Epidemiology of hyperuricemia in the elderly

BACKGROUND: Our study used data collected in Chung-Hsing Village to evaluate the relationship between hyperuricemia and the cardiovascular risk factors and the socio-demographic factors in the elderly in May 1998. METHODS: All individuals aged 65 and over were studied. A total of 1093 subjects, out of 1774 registered residents, were contacted by face-to-face interview. The response rate was 61.6 percent. However only 586 respondents had blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. To study the significant correlates of hyperuricemia, t- test, two-way ANOVA, chi-square test and multivariate logistic regression were used. RESULTS: Our results showed that 66 percent were men and 34 percent were women. The mean age was 73.1+/-5.3 years. The proportions of hyperuricemia were 57.3 percent in men and 40.9 percent in women (p < .01). In chi-square test, hypercholesterolemia, hypertriglyceridemia, renal function impairment, retirement status and marital status were related to hyperuricemia. After controlling the other covariates, the multivariate logistic regression analysis showed that the significant related factors of hyperuricemia were hypercholesterolemia, hypertriglyceridemia, and renal function impairment. CONCLUSIONS: Hyperuricemia is often found in the elderly. Hyperuricemia is more common in elderly men than in elderly women. A large-scale investigation will be suggested in the future to address causal-effect issues between hyperuricemia and hypercholesterolemia, hypertriglyceridemia, or renalfunction impairment.     

Epidemiology of serum aminotransferase activities in the elderly.

BACKGROUND: Our study used data collected in Chung-Hsing Village in May 1998 to explore the distribution of serum aminotransferase activities and the relationship between aminotransferase and its related factors in the elderly. METHODS: All individuals aged 65 and over were recruited as study subjects. A total of 1093 persons, out of 1774 registered residents, were contacted by face-to-face interview. The response rate was 61.6 percent. However, only 586 subjects had blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. In order to study the significant related factors of abnormal aminotransferase activities, the t-test, ANOVA, chi-square analysis, and multivariate logistic regression were used. RESULTS: There were 66 percent men and 34 percent women. The mean age was 73.1 +/- 5.3 years. The mean values of aspartate aminotransferase (AST) were 29.3 +/- 14.5 u/l in men and 27.8 +/- 10.7 u/l in women (p > .05). The mean values of alanine aminotransferase (ALT) were 30.9 +/- 25.2 u/l in men and 26.3 +/- 12.6 u/l in women (p < .01). The abnormality rates of AST (> or = 40 u/l) were 10.5 percent in men and 12.2 percent in women (p > .05). The abnormality rates of ALT (> or = 40 u/l) were 16.7 percent in men and 12.6 percent in women (p > .05). After controlling for the other covariates, the multivariate logistic regression analysis showed that the significant related factor of abnormal AST was retirement status (odds ratio 4.4; 95 percent confidence interval = 1.5-13.3; p < .01). The significant related factors of abnormal ALT were obesity (odds ratio = 2.2; 95 percent confidence interval = 1.1-4.2; p < .05) and hypertriglyceridemia (odds ratio = 2.7; 95 percent confidence interval = 1.5-4.9; p < .01). CONCLUSIONS: We raise the hypothesis that evidence of liver disease with abnormal ALT may co-vary with other indicators of chronic diseases. A large-scale investigation will be suggested in the future to demonstrate the causal-effect issue between abnormal ALT and obesity or hypertriglyceridemia.     

Homocysteine and cognitive function in elderly people

DEMENTIA IS HIGHLY PREVALENT AMONG ELDERLY PEOPLE, and projections show that the number of people affected might triple over the next 50 years, mainly because of a large increase in the oldest-old segment of the population. Because of this and the disease''s devastating effects, measures for the prevention and early detection of dementia are crucial. Age and years of education are among the most relevant risk factors for dementia, but in recent years the role of homocysteine has also been investigated. Homocysteine is an amino acid produced in the metabolism of methionine, a process dependent on the B vitamins cobalamin, vitamin B₆ and folic acid. There is evidence that increased serum homocysteine levels are associated with declining cognitive function and dementia. We review this evidence in addition to the potential mechanisms through which homocysteine acts on the brain to cause cognitive dysfunction, the metabolism of homocysteine and factors associated with alteration of the normal metabolism. Dementia is characterized by a progressive deterioration of cognitive skills that leads to a decline in the ability to perform daily activities. It affects 8% of people over the age of 65¹ and results in more than 60 000 new cases in Canada each year. Alzheimer''s disease accounts for more than 50% of cases of dementia in Canada.² Projections for the next 50 years show that the number of patients with dementia might triple,³ mainly because of a large increase in the oldest-old segment of the population. Because of the disease''s high prevalence and devastating effects on patients, caregivers and the health care system, measures for the prevention and early detection of dementia are crucial.Age and years of education are among the most relevant risk factors for dementia, but in recent years the role of homocysteine has also been investigated. Homocysteine is an amino acid that is produced in the metabolism of methionine, a process dependent on the B vitamins cobalamin, vitamin B₆ and folic acid. There is evidence that increased serum homocysteine levels are associated with declining cognitive function and dementia. We review this evidence in addition to the potential mechanisms through which homocysteine acts on the brain to cause cognitive dysfunction, the metabolism of homocysteine and factors associated with alteration of the normal metabolism.     

Hypercholesterolemia and its correlates in Taiwanese elderly people

BACKGROUND: Our study used data collected in Chung-Shing-Shin-Tseun community in Taiwan in May 1998 to evaluate the relationship between hypercholesterolemia and the cardiovascular and sociodemographic risk factors in elderly people. METHODS: Individuals aged 65 and over were recruited as study subjects. A total of 1,093 persons, out of 1,774 registered residents, were contacted in face-to-face interview. The response rate was 61.6 percent. However, only 586 respondents took blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. The t-test, chi-square analysis, and multivariate logistic regression were used to study the significant correlates of hypercholesterolemia. RESULTS: Our results showed that 66 percent were men and 34 percent were women. The mean age was 73.1 +/- 5.3 years. The mean total cholesterol value was 5.1 +/- 1 mmol/l in elderly men and 5.5 +/- 1.3 mmol/l in elderly women. The proportions of hypercholesterolemia were 43.7 percent in elderly men and 59.6 percent in elderly women. After controlling the other covariates, the multivariate logistic regression analysis showed that the significant related factors of hypercholesterolemia were age, hypertriglyceridemia, and hyperuricemia. No significant association was found between hypercholesterolemia and gender, obesity, high systolic pressure, high diastolic pressure, hyperglycemia, educational level, retirement status, or marital status. CONCLUSION: Hypercholesterolemia is significantly associated with hypertriglyceridemia and hyperuricemia in elderly people. It is important to determine other metabolic disorders if one metabolic disorder is disclosed.