Author: "Strandberg, T." - Searchworks@Jio Institute Digital Library Search Results

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51. The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER)

Author: Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Korkki, S. (Saana), Solomon, A. (Alina), Coley, N. (Nicola), Antikainen, R. (Riitta), Bäckman, L. (Lars), Hänninen, T. (Tuomo), Lindström, J. (Jaana), Laatikainen, T. (Tiina), Paajanen, T. (Teemu), Havulinna, S. (Satu), Peltonen, M. (Markku), Neely, A. S. (Anna Stigsdotter), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Soininen, H. (Hilkka), Kivipelto, M. (Miia), Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Korkki, S. (Saana), Solomon, A. (Alina), Coley, N. (Nicola), Antikainen, R. (Riitta), Bäckman, L. (Lars), Hänninen, T. (Tuomo), Lindström, J. (Jaana), Laatikainen, T. (Tiina), Paajanen, T. (Teemu), Havulinna, S. (Satu), Peltonen, M. (Markku), Neely, A. S. (Anna Stigsdotter), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Soininen, H. (Hilkka), and Kivipelto, M. (Miia)
Abstract: Introduction: Lifestyle interventions may prevent cognitive decline, but the sufficient dose of intervention activities and lifestyle changes is unknown. We investigated how intervention adherence affects cognition in the FINGER trial (pre-specified subgroup analyses). Methods: FINGER is a multicenter randomized controlled trial examining the efficacy of multidomain lifestyle intervention (ClinicalTrials.gov NCT01041989). A total of 1260 participants aged 60 to 77 with increased dementia risk were randomized to a lifestyle intervention and control groups. Percentage of completed intervention sessions, and change in multidomain lifestyle score (self-reported diet; physical, cognitive, and social activity; vascular risk) were examined in relation to change in Neuropsychological Test Battery (NTB) scores. Results: Active participation was associated with better trajectories in NTB total and all cognitive subdomains. Improvement in lifestyle was associated with improvement in NTB total and executive function. Discussion: Multidomain lifestyle changes are beneficial for cognitive functioning, but future interventions should be intensive enough, and supporting adherence is essential.
Published: 2022

52. Multicomponent intervention to prevent mobility disability in frail older adults:randomised controlled trial (SPRINTT project)

Author: Bernabei, R. (Roberto), Landi, F. (Francesco), Calvani, R. (Riccardo), Cesari, M. (Matteo), Del Signore, S. (Susanna), Anker, S. D. (Stefan D.), Bejuit, R. (Raphael), Bordes, P. (Philippe), Cherubini, A. (Antonio), Cruz-Jentoft, A. J. (Alfonso J.), Di Bari, M. (Mauro), Friede, T. (Tim), Ayestaran, C. G. (Carmen Gorostiaga), Goyeau, H. (Harmonie), Jonsson, P. V. (Palmi, V), Kashiwa, M. (Makoto), Lattanzio, F. (Fabrizia), Maggio, M. (Marcello), Mariotti, L. (Luca), Miller, R. R. (Ram R.), Rodriguez-Manas, L. (Leocadio), Roller-Wirnsberger, R. (Regina), Ryznarova, I. (Ingrid), Scholpp, J. (Joachim), Schols, A. M. (Annemie M. W. J.), Sieber, C. C. (Cornel C.), Sinclair, A. J. (Alan J.), Skalska, A. (Anna), Strandberg, T. (Timo), Tchalla, A. (Achille), Topinkova, E. (Eva), Tosato, M. (Matteo), Vellas, B. (Bruno), von Haehling, S. (Stephan), Pahor, M. (Marco), Roubenoff, R. (Ronenn), Marzetti, E. (Emanuele), Bernabei, R. (Roberto), Landi, F. (Francesco), Calvani, R. (Riccardo), Cesari, M. (Matteo), Del Signore, S. (Susanna), Anker, S. D. (Stefan D.), Bejuit, R. (Raphael), Bordes, P. (Philippe), Cherubini, A. (Antonio), Cruz-Jentoft, A. J. (Alfonso J.), Di Bari, M. (Mauro), Friede, T. (Tim), Ayestaran, C. G. (Carmen Gorostiaga), Goyeau, H. (Harmonie), Jonsson, P. V. (Palmi, V), Kashiwa, M. (Makoto), Lattanzio, F. (Fabrizia), Maggio, M. (Marcello), Mariotti, L. (Luca), Miller, R. R. (Ram R.), Rodriguez-Manas, L. (Leocadio), Roller-Wirnsberger, R. (Regina), Ryznarova, I. (Ingrid), Scholpp, J. (Joachim), Schols, A. M. (Annemie M. W. J.), Sieber, C. C. (Cornel C.), Sinclair, A. J. (Alan J.), Skalska, A. (Anna), Strandberg, T. (Timo), Tchalla, A. (Achille), Topinkova, E. (Eva), Tosato, M. (Matteo), Vellas, B. (Bruno), von Haehling, S. (Stephan), Pahor, M. (Marco), Roubenoff, R. (Ronenn), and Marzetti, E. (Emanuele)
Abstract: Objective: To determine whether a multicomponent intervention based on physical activity with technological support and nutritional counselling prevents mobility disability in older adults with physical frailty and sarcopenia. Design: Evaluator blinded, randomised controlled trial. Setting: 16 clinical sites across 11 European countries, January 2016 to 31 October 2019. Participants: 1519 community dwelling men and women aged 70 years or older with physical frailty and sarcopenia, operationalised as the co-occurrence of low functional status, defined as a short physical performance battery (SPPB) score of 3 to 9, low appendicular lean mass, and ability to independently walk 400 m. 760 participants were randomised to a multicomponent intervention and 759 received education on healthy ageing (controls). Interventions: The multicomponent intervention comprised moderate intensity physical activity twice weekly at a centre and up to four times weekly at home. Actimetry data were used to tailor the intervention. Participants also received personalised nutritional counselling. Control participants received education on healthy ageing once a month. Interventions and follow-up lasted for up to 36 months. Main outcome measures: The primary outcome was mobility disability (inability to independently walk 400 m in <15 minutes). Persistent mobility disability (inability to walk 400 m on two consecutive occasions) and changes from baseline to 24 and 36 months in physical performance, muscle strength, and appendicular lean mass were analysed as pre-planned secondary outcomes. Primary comparisons were conducted in participants with baseline SPPB scores of 3–7 (n=1205). Those with SPPB scores of 8 or 9 (n=314) were analysed separately for exploratory purposes. Results: Mean age of the 1519 participants (1088 women) was 78.9 (standard deviation 5.8) years. The average follow-up was 26.4 (SD 9.5) months. Among participants with SPPB scores of 3–7, mobility disability occur
Published: 2022

53. Type 2 diabetes as a predictor of muscle strength decline over 11 years among men and women aged 55 and older

Author: Tiainen, K. (Kristina), Raitanen, J. (Jani), Strandberg, T. (Timo), Koskinen, S. (Seppo), Stenholm, S. (Sari), Tiainen, K. (Kristina), Raitanen, J. (Jani), Strandberg, T. (Timo), Koskinen, S. (Seppo), and Stenholm, S. (Sari)
Abstract: Background: Long-term associations between type 2 diabetes, prediabetes, and muscle strength are obscure in older adults. The aim of this study was to examine type 2 diabetes as a predictor of handgrip strength decline during an 11-year follow-up among men and women aged 55 years. Methods: We used Finnish population-based Health 2000 Survey and its follow-up measurements in 2011. The study population consisted of 1,200 individuals, aged 55–86 years at baseline. Baseline fasting glucose level or use of diabetes medication was used to categorize the participants into diabetes (≥7.0 mmol/L), prediabetes (≥6.1 mmol/L but <7.0 mmol/L), and nondiabetes (<6.1 mmol/L) groups. Handgrip strength was measured at baseline and during 11-year follow-up. Results: Mean handgrip strength at baseline did not differ between diabetes groups in men or women. Among men during the 11-year follow-up, decline in muscle strength was significantly greater among diabetes group (−131.5 Newtons [N], 95% confidence interval (CI) −182.7 to −80.4) than nondiabetes group (−98.9 N, 95% CI −139.5 to −58.3) after adjusting for age, education, lifestyle factors, chronic conditions, and diabetes status at follow-up. Among women, muscle strength decline did not differ between diabetes, prediabetes, or nondiabetes groups after adjusting for all potential covariates, the results being −45.0 N (95% CI −73.2 to −16.7), −29.4 N (95% CI −59.7 to 0.9), and −42.3 N (95% CI −70.5 to −14.1), respectively. Conclusions: The presence of type 2 diabetes was associated with greater muscle strength decline among older men but not among older women.
Published: 2022

54. Dietary fat intake and quality in long-term care residents in two cohorts assessed 10 years apart

Author: Jyväkorpi, S. K. (Satu K.), Suominen, M. H. (Merja H.), Strandberg, T. E. (Timo E.), Salminen, K. (Karoliina), Niskanen, R. T. (Riikka T.), Roitto, H.-M. (Hanna-Maria), Saarela, R. K. (Riitta K. T.), Pitkälä, K. H. (Kaisu H.), Jyväkorpi, S. K. (Satu K.), Suominen, M. H. (Merja H.), Strandberg, T. E. (Timo E.), Salminen, K. (Karoliina), Niskanen, R. T. (Riikka T.), Roitto, H.-M. (Hanna-Maria), Saarela, R. K. (Riitta K. T.), and Pitkälä, K. H. (Kaisu H.)
Abstract: Purpose: To describe and compare detailed dietary fat intake, fat quality and associative factors between two measuring points 10 years apart of residents living in long-term care facilities, and to reflect how fat composition and fat quality corresponds to current nutrition recommendations. Methods: In 2007 long-term care residents (n = 374) of 25 assisted-living facilities and nursing homes and in 2017–18 long-term care residents (n = 486) of 17 respective facilities in Helsinki metropolitan area were recruited for this study. Information on the residents’ heights, demographic information and use of calcium and vitamin D supplementation were retrieved from medical records. Residents’ clinical assessment included Clinical Dementia Rating (CDR), the Mini Nutritional Assessment (MNA) and questionnaire related to nutrition care. Participants’ energy and fat intake were determined from 1--2-day food diaries kept by the ward nurses, and fat quality indicators calculated. Results: Age, gender distribution, MNA score or body mass index did not differ between the two cohorts. Residents’ cognitive status, subjective health and mobility were poorer in 2017 compared to 2007. Total fat and saturated fatty acid (SFA) intakes were higher and fat quality indicators lower in the 2017 cohort residents than in the 2007 cohort residents. Sugar intake, male gender, eating independently, eating larger amounts and not having dry mouth predicted higher SFA intake in the 2017 cohort. Conclusions: The fat quality in long-term care residents in our study worsened in spite of official recommendations between the two measurement points.
Published: 2022

55. Retirement as a predictor of physical functioning trajectories among older businessmen

Author: Haapanen, M. J. (Markus J.), Strandberg, T. E. (Timo E.), Törmäkangas, T. (Timo), von Bonsdorff, M. E. (Monika E.), Strandberg, A. Y. (Arto Y.), von Bonsdorff, M. B. (Mikaela B.), Haapanen, M. J. (Markus J.), Strandberg, T. E. (Timo E.), Törmäkangas, T. (Timo), von Bonsdorff, M. E. (Monika E.), Strandberg, A. Y. (Arto Y.), and von Bonsdorff, M. B. (Mikaela B.)
Abstract: Background: Associations between retirement characteristics and consequent physical functioning (PF) are poorly understood, particularly in higher socioeconomic groups, where postponing retirement has had both positive and negative implications for PF. Methods: Multiple assessments of PF, the first of which at the mean age of 73.3 years, were performed on 1709 men who were retired business executives and managers, using the RAND-36/SF-36 instrument, between 2000 and 2010. Questionnaire data on retirement age and type of pension was gathered in 2000. Five distinct PF trajectories were created using latent growth mixture modelling. Mortality- and covariate-adjusted multinomial regression models were used to estimate multinomial Odds Ratios (mOR) on the association between retirement characteristics and PF trajectories. Results: A one-year increase in retirement age was associated with decreased likelihood of being classified in the ‘consistently low’ (fully adjusted mOR = 0.82; 95%CI = 0.70, 0.97; P = 0.007), ‘intermediate and declining’ (mOR = 0.89; 95%CI = 0.83, 0.96; P = 0.002), and ‘high and declining’ (mOR = 0.92; 95%CI = 0.87, 0.98; P = 0.006) trajectories, relative to the ‘intact’ PF trajectory. Compared to old age pensioners, disability pensioners were more likely to be classified in the ‘consistently low’ (mOR = 23.77; 95% CI 2.13, 265.04; P = 0.010), ‘intermediate and declining’ (mOR = 8.24; 95%CI = 2.58, 26.35; P < 0.001), and ‘high and declining’ (mOR = 2.71; 95%CI = 1.17, 6.28; P = 0.020) PF trajectories, relative to the ‘intact’ PF trajectory. Conclusions: Among executives and managers, older age at retirement was associated with better trajectories of PF in old age. Compared to old age pensioners, those transitioning into disability and early old age pensions were at risk of having consistently lower PF in old age.
Published: 2022

56. Low body temperature and mortality in older patients with frailty in the emergency department

Author: Alakare, J. (Janne), Kemp, K. (Kirsi), Strandberg, T. (Timo), Castrén, M. (Maaret), Tolonen, J. (Jukka), Harjola, V.-P. (Veli-Pekka), Alakare, J. (Janne), Kemp, K. (Kirsi), Strandberg, T. (Timo), Castrén, M. (Maaret), Tolonen, J. (Jukka), and Harjola, V.-P. (Veli-Pekka)
Abstract: Purpose: The aim of this study was to assess the association between low body temperature and mortality in frail older adults in the emergency department (ED). Methods: Inclusion criteria were: ≥ 75 years of age, Clinical Frailty Scale (CFS) score of 4–8, and temperature documented at ED admission. Patients were allocated to three groups by body temperature: low ≤ 36.0 °C, normal 36.1–38.0 and high ≥ 38.1. Odds ratios (OR) for 30-day and 90-day mortality were analysed. Results: 1577 patients, 61.2% female, were included. Overall mortalities were 85/1577 (5.4%) and 144/1557 (9.2%) in the 30-day and 90-day follow-ups, respectively. The ORs for low body temperature were 3.03 (1.72–5.35; P < 0.001) and 2.71 (1.68–4.38; P < 0.001) for 30-day and 90-day mortality, respectively. This association remained when adjusted for age, CFS score and gender. Mortality of the high-temperature group did not differ significantly when compared to the normal-temperature group. Conclusions: Low body temperature in frail older ED patients was associated with significantly higher 30- and 90-day mortality.
Published: 2022

57. Psychosocial determinants for adherence to a healthy lifestyle and intervention participation in the FINGER trial:an exploratory analysis of a randomised clinical trial

Author: Neuvonen, E. (Elisa), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Antikainen, R. (Riitta), Havulinna, S. (Satu), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lindström, J. (Jaana), Rautio, N. (Nina), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Ngandu, T. (Tiia), Neuvonen, E. (Elisa), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Antikainen, R. (Riitta), Havulinna, S. (Satu), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lindström, J. (Jaana), Rautio, N. (Nina), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Ngandu, T. (Tiia)
Abstract: Background and aims: Psychosocial factors may affect adherence to lifestyle interventions and lifestyle changes. The role of psychosocial factors in dementia prevention needs more research. We aimed at clarify the issue in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Methods: The population included 1260 participants aged 60–77 years at risk for cognitive decline, randomised to a multidomain lifestyle intervention or regular health advice for 2 years. Adherence was evaluated as participation in the provided activities and actual lifestyle changes, separately for each domain (diet, exercise, social/cognitive activity, vascular risk management) and combined into multidomain. Psychosocial factors were measured at trial baseline (depressive symptoms; study perception; health-related quality of life, HRQoL) and earlier life (hopelessness; satisfaction with family life, achievements, and financial situation). Results: Depressive symptoms, hopelessness, and nonpositive study perception were negatively and HRQoL positively associated with participation in the multidomain intervention. Depressive symptoms, lower HRQoL, hopelessness and dissatisfaction with financial situation were associated with unhealthier lifestyles at baseline. Baseline depressive symptoms and lower HRQoL predicted less improvement in lifestyle, but did not modify the intervention effect on lifestyle change. Discussion and conclusions: Several psychosocial factors were associated with participation in lifestyle intervention, while fewer of them contributed to lifestyle changes. Although the intervention was beneficial for lifestyle changes independent of psychosocial factors, those most in need of lifestyle improvement were less likely to be active. Tailoring lifestyle-modifying strategies based on the need for psychosocial support may add efficacy in future trials.
Published: 2022

58. Body-mass index and risk of obesity-related complex multimorbidity:an observational multicohort study

Author: Kivimäki, M. (Mika), Strandberg, T. (Timo), Pentti, J. (Jaana), Nyberg, S. T. (Solja T), Frank, P. (Philipp), Jokela, M. (Markus), Ervasti, J. (Jenni), Suominen, S. B. (Sakari B), Vahtera, J. (Jussi), Sipilä, P. N. (Pyry N), Lindbohm, J. V. (Joni V), Ferrie, J. E. (Jane E), Kivimäki, M. (Mika), Strandberg, T. (Timo), Pentti, J. (Jaana), Nyberg, S. T. (Solja T), Frank, P. (Philipp), Jokela, M. (Markus), Ervasti, J. (Jenni), Suominen, S. B. (Sakari B), Vahtera, J. (Jussi), Sipilä, P. N. (Pyry N), Lindbohm, J. V. (Joni V), and Ferrie, J. E. (Jane E)
Abstract: Background: The accumulation of disparate diseases in complex multimorbidity makes prevention difficult if each disease is targeted separately. We aimed to examine obesity as a shared risk factor for common diseases, determine associations between obesity-related diseases, and examine the role of obesity in the development of complex multimorbidity (four or more comorbid diseases). Methods: We did an observational study and used pooled prospective data from two Finnish cohort studies (the Health and Social Support Study and the Finnish Public Sector Study) comprising 114 657 adults aged 16–78 years at study entry (1998–2013). A cohort of 499 357 adults (aged 38–73 years at study entry; 2006–10) from the UK Biobank provided replication in an independent population. BMI and clinical characteristics were assessed at baseline. BMIs were categorised as obesity (≥30·0 kg/m²), overweight (25·0–29·9 kg/m²), healthy weight (18·5–24·9 kg/m²), and underweight (<18·5 kg/m²). Via linkage to national health records, participants were followed-up for death and diseases diagnosed according to the International Classification of Diseases 10th Revision (ICD-10). Hazard ratios (HRs) with 95% CIs and population attributable fractions (PAFs) for associations between BMI and multimorbidity were calculated. Findings: Mean follow-up duration was 12·1 years (SD 3·8) in the Finnish cohorts and 11·8 years (1·7) in the UK Biobank cohort. Obesity was associated with 21 non-overlapping cardiometabolic, digestive, respiratory, neurological, musculoskeletal, and infectious diseases after Bonferroni multiple testing adjustment and ignoring HRs of less than 1·50. Compared with healthy weight, the confounder-adjusted HR for obesity was 2·83 (95% CI 2·74–2·93; PAF 19·9% [95% CI 19·3–20·5]) for developing at least one obesity-related disease, 5·17 (4·84–5·53; 34·4% [33·2–35·5]) for two diseases, and 12·39 (9·26–16·58; 55·2% [50·9–57·5]) for complex multimorbidity. The proportion of particip
Published: 2022

59. Associations of depressive symptoms and cognition in the FINGER trial:a secondary analysis of a randomised clinical trial

Author: Neuvonen, E. (Elisa), Lehtisalo, J. (Jenni), Ngandu, T. (Tiia), Levälahti, E. (Esko), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lindström, J. (Jaana), Paajanen, T. (Teemu), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Solomon, A. (Alina), Neuvonen, E. (Elisa), Lehtisalo, J. (Jenni), Ngandu, T. (Tiia), Levälahti, E. (Esko), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lindström, J. (Jaana), Paajanen, T. (Teemu), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Solomon, A. (Alina)
Abstract: Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60–77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group × time coefficient −0.006, 95% CI −0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (−0.140, p = 0.005) and memory (−0.231, p = 0.005). Participants with clinically significant baseline depressive symptoms (Zung ≥ 40 points) had less intervention benefit to executive functioning (group × time × Zung −0.096, 95% CI −0.163 to −0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.
Published: 2022

60. Multicomponent intervention to prevent mobility disability in frail older adults: randomised controlled trial (SPRINTT project)

Author: Bernabei, Roberto, Landi, Francesco, Calvani, Riccardo, Cesari, M., Del Signore, S., Anker, S. D., Bejuit, R., Bordes, P., Cherubini, A., Cruz-Jentoft, A. J., Di Bari, M., Friede, T., Ayestaran, C. G., Goyeau, H., Jonsson, P. V., Kashiwa, M., Lattanzio, F., Maggio, M., Mariotti, L., Miller, R. R., Rodriguez-Manas, L., Roller-Wirnsberger, R., Ryznarova, I., Scholpp, J., Schols, A. M. W. J., Sieber, C. C., Sinclair, A. J., Skalska, A., Strandberg, T., Tchalla, A., Topinkova, E., Tosato, Matteo, Vellas, B., Von Haehling, S., Pahor, M., Roubenoff, R., Marzetti, Emanuele, Bernabei R. (ORCID:0000-0002-9197-004X), Landi F. (ORCID:0000-0002-3472-1389), Calvani R. (ORCID:0000-0001-5472-2365), Tosato M., Marzetti E. (ORCID:0000-0001-9567-6983), Bernabei, Roberto, Landi, Francesco, Calvani, Riccardo, Cesari, M., Del Signore, S., Anker, S. D., Bejuit, R., Bordes, P., Cherubini, A., Cruz-Jentoft, A. J., Di Bari, M., Friede, T., Ayestaran, C. G., Goyeau, H., Jonsson, P. V., Kashiwa, M., Lattanzio, F., Maggio, M., Mariotti, L., Miller, R. R., Rodriguez-Manas, L., Roller-Wirnsberger, R., Ryznarova, I., Scholpp, J., Schols, A. M. W. J., Sieber, C. C., Sinclair, A. J., Skalska, A., Strandberg, T., Tchalla, A., Topinkova, E., Tosato, Matteo, Vellas, B., Von Haehling, S., Pahor, M., Roubenoff, R., Marzetti, Emanuele, Bernabei R. (ORCID:0000-0002-9197-004X), Landi F. (ORCID:0000-0002-3472-1389), Calvani R. (ORCID:0000-0001-5472-2365), Tosato M., and Marzetti E. (ORCID:0000-0001-9567-6983)
Abstract: Objective To determine whether a multicomponent intervention based on physical activity with technological support and nutritional counselling prevents mobility disability in older adults with physical frailty and sarcopenia. Design Evaluator blinded, randomised controlled trial. Setting 16 clinical sites across 11 European countries, January 2016 to 31 October 2019. Participants 1519 community dwelling men and women aged 70 years or older with physical frailty and sarcopenia, operationalised as the co-occurrence of low functional status, defined as a short physical performance battery (SPPB) score of 3 to 9, low appendicular lean mass, and ability to independently walk 400 m. 760 participants were randomised to a multicomponent intervention and 759 received education on healthy ageing (controls). Interventions The multicomponent intervention comprised moderate intensity physical activity twice weekly at a centre and up to four times weekly at home. Actimetry data were used to tailor the intervention. Participants also received personalised nutritional counselling. Control participants received education on healthy ageing once a month. Interventions and follow-up lasted for up to 36 months. Main outcome measures The primary outcome was mobility disability (inability to independently walk 400 m in <15 minutes). Persistent mobility disability (inability to walk 400 m on two consecutive occasions) and changes from baseline to 24 and 36 months in physical performance, muscle strength, and appendicular lean mass were analysed as pre-planned secondary outcomes. Primary comparisons were conducted in participants with baseline SPPB scores of 3-7 (n=1205). Those with SPPB scores of 8 or 9 (n=314) were analysed separately for exploratory purposes. Results Mean age of the 1519 participants (1088 women) was 78.9 (standard deviation 5.8) years. The average follow-up was 26.4 (SD 9.5) months. Among participants with SPPB scores of 3-7, mobility disability occurred in 283/605 (
Published: 2022

61. Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis – A EUFOREA‐ARIA‐EPOS‐AIRWAYS ICP statement

Author: Hellings, P. W., Fokkens, W. J., Bachert, C., Akdis, C. A., Bieber, T., Agache, I., Bernal‐Sprekelsen, M., Canonica, G. W., Gevaert, P., Joos, G., Lund, V., Muraro, A., Onerci, M., Zuberbier, T., Pugin, B., Seys, S. F., Bousquet, J., Aberer, W, Agache, I, Akdis, CA, Akdis, M, Alobid, I, Ankri, J, Annesi‐Maesano, I, Ansotegui, IJ, Anto, JM, Arnavielhe, S, Arshad, H, Asarnoj, A, Avolio, F, Bachert, C, Bachert, C, Baiardini, I, Barbagallo, M, Barbara, C, Baroody, F, Bateman, ED, Bedbrook, A, Beghé, B, Bel, EH, Bennoor, KS, Benson, M, Bergmann, KC, Bewick, M, Bialoszewski, AZ, Bieber, T, Bindslev‐Jensen, C, Bjermer, L, Blain, H, Blasi, F, Boner, AL, Bonini, M, Bonini, S, Bosnic‐Anticevich, S, Bosse, I, Bouchard, J, Boulet, LP, Bourret, R, Bousquet, J, Bousquet, PJ, Braido, F, Briggs, AH, Brightling, CE, Brozek, J, Bucca, C, Buhl, R, Bunu, C, Burte, E, Bush, A, Caballero‐Fonseca, F, Caimmi, DP, Calderon, MA, Camargos, PA, Camuzat, T, Canonica, GW, Cardona, V, Carlsen, KH, Carr, W, Carreiro‐Martins, P, Carriazo, AM, Casale, T, Cepeda Sarabia, AM, Cervin, A, Cesari, M, Chatzi, L, Chavannes, NH, Chiron, R, Chivato, T, Chkhartishvili, E, Chuchalin, AG, Chung, KF, Ciprandi, G, Cohen, N, Conzález Diaz, S, Cox, L, Crooks, G, Cruz, AA, Custovic, A, Dahl, R, Dahlen, SE, Darsow, U, De Carlo, G, De Manuel Keenoy, E, de Sousa, JC, De Vries, G, Dedeu, T, Deleanu, D, Demoly, P, Denburg, JA, Devillier, P, Didier, A, Dinh‐Xuan, AT, Dokic, D, Douagui, H, Douglas, R, Dray, G, Du Toit, G, Dubakiene, R, Durham, SR, Dykewicz, MS, Eklund, P, El‐Gamal, Y, Ellers, E, Emuzyte, R, Farrell, J, Fink Wagner, A, Fiocchi, A, Fletcher, M, Fokkens, WJ, Fonseca, J, Forastiere, F, Gaga, M, Gamkrelidze, A, Gemicioğlu, B, Georgalas, C, Gereda, JE, Gevaert, P, Goossens, H, Grisle, I, Guldemond, NA, Gutter, Z, Guzmán, MA, Haahtela, T, Harvey, R, Heinrich, J, Hellings, PW, Hellings, PW, Hellquist‐Dahl, B, Hopkins, C, Horak, F, Hourihane, JO, Humbert, M, Hyland, M, Iaccarino, G, Illario, M, Jares, EJ, Jeandel, C, Johnston, SL, Jonquet, O, Joos, G, Joos, G, Jung, KS, Just, J, Jutel, M, Kaidashev, I, Kalayci, O, Kalogjera, L, Kalyoncu, AF, Kardas, P, Keil, T, Keith, PK, Kerkhof, M, Kern, B, Kerstjens, HA, Khaitov, M, Khaltaev, N, Klimek, L, Kogevinas, M, Kolek, V, Koppelman, GH, Kowalski, M, Kowalski, ML, Kuitunen, M, Kull, I, Kuna, P, Kvedariene, V, Lambrecht, B, Larenas‐Linnemann, D, Lau, S, Laune, D, Le, LT, Li, J, Lieberman, P, Lipworth, B, Lodrup Carlsen, KC, Louis, R, Lund, VJ, Lupinek, C, MacNee, W, Magar, Y, Magnan, A, Mahboub, B, Maier, D, Majer, I, Malva, J, Manning, P, Marshall, GD, Masjedi, MR, Mathieu‐Dupas, E, Maurer, M, Mavale‐Manuel, S, Melén, E, Melo‐Gomes, E, Meltzer, EO, Mercier, J, Merk, H, Miculinic, N, Mihaltan, F, Milenkovic, B, Millot‐Keurinck, J, Mohammad, Y, Momas, I, Morais‐Almeida, M, Mösges, R, Mullol, J, Mullol, J, Muraro, A, Murray, R, Naclerio, R, Nadif, R, Namazova‐Baranova, L, Neffen, H, Nekam, K, Nieto, A, Niggemann, B, Nogueira‐Silva, L, Nogues, M, Nyembue, TD, OʼHehir, RE, Ohta, K, Okamoto, Y, Okubo, K, Olive‐Elias, M, Ouedraogo, S, Paggiaro, P, Pali‐Schöll, I, Palkonen, S, Panzner, P, Papadopoulos, NG, Papi, A, Park, HS, Passalacqua, G, Pawankar, R, Pedersen, S, Pereira, AM, Pfaar, O, Picard, R, Pigearias, B, Pin, I, Plavec, D, Pohl, W, Popov, TA, Portejoie, F, Postma, D, Potter, P, Poulsen, LK, Price, D, Price, D, Rabe, KF, Raciborski, F, Riechelmann, H, Robalo‐Cordeiro, C, Roberts, G, Rodenas, F, Rodriguez‐Mañas, L, Rolland, C, Roman Rodriguez, M, Romano, A, Rosado‐Pinto, J, Rosario, N, Rottem, M, Ryan, D, Samolinski, B, Sanchez‐Borges, M, Sastre‐Dominguez, J, Scadding, GK, Schlosser, R, Schmid‐Grendelmeier, P, Schunemann, HJ, Scichilone, N, Senior, B, Serrano, E, Sheikh, A, Shields, M, Simons, FER, Siroux, V, Sisul, JC, Skrindo, I, Smit, HA, Solé, D, Sooronbaev, T, Spranger, O, Stellato, C, Stelmach, R, Sterk, PJ, Strandberg, T, Sunyer, J, Thijs, C, Thomas, M, Todo‐Bom, A, Tomazic, PV, Toskala, E, Triggiani, M, Valenta, R, Valero, A, Valiulis, A, Valovirta, E, van Eerd, M, van Ganse, E, van Hage, M, van Wick, RG, Vandenplas, O, Varona, LL, Vazankari, T, Vellas, B, Ventura, MT, Vezzani, G, Viegi, G, Voegels, R, Vontetsianos, T, Wagenmann, M, Wahn, U, Walker, S, Wang, DY, Wang, Y, Werfel, T, Whalley, B, Wickman, M, Williams, DM, Williams, S, Wilson, N, Wormald, PJ, Wright, J, Yawn, BP, Yiallouros, PK, Yorgancioglu, A, Young, I, Yusuf, OM, Zaidi, A, Zar, HJ, Zernotti, ME, Zhang, L, Zhong, N, Zidarn, M, and Zuberbier, T
Published: 2017
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62. ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

Author: Bousquet, J., Hellings, P. W., Agache, I., Bedbrook, A., Bachert, C., Bergmann, K. C., Bewick, M., Bindslev-Jensen, C., Bosnic-Anticevitch, S., Bucca, C., Caimmi, D. P., Camargos, P. A. M., Canonica, G. W., Casale, T., Chavannes, N. H., Cruz, A. A., De Carlo, G., Dahl, R., Demoly, P., Devillier, P., Fonseca, J., Fokkens, W. J., Guldemond, N. A., Haahtela, T., Illario, M., Just, J., Keil, T., Klimek, L., Kuna, P., Larenas-Linnemann, D., Morais-Almeida, M., Mullol, J., Murray, R., Naclerio, R., O’Hehir, R. E., Papadopoulos, N. G., Pawankar, R., Potter, P., Ryan, D., Samolinski, B., Schunemann, H. J., Sheikh, A., Simons, F. E. R., Stellato, C., Todo-Bom, A., Tomazic, P. V., Valiulis, A., Valovirta, E., Ventura, M. T., Wickman, M., Young, I., Yorgancioglu, A., Zuberbier, T., Aberer, W., Akdis, C. A., Akdis, M., Annesi-Maesano, I., Ankri, J., Ansotegui, I. J., Anto, J. M., Arnavielhe, S., Asarnoj, A., Arshad, H., Avolio, F., Baiardini, I., Barbara, C., Barbagallo, M., Bateman, E. D., Beghé, B., Bel, E. H., Bennoor, K. S., Benson, M., Białoszewski, A. Z., Bieber, T., Bjermer, L., Blain, H., Blasi, F., Boner, A. L., Bonini, M., Bonini, S., Bosse, I., Bouchard, J., Boulet, L. P., Bourret, R., Bousquet, P. J., Braido, F., Briggs, A. H., Brightling, C. E., Brozek, J., Buhl, R., Bunu, C., Burte, E., Bush, A., Caballero-Fonseca, F., Calderon, M. A., Camuzat, T., Cardona, V., Carreiro-Martins, P., Carriazo, A. M., Carlsen, K. H., Carr, W., Cepeda Sarabia, A. M., Cesari, M., Chatzi, L., Chiron, R., Chivato, T., Chkhartishvili, E., Chuchalin, A. G., Chung, K. F., Ciprandi, G., de Sousa, J. Correia, Cox, L., Crooks, G., Custovic, A., Dahlen, S. E., Darsow, U., Dedeu, T., Deleanu, D., Denburg, J. A., De Vries, G., Didier, A., Dinh-Xuan, A. T., Dokic, D., Douagui, H., Dray, G., Dubakiene, R., Durham, S. R., Du Toit, G., Dykewicz, M. S., Eklund, P., El-Gamal, Y., Ellers, E., Emuzyte, R., Farrell, J., Fink Wagner, A., Fiocchi, A., Fletcher, M., Forastiere, F., Gaga, M., Gamkrelidze, A., Gemicioğlu, B., Gereda, J. E., van Wick, R. Gerth, González Diaz, S., Grisle, I., Grouse, L., Gutter, Z., Guzmán, M. A., Hellquist-Dahl, B., Heinrich, J., Horak, F., Hourihane, J. O’. B., Humbert, M., Hyland, M., Iaccarino, G., Jares, E. J., Jeandel, C., Johnston, S. L., Joos, G., Jonquet, O., Jung, K. S., Jutel, M., Kaidashev, I., Khaitov, M., Kalayci, O., Kalyoncu, A. F., Kardas, P., Keith, P. K., Kerkhof, M., Kerstjens, H. A. M., Khaltaev, N., Kogevinas, M., Kolek, V., Koppelman, G. H., Kowalski, M. L., Kuitunen, M., Kull, I., Kvedariene, V., Lambrecht, B., Lau, S., Laune, D., Le, L. T. T., Lieberman, P., Lipworth, B., Li, J., Lodrup Carlsen, K. C., Louis, R., Lupinek, C., MacNee, W., Magar, Y., Magnan, A., Mahboub, B., Maier, D., Majer, I., Malva, J., Manning, P., De Manuel Keenoy, E., Marshall, G. D., Masjedi, M. R., Mathieu-Dupas, E., Maurer, M., Mavale-Manuel, S., Melén, E., Melo-Gomes, E., Meltzer, E. O., Mercier, J., Merk, H., Miculinic, N., Mihaltan, F., Milenkovic, B., Millot-Keurinck, J., Mohammad, Y., Momas, I., Mösges, R., Muraro, A., Namazova-Baranova, L., Nadif, R., Neffen, H., Nekam, K., Nieto, A., Niggemann, B., Nogueira-Silva, L., Nogues, M., Nyembue, T. D., Ohta, K., Okamoto, Y., Okubo, K., Olive-Elias, M., Ouedraogo, S., Paggiaro, P., Pali-Schöll, I., Palkonen, S., Panzner, P., Papi, A., Park, H. S., Passalacqua, G., Pedersen, S., Pereira, A. M., Pfaar, O., Picard, R., Pigearias, B., Pin, I., Plavec, D., Pohl, W., Popov, T. A., Portejoie, F., Postma, D., Poulsen, L. K., Price, D., Rabe, K. F., Raciborski, F., Roberts, G., Robalo-Cordeiro, C., Rodenas, F., Rodriguez-Mañas, L., Rolland, C., Roman Rodriguez, M., Romano, A., Rosado-Pinto, J., Rosario, N., Rottem, M., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G. K., Scichilone, N., Schmid-Grendelmeier, P., Serrano, E., Shields, M., Siroux, V., Sisul, J. C., Skrindo, I., Smit, H. A., Solé, D., Sooronbaev, T., Spranger, O., Stelmach, R., Sterk, P. J., Strandberg, T., Sunyer, J., Thijs, C., Triggiani, M., Valenta, R., Valero, A., van Eerd, M., van Ganse, E., van Hague, M., Vandenplas, O., Varona, L. L., Vellas, B., Vezzani, G., Vazankari, T., Viegi, G., Vontetsianos, T., Wagenmann, M., Walker, S., Wang, D. Y., Wahn, U., Werfel, T., Whalley, B., Williams, D. M., Williams, S., Wilson, N., Wright, J., Yawn, B. P., Yiallouros, P. K., Yusuf, O. M., Zaidi, A., Zar, H. J., Zernotti, M. E., Zhang, L., Zhong, N., and Zidarn, M.
Published: 2016
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63. Evidence-based Medicine--How to Teach Critical Scientific Thinking to Medical Undergraduates.

Author: Pitkala, K., Mantyranta, T., Strandberg, T. E., Makela, M., Vanhanen, H., and Varonen, H.
Abstract: Discusses an evidence-based course which activates students' critical thinking, enhances social learning and group processes, and promotes attitudes towards independent information retrieval and critical appraisal. (Author/CCM)
Published: 2000

64. Secular trends in the use of vitamins, minerals and fish-oil products in two cohorts of community-dwelling older people in Helsinki — Population-based surveys in 1999 and 2009

Author: Savikko, Niina, Pitkala, K. H., Laurila, J. V., Suominen, M. H., Tilvis, R. S., Kautiainen, H., and Strandberg, T. E.
Published: 2014
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65. Statins and new-onset diabetes mellitus – a risk lacking in familial hypercholesterolaemia

Author: Vuorio, A., Strandberg, T. E., Schneider, W. J., and Kovanen, P. T.
Published: 2016
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66. Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial

Author: Bhatt, D, Steg, P, Mehta, S, Leiter, L, Simon, T, Fox, K, Held, C, Andersson, M, Himmelmann, A, Ridderstrale, W, Chen, J, Song, Y, Diaz, R, Goto, S, James, S, Ray, K, Parkhomenko, A, Kosiborod, M, Mcguire, D, Harrington, R, Santos, V, Jain, A, Lendel, I, Russo, M, Haught, W, Bouza, M, Gogia, H, Banerjee, S, Kichura, G, Kantaros, L, Padron, F, Passi, R, Stone, J, Pursley, M, D'Urso, M, Gardner, T, Bennett, J, Nour, K, Saini, S, Zhang, W, Kumbhani, D, Thomas, D, Angiolillo, D, Bertolet, B, Roman-Miranda, A, Black, R, Manshadi, R, Vaca, C, Blanco, A, Napoli, M, Brabham, D, Akyea-Djamson, A, Desai, P, Prasada, S, Khaira, A, Forgosh, L, Lieber, I, Umpierrez, G, Singal, D, Londono, J, Fraser, N, Ruiz, J, Vega, D, Rodriguez, L, Brown, C, Syed, F, Aggarwala, G, Eaves, W, Foster, M, Gupta, D, Avino, D, Asfour, W, Tonnessen, G, Zhao, X, Singh, N, Brockmyre, A, Lepor, N, Shammas, N, Blick, D, Hearne, S, Prodafikas, J, Carell, E, Izzo, M, Karim, A, Zakhary, B, Atieh, M, Leichter, S, Meadows, C, Hotchkiss, D, Abu-Fadel, M, Wiseman, A, Bander, J, Shah, M, Ganim, R, Sopko, K, Khan, M, Lloret, R, Weirick, T, Mehta, R, Thadani, U, Bhargava, A, Moya, J, Staniloae, C, Guerra, Y, Chhabra, A, Kosmicki, D, Shaheen, W, Mohammed, A, Bitters, J, Pattanayak, J, Javier, J, Srivastava, S, Phillips, R, Al-Amin, J, Lillestol, M, Simpson, P, Hazan, L, Amin, A, Shah, G, Korpas, D, Platt, B, Dickert, J, Puente, O, Hiotis, L, Doyle, T, Rajan, R, Meholick, A, Gring, C, Hage-Korban, E, Feldman, R, Colfer, H, Butman, S, Hart, T, Huling, R, Eshaghian, S, Quintana, O, Cheung, D, Handel, F, Rodriguez, M, Suh, D, Gordon, P, Pressman, G, Bauer, M, French, W, Barettella, M, Chatrathi, S, Suresh, D, Goldberg, R, Huth, M, Younis, L, Rahman, A, Mascolo, R, Welch, M, Suneja, R, Smith, S, Shurmur, S, Agaiby, J, Jingo, A, Johnston, J, Beth, M, Vlastaris, A, Kemp, S, Taheri, H, Pereira, E, Deyoung, M, Hawa, Z, Smith, R, Galski, T, Garas, S, Reddy, M, Sharma, S, Hargrove, J, Treasure, C, Emerson, R, Haddad, T, Rohr, K, Levinson, L, Gaona, R, Uretsky, B, Maheshwari, H, Lee, D, Kinnaman, S, Singal, R, Geohas, J, Gigliotti, O, Raisinghani, A, Khurana, C, Hella, B, Kelberman, M, Voyce, S, Singh, S, Lo, E, Singh, P, Goodfellow, R, Fischer, S, Lorraine, R, Turner, T, Shanes, J, Busch, R, Broker, R, Zaniewski, M, Pounds, K, Debs-Perez, G, Ong, S, Frandsen, B, Fullington, D, Jaffrani, N, Khan, A, Lee, M, Pouzar, J, Revtyak, G, Gonzalez, J, Nakhle, S, Murillo, A, Young, D, Makam, S, Syed, M, Woolf, K, Grena, P, Alfata, S, Mahal, S, Hoffman, D, Kizhakekuttu, T, Deering, J, Bhavsar, J, Mikesell, S, Wilson, W, Wilson, V, El, S, Spinale, F, Kannarkat, V, Rao, S, Hanson, L, Bertsch, J, Gonzalez-Ortiz, E, Severino, N, Willis, J, Schock, J, Bakhtari, L, Gazmuri, R, Ansari, S, Hall, J, Mehta, A, Shealy, N, Zarich, S, Singh, D, Vora, K, Andrawis, N, Molter, D, Maron, D, Cardona, J, D'Agostino, R, Arshad, T, Samaan, R, Jones, D, Presser, D, Heath, J, Green, S, Bittar, G, Henry, S, Korn, D, Schmedtje, J, Nadar, V, Graham, B, Labroo, A, Clavijo, L, Roseman, H, Ledesma, G, Rosen, R, Dor, I, Kirby, W, Sutton, J, Eder, F, Iteld, B, Gomez-Cortes, J, Buchbinder, M, Kasper, J, Terrelonge, A, Torres, G, Jagielo, T, Alvarez, J, Handelsman, Y, Guillen, M, Richwine, R, Lewy-Alterbaum, L, Corder, C, Arvind, M, Bolshoun, D, Mikhail, M, Minton, S, Alvarado, O, Abbott, J, Cauthen, B, Welter, R, Mintz, R, Cox, J, Quick, A, Weiss, M, Dy, J, Zebrack, J, Gandelman, G, Hegde, V, Silver, M, Degregorio, M, Lawson, W, Paa, C, Bortnick, A, Krolick, M, Sotolongo, R, Cheirif, J, Kumar, P, Jetty, P, Patel, A, Kruk, M, Kobielusz-Gembala, I, Rewerska, B, Madrzejewski, A, Milewski, K, Cygler, J, Petryka-Mazurkiewicz, J, Jastrzebski, W, Korecki, J, Fil, W, Prokopczuk, J, Bochenek, A, Wujkowski, M, Witek, R, Konczakowski, P, Miekus, P, Szczasny, M, Musial, W, Cymerman, K, Lampart, J, Mikosinski, J, Szynal, S, Fares, I, Opolski, G, Mazur, S, Wozakowska-Kaplon, B, Bijata-Bronisz, R, Wierucki, L, Losa, B, Drelich, G, Konieczny, M, Starczewski, P, Pawlowicz, L, Jesionowski, P, Jurowiecki, J, Gniot, J, Czyzycki, M, Stania, K, Kucharczyk-Bauman, I, Busz-Papiez, B, Karczmarczyk, A, Sudnik, W, Koszek, A, Kolodziej, P, Skwarna, B, Jaramillo, N, Jankowski, M, Czochra, W, Kinasz, L, Miklaszewicz, B, Stasinska, T, Pluta, W, Basiak, M, Rusicka, T, Niedbal-Yahfouf, I, Popenda, G, Korzeniak, R, Mirek, A, Mariankowski, R, Wojnowski, L, Korol, M, Baszak, J, Podolec, P, Piesiewicz, W, Zurakowski, A, Luengas, C, Skura, M, Pilecki, P, Majchrzak, P, Krzyzagorska, E, Drozd, M, Kaczmarek, B, Sliwinska, T, Zelazowska, K, Sztembis, R, Landa, K, Matyszczak-Toniak, L, Strojek, K, Piepiorka, M, Malinowski, R, Gorska, M, Stolarczyk-Sowa, E, Romanowski, L, Zinka, E, Reszka, Z, Skierkowska, J, Uzunow, A, Laskowska-Derlaga, E, Puntus, E, Kosmacheva, E, Koziolova, N, Pavlov, P, Supryadkina, T, Didenko, Y, Kopylov, P, Kazakov, A, Aksentiev, S, Vishneva, E, Repin, A, Smolenskaya, O, Mantserova, O, Khrustalev, O, 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C., Bakai J., Greschik I., Puski L., Nagy L., Kirschner R., Kuchar R., Hajek P., Busak L., Michalik D., Matyasek I., Marusincova I., Kucera D., Jerabek O., Honkova M., Dedek V., Rihacek I., Kos P., Slaby J., Machkova M., Zidkova E., Elbl L., Grunfeldova H., Carda J., Mrozek V., Maly J., Milkovic R., Malecha J., Skalicka H., Oral I., Krcova E., Lisa L., Belohlavek J., Miklik R., Cermak O., Bednarova J., Peroutka Z., Spinar J., Wilke A., Appel K. -F., Taggeselle J., Forster A., Toursarkissian N., Schmidt E., Bott J., Al-Zoebi A., Hennig D., Schon N., Sauter J., Simonis G., Nischik R., Rieker W., Schenkenberger I., Behnke T., Klausmann G., Jeserich M., Trenk D., Weigmann I., Reuter H., Rummel R., von Munchhausen C., von Engelhardt C., Horibe E., Shibasaki T., Sato T., Kakuta T., Michishita I., Tan M., Ishiki R., Aoyama T., Higashiue S., Niijima Y., Idogaki A., Hasegawa T., Kiyosue A., Tomobuchi Y., Kawamitsu K., Kawasaki S., Hata Y., Fukui K., Seki K., Takenaka T., Abe M., Utsu N., Oono A., Mitsuo K., Sueyoshi A., Hirohata A., Tsujimoto M., Ueda O., Takase S., Suzuki M., Sakuragi S., Yamamoto F., Fujimoto N., Kakinoki S., Sugiura T., Sugino H., Nakamura T., Kadokami T., Uehara H., Ono M., Yokoya K., Koike A., Komatsu S., Sonoda M., Ueno H., Doi T., Takagi Y., Fujimoto K., Eki Y., Okubo M., Sasaki K., van Eck M., Ronner E., The S., van de Wal R., Nierop P., de Nooijer C., Werner H., Westendorp I., van der Zwaan C., Crijns H., Cornel J. H., Strikwerda S., Bos R., de Melker E., Kuijper A., Louwerenburg H., Plomp J., Dantzig J. -M., Prins F., van Kesteren H., Willems F., Amoroso G., Carnero G., Duronto E., Besada D., Chacon C., Zangroniz P., Solis S., Liberman A., Sernia V., Alvarisqueta A., Maffei L., Vilamajo O. G., Garcia C., Sicer M., Muntaner J., Bordonava A., Albisu J., Zanini A., Rista L., Hominal M., Estrada J. N., Prado A., Gosparini D. M., Schiavi B., Castillo A. G., Ruiz J. G., Martinez G. R., Lopez V. G., Rosas E. L., Lopez G. R., Cantu E. G., de los Rios Ibarra M., Padilla F. P., Carrasco J. P., Carrillo L. V., Garcia J. D., Askar A. N., Salinas C. A., Gamba M. A., Sanchez C. G., Cantu A. G., Sanchez R. V., Madrigal J. C., Urbano R. H., Romo A. I., Gonzalez Juanatey J. R., Racugno P., Fillat A. C., de la Torre Hernandez J. M., Pelaez J. A., Cortada J. B., Pavia P. G., Navarro M. J., Asenjo R. M., Diaz F. F., Peligero E. B., Manterola F. A., Ortiz A. F., Mediavilla Garcia J. D., Ortuno F. M., Vera T. R., Gonzalez A. S., Vinas J. A., Fernandez Portales F. J., Mayordomo P. S., Ojeda F. B., Dominguez A. R., Gonzalez R. S., Guerrero D. B., Ruiz Nodar J. M., Marimon X. G., Margaez J. G., Aguilera R. M., Diaz Fernandez J. F., Zamorano Gomez J. L., Gonzalez V. B., del Blanco B. G., Perez I. P., Moreno M. R., Ereno A. R., Garcia Lledo J. A., Prieto J., Villablanca A., Raffo C., Pincetti C., Conejeros C., Roman O., Varleta P., Goldberg C., Sandoval J., Arriagada G., Corbalan R., Leon L., Potthoff S., Cobos J., Figueroa C., Makotoko E., Fourie N., Burgess L., Nortje H., Theron R., Pillai P., Ranjith N., Trokis J., Pillay S., Reddy J., Nunkoo T., Kapp C., Urbach D., Distiller L., Horak A., van Zyl L., Coetzee K., Punt Z., Bayat J., Dawood S., Mitha I., Padayachee T., Hoosen F., Dalby A., Gowdaiah P., Mehta V., Chag M., Gadkari M., Ramamurthee K., Das A., Sawhney J. S., Sathe P., Adhyapak S., Nguyen T., Pham V., Do H., Nguyen A., Nguyen H., Truong B., Jamil-Copley S., Lang C., Pell A., Zaman A., Storey R., Swanson N., Sharman D., Braganza D., Hammond P., Moriarty A., Bain S., Pye M., Sharp A., Blagden M., Randeva H., Myhill T., Viswanathan G., Keeling P., Clifford P., Saxena M., Lyons K., McMurray J., Jaafar F., Murphy C., Cartwright S., Abouglila K., Antalik L., Krajci P., Urban M., Fazekas F., Pella D., Koleny D., Vykoukalova T., Macek V., Vinanska D., Jamriskova L., Such S., Fulop P., Farsky S., Bugan V., Strbova J., Micko K., Palka Jr J., Sivak V., Kristensen D., Refsgaard J., Holmvang L., Dixen U., Nielsen H., Egstrup K., Jensen L. O., Sykulski R., Rasmussen O., Andries A., Luckow A., Nielsen G., Sorensen T., Wongvipaporn C., Chamnarnphol N., Srimahachota S., Sansanayudh N., Kuanprasert S., Tresukosol D., Sookananchai B., Kanadasi M., Ozcan T., Kucuk M., Ongen Z., Okuyan E., Arat A., Acikel S., Yalcin A., Guray U., Ceyhan C., Ozer N., Arslan S., Angeras O., Johnston N., Weiderman A. -C., Bandh S., Hansen O., Larnefeldt H., Kusiak D., Lindholm C. -J., Hedman A., Erlinge D., Curiac D., Lundman P., Zucconi-Mazzini R., Aladellie L., Jensen J., Verwerft J., Vrolix M., Faes D., Striekwold H., Sinnaeve P., Timmermans P., Guedes A., Delforge M., Nimmegeers J., Stammen F., Buysschaert I., Hoffer E., Hollanders G., Vervoort G., Coussement P., de Maeseneire S., Janssens L., Gravdal S. A., Risberg K., Gullestad L., Hofseth O. D., Nilsen D., Lappegard K. T., van den Heuvel C., Gibbs C., Khusrawi A., Arora S., Tomala T., Kjaernli T., Berg-Johansen J., Hagemeier R., Skjelvan G., Colquhoun D., Amerena J., Morbey C., Hammett C., Dart A., Lehman R., Hamilton A., Worthley M., Purnell P., Whelan A., MacIsaac R., Arya K., Linjawi S., Proietto J., Prasad L., Rodriguez A., Godoy A., Rodriguez V., Berrospi P., Chavez C., Negron S., Heredia J., Medina F., Manrique H., Cabrera W., Cordova F., Quinteros T., Haro J. M., Regalado S., Guitton J., Arbanil H., Pansieri M., Decoulx E., Goube P., de Labriolle A., Labeque J. N., Range G., Cottin Y., Montalescot G., Cayla G., Danchin N., Angoulvant D., Ferrario E., Elbaz M., Dubreuil O., Fontaine C., Sorbets E., Omer H., Al-Saif S., Al-Faleh H., Al-Shehri A., El-Amin O., Alshehri H., Bazari R., Hei P., Ying M., Chan M., Wong M., Ma R., Siu S. C., Tsang C. C., Ferrario M., Assanelli E., Senni M., Piatti P., Calabro P., Urbinati S., Michisanti M., Varbella F., de Cosmo S., Trevisan R., Bellotti S., Di Pasquale G., Bongo A. S., Uguccioni M., Mannucci E., Mauro C., Ragonese M., Fresco C., Turturo M., Marcucci R., Lievano Triana M. J., Arana C., Accini J., Botero R., Muzyk-Osikowicz M., Dada F. T., Vallejo G. S., Manzur F., Isaza D., Molina D., Mesa J. G., Quintero A., Nyman K., Makela J., Strand J., Nieminen S., Taurio J., Kuusela M., Valle T., Pietila M., Kekki S., Strandberg T., Klutstein M., Greenberg G., Rozenman Y., Chorin E., Roguin A., Lewis B., Bashkin A., Tan E., Prado J. P., Ferrolino A., Babilonia N., Barbas B., Matiga G., Coching R. M., Drexel H., Brath H., Schnack C., Hanusch U., Fliesser-Gorzer E., Paulweber B., Ebenbichler C., Prager R., Huber K., Wolzt M., Auer J., Berger R., Schernthaner G. -H., Stanciulescu G., Creteanu M., Spiridon M., Dobreanu V., Vinereanu D., Iosipescu L. C., Istratoaie O., Coman I., Militaru C., Cinteza M., Sinnaeve P. R., Nicolau J. C., Kerr Saraiva J. F., Widimsky P., Kristensen S. D., Hartikainen J., Darius H., Tse H. F., Pais P., Lev E., de Luca L., Ramos Lopez G. A., Kontny F., Babilonia N. A., Zateyshchikov D. A., Ruda M., Elamin O., Kovar F., Dalby A. J., Bueno H., Chiang C. -E., Parkhomenko A., Nguyen T. Q., and Leonsson-Zachrisson M.
Abstract: Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, pinteraction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo
Published: 2019

67. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation

Author: Bousquet, J., Schunemann, H. J., Fonseca, J., Samolinski, B., Bachert, C., Canonica, G. W., Casale, T., Cruz, A. A., Demoly, P., Hellings, P., Valiulis, A., Wickman, M., Zuberbier, T., Bosnic-Anticevitch, S., Bedbrook, A., Bergmann, K. C., Caimmi, D., Dahl, R., Fokkens, W. J., Grisle, I., Carlsen, Lodrup K., Mullol, J., Muraro, A., Palkonen, S., Papadopoulos, N., Passalacqua, G., Ryan, D., Valovirta, E., Yorgancioglu, A., Aberer, W., Agache, I., Adachi, M., Akdis, C. A., Akdis, M., Annesi-Maesano, I., Ansotegui, I. J., Anto, J. M., Arnavielhe, S., Arshad, H., Baiardini, I., Baigenzhin, A. K., Barbara, C., Bateman, E. D., Beghé, B., Bel, E. H., Ben Kheder, A., Bennoor, K. S., Benson, M., Bewick, M., Bieber, T., Bindslev-Jensen, C., Bjermer, L., Blain, H., Boner, A. L., Boulet, L. P., Bonini, M., Bonini, S., Bosse, I., Bourret, R., Bousquet, P. J., Braido, F., Briggs, A. H., Brightling, C. E., Brozek, J., Buhl, R., Burney, P. G., Bush, A., Caballero-Fonseca, F., Calderon, M. A., Camargos, P. A. M., Camuzat, T., Carlsen, K. H., Carr, W., Cepeda Sarabia, A. M., Chavannes, N. H., Chatzi, L., Chen, Y. Z., Chiron, R., Chkhartishvili, E., Chuchalin, A. G., Ciprandi, G., Cirule, I., de Sousa, Correia J., Cox, L., Crooks, G., Costa, D. J., Custovic, A., Dahlen, S. E., Darsow, U., De Carlo, G., De Blay, F., Dedeu, T., Deleanu, D., Denburg, J. A., Devillier, P., Didier, A., Dinh-Xuan, A. T., Dokic, D., Douagui, H., Dray, G., Dubakiene, R., Durham, S. R., Dykewicz, M. S., El-Gamal, Y., Emuzyte, R., Wagner, Fink A., Fletcher, M., Fiocchi, A., Forastiere, F., Gamkrelidze, A., Gemicioğlu, B., Gereda, J. E., Diaz, González S., Gotua, M., Grouse, L., Guzmán, M. A., Haahtela, T., Hellquist-Dahl, B., Heinrich, J., Horak, F., Hourihane, J. O.‘B., Howarth, P., Humbert, M., Hyland, M. E., Ivancevich, J. C., Jares, E. J., Johnston, S. L., Joos, G., Jonquet, O., Jung, K. S., Just, J., Kaidashev, I., Kalayci, O., Kalyoncu, A. F., Keil, T., Keith, P. K., Khaltaev, N., Klimek, L., NʼGoran, Koffi B., Kolek, V., Koppelman, G. H., Kowalski, M. L., Kull, I., Kuna, P., Kvedariene, V., Lambrecht, B., Lau, S., Larenas-Linnemann, D., Laune, D., Le, L. T. T., Lieberman, P., Lipworth, B., Li, J., Louis, R., Magard, Y., Magnan, A., Mahboub, B., Majer, I., Makela, M. J., Manning, P., De Manuel Keenoy, E., Marshall, G. D., Masjedi, M. R., Maurer, M., Mavale-Manuel, S., Melén, E., Melo-Gomes, E., Meltzer, E. O., Merk, H., Miculinic, N., Mihaltan, F., Milenkovic, B., Mohammad, Y., Molimard, M., Momas, I., Montilla-Santana, A., Morais-Almeida, M., Mösges, R., Namazova-Baranova, L., Naclerio, R., Neou, A., Neffen, H., Nekam, K., Niggemann, B., Nyembue, T. D., OʼHehir, R. E., Ohta, K., Okamoto, Y., Okubo, K., Ouedraogo, S., Paggiaro, P., Pali-Schöll, I., Palmer, S., Panzner, P., Papi, A., Park, H. S., Pavord, I., Pawankar, R., Pfaar, O., Picard, R., Pigearias, B., Pin, I., Plavec, D., Pohl, W., Popov, T. A., Portejoie, F., Postma, D., Potter, P., Price, D., Rabe, K. F., Raciborski, F., Pontal, Radier F., Repka-Ramirez, S., Robalo-Cordeiro, C., Rolland, C., Rosado-Pinto, J., Reitamo, S., Rodenas, F., Rodriguez, Roman M., Romano, A., Rosario, N., Rosenwasser, L., Rottem, M., Sanchez-Borges, M., Scadding, G. K., Serrano, E., Schmid-Grendelmeier, P., Sheikh, A., Simons, F. E. R., Sisul, J. C., Skrindo, I., Smit, H. A., Solé, D., Sooronbaev, T., Spranger, O., Stelmach, R., Strandberg, T., Sunyer, J., Thijs, C., Todo-Bom, A., Triggiani, M., Valenta, R., Valero, A. L., van Hage, M., Vandenplas, O., Vezzani, G., Vichyanond, P., Viegi, G., Wagenmann, M., Walker, S., Wang, D. Y., Wahn, U., Williams, D. M., Wright, J., Yawn, B. P., Yiallouros, P. K., Yusuf, O. M., Zar, H. J., Zernotti, M. E., Zhang, L., Zhong, N., Zidarn, M., and Mercier, J.
Published: 2015
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68. Pathways to longevity - but is it successful?

Author: Strandberg, T. E., HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, Department of Medicine, Clinicum, and Helsinki University Hospital Area
Subjects: OLD-AGE, QUALITY-OF-LIFE, CHOLESTEROL, MORTALITY, 3121 General medicine, internal medicine and other clinical medicine, education, MIDLIFE
Abstract: Non
Published: 2021

69. Challenges of treating cardiovascular risk in old age

Author: Strandberg, T. E. (Timo E.)
Published: 2021

70. Symptom burden in community-dwelling older people:temporal trends in the Helsinki Aging Study

Author: Lehti, T. E. (T. E.), Öhman, H. (H.), Knuutila, M. (M.), Kautiainen, H. (H.), Karppinen, H. (H.), Tilvis, R. (R.), Strandberg, T. (T.), and Pitkälä, K. H. (K. H.)
Subjects: Oldest-old, Temporal trends, Multimorbidity, Symptom burden, Psychological wellbeing, Aged
Abstract: Background: Changes in older people’s symptoms across recent decades have not been investigated. Aims: We analyzed temporal trends in symptom burden by comparing data from independent, cross-sectional cohorts retrieved in 1989, 1999, 2009, and 2019. Furthermore, we compared the association between symptom burden and psychological wellbeing (PWB) in older men and women. Methods: The Helsinki Aging Study recruited a random sample of people aged 75, 80, and 85 in 1989, and random samples aged 75, 80, 85, 90, and 95 in 1999, 2009, and 2019 (four study waves). Altogether, 6263 community-dwelling people answered the questions concerning symptoms in the questionnaire surveys. The symptoms inquired in all study waves were dizziness, back pain, joint pain, chest pain, shortness of breath, and loss of appetite. Symptom burden was calculated according to the number of symptoms and their frequency (score range: 0–6). PWB and the Charlson comorbidity index were calculated. Results: Symptom burden decreased in both men and women aged 75 and 80 from 1989 to 2019. Changes in cohorts aged 85 + were nonsignificant. There was a significant difference in symptom burden between men and women in all ages with men having fewer symptoms. PWB decreased with increasing symptom burden. Men had greater PWB than women up to severe levels of symptom burden. Conclusions: Symptom burden decreased from 1989 to 2019 in cohorts aged 75–80, whereas changes remained nonsignificant in cohorts aged 85 +. To our knowledge, this is the first study to examine temporal trends in symptom burden.
Published: 2021

71. Coronary artery disease:‘gout’ in the artery?

Author: Strandberg, T. E. (Timo E.) and Kovanen, P. T. (Petri T.)
Published: 2021

72. Sarkopenia:lihasmassan ja -voiman kato

Author: Strandberg, T. (Timo), Pitkälä, K. (Kaisu), and Sipilä, S. (Sarianna)
Abstract: Tiivistelmä Sarkopenia tarkoittaa etenevää yleistynyttä lihasmassan ja -voiman vähenemistä. Se ei ole ikään sidottu, mutta se on tavallisempi vanhalla iällä. Patofysiologia on monimutkainen ja etiologia moninainen. Tehokas ehkäisy edellyttää elämänaikaisia toimia. Sarkopenia lisää merkittävien kliinisten tapahtumien riskiä, mm. kaatumisia, toimintakyvyn heikentymistä ja gerastenian kehittymistä. Toistaiseksi paras hoito koostuu lihasvoimaharjoitusten ja ravitsemushoidon yhdistämisestä. Spesifisiä lääkehoitomahdollisuuksia tutkitaan. Abstract Sarcopenia is a progressive and generalized reduction of both skeletal muscle mass and muscle strength. Sarcopenia is associated with increased risk of significant clinical outcomes, such as falls, reduced function and development of frailty. Although not age-dependent, the incidence of sarcopenia increases with age. Sarcopenia has a multifactorial aetiology and its pathogenesis is complicated and as yet poorly understood. Effective prevention requires life-course measures. The present treatment possibilities include combining of resistance exercise and nutritional treatment; specific drug treatments are under investigation.
Published: 2021

73. Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Author: de Rojas, I. Moreno-Grau, S. Tesi, N. Grenier-Boley, B. Andrade, V. Jansen, I.E. Pedersen, N.L. Stringa, N. Zettergren, A. Hernández, I. Montrreal, L. Antúnez, C. Antonell, A. Tankard, R.M. Bis, J.C. Sims, R. Bellenguez, C. Quintela, I. González-Perez, A. Calero, M. Franco-Macías, E. Macías, J. Blesa, R. Cervera-Carles, L. Menéndez-González, M. Frank-García, A. Royo, J.L. Moreno, F. Huerto Vilas, R. Baquero, M. Diez-Fairen, M. Lage, C. García-Madrona, S. García-González, P. Alarcón-Martín, E. Valero, S. Sotolongo-Grau, O. Ullgren, A. Naj, A.C. Lemstra, A.W. Benaque, A. Pérez-Cordón, A. Benussi, A. Rábano, A. Padovani, A. Squassina, A. de Mendonça, A. Arias Pastor, A. Kok, A.A.L. Meggy, A. Pastor, A.B. Espinosa, A. Corma-Gómez, A. Martín Montes, A. Sanabria, Á. DeStefano, A.L. Schneider, A. Haapasalo, A. Kinhult Ståhlbom, A. Tybjærg-Hansen, A. Hartmann, A.M. Spottke, A. Corbatón-Anchuelo, A. Rongve, A. Borroni, B. Arosio, B. Nacmias, B. Nordestgaard, B.G. Kunkle, B.W. Charbonnier, C. Abdelnour, C. Masullo, C. Martínez Rodríguez, C. Muñoz-Fernandez, C. Dufouil, C. Graff, C. Ferreira, C.B. Chillotti, C. Reynolds, C.A. Fenoglio, C. Van Broeckhoven, C. Clark, C. Pisanu, C. Satizabal, C.L. Holmes, C. Buiza-Rueda, D. Aarsland, D. Rujescu, D. Alcolea, D. Galimberti, D. Wallon, D. Seripa, D. Grünblatt, E. Dardiotis, E. Düzel, E. Scarpini, E. Conti, E. Rubino, E. Gelpi, E. Rodriguez-Rodriguez, E. Duron, E. Boerwinkle, E. Ferri, E. Tagliavini, F. Küçükali, F. Pasquier, F. Sanchez-Garcia, F. Mangialasche, F. Jessen, F. Nicolas, G. Selbæk, G. Ortega, G. Chêne, G. Hadjigeorgiou, G. Rossi, G. Spalletta, G. Giaccone, G. Grande, G. Binetti, G. Papenberg, G. Hampel, H. Bailly, H. Zetterberg, H. Soininen, H. Karlsson, I.K. Alvarez, I. Appollonio, I. Giegling, I. Skoog, I. Saltvedt, I. Rainero, I. Rosas Allende, I. Hort, J. Diehl-Schmid, J. Van Dongen, J. Vidal, J.-S. Lehtisalo, J. Wiltfang, J. Thomassen, J.Q. Kornhuber, J. Haines, J.L. Vogelgsang, J. Pineda, J.A. Fortea, J. Popp, J. Deckert, J. Buerger, K. Morgan, K. Fließbach, K. Sleegers, K. Molina-Porcel, L. Kilander, L. Weinhold, L. Farrer, L.A. Wang, L.-S. Kleineidam, L. Farotti, L. Parnetti, L. Tremolizzo, L. Hausner, L. Benussi, L. Froelich, L. Ikram, M.A. Deniz-Naranjo, M.C. Tsolaki, M. Rosende-Roca, M. Löwenmark, M. Hulsman, M. Spallazzi, M. Pericak-Vance, M.A. Esiri, M. Bernal Sánchez-Arjona, M. Dalmasso, M.C. Martínez-Larrad, M.T. Arcaro, M. Nöthen, M.M. Fernández-Fuertes, M. Dichgans, M. Ingelsson, M. Herrmann, M.J. Scherer, M. Vyhnalek, M. Kosmidis, M.H. Yannakoulia, M. Schmid, M. Ewers, M. Heneka, M.T. Wagner, M. Scamosci, M. Kivipelto, M. Hiltunen, M. Zulaica, M. Alegret, M. Fornage, M. Roberto, N. van Schoor, N.M. Seidu, N.M. Banaj, N. Armstrong, N.J. Scarmeas, N. Scherbaum, N. Goldhardt, O. Hanon, O. Peters, O. Skrobot, O.A. Quenez, O. Lerch, O. Bossù, P. Caffarra, P. Dionigi Rossi, P. Sakka, P. Hoffmann, P. Holmans, P.A. Fischer, P. Riederer, P. Yang, Q. Marshall, R. Kalaria, R.N. Mayeux, R. Vandenberghe, R. Cecchetti, R. Ghidoni, R. Frikke-Schmidt, R. Sorbi, S. Hägg, S. Engelborghs, S. Helisalmi, S. Botne Sando, S. Kern, S. Archetti, S. Boschi, S. Fostinelli, S. Gil, S. Mendoza, S. Mead, S. Ciccone, S. Djurovic, S. Heilmann-Heimbach, S. Riedel-Heller, S. Kuulasmaa, T. del Ser, T. Lebouvier, T. Polak, T. Ngandu, T. Grimmer, T. Bessi, V. Escott-Price, V. Giedraitis, V. Deramecourt, V. Maier, W. Jian, X. Pijnenburg, Y.A.L. Smith, A.D. Saenz, A. Bizzarro, A. Lauria, A. Vacca, A. Solomon, A. Anastasiou, A. Richardson, A. Boland, A. Koivisto, A. Daniele, A. Greco, A. Marianthi, A. McGuinness, B. Fin, B. Ferrari, C. Custodero, C. Ferrarese, C. Ingino, C. Mangone, C. Reyes Toso, C. Martínez, C. Cuesta, C. Muchnik, C. Joachim, C. Ortiz, C. Besse, C. Johansson, C. Zoia, C.P. Laske, C. Anastasiou, C. Palacio, D.L. Politis, D.G. Janowitz, D. Craig, D. Mann, D.M. Neary, D. Jürgen, D. Daian, D. Belezhanska, D. Kohler, E. Castaño, E.M. Koutsouraki, E. Chipi, E. De Roeck, E. Costantini, E. Vardy, E.R.L.C. Piras, F. Roveta, F. Piras, F. Prestia, F.A. Assogna, F. Salani, F. Sala, G. Lacidogna, G. Novack, G. Wilcock, G. Thonberg, H. Kölsch, H. Weber, H. Boecker, H. Etchepareborda, I. Piaceri, I. Tuomilehto, J. Lindström, J. Laczo, J. Johnston, J. Deleuze, J.-F. Harris, J. Schott, J.M. Priller, J. Bacha, J.I. Snowden, J. Lisso, J. Mihova, K.Y. Traykov, L. Morelli, L. Brusco, L.I. Rainer, M. Takalo, M. Bjerke, M. Del Zompo, M. Serpente, M. Sanchez Abalos, M. Rios, M. Peltonen, M. Herrman, M.J. Kosmidis, M.H. Kohler, M. Rojo, M. Jones, M. Orsini, M. Medel, N. Olivar, N. Fox, N.C. Salvadori, N. Hooper, N.M. Galeano, P. Solis, P. Bastiani, P. Mecocci, P. Passmore, P. Heun, R. Antikainen, R. Olaso, R. Perneczky, R. Germani, S. López-García, S. Love, S. Mehrabian, S. Bagnoli, S. Kochen, S. Andreoni, S. Teipel, S. Todd, S. Pickering-Brown, S. Natunen, T. Tegos, T. Laatikainen, T. Strandberg, T. Polvikoski, T.M. Matoska, V. Ciullo, V. Cores, V. Solfrizzi, V. Lisetti, V. Sevillano, Z. Abdelnour, C. Aguilera, N. Alarcon, E. Alegret, M. Benaque, A. Boada, M. Buendia, M. Cañabate, P. Carracedo, A. Corbatón-Anchuelo, A. Diego, S. Espinosa, A. Gailhajenet, A. Gil, S. Guitart, M. Hernández, I. Ibarria, M. Lafuente, A. Macias, J. Maroñas, O. Martín, E. Martínez, M.T. Marquié, M. Mauleón, A. Montrreal, L. Moreno-Grau, S. Moreno, M. Orellana, A. Ortega, G. Pancho, A. Pelejá, E. Pérez-Cordon, A. Pineda, J.A. Preckler, S. Quintela, I. Real, L.M. Rosende-Roca, M. Ruiz, A. Sáez, M.E. Sanabria, A. Serrano-Rios, M. Sotolongo-Grau, O. Tárraga, L. Valero, S. Vargas, L. Adarmes-Gómez, A.D. Alarcón-Martín, E. Alonso, M.D. Álvarez, I. Álvarez, V. Amer-Ferrer, G. Antequera, M. Antúnez, C. Baquero, M. Bernal, M. Blesa, R. Boada, M. Buiza-Rueda, D. Bullido, M.J. Burguera, J.A. Calero, M. Carrillo, F. Carrión-Claro, M. Casajeros, M.J. Clarimón, J. Cruz-Gamero, J.M. de Pancorbo, M.M. del Ser, T. Diez-Fairen, M. Escuela, R. Garrote-Espina, L. Fortea, J. Franco-Macías, E. Frank-García, A. García-Alberca, J.M. Garcia Madrona, S. Garcia-Ribas, G. Gómez-Garre, P. Hernández, I. Hevilla, S. Jesús, S. Labrador Espinosa, M.A. Lage, C. Legaz, A. Lleó, A. Lopez de Munain, A. López-García, S. Macias-García, D. Manzanares, S. Marín, M. Marín-Muñoz, J. Marín, T. Marquié, M. Martín Montes, A. Martínez, B. Martínez, C. Martínez, V. Martínez-Lage Álvarez, P. Medina, M. Mendioroz Iriarte, M. Mir, P. Molinuevo, J.L. Pastor, P. Pérez Tur, J. Periñán-Tocino, T. Pineda-Sanchez, R. Piñol-Ripoll, G. Rábano, A. Real de Asúa, D. Rodrigo, S. Rodríguez-Rodríguez, E. Royo, J.L. Ruiz, A. Sanchez del Valle Díaz, R. Sánchez-Juan, P. Sastre, I. Valero, S. Vicente, M.P. Vigo-Ortega, R. Vivancos, L. Macleod, C. McCracken, C. Brayne, C. Bresner, C. Grozeva, D. Bellou, E. Sommerville, E.W. Matthews, F. Leonenko, G. Menzies, G. Windle, G. Harwood, J. Phillips, J. Bennett, K. Luckuck, L. Clare, L. Woods, R. Saad, S. Burholt, V. Jansen, I.E. Rongve, A. Kehoe, P.G. Garcia-Ribas, G. Sánchez-Juan, P. Pastor, P. Pérez-Tur, J. Piñol-Ripoll, G. Lopez de Munain, A. García-Alberca, J.M. Bullido, M.J. Álvarez, V. Lleó, A. Real, L.M. Scheltens, P. Holstege, H. Marquié, M. Sáez, M.E. Carracedo, Á. Amouyel, P. Schellenberg, G.D. Williams, J. Seshadri, S. van Duijn, C.M. Mather, K.A. Sánchez-Valle, R. Serrano-Ríos, M. Orellana, A. Tárraga, L. Blennow, K. Huisman, M. Andreassen, O.A. Posthuma, D. Clarimón, J. Boada, M. van der Flier, W.M. Ramirez, A. Lambert, J.-C. van der Lee, S.J. Ruiz, A. EADB contributors The GR@ACE study group DEGESCO consortium IGAP (ADGC, CHARGE, EADI, GERAD) PGC-ALZ consortia
Abstract: Genetic discoveries of Alzheimer’s disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer’s disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer’s disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer’s disease. © 2021, The Author(s).
Published: 2021

74. Telomere length change in a multidomain lifestyle intervention to prevent cognitive decline:a randomized clinical trial

Author: Sindi, S. (Shireen), Solomon, A. (Alina), Kåreholt, I. (Ingemar), Hovatta, I. (Iiris), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Levälahti, E. (Esko), Laatikainen, T. (Tiina), Lehtisalo, J. (Jenni), Lindström, J. (Jaana), Paajanen, T. (Teemu), Peltonen, M. (Markku), Singh Khalsa, D. (Dharma), Wolozin, B. (Benjamin), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Soininen, H. (Hilkka), Ngandu, T. (Tiia), Kivipelto, M. (Miia), and F. S. (FINGER Study Group)
Subjects: behavioural intervention, dementia prevention, telomeres, older adults
Abstract: Background: Shorter leukocyte telomere length (LTL) is associated with aging and dementia. Impact of lifestyle changes on LTL, and relation to cognition and genetic susceptibility for dementia, has not been investigated in randomized controlled trials (RCTs). Methods: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability is a 2-year RCT enrolling 1260 participants at risk for dementia from the general population, aged 60–77 years, randomly assigned (1:1) to multidomain lifestyle intervention or control group. The primary outcome was cognitive change (Neuropsychological Test Battery z-score). Relative LTL was measured using quantitative real-time polymerase chain reaction (trial registration: NCT01041989). Results: This exploratory LTL substudy included 756 participants (377 intervention, 379 control) with baseline and 24-month LTL measurements. The mean annual LTL change (SD) was −0.016 (0.19) in the intervention group and −0.023 (0.17) in the control group. Between-group difference was nonsignificant (unstandardized β-coefficient 0.007, 95% CI −0.015 to 0.030). Interaction analyses indicated better LTL maintenance among apolipoprotein E (APOE)-ε4 carriers versus noncarriers: 0.054 (95% CI 0.007 to 0.102); younger versus older participants: −0.005 (95% CI −0.010 to −0.001); and those with more versus less healthy lifestyle changes: 0.047 (95% CI 0.005 to 0.089). Cognitive intervention benefits were more pronounced among participants with better LTL maintenance for executive functioning (0.227, 95% CI 0.057 to 0.396) and long-term memory (0.257, 95% CI 0.024 to 0.489), with a similar trend for Neuropsychological Test Battery total score (0.127, 95% CI −0.011 to 0.264). Conclusions: This is the first large RCT showing that a multidomain lifestyle intervention facilitated LTL maintenance among subgroups of older people at risk for dementia, including APOE-ε4 carriers. LTL maintenance was associated with more pronounced cognitive intervention benefits. Clinical Trials Registration Number: NCT01041989
Published: 2021

75. Familial hypercholesterolemia and COVID-19:a menacing but treatable vasculopathic condition

Author: Vuorio, A. (Alpo), Strandberg, T. E. (Timo E.), Raal, F. (Frederik), Santos, R. D. (Raul D.), and Kovanen, P. T. (Petri T.)
Subjects: Cholesterol, PCSK9 inhibitor, Diabetes, Familial hypercholesterolemia, COVID-19, Statin, Endothelial dysfunction
Abstract: SARS-CoV-2 infection continues to cause increased morbidity and mortality, and due to the slow pace of vaccination COVID-19 will probably remain a global burden to health systems for a long time. Unfortunately, the necessary prevention and treatment strategies of COVID-19 have led to restriction measures that are hampering the routine care of common chronic metabolic conditions like hypercholesterolemia. It is of particular concern that during the acute phase of COVID-19, the control of pre-existing metabolic diseases tends to get worse which again increases the risk for complications and a poor outcome in these patients. A significant contributor to these complications is endothelial dysfunction which is associated with COVID-19. This Commentary will discuss the impact of COVID-19 on endothelial function particularly in patients with familial hypercholesterolemia (FH), a metabolic inherited disease known to in itself adversely affect endothelial function. There should be no hesitation to continue with statin therapy in severe hypercholesterolemic patients with COVID-19. We argue that in FH patients with COVID-19 the clinicians need even consider intensifying statin therapy as well as the addition of other lipid-lowering agents, such as proprotein convertase subtilisin/kexin type 9(PCSK9) inhibitors. In contrast to statins, the PCSK9 inhibitors lower lipoprotein(a) [Lp(a)] level, and, accordingly, these latter drugs need to be considered particularly in FH patients with an elevated level of Lp(a). This call applies to the in-hospital stay and also beyond. When considering that the vasculopathic effects of COVID-19 may persist, a long-term follow-up of individualized therapies in FH patients is warranted.
Published: 2021

76. Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Author: de Rojas, I., Moreno-Grau, S., Tesi, N., Grenier-Boley, B., Andrade, V., Jansen, I. E., Pedersen, N. L., Stringa, N., Zettergren, A., Hernandez, I., Montrreal, L., Antunez, C., Antonell, A., Tankard, R. M., Bis, J. C., Sims, R., Bellenguez, C., Quintela, I., Gonzalez-Perez, A., Calero, M., Franco-Macias, E., Macias, J., Blesa, R., Cervera-Carles, L., Menendez-Gonzalez, M., Frank-Garcia, A., Royo, J. L., Moreno, F., Huerto Vilas, R., Baquero, M., Diez-Fairen, M., Lage, C., Garcia-Madrona, S., Garcia-Gonzalez, P., Alarcon-Martin, E., Valero, S., Sotolongo-Grau, O., Ullgren, A., Naj, A. C., Lemstra, A. W., Benaque, A., Perez-Cordon, A., Benussi, A., Rabano, A., Padovani, A., Squassina, A., de Mendonca, A., Arias Pastor, A., Kok, A. A. L., Meggy, A., Pastor, A. B., Espinosa, A., Corma-Gomez, A., Martin Montes, A., Sanabria, A., DeStefano, A. L., Schneider, A., Haapasalo, A., Kinhult Stahlbom, A., Tybjaerg-Hansen, A., Hartmann, A. M., Spottke, A., Corbaton-Anchuelo, A., Rongve, A., Borroni, B., Arosio, B., Nacmias, B., Nordestgaard, B. G., Kunkle, B. W., Charbonnier, C., Abdelnour, C., Masullo, C., Martinez Rodriguez, C., Munoz-Fernandez, C., Dufouil, C., Graff, C., Ferreira, C. B., Chillotti, C., Reynolds, C. A., Fenoglio, C., Van Broeckhoven, C., Clark, C., Pisanu, C., Satizabal, C. L., Holmes, C., Buiza-Rueda, D., Aarsland, D., Rujescu, D., Alcolea, D., Galimberti, D., Wallon, D., Seripa, D., Grunblatt, E., Dardiotis, E., Duzel, E., Scarpini, E., Conti, E., Rubino, E., Gelpi, E., Rodriguez-Rodriguez, E., Duron, E., Boerwinkle, E., Ferri, E., Tagliavini, F., Kucukali, F., Pasquier, F., Sanchez-Garcia, F., Mangialasche, F., Jessen, F., Nicolas, G., Selbaek, G., Ortega, G., Chene, G., Hadjigeorgiou, G., Rossi, G., Spalletta, G., Giaccone, G., Grande, G., Binetti, G., Papenberg, G., Hampel, H., Bailly, H., Zetterberg, H., Soininen, H., Karlsson, I. K., Alvarez, I., Appollonio, I., Giegling, I., Skoog, I., Saltvedt, I., Rainero, I., Rosas Allende, I., Hort, J., Diehl-Schmid, J., Van Dongen, J., Vidal, J. -S., Lehtisalo, J., Wiltfang, J., Thomassen, J. Q., Kornhuber, J., Haines, J. L., Vogelgsang, J., Pineda, J. A., Fortea, J., Popp, J., Deckert, J., Buerger, K., Morgan, K., Fliessbach, K., Sleegers, K., Molina-Porcel, L., Kilander, L., Weinhold, L., Farrer, L. A., Wang, L. -S., Kleineidam, L., Farotti, L., Parnetti, L., Tremolizzo, L., Hausner, L., Benussi, L., Froelich, L., Ikram, M. A., Deniz-Naranjo, M. C., Tsolaki, M., Rosende-Roca, M., Lowenmark, M., Hulsman, M., Spallazzi, M., Pericak-Vance, M. A., Esiri, M., Bernal Sanchez-Arjona, M., Dalmasso, M. C., Martinez-Larrad, M. T., Arcaro, M., Nothen, M. M., Fernandez-Fuertes, M., Dichgans, M., Ingelsson, M., Herrmann, M. J., Scherer, M., Vyhnalek, M., Kosmidis, M. H., Yannakoulia, M., Schmid, M., Ewers, M., Heneka, M. T., Wagner, M., Scamosci, M., Kivipelto, M., Hiltunen, M., Zulaica, M., Alegret, M., Fornage, M., Roberto, N., van Schoor, N. M., Seidu, N. M., Banaj, N., Armstrong, N. J., Scarmeas, N., Scherbaum, N., Goldhardt, O., Hanon, O., Peters, O., Skrobot, O. A., Quenez, O., Lerch, O., Bossu, P., Caffarra, P., Dionigi Rossi, P., Sakka, P., Hoffmann, P., Holmans, P. A., Fischer, P., Riederer, P., Yang, Q., Marshall, R., Kalaria, R. N., Mayeux, R., Vandenberghe, R., Cecchetti, R., Ghidoni, R., Frikke-Schmidt, R., Sorbi, S., Hagg, S., Engelborghs, S., Helisalmi, S., Botne Sando, S., Kern, S., Archetti, S., Boschi, S., Fostinelli, S., Gil, S., Mendoza, S., Mead, S., Ciccone, S., Djurovic, S., Heilmann-Heimbach, S., Riedel-Heller, S., Kuulasmaa, T., del Ser, T., Lebouvier, T., Polak, T., Ngandu, T., Grimmer, T., Bessi, V., Escott-Price, V., Giedraitis, V., Deramecourt, V., Maier, W., Jian, X., Pijnenburg, Y. A. L., Smith, A. D., Saenz, A., Bizzarro, A., Lauria, A., Vacca, A., Solomon, A., Anastasiou, A., Richardson, A., Boland, A., Koivisto, A., Daniele, A., Greco, A., Marianthi, A., McGuinness, B., Fin, B., Ferrari, C., Custodero, C., Ferrarese, C., Ingino, C., Mangone, C., Reyes Toso, C., Martinez, C., Cuesta, C., Muchnik, C., Joachim, C., Ortiz, C., Besse, C., Johansson, C., Zoia, C. P., Laske, C., Anastasiou, C., Palacio, D. L., Politis, D. G., Janowitz, D., Craig, D., Mann, D. M., Neary, D., Jurgen, D., Daian, D., Belezhanska, D., Kohler, E., Castano, E. M., Koutsouraki, E., Chipi, E., De Roeck, E., Costantini, E., Vardy, E. R. L. C., Piras, F., Roveta, F., Prestia, F. A., Assogna, F., Salani, F., Sala, G., Lacidogna, G., Novack, G., Wilcock, G., Thonberg, H., Kolsch, H., Weber, H., Boecker, H., Etchepareborda, I., Piaceri, I., Tuomilehto, J., Lindstrom, J., Laczo, J., Johnston, J., Deleuze, J. -F., Harris, J., Schott, J. M., Priller, J., Bacha, J. I., Snowden, J., Lisso, J., Mihova, K. Y., Traykov, L., Morelli, L., Brusco, L. I., Rainer, M., Takalo, M., Bjerke, M., Del Zompo, M., Serpente, M., Sanchez Abalos, M., Rios, M., Peltonen, M., Herrman, M. J., Kohler, M., Rojo, M., Jones, M., Orsini, M., Medel, N., Olivar, N., Fox, N. C., Salvadori, N., Hooper, N. M., Galeano, P., Solis, P., Bastiani, P., Mecocci, P., Passmore, P., Heun, R., Antikainen, R., Olaso, R., Perneczky, R., Germani, S., Lopez-Garcia, S., Love, S., Mehrabian, S., Bagnoli, S., Kochen, S., Andreoni, S., Teipel, S., Todd, S., Pickering-Brown, S., Natunen, T., Tegos, T., Laatikainen, T., Strandberg, T., Polvikoski, T. M., Matoska, V., Ciullo, V., Cores, V., Solfrizzi, V., Lisetti, V., Sevillano, Z., Aguilera, N., Alarcon, E., Boada, M., Buendia, M., Canabate, P., Carracedo, A., Diego, S., Gailhajenet, A., Guitart, M., Ibarria, M., Lafuente, A., Maronas, O., Martin, E., Martinez, M. T., Marquie, M., Mauleon, A., Moreno, M., Orellana, A., Pancho, A., Peleja, E., Preckler, S., Real, L. M., Ruiz, A., Saez, M. E., Serrano-Rios, M., Tarraga, L., Vargas, L., Adarmes-Gomez, A. D., Alonso, M. D., Alvarez, V., Amer-Ferrer, G., Antequera, M., Bernal, M., Bullido, M. J., Burguera, J. A., Carrillo, F., Carrion-Claro, M., Casajeros, M. J., Clarimon, J., Cruz-Gamero, J. M., de Pancorbo, M. M., Escuela, R., Garrote-Espina, L., Garcia-Alberca, J. M., Garcia Madrona, S., Garcia-Ribas, G., Gomez-Garre, P., Hevilla, S., Jesus, S., Labrador Espinosa, M. A., Legaz, A., Lleo, A., Lopez de Munain, A., Macias-Garcia, D., Manzanares, S., Marin, M., Marin-Munoz, J., Marin, T., Martinez, B., Martinez, V., Martinez-Lage Alvarez, P., Medina, M., Mendioroz Iriarte, M., Mir, P., Molinuevo, J. L., Pastor, P., Perez Tur, J., Perinan-Tocino, T., Pineda-Sanchez, R., Pinol-Ripoll, G., Real de Asua, D., Rodrigo, S., Sanchez del Valle Diaz, R., Sanchez-Juan, P., Sastre, I., Vicente, M. P., Vigo-Ortega, R., Vivancos, L., Macleod, C., McCracken, C., Brayne, C., Bresner, C., Grozeva, D., Bellou, E., Sommerville, E. W., Matthews, F., Leonenko, G., Menzies, G., Windle, G., Harwood, J., Phillips, J., Bennett, K., Luckuck, L., Clare, L., Woods, R., Saad, S., Burholt, V., Kehoe, P. G., Perez-Tur, J., Scheltens, P., Holstege, H., Amouyel, P., Schellenberg, G. D., Williams, J., Seshadri, S., van Duijn, C. M., Mather, K. A., Sanchez-Valle, R., Blennow, K., Huisman, M., Andreassen, O. A., Posthuma, D., van der Flier, W. M., Ramirez, A., Lambert, J. -C., and van der Lee, S. J.
Subjects: Age of Onset, Aged, Aged, 80 and over, Alzheimer Disease, Amyloid beta-Protein Precursor, Apolipoproteins E, Case-Control Studies, Cohort Studies, Datasets as Topic, Female, Follow-Up Studies, Genetic Predisposition to Disease, Genome-Wide Association Study, Heterozygote, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Risk Assessment, Risk Factors, Multifactorial Inheritance
Published: 2021

77. Prevalence of musculoskeletal pain and analgesic treatment among community-Dwelling older adults:changes from 1999 to 2019

Author: Lehti, T. E. (Tuuli Elina), Rinkinen, M.-O. (M.-O.), Aalto, U. (U.), Roitto, H. M. (H. M.), Knuutila, M. (M.), Öhman, H. (H.), Kautiainen, H. (H.), Karppinen, H. (H.), Tilvis, R. (R.), Strandberg, T. (T.), and Pitkälä, K. H. (K. H.)
Abstract: Background: Pain is undertreated in older populations. At the same time, increased use of opioids is of concern in the Western world. Aims: We sought to analyze temporal trends in musculoskeletal pain and prescribed analgesic treatment among community-dwelling people aged 75–95 years using cross-sectional cohort data spanning 20 years. Methods: The Helsinki Aging Study recruited random samples of people aged 75, 80, 85, 90, and 95 years in 1999, 2009, and 2019. In total, 5707 community-dwelling persons participated in the study. The participants reported their medical diagnoses, regular prescription medications, and the presence of back pain or joint pain within the last 2 weeks (never, sometimes, or daily). We compared analgesic use among participants reporting and not reporting musculoskeletal pain in 1999, 2009, and 2019. Results: Of the participants, 57–61% reported intermittent or daily musculoskeletal pain. The percentage receiving a prescribed daily analgesic increased from 9% in 1999 to 16% in 2019. The use of non-steroidal anti-inflammatory drugs (NSAIDs) decreased from 1999 to 2019, while the use of paracetamol increased from 2 to 11%. Opioids were taken by 2% in 1999 and 3% in 2019. Of those reporting daily musculoskeletal pain, 20%, 35%, and 32% received regular pain medication in 1999, 2009, and 2019, respectively. Conclusions: Pain remains undertreated in the community-dwelling older population, although the use of regular prescribed analgesics increased between 1999 and 2019. The use of NSAIDs has decreased, while the use of paracetamol has increased. Daily opioid use has remained modest.
Published: 2021

78. Ateroskleroottisen valtimotaudin riskin vähentäminen ruokavalion keinoin:mitä uutta?

Author: Simonen, P. (Piia), Vartiainen, E. (Erkki), Kovanen, P. T. (Petri T.), Strandberg, T. E. (Timo E.), and Gylling, H. (Helena)
Abstract: Tiivistelmä Ateroskleroottiset valtimotaudit aiheuttavat maailmassa yhä eniten kuolemia. Pienentämällä LDL-kolesterolipitoisuutta valtimotautitapahtumien riski vähenee. Ruokavalion muutos on keskeinen LDL-kolesterolipitoisuuden pienentämisessä. Kasvistanoli rasvahappoesterinä vähentää kolesterolin imeytymistä ja pienentää LDL-kolesterolipitoisuutta. FINRISKI-laskurin mukaan ruokavalion rasvan laadun muutos yhdistettynä kasvistanoliesterituotteiden käyttöön vähentäisi sepelvaltimotaudin ilmaantuvuutta 23 %. Abstract Atherosclerotic cardiovascular diseases (ASCVDs) cause more deaths than any other disease group worldwide. However, it is possible to prevent the progression of atherosclerosis and the risk of ASCVD events by reducing the circulating concentrations of low-density-lipoprotein cholesterol (LDL-C). Large meta-analyses have demonstrated that decreasing the dietary intake of saturated fat and cholesterol can reduce the risk of ASCVD events. Here, we discuss the recent information regarding the prevention of subclinical atherosclerosis, ASCVD, and the risk of ASCVD events with a focus on dietary means. Plant stanols as fatty-acid esters were developed as a dietary adjunct to reduce LDL-C levels as part of a heart-healthy diet. They reduce cholesterol absorption so that less cholesterol is transported to the liver, the expression of LDL receptors is upregulated, and LDL-C concentrations are reduced on average by 0.40 mmol/L (12%) by consuming 3 g of plant stanols as esters/day. Using the equations of Keys, Anderson, and Grande, and the FINRISKI-counter equation, we also demonstrate that a heart-healthy diet combined with plant stanol ester consumption plausibly reduces the risk of coronary artery disease events by 23%. Thus, plant stanol esters as part of a heart-healthy diet seem to offer an effective means to reduce the risk of ASCVD events both at a population level and for subjects with different risk levels of ASCVD, when needed, in combination with statins.
Published: 2021

79. The prevalence of frailty using three different frailty measurements in two Finnish cohorts born before and after the Second World War

Author: Koivukangas, M. M. (M. M.), Hietikko, E. (E.), Strandberg, T. (T.), Keinänen-Kiukaanniemi, S. (S.), Leskinen, R. (R.), Peters, R. (R.), and Antikainen, R. (R.)
Subjects: Frailty, frailty trajectories, secular trends, mortality, frailty definitions
Abstract: Objectives: To study the prevalence of frailty and its relationship to mortality in cohorts born before and after the Second World War using three different frailty measures. Methods: Cross-sectional data from two cohorts born in 1935 (n=593) and 1945 (n=714) were studied for frailty at the mean age of 70.7 (SD 1.8) years. Frailty was measured using the Frailty Phenotype (FP), the Frail Scale (FS) and the 74-item Frailty Index (FI>0.21 denoted frailty). Information on socioeconomic factors was obtained via a study questionnaire and the data on mortality were obtained from the Population Information System. Results: The prevalence of frailty by FI was more common in the older 1935 cohort than in the 1945 cohort (p
Published: 2021

80. Phenotypic frailty and multimorbidity are independent 18-year mortality risk indicators in older men

Author: Strandberg, T. E. (Timo E.), Lindström, L. (Linda), Jyväkorpi, S. (Satu), Urtamo, A. (Annele), Pitkälä, K. H. (Kaisu H.), and Kivimäki, M. (Mika)
Subjects: Disability, Frailty, Multimorbidity, Prefrailty, Mortality
Abstract: Purpose: Multimorbidity, prefrailty, and frailty are frequent in ageing populations, but their independent relationships to long-term prognosis in home-dwelling older people are not well recognised. Methods: In the Helsinki Businessmen Study (HBS) men with high socioeconomic status (born 1919–1934, n = 3490) have been followed-up from midlife. In 2000, multimorbidity (≥ 2 conditions), phenotypic prefrailty and frailty were determined in 1365 home-dwelling men with median age of 73 years). Disability was assessed as a possible confounder. 18-year mortality follow-up was established from registers and Cox regression used for analyses. Results: Of the men, 433 (31.7%) were nonfrail and without multimorbidity at baseline (reference group), 500 (36.6%) and 82 (6.0%) men had prefrailty or frailty, respectively, without multimorbidity, 84 (6.2%) men had multimorbidity only, and 201 (14.7%) and 65 (4.8%) men had prefrailty or frailty together with multimorbidity. Only 30 (2.2%) and 86 (6.3%) showed signs of ADL or mobility disability. In the fully adjusted analyses (including ADL disability, mental and cognitive status) of 18-year mortality, frailty without multimorbidity (hazard ratio 1.62, 95% confidence interval 1.13–2.31) was associated with similar mortality risk than multimorbidity without frailty (1.55, 1.17–2.06). The presence of both frailty and multimorbidity indicated a strong mortality risk (2.93, 2.10–4.07). Conclusion: Although multimorbidity is generally considered a substantial health problem, our long-term observational study emphasises that phenotypic frailty alone, independently of disability, may be associated with a similar risk, and a combination of multimorbidity and frailty is an especially strong predictor of mortality.
Published: 2021

81. The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project:description and feasibility of a nutrition intervention in community-dwelling older Europeans

Author: Jyvakorpi, S. K. (S. K.), Ramel, A. (A.), Strandberg, T. E. (T. E.), Piotrowicz, K. (K.), Blaszczyk-Bebenek, E. (E.), Urtamo, A. (A.), Rempe, H. M. (H. M.), Geirsdottir, O. (O.), Vagnerova, T. (T.), Billot, M. (M.), Larreur, A. (A.), Savera, G. (G.), Soriano, G. (G.), Picauron, C. (C.), Tagliaferri, S. (S.), Sanchez-Puelles, C. (C.), Cadenas, V. S. (V. Sanchez), Perl, A. (A.), Tirrel, L. (L.), Ohman, H. (H.), Weling-Scheepers, C. (C.), Ambrosi, S. (S.), Costantini, A. (A.), Pavelkova, K. (K.), Klimkova, M. (M.), Freiberger, E. (E.), Jonsson, P. V. (P., V), Marzetti, E. (E.), Pitkala, K. H. (K. H.), Landi, F. (F.), and Calvani, R. (R.)
Subjects: SPRINTT, Protein intake, Nutrition counselling, Nutrition intervention, Energy intake
Abstract: Background: The “Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies” (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. Methods: SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3–9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0–1.2 g/kg body weight, energy intake of 25–30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. Results: Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. Conclusion: The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations.
Published: 2021

82. Change in CAIDE dementia risk score and neuroimaging biomarkers during a 2-year multidomain lifestyle randomized controlled trial:results of a post-hoc subgroup analysis

Author: Stephen, R. (Ruth), Ngandu, T. (Tiia), Liu, Y. (Yawu), Peltonen, M. (Markku), Antikainen, R. (Riitta), Kemppainen, N. (Nina), Laatikainen, T. (Tiina), Lötjönen, J. (Jyrki), Rinne, J. (Juha), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Vanninen, R. (Ritva), Soininen, H. (Hilkka), Kivipelto, M. (Miia), Solomon, A. (Alina), and h. F. (he FINGER Study Group)
Subjects: Prevention, Risk reduction, Dementia, Hippocampus
Abstract: The CAIDE (Cardiovascular Risk Factors, Aging and Dementia) Risk Score is a validated tool estimating dementia risk. It was previously associated with imaging biomarkers. However, associations between dementia risk scores (including CAIDE) and dementia-related biomarkers have not been studied in the context of an intervention. This study investigated associations between change in CAIDE score and change in neuroimaging biomarkers (brain magnetic resonance imaging [MRI] and Pittsburgh Compound B-positron emission tomography [PiB-PET] measures) during the 2-year Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) (post-hoc analyses). FINGER targeted at-risk older adults, aged 60–77 years, from the general population. Participants were randomized to either multidomain intervention (diet, exercise, cognitive training, and vascular risk management) or control group (general health advice). Neuroimaging (MRI and PiB-PET) data from baseline and 2-year visits were used. A toal of 112 participants had repeated brain MRI measures (hippocampal, total gray matter, and white matter lesion volumes, and Alzheimer’s disease signature cortical thickness). Repeated PiB-PET scans were available for 39 participants. Reduction in CAIDE score (indicating lower dementia risk) during the intervention was associated with less decline in hippocampus volume in the intervention group, but not the control group (Randomization group × CAIDE change interaction β coefficient = −0.40, p = .02). Associations for other neuroimaging measures were not significant. The intervention may have benefits on hippocampal volume in individuals who succeed in improving their overall risk level as indicated by a reduction in CAIDE score. This exploratory finding requires further testing and validation in larger studies.
Published: 2021

83. DNA methylation signatures of aggression and closely related constructs: A meta-analysis of epigenome-wide studies across the lifespan

Author: Dongen, J. Van, Hagenbeek, F.A., Suderman, M., Roetman, P.J., Sugden, K., Chiocchetti, A.G., Ismail, K., Mulder, R.H., Hafferty, J.D., Adams, M.J., Walker, R.M., Morris, S.W., Lahti, J., Küpers, L.K., Escaramis, G., Alemany, S., Bonder, M. Jan, Meijer, M., Ip, H.F., Jansen, R., Baselmans, B.M.L., Parmar, P., Lowry, E., Streit, F., Sirignano, L., Send, T.S., Frank, J., Jylhävä, J., Wang, Y., Mishra, P.P., Colins, O.F., Corcoran, D.L., Poulton, R., Mill, J., Hannon, E., Arseneault, L., Korhonen, T., Vuoksimaa, E., Felix, J.F., Bakermans-Kranenburg, M.J., Campbell, A., Czamara, D., Binder, E., Corpeleijn, E., Gonzalez, J.R., Grazuleviciene, R., Gutzkow, K.B., Evandt, J., Vafeiadi, M., Klein, M., Meer, D. van der, Ligthart, L., Kluft, C., Davies, G.E., Hakulinen, C., Keltikangas-Järvinen, L., Franke, B., Freitag, C.M., Konrad, K., Hervas, A., Fernández-Rivas, A., Vetro, A., Raitakari, O., Lehtimäki, T., Vermeiren, R., Strandberg, T., Räikkönen, K., Snieder, H., Witt, S.H., Deuschle, M., Pedersen, N.L., Hägg, S., Sunyer, J., Franke, L., Kaprio, J., Ollikainen, M., Moffitt, T.E., Tiemeier, H., van, I.M.H., Relton, C., Vrijheid, M., Sebert, S., Jarvelin, M.R., Caspi, A., Evans, K.L., McIntosh, A.M., Bartels, M., Boomsma, D.I., Dongen, J. Van, Hagenbeek, F.A., Suderman, M., Roetman, P.J., Sugden, K., Chiocchetti, A.G., Ismail, K., Mulder, R.H., Hafferty, J.D., Adams, M.J., Walker, R.M., Morris, S.W., Lahti, J., Küpers, L.K., Escaramis, G., Alemany, S., Bonder, M. Jan, Meijer, M., Ip, H.F., Jansen, R., Baselmans, B.M.L., Parmar, P., Lowry, E., Streit, F., Sirignano, L., Send, T.S., Frank, J., Jylhävä, J., Wang, Y., Mishra, P.P., Colins, O.F., Corcoran, D.L., Poulton, R., Mill, J., Hannon, E., Arseneault, L., Korhonen, T., Vuoksimaa, E., Felix, J.F., Bakermans-Kranenburg, M.J., Campbell, A., Czamara, D., Binder, E., Corpeleijn, E., Gonzalez, J.R., Grazuleviciene, R., Gutzkow, K.B., Evandt, J., Vafeiadi, M., Klein, M., Meer, D. van der, Ligthart, L., Kluft, C., Davies, G.E., Hakulinen, C., Keltikangas-Järvinen, L., Franke, B., Freitag, C.M., Konrad, K., Hervas, A., Fernández-Rivas, A., Vetro, A., Raitakari, O., Lehtimäki, T., Vermeiren, R., Strandberg, T., Räikkönen, K., Snieder, H., Witt, S.H., Deuschle, M., Pedersen, N.L., Hägg, S., Sunyer, J., Franke, L., Kaprio, J., Ollikainen, M., Moffitt, T.E., Tiemeier, H., van, I.M.H., Relton, C., Vrijheid, M., Sebert, S., Jarvelin, M.R., Caspi, A., Evans, K.L., McIntosh, A.M., Bartels, M., and Boomsma, D.I.
Abstract: Item does not contain fulltext, DNA methylation profiles of aggressive behavior may capture lifetime cumulative effects of genetic, stochastic, and environmental influences associated with aggression. Here, we report the first large meta-analysis of epigenome-wide association studies (EWAS) of aggressive behavior (N = 15,324 participants). In peripheral blood samples of 14,434 participants from 18 cohorts with mean ages ranging from 7 to 68 years, 13 methylation sites were significantly associated with aggression (alpha = 1.2 × 10(-7); Bonferroni correction). In cord blood samples of 2425 children from five cohorts with aggression assessed at mean ages ranging from 4 to 7 years, 83% of these sites showed the same direction of association with childhood aggression (r = 0.74, p = 0.006) but no epigenome-wide significant sites were found. Top-sites (48 at a false discovery rate of 5% in the peripheral blood meta-analysis or in a combined meta-analysis of peripheral blood and cord blood) have been associated with chemical exposures, smoking, cognition, metabolic traits, and genetic variation (mQTLs). Three genes whose expression levels were associated with top-sites were previously linked to schizophrenia and general risk tolerance. At six CpGs, DNA methylation variation in blood mirrors variation in the brain. On average 44% (range = 3-82%) of the aggression-methylation association was explained by current and former smoking and BMI. These findings point at loci that are sensitive to chemical exposures with potential implications for neuronal functions. We hope these results to be a starting point for studies leading to applications as peripheral biomarkers and to reveal causal relationships with aggression and related traits.
Published: 2021

84. DNA methylation signatures of aggression and closely related constructs: A meta-analysis of epigenome-wide studies across the lifespan

Author: Dongen, J. (Jenny) van, Hagenbeek, F.A. (Fiona A.), Suderman, M.J. (Matthew J.), Roetman, P.J. (Peter J.), Sugden, K. (Karen), Chiocchetti, A.G. (Andreas G.), Ismail, K. (Khadeeja), Mulder, R.H. (Rosa), Hafferty, J.D. (Jonathan D.), Adams, M.J. (Mark J.), Walker, R.M. (Rosie M.), Morris, S.W. (Stewart W.), Lahti, J. (Jari), Küpers, A.M. (Marlijn), Escaramis, G. (Georgia), Alemany, S. (Silvia), Jan Bonder, M. (Marc), Meijer, M. (Mandy), Ip, H.F. (Hill F.), Jansen, R. (Rick), Baselmans, B.M.L. (Bart M. L.), Parmar, P. (Priyanka), Lowry, E. (Estelle), Streit, F. (Fabian), Sirignano, L. (Lea), Send, T.S. (Tabea S.), Frank, J. (Josef), Jylhävä, J. (Juulia), Wang, Y. (Yunzhang), Mishra, P.P. (Pashupati Prasad), Colins, O.F. (Olivier F.), Corcoran, D.L. (David L.), Poulton, R. (Richie), Mill, J. (Jonathan), Hannon, E. (Eilis), Arseneault, L. (Louise), Korhonen, T. (Tellervo), Vuoksimaa, E. (Eero), Felix, J.F. (Janine), Bakermans-Kranenburg, M.J. (Marian), Campbell, A. (Archie), Czamara, D. (Darina), Binder, E.B. (Elisabeth), Corpeleijn, E. (Eva), Gonzalez, J.R. (Juan R.), Grazuleviciene, R. (Regina), Gutzkow, K.B. (Kristine B.), Evandt, J. (Jorunn), Vafeiadi, M. (Marina), Klein, M. (Marieke), van der Meer, D. (Dennis), Ligthart, L. (Lannie), Kluft, C. (Cornelis), Davies, G.E. (Gareth E.), Hakulinen, C. (Christian), Keltikangas-Järvinen, L. (Liisa), Franke, B. (Barbara), Freitag, C.M. (Christine), Konrad, K. (Kerstin), Hervas, A. (Amaia), Fernández-Rivas, A. (Aranzazu), Vetro, A. (Agnes), Raitakari, O. (Olli), Lehtimäki, T. (Terho), Vermeiren, R.R.J.M. (Robert R.J.M.), Strandberg, T. (Timo), Räikkönen, K. (Katri), Snieder, H. (Harold), Witt, S.H. (Stephanie H), Deuschle, M. (Michael), Pedersen, N.L. (Nancy), Hägg, S. (Sara), Sunyer, J. (Jordi), Franke, L. (Lude), Kaprio, J. (Jaakko), Ollikainen, M. (Miina), Moffitt, T.E. (Terrie E.), Tiemeier, H.W. (Henning), IJzendoorn, M.H. (Rien) van, Relton, C.L. (Caroline), Vrijheid, M. (Martine), Sebert, S. (Sylvain), Jarvelin, M.-R. (Marjo-Riitta), Caspi, A. (Avshalom), Evans, K.L. (Kathryn L.), McIntosh, A.M. (Andrew), Bartels, M. (Meike), Boomsma, D.I. (Dorret I.), Dongen, J. (Jenny) van, Hagenbeek, F.A. (Fiona A.), Suderman, M.J. (Matthew J.), Roetman, P.J. (Peter J.), Sugden, K. (Karen), Chiocchetti, A.G. (Andreas G.), Ismail, K. (Khadeeja), Mulder, R.H. (Rosa), Hafferty, J.D. (Jonathan D.), Adams, M.J. (Mark J.), Walker, R.M. (Rosie M.), Morris, S.W. (Stewart W.), Lahti, J. (Jari), Küpers, A.M. (Marlijn), Escaramis, G. (Georgia), Alemany, S. (Silvia), Jan Bonder, M. (Marc), Meijer, M. (Mandy), Ip, H.F. (Hill F.), Jansen, R. (Rick), Baselmans, B.M.L. (Bart M. L.), Parmar, P. (Priyanka), Lowry, E. (Estelle), Streit, F. (Fabian), Sirignano, L. (Lea), Send, T.S. (Tabea S.), Frank, J. (Josef), Jylhävä, J. (Juulia), Wang, Y. (Yunzhang), Mishra, P.P. (Pashupati Prasad), Colins, O.F. (Olivier F.), Corcoran, D.L. (David L.), Poulton, R. (Richie), Mill, J. (Jonathan), Hannon, E. (Eilis), Arseneault, L. (Louise), Korhonen, T. (Tellervo), Vuoksimaa, E. (Eero), Felix, J.F. (Janine), Bakermans-Kranenburg, M.J. (Marian), Campbell, A. (Archie), Czamara, D. (Darina), Binder, E.B. (Elisabeth), Corpeleijn, E. (Eva), Gonzalez, J.R. (Juan R.), Grazuleviciene, R. (Regina), Gutzkow, K.B. (Kristine B.), Evandt, J. (Jorunn), Vafeiadi, M. (Marina), Klein, M. (Marieke), van der Meer, D. (Dennis), Ligthart, L. (Lannie), Kluft, C. (Cornelis), Davies, G.E. (Gareth E.), Hakulinen, C. (Christian), Keltikangas-Järvinen, L. (Liisa), Franke, B. (Barbara), Freitag, C.M. (Christine), Konrad, K. (Kerstin), Hervas, A. (Amaia), Fernández-Rivas, A. (Aranzazu), Vetro, A. (Agnes), Raitakari, O. (Olli), Lehtimäki, T. (Terho), Vermeiren, R.R.J.M. (Robert R.J.M.), Strandberg, T. (Timo), Räikkönen, K. (Katri), Snieder, H. (Harold), Witt, S.H. (Stephanie H), Deuschle, M. (Michael), Pedersen, N.L. (Nancy), Hägg, S. (Sara), Sunyer, J. (Jordi), Franke, L. (Lude), Kaprio, J. (Jaakko), Ollikainen, M. (Miina), Moffitt, T.E. (Terrie E.), Tiemeier, H.W. (Henning), IJzendoorn, M.H. (Rien) van, Relton, C.L. (Caroline), Vrijheid, M. (Martine), Sebert, S. (Sylvain), Jarvelin, M.-R. (Marjo-Riitta), Caspi, A. (Avshalom), Evans, K.L. (Kathryn L.), McIntosh, A.M. (Andrew), Bartels, M. (Meike), and Boomsma, D.I. (Dorret I.)
Abstract: DNA methylation profiles of aggressive behavior may capture lifetime cumulative effects of genetic, stochastic, and environmental influences associated with aggression. Here, we report the first large meta-analysis of epigenome-wide association studies (EWAS) of aggressive behavior (N = 15,324 participants). In peripheral blood samples of 14,434 participants from 18 cohorts with mean ages ranging from 7 to 68 years, 13 methylation sites were significantly associated with aggression (alpha = 1.2 × 10−7; Bonferroni correction). In cord blood samples of 2425 children from five cohorts with aggression assessed at mean ages ranging from 4 to 7 years, 83% of these sites showed the same direction of association with childhood aggression (r = 0.74, p = 0.006) but no epigenome-wide significant sites were found. Top-sites (48
Published: 2021
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85. DNA methylation signatures of aggression and closely related constructs:a meta-analysis of epigenome-wide studies across the lifespan

Author: van Dongen, J. (Jenny), Hagenbeek, F. A. (Fiona A.), Suderman, M. (Matthew), Roetman, P. J. (Peter J.), Sugden, K. (Karen), Chiocchetti, A. G. (Andreas G.), Ismail, K. (Khadeeja), Mulder, R. H. (Rosa H.), Hafferty, J. D. (Jonathan D.), Adams, M. J. (Mark J.), Walker, R. M. (Rosie M.), Morris, S. W. (Stewart W.), Lahti, J. (Jari), Kupers, L. K. (Leanne K.), Escaramis, G. (Georgia), Alemany, S. (Silvia), Bonder, M. J. (Marc Jan), Meijer, M. (Mandy), Ip, H. F. (Hill F.), Jansen, R. (Rick), Baselmans, B. M. (Bart M. L.), Parmar, P. (Priyanka), Lowry, E. (Estelle), Streit, F. (Fabian), Sirignano, L. (Lea), Send, T. S. (Tabea S.), Frank, J. (Josef), Jylhava, J. (Juulia), Wang, Y. (Yunzhang), Mishra, P. P. (Pashupati Prasad), Colins, O. F. (Olivier F.), Corcoran, D. L. (David L.), Poulton, R. (Richie), Mill, J. (Jonathan), Hannon, E. (Eilis), Arseneault, L. (Louise), Korhonen, T. (Tellervo), Vuoksimaa, E. (Eero), Felix, J. F. (Janine F.), Bakermans-Kranenburg, M. J. (Marian J.), Campbell, A. (Archie), Czamara, D. (Darina), Binder, E. (Elisabeth), Corpeleijn, E. (Eva), Gonzalez, J. R. (Juan R.), Grazuleviciene, R. (Regina), Gutzkow, K. B. (Kristine B.), Evandt, J. (Jorunn), Vafeiadi, M. (Marina), Klein, M. (Marieke), van der Meer, D. (Dennis), Ligthart, L. (Lannie), Kluft, C. (Cornelis), Davies, G. E. (Gareth E.), Hakulinen, C. (Christian), Keltikangas-Jarvinen, L. (Liisa), Franke, B. (Barbara), Freitag, C. M. (Christine M.), Konrad, K. (Kerstin), Hervas, A. (Amaia), Fernandez-Rivas, A. (Aranzazu), Vetro, A. (Agnes), Raitakari, O. (Olli), Lehtimaki, T. (Terho), Vermeiren, R. (Robert), Strandberg, T. (Timo), Raikkonen, K. (Katri), Snieder, H. (Harold), Witt, S. H. (Stephanie H.), Deuschle, M. (Michael), Pedersen, N. L. (Nancy L.), Hagg, S. (Sara), Sunyer, J. (Jordi), Franke, L. (Lude), Kaprio, J. (Jaakko), Ollikainen, M. (Miina), Moffitt, T. E. (Terrie E.), Tiemeier, H. (Henning), van IJzendoorn, M. H. (Marinus H.), Relton, C. (Caroline), Vrijheid, M. (Martine), Sebert, S. (Sylvain), Järvelin, M.-R. (Marjo-Riitta), Caspi, A. (Avshalom), Evans, K. L. (Kathryn L.), McIntosh, A. M. (Andrew M.), Bartels, M. (Meike), Boomsma, D. I. (Dorret, I), van Dongen, J. (Jenny), Hagenbeek, F. A. (Fiona A.), Suderman, M. (Matthew), Roetman, P. J. (Peter J.), Sugden, K. (Karen), Chiocchetti, A. G. (Andreas G.), Ismail, K. (Khadeeja), Mulder, R. H. (Rosa H.), Hafferty, J. D. (Jonathan D.), Adams, M. J. (Mark J.), Walker, R. M. (Rosie M.), Morris, S. W. (Stewart W.), Lahti, J. (Jari), Kupers, L. K. (Leanne K.), Escaramis, G. (Georgia), Alemany, S. (Silvia), Bonder, M. J. (Marc Jan), Meijer, M. (Mandy), Ip, H. F. (Hill F.), Jansen, R. (Rick), Baselmans, B. M. (Bart M. L.), Parmar, P. (Priyanka), Lowry, E. (Estelle), Streit, F. (Fabian), Sirignano, L. (Lea), Send, T. S. (Tabea S.), Frank, J. (Josef), Jylhava, J. (Juulia), Wang, Y. (Yunzhang), Mishra, P. P. (Pashupati Prasad), Colins, O. F. (Olivier F.), Corcoran, D. L. (David L.), Poulton, R. (Richie), Mill, J. (Jonathan), Hannon, E. (Eilis), Arseneault, L. (Louise), Korhonen, T. (Tellervo), Vuoksimaa, E. (Eero), Felix, J. F. (Janine F.), Bakermans-Kranenburg, M. J. (Marian J.), Campbell, A. (Archie), Czamara, D. (Darina), Binder, E. (Elisabeth), Corpeleijn, E. (Eva), Gonzalez, J. R. (Juan R.), Grazuleviciene, R. (Regina), Gutzkow, K. B. (Kristine B.), Evandt, J. (Jorunn), Vafeiadi, M. (Marina), Klein, M. (Marieke), van der Meer, D. (Dennis), Ligthart, L. (Lannie), Kluft, C. (Cornelis), Davies, G. E. (Gareth E.), Hakulinen, C. (Christian), Keltikangas-Jarvinen, L. (Liisa), Franke, B. (Barbara), Freitag, C. M. (Christine M.), Konrad, K. (Kerstin), Hervas, A. (Amaia), Fernandez-Rivas, A. (Aranzazu), Vetro, A. (Agnes), Raitakari, O. (Olli), Lehtimaki, T. (Terho), Vermeiren, R. (Robert), Strandberg, T. (Timo), Raikkonen, K. (Katri), Snieder, H. (Harold), Witt, S. H. (Stephanie H.), Deuschle, M. (Michael), Pedersen, N. L. (Nancy L.), Hagg, S. (Sara), Sunyer, J. (Jordi), Franke, L. (Lude), Kaprio, J. (Jaakko), Ollikainen, M. (Miina), Moffitt, T. E. (Terrie E.), Tiemeier, H. (Henning), van IJzendoorn, M. H. (Marinus H.), Relton, C. (Caroline), Vrijheid, M. (Martine), Sebert, S. (Sylvain), Järvelin, M.-R. (Marjo-Riitta), Caspi, A. (Avshalom), Evans, K. L. (Kathryn L.), McIntosh, A. M. (Andrew M.), Bartels, M. (Meike), and Boomsma, D. I. (Dorret, I)
Abstract: DNA methylation profiles of aggressive behavior may capture lifetime cumulative effects of genetic, stochastic, and environmental influences associated with aggression. Here, we report the first large meta-analysis of epigenome-wide association studies (EWAS) of aggressive behavior (N = 15,324 participants). In peripheral blood samples of 14,434 participants from 18 cohorts with mean ages ranging from 7 to 68 years, 13 methylation sites were significantly associated with aggression (alpha = 1.2 × 10−7; Bonferroni correction). In cord blood samples of 2425 children from five cohorts with aggression assessed at mean ages ranging from 4 to 7 years, 83% of these sites showed the same direction of association with childhood aggression (r = 0.74, p = 0.006) but no epigenome-wide significant sites were found. Top-sites (48 at a false discovery rate of 5% in the peripheral blood meta-analysis or in a combined meta-analysis of peripheral blood and cord blood) have been associated with chemical exposures, smoking, cognition, metabolic traits, and genetic variation (mQTLs). Three genes whose expression levels were associated with top-sites were previously linked to schizophrenia and general risk tolerance. At six CpGs, DNA methylation variation in blood mirrors variation in the brain. On average 44% (range = 3–82%) of the aggression–methylation association was explained by current and former smoking and BMI. These findings point at loci that are sensitive to chemical exposures with potential implications for neuronal functions. We hope these results to be a starting point for studies leading to applications as peripheral biomarkers and to reveal causal relationships with aggression and related traits.
Published: 2021

86. Hospital-treated infectious diseases and the risk of dementia:a large, multicohort, observational study with a replication cohort

Author: Sipilä, P. N. (Pyry N.), Heikkilä, N. (Nelli), Lindbohm, J. V. (Joni V.), Hakulinen, C. (Christian), Vahtera, J. (Jussi), Elovainio, M. (Marko), Suominen, S. (Sakari), Väänänen, A. (Ari), Koskinen, A. (Aki), Nyberg, S. T. (Solja T.), Pentti, J. (Jaana), Strandberg, T. E. (Timo E.), Kivimäki, M. (Mika), Sipilä, P. N. (Pyry N.), Heikkilä, N. (Nelli), Lindbohm, J. V. (Joni V.), Hakulinen, C. (Christian), Vahtera, J. (Jussi), Elovainio, M. (Marko), Suominen, S. (Sakari), Väänänen, A. (Ari), Koskinen, A. (Aki), Nyberg, S. T. (Solja T.), Pentti, J. (Jaana), Strandberg, T. E. (Timo E.), and Kivimäki, M. (Mika)
Abstract: Summary Background: Infections have been hypothesised to increase the risk of dementia. Existing studies have included a narrow range of infectious diseases, relied on short follow-up periods, and provided little evidence for whether the increased risk is limited to specific dementia subtypes or attributable to specific microbes rather than infection burden. We aimed to compare the risk of Alzheimer’s disease and other dementias across a wide range of hospital-treated bacterial and viral infections in two large cohorts with long follow-up periods. Methods: In this large, multicohort, observational study, the analysis was based on a primary cohort consisting of pooled individual-level data from three prospective cohort studies in Finland (the Finnish Public Sector study, the Health and Social Support study, and the Still Working study) and an independent replication cohort from the UK Biobank. Community-dwelling adults (≥18 years) with no dementia at study entry were included. Follow-up was until Dec 31, 2012, in the Health and Social Support study, Dec 31, 2016, in the public sector study and the Still Working study, and Feb 7, 2018, in the replication cohort. Through record linkage to national hospital inpatient registers, we ascertained exposure to 925 infectious diseases (using the International Classification of Diseases 10th Revision codes) before dementia onset, and identified incident dementia from hospital records, medication reimbursement entitlements, and death certificates. Hazard ratios (HRs) for the associations of each infectious disease or disease group (index infection) with incident dementia were assessed by use of Cox proportional hazards models. We then repeated the analysis after excluding incident dementia cases that occurred during the first 10 years after initial hospitalisation due to the index infection. Findings: From March 1, 1986, to Jan 1, 2005, 260 490 people were included in the primary cohort, and from Dec 19, 2006, to Oct 1, 2010, 48
Published: 2021

87. Evaluation of contemporary treatment of high- and very high-risk patients for the prevention of cardiovascular events in Europe:methodology and rationale for the multinational observational SANTORINI study

Author: Ray, K. K. (Kausik K.), Haq, I. (Inaam), Bilitou, A. (Aikaterini), Aguiar, C. (Carlos), Arca, M. (Marcello), Connolly, D. L. (Derek L), Eriksson, M. (Mats), Ferrières, J. (Jean), Hildebrandt, P. (Per), Laufs, U. (Ulrich), Mostaza, J. M. (Jose M.), Nanchen, D. (David), Rietzschel, E. (Ernst), Strandberg, T. (Timo), Toplak, H. (Hermann), Visseren, F. L. (Frank L. J.), Catapano, A. L. (Alberico L.), Ray, K. K. (Kausik K.), Haq, I. (Inaam), Bilitou, A. (Aikaterini), Aguiar, C. (Carlos), Arca, M. (Marcello), Connolly, D. L. (Derek L), Eriksson, M. (Mats), Ferrières, J. (Jean), Hildebrandt, P. (Per), Laufs, U. (Ulrich), Mostaza, J. M. (Jose M.), Nanchen, D. (David), Rietzschel, E. (Ernst), Strandberg, T. (Timo), Toplak, H. (Hermann), Visseren, F. L. (Frank L. J.), and Catapano, A. L. (Alberico L.)
Abstract: Background and aims: Clinical practice before 2019 suggests a substantial proportion of high and very high CV risk patients taking lipid-lowering therapy (LLT) would not achieve the new LDL-C goals recommended in the 2019 ESC/EAS guidelines (<70 and <55 mg/dL, respectively). To what extent practice has changed since the last ESC/EAS guideline update is uncertain, and quantification of remaining implementation gaps may inform health policy. Methods: The SANTORINI study is a multinational, multicentre, prospective, observational, non-interventional study documenting patient data at baseline (enrolment) and at 12-month follow-up. The study recruited 9606 patients ≥18 years of age with high and very high CV risk (as assigned by the investigators) requiring LLT, with no formal patient or comparator groups. The primary objective is to document, in the real-world setting, the effectiveness of current treatment modalities in managing plasma levels of LDL-C in high- and very high-risk patients requiring LLT. Key secondary effectiveness objectives include documenting the relationship between LLT and levels of other plasma lipids, high-sensitivity C-reactive protein (hsCRP) and overall predicted CV risk over one year. Health economics and patient-relevant parameters will also be assessed. Conclusions: The SANTORINI study, which commenced after the 2019 ESC/EAS guidelines were published, is ideally placed to provide important contemporary insights into the evolving management of LLT in Europe and highlight factors contributing to the low levels of LDL-C goal achievement among high and very high CV risk patients. It is hoped the findings will help enhance patient management and reduce the burden of ASCVD in Europe.
Published: 2021

88. Loman terveysvaikutukset

Author: Strandberg, T. (Timo), Kivimäki, M. (Mika), Strandberg, T. (Timo), and Kivimäki, M. (Mika)
Abstract: Tiivistelmä Loman tarkoitus on palauttaa työntekijän voimavarat. Lomaan liittyy pääsääntöisesti terveyshyötyjä, mutta myös mahdollisia haittoja. Loman terveysvaikutukset ovat yksilöllisiä ja myös työn laatu voi vaikuttaa niihin. Lyhytkin loma hyödyttää, mutta sen vaikutus jää usein lyhytaikaiseksi. Sitä voi pyrkiä pidentämään loman sisällöllä. Terveyshyötyjen kannalta usea lyhyt lomajakso vuoden mittaan voi olla parempi kuin yksi pitkä, mutta tutkimusta tästä on vasta vähän., Vacation (holidays) generally implies a restricted period of time which an individual spends during the year outside their ordinary work or duties using the time for recovery, rest, recreation, traveling or other leisure activity. Vacation is usually taken annually but its frequency, duration and quality may vary. Vacation is mainly considered to be associated with health benefits, but potential harms must also be recognized, such as seen during the COVID-19 pandemic and its spread in holiday resorts. In a few observational follow-up studies, shorter annual vacation has been associated with higher long-term morbidity and mortality, especially depression and cardiovascular disease. Benefits of vacation are often explained by the effect-recovery theory: allostatic load accumulated during work is relieved during vacation leading to biological, psychological and social recovery. These effects have been supported by randomized trials, although the effects are often short lived. Improving the quality and form of vacation could be a solution.
Published: 2021

89. Systematic geriatric assessment for older patients with frailty in the emergency department:a randomised controlled trial

Author: Alakare, J. (Janne), Kemp, K. (Kirsi), Strandberg, T. (Timo), Castrén, M. (Maaret), Jakovljević, D. (Dimitrije), Tolonen, J. (Jukka), Harjola, V.-P. (Veli-Pekka), Alakare, J. (Janne), Kemp, K. (Kirsi), Strandberg, T. (Timo), Castrén, M. (Maaret), Jakovljević, D. (Dimitrije), Tolonen, J. (Jukka), and Harjola, V.-P. (Veli-Pekka)
Abstract: Background: Comprehensive geriatric assessment provided in hospital wards in frail patients admitted to hospital has been shown to reduce mortality and increase the likelihood of living at home later. Systematic geriatric assessment provided in emergency departments (ED) may be effective for reducing days in hospital and unnecessary hospital admissions, but this has not yet been proven in randomised trials. Methods: We conducted a single-centre, randomised controlled trial with a parallel-group, superiority design in an academic hospital ED. ED patients aged ≥ 75 years who were frail, or at risk of frailty, as defined by the Clinical Frailty Scale, were included in the trial. Patients were recruited during the period between December 11, 2018 and June 7, 2019, and followed up for 365 days. For the intervention group, systematic geriatric assessment was added to their standard care in the ED, whereas the control group received standard care only. The primary outcome was cumulative hospital stay during 365-day follow-up. The secondary outcomes included: admission rate from the index visit, total hospital admissions, ED-readmissions, proportion of patients living at home at 365 days, 365-day mortality, and fall-related ED-visits. Results: A total of 432 patients, 63 % female, with median age of 85 years, formed the analytic sample of 213 patients in the intervention group and 219 patients in the control group. Cumulative hospital stay during one-year follow-up as rate per 100 person-years for the intervention and control groups were: 3470 and 3149 days, respectively, with rate ratio of 1.10 (95 % confidence interval, 0.55–2.19, P = .78). Admission rates to hospital wards from the index ED visit for the intervention and control groups were: 62 and 70 %, respectively (P = .10). No significant differences were observed between the groups for any outcomes. Conclusion: Systematic geriatric assessment for older adults with frailty in the ED did not reduce hospital s
Published: 2021

90. Effect of a multidomain lifestyle intervention on estimated dementia risk

Author: Solomon, A. (Alina), Handels, R. (Ron), Wimo, A. (Anders), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Levälahti, E. (Esko), Peltonen, M. (Markku), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Ngandu, T. (Tiia), Solomon, A. (Alina), Handels, R. (Ron), Wimo, A. (Anders), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Levälahti, E. (Esko), Peltonen, M. (Markku), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Ngandu, T. (Tiia)
Abstract: We investigated the effect of a multidomain lifestyle intervention on the risk of dementia estimated using the validated CAIDE risk score (post-hoc analysis). The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is a 2-year randomized controlled trial among 1,260 at-risk older adults (60–77 years). Difference in the estimated mean change in CAIDE score at 2 years in the intervention compared to the control group was –0.16 (95 %CI –0.31 to 0.00) (p = 0.013), corresponding to a relative dementia risk reduction between 6.04–6.50%. This could be interpreted as a reflection of the prevention potential of the intervention.
Published: 2021

91. Quantifying dementia prevention potential in the FINGER randomized controlled trial using the LIBRA prevention index

Author: Deckers, K. (Kay), Köhler, S. (Sebastian), Ngandu, T. (Tiia), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Soininen, H. (Hilkka), Strandberg, T. (Timo), Verhey, F. (Frans), Kivipelto, M. (Miia), Solomon, A. (Alina), Deckers, K. (Kay), Köhler, S. (Sebastian), Ngandu, T. (Tiia), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Soininen, H. (Hilkka), Strandberg, T. (Timo), Verhey, F. (Frans), Kivipelto, M. (Miia), and Solomon, A. (Alina)
Abstract: Introduction: Individuals in early dementia prevention trials may differ in how much they benefit from interventions depending on their initial risk level. Additionally, modifiable dementia risk scores might be used as surrogate/intermediate outcomes. Methods: In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we investigated in post hoc analyses (N = 1207) whether the cognitive benefits of the 2-year multi-domain lifestyle intervention differed by baseline dementia risk measured with the “LIfestyle for BRAin Health” (LIBRA) score. We also investigated intervention effects on change in LIBRA score over time. Results: Overall, higher baseline LIBRA was related to less cognitive improvement over time. This association did not differ between the intervention and control groups. The intervention was effective in decreasing LIBRA scores over time, regardless of baseline demographics or cognition. Discussion: The cognitive benefit of the FINGER intervention was similar across individuals with different LIBRA scores at baseline. Furthermore, LIBRA may be useful as a surrogate/intermediate endpoint and surveillance tool to monitor intervention success during trial execution.
Published: 2021

92. Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

Author: Alves, M. (Mariana), Fernandes, M. A. (Marília Andreia), Bahat, G. (Gülistan), Benetos, A. (Athanase), Clemente, H. (Hugo), Grodzicki, T. (Tomasz), Martínez-Sellés, M. (Manuel), Mattace-Raso, F. (Francesco), Rajkumar, C. (Chakravarthi), Ungar, A. (Andrea), Werner, N. (Nikos), Strandberg, T. E. (Timo E.), E. S. (EuGMS Special Interest Group in Cardiovascular Medicine (Chairpersons A. Ungar and A. Benetos)), Alves, M. (Mariana), Fernandes, M. A. (Marília Andreia), Bahat, G. (Gülistan), Benetos, A. (Athanase), Clemente, H. (Hugo), Grodzicki, T. (Tomasz), Martínez-Sellés, M. (Manuel), Mattace-Raso, F. (Francesco), Rajkumar, C. (Chakravarthi), Ungar, A. (Andrea), Werner, N. (Nikos), Strandberg, T. E. (Timo E.), and E. S. (EuGMS Special Interest Group in Cardiovascular Medicine (Chairpersons A. Ungar and A. Benetos))
Abstract: Purpose: In the pathogenesis of severe COVID-19 complications, derangements of renin–angiotensin–aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods: We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results: Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions: Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.
Published: 2021

93. The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans

Author: Jyväkorpi, S K, Ramel, A, Strandberg, T E, Piotrowicz, K, Błaszczyk-Bębenek, E, Urtamo, A, Rempe, H M, Geirsdóttir, Ó, Vágnerová, T, Billot, M, Larreur, A, Savera, Giulia, Soriano, G, Picauron, C, Tagliaferri, S, Sanchez-Puelles, C, Cadenas, V Sánchez, Perl, A, Tirrel, L, Öhman, H, Weling-Scheepers, C, Ambrosi, S, Costantini, A, Pavelková, K, Klimkova, M, Freiberger, E, Jonsson, P V, Marzetti, Emanuele, Pitkälä, K H, Landi, Francesco, Calvani, Riccardo, Savera, G, Marzetti, E (ORCID:0000-0001-9567-6983), Landi, F (ORCID:0000-0002-3472-1389), Calvani, R (ORCID:0000-0001-5472-2365), Jyväkorpi, S K, Ramel, A, Strandberg, T E, Piotrowicz, K, Błaszczyk-Bębenek, E, Urtamo, A, Rempe, H M, Geirsdóttir, Ó, Vágnerová, T, Billot, M, Larreur, A, Savera, Giulia, Soriano, G, Picauron, C, Tagliaferri, S, Sanchez-Puelles, C, Cadenas, V Sánchez, Perl, A, Tirrel, L, Öhman, H, Weling-Scheepers, C, Ambrosi, S, Costantini, A, Pavelková, K, Klimkova, M, Freiberger, E, Jonsson, P V, Marzetti, Emanuele, Pitkälä, K H, Landi, Francesco, Calvani, Riccardo, Savera, G, Marzetti, E (ORCID:0000-0001-9567-6983), Landi, F (ORCID:0000-0002-3472-1389), and Calvani, R (ORCID:0000-0001-5472-2365)
Abstract: Background The "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. Methods SPRINTT RCT recruited older adults (>= 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3-9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0-1.2 g/kg body weight, energy intake of 25-30 kcal/kg of body weight/day, and serum vitamin D concentration >= 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. Results Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. Conclusion The SPRINTT nutrition intervention was feasible and able to adapt flexibly
Published: 2021

94. Macronutrient composition and sarcopenia in the oldest-old men : The Helsinki Businessmen Study (HBS)

Author: Jyväkorpi, S. K., Urtamo, A., Kivimäki, M., Strandberg, T. E., Department of General Practice and Primary Health Care, University of Helsinki, Helsinki University Hospital Area, Clinicum, HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, and Department of Medicine
Subjects: body regions, POLYUNSATURATED FATTY-ACIDS, Sarcopenia, Fat quality, Protein intake, 3121 General medicine, internal medicine and other clinical medicine, Protein composition, 3143 Nutrition, Vitamin D, musculoskeletal system, gerontologia, human activities, Macronutrient composition of the diet
Abstract: Background & aim: Sarcopenia is associated with increased risk for several adverse health outcomes including frailty, disability, loss of independence, and mortality. We examined cross-sectional associations between sarcopenia and detailed dietary macronutrient composition in community-living oldest-old men (mean age 87). Methods: Participants were invited to a clinic visit in 2017/2018 including assessments of sarcopenia status using European Working Group on Sarcopenia in Older People's 2 (EWGSOP2) criteria and detailed macronutrient, vitamin D and food intakes retrieved from 3-day food diaries. Results: Of the 126 participants, 48 had probable sarcopenia and 27 sarcopenia. Sarcopenia was associated with lower energy (p = 0.020), total protein (p = 0.019), plant (p = 0.008) and fish proteins (p = 0.041), total fat (p = 0.015), monounsaturated fatty acids (MUFA) (p = 0.011), polyunsaturated fatty acids (p = 0.002), vitamin D intakes (p = 0.005) and, of fat quality indicators, MUFA: saturated fatty acid-ratio (p = 0.042). Conclusion: These findings suggest that sufficient energy and protein intakes, but also fat quality may be important along with healthy dietary patterns for prevention of sarcopenia in the oldest-old.
Published: 2020

95. Body size at birth and cardiovascular response to and recovery from mental stress in children

Author: Feldt, K, Räikkönen, K, Pyhälä, R, Jones, A, Phillips, D I W, Eriksson, J G, Pesonen, A K, Heinonen, K, Järvenpää, A-L, Strandberg, T E, and Kajantie, E
Published: 2011
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96. Precipitating factors of delirium: Stress response to multiple triggers among patients with and without dementia

Author: Hölttä, E. H., Laurila, J. V., Laakkonen, M. L., Strandberg, T. E., Tilvis, R. S., and Pitkala, K. H.
Published: 2014
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97. Association between sarcopenia and diabetes: a systematic review and meta-analysis of observational studies

Author: Veronese, N., Pizzol, D., Demurtas, J., Soysal, P., Smith, L., Sieber, C., Strandberg, T., Bourdel-Marchasson, I., Sinclair, A., Petrovic, M., Maggi, S., on behalf of the Special Interest Groups of Systematic Reviews and Meta-Analysis for Healthy Ageing, Diabetes, Sarcopenia of European Geriatric Medicine Society (EuGMS), SOYSAL, PINAR, Veronese, N., Pizzol, D., Demurtas, J., Soysal, P., Smith, L., Sieber, C., Strandberg, T., Bourdel-Marchasson, I., Sinclair, A., Petrovic, M., Maggi, S., and on behalf of the Special Interest Groups of Systematic Reviews and Meta-Analysis for Healthy Ageing, Diabetes, Sarcopenia of European Geriatric Medicine Society (EuGMS)
Subjects: medicine.medical_specialty, Sarcopenia, Diabete, Physical performance, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, systematic review, Internal medicine, Diabetes mellitus, medicine, 030212 general & internal medicine, 030214 geriatrics, business.industry, Confounding, Diabetes, Odds ratio, musculoskeletal system, medicine.disease, Confidence interval, body regions, Meta-analysis, Observational study, business, human activities
Abstract: To summarize the prevalence of diabetes in people with sarcopenia (and vice versa) through a meta-analytic approach of available observational studies. In this work, we have presented the findings of the first full methodological systematic review and meta-analysis of observational studies exploring the relationship between diabetes and sarcopenia. Our findings overall emphasize the reciprocal relationship between diabetes and sarcopenia in terms of risk of occurrence, that is sarcopenia increases the risk of diabetes being present and vice versa. This study provides support for further research into the prognosis of people with both diabetes and sarcopenia and the value of interventional strategies in sarcopenia to minimize adverse outcomes such as premature death, hospitalization, and disability. Sarcopenia and diabetes are two common conditions in older people. Some recent literature has proposed that these two conditions can be associated. However, to date, no attempt has been made to collate this literature. Therefore, we aimed to summarize the prevalence of sarcopenia in diabetes (and vice versa) and the prevalence of sarcopenia in people with diabetes complications, through a systematic review and meta-analysis. Two authors searched major electronic databases from inception until March 2019 for case control/cross-sectional/longitudinal studies investigating sarcopenia and diabetes. The strength of the reciprocal associations between sarcopenia and diabetes was assessed through odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for potential confounders, where possible. From 953 potential eligible articles, 20 were included in the systematic review, with 17 providing data for meta-analysis. Overall, 54,676 participants were included (mean age = 65.4 years). Diabetic participants had an increased prevalence of sarcopenia compared to controls (n = 10; OR = 1.635; 95% CI 1.204–2.220; p = 0.002; I2 = 67%), whilst, after adjusting for potential confounders, sarcopenia was associated with an increased odds of having diabetes (OR = 2.067; 95% CI 1.396–3.624; p
Published: 2019

98. Chocolate, well-being and health among elderly men

Author: Strandberg, T E, Strandberg, A Y, Pitkälä, K, Salomaa, V V, Tilvis, R S, and Miettinen, T A
Published: 2008
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99. Correction to: Is diet partly responsible for differences in COVID-19 death rates between and within countries? (Clinical and Translational Allergy, (2020), 10, 1, (16), 10.1186/s13601-020-00323-0)

Author: Bousquet, J. Anto, J.M. Iaccarino, G. Czarlewski, W. Haahtela, T. Anto, A. Akdis, C.A. Blain, H. Canonica, G.W. Cardona, V. Cruz, A.A. Illario, M. Ivancevich, J.C. Jutel, M. Klimek, L. Kuna, P. Laune, D. Larenas-linnemann, D. Mullol, J. Papadopoulos, N.G. Pfaar, O. Samolinski, B. Valiulis, A. Yorgancioglu, A. Zuberbier, T. Latiff, A.H.A. Abdullah, B. Aberer, W. Abusada, N. Adcock, I. Afani, A. Agache, I. Aggelidis, X. Agustin, J. Akdis, C. Akdis, M. Al-Ahmad, M. Bassam, A.A.-Z. Aldrey-Palacios, O. Cuesta, E.A. Alzaabi, A. Amad, S. Ambrocio, G. Annesi-Maesano, I. Ansotegui, I. Anto, J. Arshad, H. Artesani, M.C. Asayag, E. Avolio, F. Azhari, K. Baiardini, I. Bajrović, N. Bakakos, P. Mongono, S.B. Balotro-Torres, C. Barba, S. Barbara, C. Barbosa, E. Barreto, B. Bartra, J. Bateman, E.D. Battur, L. Bedbrook, A. Barajas, M.B. Beghé, B. Bel, E. Kheder, A.B. Benson, M. Berghea, C. Bergmann, K.-C. Bernstein, D. Bewick, M. Bialek, S. Białoszewski, A. Bieber, T. Billo, N. Bilo, M.B. Bindslev-Jensen, C. Bjermer, L. Blain, H. Marciniak, M.B. Bond, C. Boner, A. Bonini, M. Bonini, S. Bosnic-Anticevich, S. Bosse, I. Botskariova, S. Bouchard, J. Boulet, L.-P. Bourret, R. Bousquet, P. Braido, F. Briggs, A. Brightling, C. Brozek, J. Buhl, R. Bumbacea, R. Cabañas, M.T.B. Bush, A. Busse, W.W. Buters, J. Caballero-Fonseca, F. Calderon, M.A. Calvo, M. Camargos, P. Camuzat, T. Cano, A. Capriles-Hulett, A. Caraballo, L. Cardona, V. Carlsen, K.-H. Caro, J. Carr, W. Carreon-Asun-cion, F. Carriazo, A.M. Casale, T. Castor, M.A. Castro, E. Cecchi, L. Sarabia, A.C. Chandrasekharan, R. Chang, Y.-S. Chato-Andeza, V. Chatzi, L. Chatzidaki, C. Chavannes, N.H. Chen, Y. Cheng, L. Chivato, T. Chkhartishvili, E. Christoff, G. Chrystyn, H. Chu, D.K. Chua, A. Chuchalin, A. Chung, K.F. Cicerán, A. Cingi, C. Ciprandi, G. Cirule, I. Coelho, A.C. Constantinidis, J. Sousa, J.C. Costa, E. Costa, D. Domínguez, M.C.C. Coste, A. Cox, L. Cruz, A.A. Cullen, J. Custovic, A. Cvetkovski, B. Czarlewski, W. D’amato, G. Silva, J.D. Dahl, R. Dahlen, S.-E. Daniilidis, V. Nahhas, L.D. Darsow, U. Blay, F. Guia, E.D. Santos, C. Keenoy, E.D.M. Vries, G.D. Deleanu, D. Demoly, P. Denburg, J. Devillier, P. Didier, A. Dimou, M. Dinh-Xuan, A.T. Djukanovic, R. Dokic, D. Silva, M.G.D. Douagui, H. Douladiris, N. Doulaptsi, M. Dray, G. Dubakiene, R. Durham, S. Dykewicz, M. Ebo, D. Edelbaher, N. Eklund, P. El-Gamal, Y. El-Sayed, Z.A. El-Sayed, S.S. El-Seify, M. Emuzyte, R. Enecilla, L. Espinoza, H. Farrell, J. Fernandez, L. Wagner, A.F. Fiocchi, A. Fokkens, W.J. Fontaine, J.-F. Forastiere, F. Fuentes, J.M. Gaerlan–resureccion, E. Gaga, M. Romero, J.L.G. Gamkrelidze, A. Garcia, A. Cobas, C.Y.G. Gayraud, J. Gemicioglu, B. Genova, S. Gereda, J. Wijk, R.G. Gomez, M. Diaz, S.G. Gotua, M. Grigoreas, C. Grisle, I. Guidacci, M. Guldemond, N. Gutter, Z. Guzmán, A. Haahtela, T. Halloum, R. Hamelmann, E. Hammadi, S. Harvey, R. Heinrich, J. Hejjaoui, A. Hellquist-Dahl, B. Velázquez, L.H. Hew, M. Hossny, E. Howarth, P. Hrubiško, M. Villalobos, Y.R.H. Humbert, M. Hyland, M. Iaccarino, G. Ibrahim, M. Illario, M. Ilyina, N. Irani, C. Ispayeva, Z. Ivancevich, J.C. Jares, E. Jarvis, D. Jassem, E. Jenko, K. Uscanga, R.D.J. Johnston, S. Joos, G. Jošt, M. Julge, K. Jung, K.-S. Just, J. Jutel, M. Kaidashev, I. Kalayci, O. Kalyoncu, F. Kapsali, J. Kardas, P. Karjalainen, J. Kasala, C.A. Katotomichelakis, M. Kazi, B. Keil, T. Keith, P. Khaitov, M. Khaltaev, N. Kim, Y.-Y. Kleine-Tebbe, J. Klimek, L. Koffi N’Goran, B. Kompoti, E. Kopač, P. Koppelman, G. Jeverica, A.K. Košnik, M. Kostov, K.V. Kowalski, M.L. Kralimarkova, T. Vrščaj, K.K. Kraxner, H. Kreft, S. Kritikos, V. Kudlay, D. Kull, I. Kuna, P. Kupczyk, M. Kvedariene, V. Kyriakakou, M. Lalek, N. Lane, S. Larenas-Linnemann, D. Latiff, A. Lau, S. Laune, D. Lavrut, J. Le, L. Lessa, M. Levin, M. Li, J. Lieberman, P. Liotta, G. Lipworth, B. Liu, X. Lobo, R. Lodrup Carlsen, K.C. Lombardi, C. Louis, R. Loukidis, S. Lourenço, O. Luna Pech, J.A. Madjar, B. Magnan, A. Mahboub, B. Mair, A. Mais, Y. van der Zee, A.-H.M. Makela, M. Makris, M. Malling, H.-J. Mandajieva, M. Manning, P. Manousakis, M. Maragoudakis, P. Marshall, G. Martins, P. Masjedi, M.R. Máspero, J.F. Campos, J.J.M. Maurer, M. Mavale-Manuel, S. Meço, C. Melén, E. Melo-Gomes, E. Meltzer, E.O. Menditto, E. Menzies-Gow, A. Merk, H. Michel, J.-P. Miculinic, N. Midão, L. Mihaltan, F. Mikael, K. Mikos, N. Milenkovic, B. Mitsias, D. Moalla, B. Moda, G. Martínez, M.D.M. Mohammad, Y. Moin, M. Molimard, M. Momas, I. Monaco, A. Montefort, S. Mora, D. Morais-Almeida, M. Mösges, R. Mostafa, B.E. Mullol, J. Münter, L. Muraro, A. Murray, R. Mustakov, T. Naclerio, R. Nadif, R. Nakonechna, A. Namazova-Baranova, L. Navarro-Locsin, G. Neffen, H. Nekam, K. Neou, A. Nicod, L. Niederberger-Leppin, V. Niedoszytko, M. Nieto, A. Novellino, E. Nunes, E. Nyembue, D. O’hehir, R. Odjakova, C. Ohta, K. Okamoto, Y. Okubo, K. Oliver, B. Onorato, G.L. Orru, M.P. Ouédraogo, S. Ouoba, K. Paggiaro, P.L. Pagkalos, A. Palaniappan, S.P. Pali-Schöll, I. Palkonen, S. Palmer, S. Bunu, C.P. Panzner, P. Papadopoulos, N.G. Papanikolaou, V. Papi, A. Paralchev, B. Paraskevopoulos, G. Park, H.S. Passalacqua, G. Patella, V. Pavord, I. Pawankar, R. Pedersen, S. Peleve, S. Pereira, A. Pérez, T. Pfaar, O. Pham-Thi, N. Pigearias, B. Pin, I. Piskou, K. Pitsios, C. Pitsios, K. Plavec, D. Poethig, D. Pohl, W. Susic, A.P. Popov, T.A. Portejoie, F. Potter, P. Poulsen, L. Prados-Torres, A. Prarros, F. Price, D. Prokopakis, E. Puy, R. Rabe, K. Raciborski, F. Ramos, J. Recto, M.T. Reda, S.M. Regateiro, F. Reider, N. Reitsma, S. Repka-Ramirez, S. Rimmer, J. Yeverino, D.R. Rizzo, J.A. Robalo-Cordeiro, C. Roberts, G. Roche, N. González, M.R. Zagal, E.R. Rolland, C. Roller-Wirns-berger, R. Rodriguez, M.R. Romano, A. Rombaux, P. Romualdez, J. Rosado-Pinto, J. Rosario, N. Rosenwasser, L. Rottem, M. Rouadi, P. Rovina, N. Sinur, I.R. Ruiz, M. Segura, L.T.R. Ryan, D. Sagara, H. Sakai, D. Sakurai, D. Saleh, W. Salimaki, J. Salina, H. Samitas, K.-N. Coronel, M.G.S. Sanchez-Borges, M. Sanchez-Lopez, J. Sarafoleanu, C. Serpa, F.S. Sastre-Dominguez, J. Scadding, G. Scheire, S. Schmid-Grendelmeier, P. Schuhl, J.F. Schunemann, H. Schvalbová, M. Scichilone, N. Sepúlveda, C. Serrano, E. Sheikh, A. Shields, M. Shishkov, V. Siafakas, N. Simeonov, A. Simons, E.F. Sisul, J.C. Sitkauskiene, B. Skrindo, I. Soklič, T. Solé, D. Sooronbaev, T. Soto-Martinez, M. Sova, M. Spertini, F. Spranger, O. Stamataki, S. Stefanaki, L. Stellato, C. Stelmach, R. Sterk, P. Strandberg, T. Stute, P. Subramaniam, A. Ulrik, C.S. Sutherland, M. Sylvestre, S. Syrigou, A. Barata, L.T. Takovska, N. Tan, R. Tan, F. Tan, V. Tang, I.P. Taniguchi, M. Tannert, L. Tattersall, J. Teixeira, M.D.C. Thijs, C. Thomas, M. To, T. Todo-Bom, A.M. Togias, A. Tomazic, P.-V. Toppila-Salmi, S. Toskala, E. Triggiani, M. Triller, N. Triller, K. Tsiligianni, I. Ulmeanu, R. Urbancic, J. Pereira, M.U. Vachova, M. Valdés, F. Valenta, R. Rostan, M.V. Valero, A. Valiulis, A. Vallianatou, M. Valovirta, E. Eerd, M.V. Ganse, E.V. Hage, M. Vandenplas, O. Vasankari, T. Vassileva, D. Ventura, M.T. Vera-Munoz, C. Vicheva, D. Vichyanond, P. Vidgren, P. Viegi, G. Vogelmeier, C. Hertzen, L.V. Vontetsianos, T. Vourdas, D. Wagenmann, M. Walker, S. Wallace, D. Wang, D.Y. Waserman, S. Wickman, M. Williams, S. Williams, D. Wilson, N. Woo, K. Wright, J. Wroczynski, P. Xepapadaki, P. Yakovliev, P. Yamaguchi, M. Yan, K. Yap, Y.Y. Yawn, B. Yiallouros, P. Yorgancioglu, A. Yoshihara, S. Young, I. Yusuf, O.B. Zaidi, A. Zaitoun, F. Zar, H. Zernotti, M. Zhang, L. Zhong, N. Zidarn, M. Zuberbier, T.
Abstract: Following publication of the original article [1], the authors identified an error in the affiliation list. The affiliation of author G. Walter Canonica should have been split up into two affiliations: • Personalized Medicine, Asthma and Allergy – Humanitas Clinical and Research Center – IRCCS, Rozzano (MI), Italy • Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy The corrected affiliation list is reflected in this Correction. © 2020, The Author(s).
Published: 2020

100. Major cardiovascular disease (CVD) risk factors in midlife and extreme longevity

Author: Urtamo, A. (Annele), Jyväkorpi, S. K. (Satu K.), Kautiainen, H. (Hannu), Pitkälä, K. H. (Kaisu H.), and Strandberg, T. E. (Timo E.)
Subjects: Life-course, Nonagenarians, Longevity, Successful ageing, Cardiovascular risk factors
Abstract: Background: The studies on the association of various midlife risk factors with reaching 90 years or more are scarce. We studied this association in a socioeconomically homogenous cohort of businessmen. Methods: The study consists of men (n = 970) from the Helsinki Businessmen Study cohort (born 1919–1928). Five major cardiovascular disease (CVD) risk factors (smoking, BMI, blood pressure, serum lipids, fasting glucose), consumption of alcohol and coffee, self-rated health and self-rated fitness, were assessed in 1974, at an average age of 50 years. The number of major risk factors was tested as a risk burden. The Charlson Comorbidity Index and the RAND-36 (SF-36) Physical and Mental health summary scores were calculated from surveys in year 2000, at age of 73 years. Mortality dates were retrieved through 31 March 2018 from the Population Information System of Finland. Results: 244 men survived to the age of 90 representing 25.2% of the study cohort. The survivors had less risk factor burden in midlife, and less morbidity and higher physical health summary score in 2000. Of those with five major risk factors only 7% survived up to 90 years, whereas 51% of those without any risk factors reached that age. Single risk factors reducing odds of reaching 90 years were smoking (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.34–0.67), glucose (0.66, 0.49–0.88), BMI (0.63, 0.46–0.86), and cholesterol (0.71, 0.53–0.96). Conclusion: Lack of five major CVD risk factors in midlife strongly increased odds of reaching 90 years of age and also predicted factors related to successful ageing in late life.
Published: 2020

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