ATHLOS Healthy Ageing Scale score as the predictor of mortality in Poland and the Czech Republic

Abstract Background A novel tool to measure healthy ageing was developed by the ATHLOS consortium (Ageing Trajectories of Health-Longitudinal Opportunities and Synergies). ATHLOS Healthy Ageing Scale, constructed using harmonized data from 16 independent ageing cohorts, was designed to contribute to worldwide research on healthy ageing. The aim of the analysis was to assess the relation between ATHLOS Healthy Ageing Scale and all-cause mortality in Central European populations. Methods Participants of the Polish and Czech HAPIEE cohorts (baseline age 45-69 years) were followed for 14 years. ATHLOS Healthy Ageing Scale was based on over 40 health indicators related to intrinsic capacity and functional ability. Cox proportional hazards models were used to determine the relationship between the ATHLOS Healthy Ageing Scale scores and all-cause mortality. Results As many as 9,922 Polish and 8,518 Czech participants had non-missing data on the ATHLOS Healthy Ageing Scale score and mortality (1828 and 1700 deaths, respectively). After adjustment for age, dose-response associations with mortality in both genders and countries were found (HR for lowest vs. highest quintile of the ATHLOS Healthy Ageing Scale: 2.98 and 1.96 in Czech and Polish women and 2.83 and 2.66 in Czech and Polish men, respectively). Only modest attenuation was observed when additionally adjusted for education, economic activity, smoking and self-rated health. Conclusions The ATHLOS Healthy Ageing Scale was found to be a good predictor of all-cause mortality in urban populations of Poland and Czechia. This composite indicator seems to be an important contributor to a better assessment of healthy ageing. Key messages Independent inverse associations between ATHLOS Healthy Ageing Scale and all-cause mortality were found in both men and women in urban population samples from Central and Eastern Europe. Given its predictive validity for all-cause mortality, this novel tool may substantially contribute to a better assessment of healthy ageing.


Background:
Thyroid cancer is 2-3 times more common in females and is currently the fastest growing cancer worldwide. Exposure to ionizing radiation is the only established risk factor for thyroid cancer. Other factors include obesity, history of benign thyroid conditions, and family history. We conducted a retrospective population-based cohort study to examine whether there have been changes in the incidence of thyroid cancer in England during the past four decades. Methods: Individual level data for patients diagnosed with thyroid cancer in England during 1985-2019 were obtained from the Office for National Statistics/Public Health England. Average annual incidence rates were calculated by two age categories (0-49, 50+ years) and all ages combined during the seven five-year time periods (1985-89 to 2015-19). The percentage change in incidence was calculated as change in the average annual incidence rate from the first  to the last time period .

Conclusions:
There has been a steady and substantial increase in the incidence of thyroid cancer in England over the past four decades. The largest increase in incidence was observed in young people aged 0-49 years. Some of this increase is due to enhanced surveillance and sensitive diagnostic methods, but other factors (e.g., obesity and history of benign thyroid conditions) need to be considered.

Key messages:
The unexpected substantial increase in the incidence of thyroid cancer in young people aged 0-49 years needs further investigation. It is important to determine what proportion of the cases are due to enhanced surveillance and what proportion are due to environmental exposures.
worldwide research on healthy ageing. The aim of the analysis was to assess the relation between ATHLOS Healthy Ageing Scale and all-cause mortality in Central European populations.

Methods:
Participants of the Polish and Czech HAPIEE cohorts (baseline age 45-69 years) were followed for 14 years. ATHLOS Healthy Ageing Scale was based on over 40 health indicators related to intrinsic capacity and functional ability. Cox proportional hazards models were used to determine the relationship between the ATHLOS Healthy Ageing Scale scores and allcause mortality.
Results: As many as 9,922 Polish and 8,518 Czech participants had non-missing data on the ATHLOS Healthy Ageing Scale score and mortality (1828 and 1700 deaths, respectively). After adjustment for age, dose-response associations with mortality in both genders and countries were found (HR for lowest vs. highest quintile of the ATHLOS Healthy Ageing Scale: 2.98 and 1.96 in Czech and Polish women and 2.83 and 2.66 in Czech and Polish men, respectively). Only modest attenuation was observed when additionally adjusted for education, economic activity, smoking and self-rated health.

Conclusions:
The ATHLOS Healthy Ageing Scale was found to be a good predictor of all-cause mortality in urban populations of Poland and Czechia. This composite indicator seems to be an important contributor to a better assessment of healthy ageing. Key messages: Independent inverse associations between ATHLOS Healthy Ageing Scale and all-cause mortality were found in both men and women in urban population samples from Central and Eastern Europe. Given its predictive validity for all-cause mortality, this novel tool may substantially contribute to a better assessment of healthy ageing.

Background:
Early detection of cognitive impairment can slow progression to dementia when using appropriate therapy. For early detection of dementia dual task combining cognitive tasks and walking might be suitable, since individuals with cognitive impairment have shown greater changes in gait specific parameters on dual task test (DT) compared to single task test (ST). This study investigates whether these changes correlate with poorer cognitive function in healthy older adults.

Methods:
In a cross-sectional study 174 healthy adults (66,48AE4,26years; 40%female) completed the Cognitive Functions Dementia Test (CFD), with a lower CFD index indicating lower cognitive function. Participants performed ST (walking 20m) and DT (walking 20m & counting backwards), in which step frequency, stride length and gait speed were monitored by Pablo sensors. Cognitive cost (CC) was determined for each gait variable. CC represents a change score between SD & DT and quantifies cognitive demands, with higher CC indicating poorer cognitive function. Pearson correlations and stepwise linear regression adjusted for age and gender were applied to analyze the association between CFD Index (dependent variable) and CC gate variables (predictors) (a = 5%).

Conclusions:
Changes in gait speed might be sensitive enough to indicate differences of cognitive performance among older individuals. Therefore, DT could be included in screening procedures as alert for potential cognitive decline. Key messages: Changes in gait speed might be sensitive enough to indicate differences of cognitive performance among older individuals. DT is sensitive to distinguish different cognitive performance in healthy elderly with potential for early detection of mild cognitive impairments.