Andrea Schneider

Mortality Excess in Individuals with Elevated IgA Anti-Transglutaminase Antibodies: The KORA/MONICA Augsburg Cohort Study 1989–1998

Objectives: Immunoglobulin A (IgA) autoantibodies to tissue transglutaminase (tTG) are commonly used for screening and diagnosing of celiac disease. We examined the hypothesis that elevated IgA anti-tTG antibodies were associated with higher all-cause mortality risk.MethodsThe cohort, 2333 men and 2300 women, was based on the follow-up of participants of a representative population-based survey in Southern Germany (KORA/MONICA Augsburg project) conducted in 1989–1990. The endpoint for the vital status with cause of death was the year 1998. The sera drawn at baseline and stored at −80xa0°C, were recently screened with an IgA enzyme-linked immunosorbent assay (ELISA) using human recombinant tTG. Age-standardized mortality rates and age-adjusted hazard ratios were calculated.ResultsFrom the 4633 sera analyzed, 63 had an IgA anti-tTG concentration ≥7xa0AU/ml. Of these 63 individuals, 15 died between 1989 and 1998. The age-adjusted hazard ratio (HRa) of all-cause mortality was 1.86 (95% CI: 1.01–3.41) and 3.92 (95% CI: 1.44–10.71) for men and women, respectively. The excess of cancer mortality was even higher with an HRa of 2.47 (95% CI: 0.89–6.83) in men and of 6.65 (95% CI: 2.04–21.63) in women.Conclusions :Individuals with elevated IgA anti-tTG antibodies had a highly increased mortality risk, particularly due to cancer. New studies are necessary to clarify if this increased risk is due to undiagnosed celiac disease or/and if this elevated IgA anti-tTG antibodies level is a marker of serious diseases like cancer, chronic liver disease or end-stage heart failure.

Multimorbidität und erfolgreiches Altern

BACKGROUNDnThe objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public.nnnPATIENTS AND METHODSnIn the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics.nnnRESULTSnA total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%).nnnCONCLUSIONnThe KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.ZusammenfassungHintergrundDas KORA-Age-Verbundprojekt hat zum Ziel, die Determinanten und Folgen von Multimorbidität im Alter zu ermitteln und nach Faktoren des erfolgreichen Alterns in der Allgemeinbevölkerung zu suchen.Material und MethodenDie KORA-Age-Kohorte besteht aus 9197xa0Personen, die 1943 oder früher geboren wurden und Teilnehmer der KORA-Kohorte (KORA: Kooperative Gesundheitsforschung in der Region Augsburg) zwischen 1984 und 2001 waren. In der randomisierten Interventionsstudie KORINNA (Koronarinfarktnachbehandlung im Alter) wurde ein von Krankenschwestern durchgeführtes Case-Management-Programm mit 338xa0Herzinfarktpatienten getestet und gesundheitsökonomisch bewertet.ErgebnisseIn der KORA-Age-Kohorte wurden 2734xa0Todesfälle registriert, 4565xa0Personen nahmen an einer schriftlichen Befragung und 4127xa0Personen an einem Telefoninterview teil (Teilnahme: 76,2% bzw. 68,9%). Zusätzlich wurde eine alters- und geschlechtsstratifizierte Stichprobe von 1079xa0Personen untersucht (Teilnahme: 53,8%).SchlussfolgerungDas KORA-Age-Verbundprojekt untersuchte eine große bevölkerungsbezogene Stichprobe älterer Menschen, die Aufschluss über die Verteilung und Determinanten von Multimorbidität und erfolgreichem Altern gibt.AbstractBackgroundThe objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public.Patients and methodsIn the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics.ResultsA total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%).ConclusionThe KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.

[Multimorbidity and successful aging: the population-based KORA-Age study].

BACKGROUNDnThe objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public.nnnPATIENTS AND METHODSnIn the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics.nnnRESULTSnA total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%).nnnCONCLUSIONnThe KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.ZusammenfassungHintergrundDas KORA-Age-Verbundprojekt hat zum Ziel, die Determinanten und Folgen von Multimorbidität im Alter zu ermitteln und nach Faktoren des erfolgreichen Alterns in der Allgemeinbevölkerung zu suchen.Material und MethodenDie KORA-Age-Kohorte besteht aus 9197xa0Personen, die 1943 oder früher geboren wurden und Teilnehmer der KORA-Kohorte (KORA: Kooperative Gesundheitsforschung in der Region Augsburg) zwischen 1984 und 2001 waren. In der randomisierten Interventionsstudie KORINNA (Koronarinfarktnachbehandlung im Alter) wurde ein von Krankenschwestern durchgeführtes Case-Management-Programm mit 338xa0Herzinfarktpatienten getestet und gesundheitsökonomisch bewertet.ErgebnisseIn der KORA-Age-Kohorte wurden 2734xa0Todesfälle registriert, 4565xa0Personen nahmen an einer schriftlichen Befragung und 4127xa0Personen an einem Telefoninterview teil (Teilnahme: 76,2% bzw. 68,9%). Zusätzlich wurde eine alters- und geschlechtsstratifizierte Stichprobe von 1079xa0Personen untersucht (Teilnahme: 53,8%).SchlussfolgerungDas KORA-Age-Verbundprojekt untersuchte eine große bevölkerungsbezogene Stichprobe älterer Menschen, die Aufschluss über die Verteilung und Determinanten von Multimorbidität und erfolgreichem Altern gibt.AbstractBackgroundThe objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public.Patients and methodsIn the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics.ResultsA total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%).ConclusionThe KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.

Prevalence and Predictors of Subclinical Micronutrient Deficiency in German Older Adults: Results from the Population-Based KORA-Age Study

Subclinical micronutrient deficiency in older adults is associated with chronic age-related diseases and adverse functional outcomes. In Germany, the older population is at risk of insufficient micronutrient intake, but representative studies on micronutrient status in old and very old adults are scarce. This study’s objectives were to estimate the prevalence of subclinical vitamin D, folate, vitamin B12 and iron deficiencies among older adults, aged 65 to 93, from the KORA-Age study in Augsburg, Germany (n = 1079), and to examine associated predictors, using multiple logistic regression. Serum concentrations of 25-hydroxyvitamin D (25OHD), folate, vitamin B12, and iron were analyzed. The prevalence of subclinical vitamin D and vitamin B12 deficiencies were high, with 52.0% and 27.3% of individuals having low 25OHD (<50 nmol/L) and low vitamin B12 concentrations (<221 pmol/L), respectively. Furthermore, 11.0% had low iron (men <11.6 µmol/L, women <9.0 µmol/L) and 8.7% had low folate levels (<13.6 nmol/L). Common predictors associated with subclinical micronutrient deficiency included very old age, physical inactivity, frailty and no/irregular use of supplements. Subclinical micronutrient deficiency is a public health concern among KORA-Age participants, especially for vitamins D and B12. The predictors identified provide further rationale for screening high-risk subgroups and developing targeted public health interventions to tackle prevailing micronutrient inadequacies among older adults.

Multimorbidität und erfolgreiches Altern: ein Blick auf die Bevölkerung im Rahmen der KORA-Age-Studie

BACKGROUNDnThe objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public.nnnPATIENTS AND METHODSnIn the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics.nnnRESULTSnA total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%).nnnCONCLUSIONnThe KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.ZusammenfassungHintergrundDas KORA-Age-Verbundprojekt hat zum Ziel, die Determinanten und Folgen von Multimorbidität im Alter zu ermitteln und nach Faktoren des erfolgreichen Alterns in der Allgemeinbevölkerung zu suchen.Material und MethodenDie KORA-Age-Kohorte besteht aus 9197xa0Personen, die 1943 oder früher geboren wurden und Teilnehmer der KORA-Kohorte (KORA: Kooperative Gesundheitsforschung in der Region Augsburg) zwischen 1984 und 2001 waren. In der randomisierten Interventionsstudie KORINNA (Koronarinfarktnachbehandlung im Alter) wurde ein von Krankenschwestern durchgeführtes Case-Management-Programm mit 338xa0Herzinfarktpatienten getestet und gesundheitsökonomisch bewertet.ErgebnisseIn der KORA-Age-Kohorte wurden 2734xa0Todesfälle registriert, 4565xa0Personen nahmen an einer schriftlichen Befragung und 4127xa0Personen an einem Telefoninterview teil (Teilnahme: 76,2% bzw. 68,9%). Zusätzlich wurde eine alters- und geschlechtsstratifizierte Stichprobe von 1079xa0Personen untersucht (Teilnahme: 53,8%).SchlussfolgerungDas KORA-Age-Verbundprojekt untersuchte eine große bevölkerungsbezogene Stichprobe älterer Menschen, die Aufschluss über die Verteilung und Determinanten von Multimorbidität und erfolgreichem Altern gibt.AbstractBackgroundThe objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public.Patients and methodsIn the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics.ResultsA total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%).ConclusionThe KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.

Do siblings of myocardial infarction patients have a specific management of hypertension

The aim of this study was to determine whether the management of hypertension differs between siblings of myocardial infarction patients and the general population. Siblings aged 35 to 74 years, unaffected by myocardial infarction, were drawn from the Augsburg Family Heart Study, conducted in 1996–1997 in southern Germany (n = 524). The reference group consisted of participants of the third MONICA population-based survey conducted in 1994–1995 in the same area, who were aged 35 to 74 years and also unaffected by myocardial infarction (n = 3802). Prevalence, awareness, treatment and control of hypertension (defined by blood pressure ⩾140/90 mmu2009Hg or use of antihypertensive medication) were compared between the two groups. The result was that the prevalence of hypertension was higher in the siblings (men: age-adjusted OR = 1.31, 95% CI: 0.99–1.75; women: age-adjusted OR = 1.83, 95% CI: 1.39–2.41). Male hypertensive siblings were more often aware and treated for hypertension than male hypertensives of the reference group whereas the level of awareness and treatment was comparable between female hypertensives of the two groups. In both genders, no difference in the degree of control was shown between hypertensives of the two groups. In conclusion the siblings and their physicians should pay more attention to the family history of myocardial infarction in order to improve the management of hypertension in this high risk group.