Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry.

STUDY OBJECTIVES: To investigate the association between admission blood glucose levels and 28-day mortality as well as in-hospital complications in older patients with incident acute myocardial infarction (AMI) undergoing modern treatment. METHODS: From a German population-based regional MI registry, 5530 patients (2016 women), aged 65-84 years, hospitalised with an incident AMI between 1 January 2009 and 31 December 2016 were included in the study. Multivariable logistic regression models were used to assess the associations between admission blood glucose and 28-day mortality as well as in-hospital complications after AMI. Analyses stratified according to age, diabetes and type of infarction (ST-elevation MI (STEMI)/non-STEMI) were conducted. RESULTS: The adjusted ORs for the association between admission blood glucose and 28-day mortality in young-old (65-74 years) and old (75-84 years) patients with AMI were 1.40 (95% CI: 1.21 to 1.62) and 1.21 (95% CI: 0.98 to 1.50) per 1 SD increase in admission blood glucose, respectively. Furthermore, higher admission blood glucose was related to case fatality irrespective of the diabetes status and type of infarction only in the under-75 group. For the patients aged 75-84 years, it was only true for those without diabetes and STEMI. Admission blood glucose was also associated with major cardiac complications in both age groups. CONCLUSION: Admission blood glucose was significantly associated with 28-day case fatality in patients with AMI aged 65-74 years but not 75-84 years; furthermore, in both age groups there was an increased risk of major complications. It seems that admission glucose may play a rather minor role in terms of case fatality in higher aged patients with AMI.

Sedentary behavior and kidney function in adults: a narrative review.

There is increasing evidence for an association between SB and CKD, an emerging public health problem particularly affecting old people. For this reason a systematic literature search was carried out in Embase and PubMed (Jan 2000-Dec 2018) looking for an association between SB and kidney function. A total of 10 studies met the inclusion criteria (7 cross-sectional and 3 longitudinal investigations). A sedentary lifestyle was positively and independently of several confounders related to an impaired kidney function (chronic kidney disease or decrease of glomerular filtration rate), particularly in cross-sectional studies; however, more studies are needed to further establish the current evidence and to explore the exact independent mechanisms of sedentary behavior in relation to kidney function. Due to the inconsistency of the few longitudinal studies, future investigations are required to explore if SB is prospectively associated with a higher risk of developing CKD.

Association between muscular strength and depressive symptoms : A narrative review.

There is increasing evidence for an association between low muscular strength and depressive symptoms. In this review the existing literature on the association between muscular strength and depression particularly in older people as reported in epidemiological studies is summarized. From the literature search, conducted in PubMed (January 1980-May 2018), 17 papers (8 cross-sectional and 9 longitudinal studies) were selected. All cross-sectional studies reported significantly lower odds of having depressive symptoms with increased levels of muscular strength and this association persisted even after adjusting for several confounders including the level of physical activity. The majority of the longitudinal studies also reported that low muscular strength was independently associated with a higher risk of developing depression but more studies are needed to confirm this evidence. Furthermore, future investigations are needed to explore the exact mechanisms of muscular strength in relation to depression. Low muscular strength is a modifiable factor for depression, which is of great public health interest.