Posts Tagged ‘mortality’

Estimated age based on exercise stress testing performance may be a better predictor of mortality than chronological age, according to a study published online Feb. 13 in the European Journal of Preventive Cardiology.

Serge C. Harb, M.D., from the Cleveland Clinic, and colleagues evaluated whether age based on stress testing exercise performance (A-BEST) would be a better predictor of mortality than chronological age among 126,356 consecutive patients (mean age, 53.5 years) referred for exercise (electrocardiography, echocardiography, or myocardial perfusion imaging) stress testing between Jan. 1, 1991, and Feb. 27, 2015. Exercise capacity (number of peak estimated metabolic equivalents of task), chronotropic reserve index, and heart rate recovery were used to compute estimated age taking into account patient’s gender and medications that affect heart rate.

The researchers found that after adjustment for clinical comorbidities, improved survival was associated with higher metabolic equivalents of task (adjusted hazard ratio [aHR] for mortality, 0.71) and higher chronotropic reserve index (aHR for mortality, 0.97). Higher mortality was associated with abnormal heart rate recovery (aHR for mortality, 1.53) and higher A-BEST (aHR for mortality, 1.05). There was a significant increase in the area under the curve when A-BEST rather than chronological age was used in prediction models (0.82 versus 0.79). The overall net reclassification improvement was significant.

“For the first time we can quantify the impact of your performance level on a treadmill test in adding or subtracting years from your actual age,” Harb said in a statement.

https://www.physiciansbriefing.com/cardiology-2/age-health-news-7/stress-test-based-physiological-age-may-be-superior-mortality-predictor-742824.html

There’s always the Magic 8 Ball, but when it comes to determining life expectancy, some people want a little more scientific help. Thankfully, there are some useful tests and calculators to help us figure out how many more years we have left — at least until the Fountain of Youth is available in pill form. With that in mind, here are six ways to help predict whether you should keep on working and paying the mortgage or just blow it all on a big beach vacation.

Treadmill test
Want to know if you’ll survive the decade? Hop on a treadmill. Johns Hopkins researchers analyzed more than 58,000 stress tests and concluded that the results of a treadmill test can predict survival over the next 10 years. They came up with a formula, called the FIT Treadmill Score, which helps use fitness to predict mortality.

“The notion that being in good physical shape portends lower death risk is by no means new, but we wanted to quantify that risk precisely by age, gender and fitness level, and do so with an elegantly simple equation that requires no additional fancy testing beyond the standard stress test,” says lead investigator Haitham Ahmed, M.D. M.P.H., a cardiology fellow at the Johns Hopkins University School of Medicine.

In addition to age and gender, the formula factors in your ability to tolerate physical exertion — measured in “metabolic equivalents” or METs. Slow walking equals two METs, while running equals eight.

Researchers used the most common treadmill test, called the Bruce Protocol. The test utilizes three-minute segments, starting at 1.7 mph and a 10 percent grade, which slowly increase in speed and grade.

Researchers analyzed information on the thousands of people ages 18 to 96 who took the treadmill test. They tracked down how many of them died for whatever reason over the next decade. They found that fitness level, as measured by METs and peak heart rate reached during exercise, were the best predictors of death and survival, even after accounting for important variables such as diabetes and family history of premature death.

Sitting test
You don’t need special equipment for this adult version of crisscross applesauce that uses flexibility, balance and strength to measure life expectancy. Brazilian physician Claudio Gil Araujo created the test when he noticed many of his older patients had trouble picking things up off the floor or getting out of a chair.

To try, start by standing upright in the middle of a room. Without using your arms or hands for balance, carefully squat into a cross-legged sitting position. Once you’re settled, stand up from the sitting position — again, without using your arms for help.

You can earn up to 10 points for this maneuver. You get five points for sitting, five for standing, and you subtract a point each time you use an arm or knee for leverage or 1/2 point any time you lose your balance or the movement gets clumsy.

The test seems fairly simple, but Araujo found that it was an accurate predictor of life expectancy. He tested it on more than 2,000 of his patients age 51 to 80, and found that those who scored fewer than eight points were twice as likely to die within the next six years. Those who scored three points or even lower were five times more likely to die within the same time frame.

Araujo didn’t have anyone under 50 try the test, so the results won’t mean the same if you’re younger. As MNN’s Bryan Nelson writes, “If you’re younger than 50 and have trouble with the test, it ought to be a wake-up call. The good news is that the younger you are, the more time you have to get into better shape.”

Test your telomeres

A simple test may help determine your “biological age” by measuring the length of your telomeres. Telomeres are protective sections of DNA located at the end of your chromosomes. They’re sometimes compared to the plastic tips of shoelaces that keep the laces from fraying.

Each time a cell replicates, the telomeres become shorter. Some researchers believe that lifespan can be roughly predicted based upon how long your telomeres are. Shorter telomeres hint at a shorter lifespan for cells. Longer telomeres may mean you have more cell replications left.

Originally offered a few years ago only as an expensive — and relatively controversial — blood test in Britain, telomere testing in now available all over the world, and some companies even test using saliva. The results tell you where your telomere lengths fall in relation to other participants your age.

The link between genetics and longevity has been so embraced that testing companies have since been founded by respected scientists and researchers including Nobel laureate Elizabeth Blackburn of UC San Francisco and George Church, director of Harvard University’s Molecular Technology Group.

The increase in the number of at-home tests is getting the attention of concerned federal regulators and other researchers who question whether the science should stay in the lab.

“It is worth doing. It does tell us something. It is the best measure we have” of cellular aging, aging-researcher and Genescient CEO Bryant Villeponteau told the San Jose Mercury News. But testing still belongs in a research setting, he said, not used as a personal diagnostic tool.

As more people take them, he said, “I think the tests will get better, with more potential to learn something.”

Grip strength

Do you have an iron handshake or a limp fish grasp? Your grip strength can be an indicator of your longevity.

Recent research has shown a link between grip strength and your biological age. Hand-grip strength typically decreases as you age, although many studies have shown links between stronger grip strength and increased mortality.

You can keep your grip strong by doing regular hand exercises such as slowly squeezing and holding a tennis or foam ball, then repeating several more times.

Take a sniff

Does every little smell bug you? People who wear too much perfume? Grilled fish in the kitchen? A sensitive sense of smell is good news for your lifespan.

In a study last fall, University of Chicago researchers asked more than 3,000 people to identify five different scents. The found that 39 percent of the study subjects who failed the smelling test died within five years, compared to 19 percent of those with moderate smell loss and just 10 percent of those with a healthy sense of smell.

“We think loss of the sense of smell is like the canary in the coal mine,” said the study’s lead author Jayant M. Pinto, M.D., an associate professor of surgery at the University of Chicago who specializes in the genetics and treatment of olfactory and sinus disease. “It doesn’t directly cause death, but it’s a harbinger, an early warning that something has gone badly wrong, that damage has been done. Our findings could provide a useful clinical test, a quick and inexpensive way to identify patients most at risk.”

Life expectancy calculator

There are many online calculators that can serve up you estimated last birthday — thanks to some fancy algorithms. Some only take into account a few simple factors such as your age, height and weight. The better ones consider a range of variables including family health history, diet and exercise practices, marital and education status, smoking, drinking and sex habits, and even where you live.

Enter as much data as you can into an online form, like this one from researchers at the University of Pennsylvania, and click to get your results: http://gosset.wharton.upenn.edu/mortality/perl/CalcForm.html

Read more: http://www.mnn.com/health/fitness-well-being/stories/6-tools-to-help-predict-how-long-youll-live#ixzz3WScKjbUW

There’s been a fast growing body of evidence in the last several years that lack of exercise – or sedentariness – is a major risk factor in health. It’s been linked to heart disease, cancer, and to an early death. And now, a new study finds that lack of exercise may actually be even more of a risk than obesity in early mortality: The researchers calculate that a sedentary lifestyle may actually confer twice the risk of death as being obese. That said, the two are both important and, luckily, closely related: So if you start getting active, you’ll probably lose a little weight along the way, which itself is a very good thing.

The new study looked at data from over 334,000 people who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. Over a period of 12 years, the participants’ height, weight, and waist circumferences were tracked, along with self-reports of activity levels, both at work and in free time. All-cause mortality (i.e., death from any cause) was the main outcome of interest.

It turned out that lack of physical activity was linked to the greatest risk of death – and the greatest reduction in death risk was in the difference between the lowest two activity groups. In other words, just moving from “inactive” to “moderately inactive” showed the largest reduction in death risk, especially for normal weight people, but true for people of all body weights. And, the authors say, just taking a brisk 20-minute walk per day can move you from one category to the other, and reduce the risk of death anywhere from 16% to 30%.

Using a statistical model, the team also calculated that being sedentary may account for double the death risk of obesity. According to their math, of the 9.2 million deaths in Europe in 2008, about 337,000 were attributable to obesity, whereas 676,000 were attributable to sedentariness.

Another takeaway from the study, however, is that waist circumference is a bigger player in mortality risk than overall body weight, which has certainly been suggested by previous studies. Belly fat seems to be disproportionately linked to chronic health issues like heart disease, stroke, diabetes, cancer, and of course, early mortality. So reducing belly fat is always a significant benefit to one’s health.

“This large study is rather complex in its details, but the take-away messages are actually both clear and simple,” says David L, Katz, Director of the Yale University Prevention Research CenterGriffin Hospital. “At any given body weight, going from inactive to active can reduce the risk of premature mortality substantially. At any given level of activity, going from overweight to a more optimal weight can do the same. We have long known that not all forms of obesity are equally hazardous, and this study reaffirms that. Losing weight if you have an excess around the middle, where it is most dangerous, exerts an influence on mortality comparable to physical activity. Losing excess weight that is not associated with a high waist circumference reduces mortality risk, but less — as we would expect.”

But perhaps the main point in all of this is that being active and being a healthy weight are inextricably linked. Though activity by itself can offer an immediate health benefit if you remain overweight, getting active also leads naturally to loss of body weight. “This study reminds that being both fit and unfat are good for health,” says Katz, “and can add both life to years, and years to life. These are not really disparate challenges, since the physical activity that leads to fitness is on the short list of priorities for avoiding fatness as well. The challenge before us now is for our culture to make it easier to get there from here.”

Earlier this month a study showed that the concept of “healthy obesity” may be very misleading, since health markers in an obese person tend to deteriorate over time. Though the current study suggests that fitness may matter more than fatness, the two are really two sides of a coin: It would be silly to become active and not lose weight — and it would be very hard to do, since the one leads to the other. But perhaps given the great benefits of exercise alone, public health campaigns should focus not just on losing weight, but on encouraging people to add just small amounts physical activity to their lives right off the bat, and to see where it goes from there.

http://www.forbes.com/sites/alicegwalton/2015/01/15/is-lack-of-exercise-worse-for-your-health-than-obesity/