representative cohort study of Irish adults aged 50+. Beat-to-beat blood pressure records were analysed among those who underwent an active stand test. Individuals were identified as having orthostatic hypotension (OH), if on standing they demonstrated sustained blood pressure drops of ≥20/10mmHg below resting values at 10 second intervals. Relationships with a history of falls were assessed by logistic regression adjusting for age, gender, education, comorbidities and medications.Results: A sample of N = 4490 older adults was considered. The prevalence of OH is 6.9% (95% CI: 5.9–7.8) being higher in women (8.2% (95% CI: 6.8–9.5) vs. 5.6% (95% CI: 5.9–7.8)) and increases with age to 18.9% (95% CI: 6.21–31.60) in older men. Impaired recovery at 40 seconds, affecting 24.5% (95% CI: 18.9–30.0) of the sample, is associated with an increased odds of having a history of falls OR: 1.57 (95% CI:1.2–2.0); p < 0.001).Conclusions: Using beat-to-beat approaches sustained blood pressure drops at 40 seconds are associated with increased odds of having a falls history. When considering health outcomes in older adults, the time course of blood pressure responses to standing are paramount with impaired recovery at 40 seconds independently associated with falls. [ABSTRACT FROM PUBLISHER]