WorldCat Identities

Carvalho, Livia A.

Works: 3 works in 3 publications in 1 language and 3 library holdings
Publication Timeline
Most widely held works by Livia A Carvalho
Vision impairment and risk of frailty: the English Longitudinal Study of Ageing( )

1 edition published in 2016 in English and held by 1 WorldCat member library worldwide

Abstract: Background: Age-related vision impairment has been associated with comorbidities, current disability, and poor quality of life. However, it is unclear whether vision impairment is associated with increasing future frailty, further affecting ability to live independently. We investigated the association of poor vision with incident pre-frailty and frailty. Methods: 2836 men and women aged 60 years or more with data on vision (self-reported vision problems) and frailty status (Fried phenotype) from the nationally representative English Longitudinal Study of Ageing were followed up for 4 years for pre-frailty and frailty between 2004 and 2008. Frailty was defined according to number of Fried phenotype components present (slow walking, weak grip, self-reported exhaustion, weight loss, low physical activity) as non-frail (0 components), pre-frail (1–2), and frail (≥3). Participants non-frail at baseline were followed up for incident pre-frailty and frailty. Participants pre-frail at baseline were followed up for incident frailty. Findings: At baseline, 1396 participants (49%) were non-frail, 1178 (42%) pre-frail, and 262 (9%) frail. At follow-up, there were 367 new cases of pre-frailty and frailty among those non-frail at baseline, and 133 new cases of frailty among those pre-frail at baseline. Cross-sectional analysis showed an association between vision impairment and frailty (age-adjusted and sex-adjusted odds ratio 2·53, 95% CI 1·95–3·30; p<0·0001) which remained after further adjustment for wealth, education, cardiovascular disease, diabetes, falls, cognition, and depression. In longitudinal analysis, compared with non-frail participants with no vision impairment, non-frail participants with vision impairment had double the risk of becoming pre-frail or frail at follow-up (2·07, 1·32–3·24; p=0·002) and the association remained after further adjustment for covariates (1·86, 1·17–2·95; p=0·009). Pre-frail participants with vision impairment did not have greater risks of becoming frail at follow-up (1·34, 0·82–2·19). Interpretation: Older adults who experience poor vision and are not frail have double the risk of becoming pre-frail or frail over 4 years. Public health interventions aiming to identify and actively manage vision impairment might prevent frailty. Funding: AEML is funded by theNational Institute for Health Research School for Public Health Research (509546 ). LAC is funded by theBritish Heart Foundation (RG/10/001/28296 ) and the Medical Research Council (RG71546). SER is funded by aUK Medical Research Council fellowship (G1002391 )
Sensory impairments and incident disability in older men living in a British community: a 2 year follow-up study( )

1 edition published in 2015 in English and held by 1 WorldCat member library worldwide

Abstract: Background: Sensory impairments are common in older adults, who are a rapidly growing proportion of the UK population, making age-related sensory impairments an increasingly important public health concern. We explored the association between impairments in hearing and vision and the risk of incident mobility disability, activities of daily living (ADL), and instrumental ADL (IADL). Methods: 3981 men aged 63–85 years from the population-based British Regional Heart Study were followed from Jan 1, 2003, to April 30, 2005. Self-reported data on hearing aid use and ability to follow television at a volume acceptable to others allowed for four categories of hearing: could hear (reference group), could hear with hearing aid, could not hear and no aid, and could not hear despite aid. Vision impairment was defined as not being able to recognise a friend across a road. Measures of disability included mobility disability (defined as unable to take stairs up or down, or unable to walk 400 yards, or a combination of these movements), ADL difficulties, and IADL difficulties. Logistic regression was used to assess associations. All participants provided written, informed consent. Ethics approval was obtained from local research ethics committees. Findings: At baseline, 3108 men were free from mobility disability, 3346 were free from ADL difficulties, and 3410 were free from IADL difficulties. New cases of disability at follow-up included mobility disability (n=238), ADL (n=260), and IADL (n=207). Men who could not hear and did not use a hearing aid had greater risks of mobility disability (age-adjusted relative risk 2·24, 95% CI 1·29–3·89). Being unable to hear, irrespective of hearing aid, was associated with increased risks of ADL (without aid 1·74, 1·19–2·55; with aid 2·01, 1·16–3·46). Men who could hear and used a hearing aid and men who could not hear despite an aid had increased risks of IADL (1·86, 1·29–2·70 and 2·74, 1·53–4·93, respectively). Vision impairment was not associated with incident mobility disability. Interpretation: Older men with hearing impairment have an increased risk of subsequent disability. Prevention and correction of hearing impairment could enhance independent living in later life. Further research is warranted on the possible pathways underlying the associations, to prevent adverse health outcomes associated with age-related hearing impairment. Funding: The British Regional Heart Study is funded by the British Heart Foundation. AEML is funded by the National Institute for Health Research School for Public Health Research (509546). SER is funded by a UK Medical Research Council Fellowship (G1002391)
Blunted glucocorticoid and mineralocorticoid sensitivity to stress in people with diabetes( )

1 edition published in 2015 in English and held by 1 WorldCat member library worldwide

Highlights: Impaired stress responsivity in type 2 diabetes is associated with a lack of mineralocorticoid and glucocorticoid sensitivity. Corticosteroid sensitivity in type 2 diabetes correlates to HbA1c. Type 2 diabetes participants showed blunted response to stress in inflammatory cytokines. Summary: Psychological stress may contribute to type 2 diabetes but mechanisms are still poorly understood. In this study, we examined whether stress responsiveness is associated with glucocorticoid and mineralocorticoid sensitivity in a controlled experimental comparison of people with type 2 diabetes and non-diabetic participants. Thirty-seven diabetes patients and 37 healthy controls underwent psychophysiological stress testing. Glucocorticoid (GR) and mineralocorticoid sensitivity (MR) sensitivity were measured by dexamethasone- and prednisolone-inhibition of lipopolysaccharide (LPS)-induced interleukin (IL) 6 levels, respectively. Blood pressure (BP) and heart rate were monitored continuously, and we periodically assessed salivary cortisol, plasma IL-6 and monocyte chemotactic protein (MCP-1). Following stress, both glucocorticoid and mineralocorticoid sensitivity decreased among healthy controls, but did not change in people with diabetes. There was a main effect of group on dexamethasone (F (1, 74) = 6.852, p = 0.013) and prednisolone (F (1, 74) = 7.295, p = 0.010) sensitivity following stress at 45 min after tasks. People with diabetes showed blunted stress responsivity in systolic BP, diastolic BP, heart rate, IL-6, MCP-1, and impaired post-stress recovery in heart rate. People with Diabetes had higher cortisol levels as measured by the total amount excreted over the day and increased glucocorticoid sensitivity at baseline. Our study suggests that impaired stress responsivity in type-2 diabetes is in part due to a lack of stress-induced changes in mineralocorticoid and glucocorticoid sensitivity
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