Introduction: The association between obesity and outcome in critical illness is unclear. Since the amount of visceral adipose tissue(VAT) rather than BMI mediates the health effects of obesity we aimed to investigate the association between visceral obesity, BMI and 90-day mortality in critically ill patients. Method: In 555 critically ill patients (68% male), the VAT Index(VATI) was measured using Computed Tomography scans on the level of vertebra L3. The association between visceral obesity, BMI and 90-day mortality was investigated using univariable and multivariable analyses, correcting for age, sex, APACHE II score, sarcopenia and muscle quality. Results: Visceral obesity was present in 48.1% of the patients and its prevalence was similar in males and females. Mortality was similar amongst patients with and without visceral obesity (27.7% vs 24.0%, p = 0.31). The corrected odds ratio of 90-day mortality for visceral obesity was 0.667 (95%CI 0.424–1.049, p = 0.080). Using normal BMI as reference, the corrected odds ratio for overweight was 0.721 (95%CI 0.447–1.164 p = 0.181) and for obesity 0.462 (95%CI 0.208–1.027, p = 0.058). Conclusion: No significant association of visceral obesity and BMI with 90-day mortality was observed in critically ill patients, although obesity and visceral obesity tended to be associated with improved 90-day mortality.
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Purpose: To investigate the prevalence of multidimensional frailty in older people with hypertension and to examine a possible relationship of general obesity and abdominal obesity to frailty in older people with hypertension. Patients and Methods: A sample of 995 community-dwelling older people with hypertension, aged 65 years and older and living in Zhengzhou (China), completed the Tilburg Frailty Indicator (TFI), a validated self-report questionnaire for assessing multidimensional frailty. In addition, socio-demographic and lifestyle characteristics were assessed by self-report, and obesity was determined by measuring waist circumference and calculating the body mass index. Results: The prevalence of multidimensional frailty in this older population with hypertension was 46.5%. Using multiple linear regression analysis, body mass index was significantly associated with physical frailty (p = 0.001), and waist circumference was significantly positively associated with multidimensional frailty and all three frailty domains. Older age was positively associated with multidimensional frailty, physical frailty, and psychological frailty, while gender (woman) was positively associated with multidimensional, psychological, and social frailty. Furthermore, comorbid diseases and being without a partner were positively associated with multidimensional, physical, psychological, and social frailty. Of the lifestyle characteristics, drinking alcohol was positively associated with frailty domains. Conclusion: Multidimensional frailty was highly prevalent among Chinese community-dwelling older people with hypertension. Abdominal obesity could be a concern in physical frailty, psychological frailty, and social frailty, while general obesity was concerning in relation to physical frailty.
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Obesity, especially morbid obesity, is a major health problem with considerable impact on physical, mental and social quality of life. Assessment of quality of life is considered crucial to understand and evaluate the consequences of obesity. Obesity has major consequences for quality of life, e.g., as a result of co-morbidities of obesity and weight stigmatization.Bariatric surgery has been proven to lead to significant weight loss and improvement of quality of life. Besides obesity, also personal and psychosocial variables influence quality of life and affect the outcome of surgery. Moreover, obesity, even after substantial weight loss by gastric bypass surgery, is a chronic disease requiring life long consideration, in order to sustain long standing quality of life improvement.
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An important line of research within the Center of Expertise HAN BioCentre is the development of the nematode Caenorhabditis elegans as an animal testing replacement organism. In the context of this, us and our partners in the research line Elegant! (project number. 2014-01-07PRO) developed reliable test protocols, data analysis strategies and new technology, to determine the expected effects of exposure to specific substances using C. elegans. Two types of effects to be investigated were envisaged, namely: i) testing of possible toxicity of substances to humans; and ii) testing for potential health promotion of substances for humans. An important deliverable was to show that the observed effects in the nematode can indeed be translated into effects in humans. With regard to this aspect, partner Preventimed has conducted research in obesity patients during the past year into the effect of a specific cherry extract that was selected as promising on the basis of the study with C. elegans. This research is currently being completed and a scientific publication will have to be written. The Top Up grant is intended to support the publication of the findings from Elegant! and also to help design experimental protocols that enable students to become acquainted with alternative medical testing systems to reduce the use of laboratory animals during laboratory training.
More and more aged people are joining the traffic, either using a passenger car or through a special low speed two-seater for in-city use. For elderly people, self-management in staying mobile is an essential part of their quality of life. However, with increased involvement of elderly in traffic, the risk of serious accidents increases, especially in cities. Fortunately, a rapid development of innovative technology is shown in vehicle design, with focus on advanced driver support, herewith referred to as ‘ambient intelligence’. This holds a promise to improve the safety situation, under the condition that adaption to the elderly driver’s need is accounted for. And that is not a straightforward issue, since ‘no size fits all’. With increasing age, we see an increased variety in driving skills with emphasis on cognitive, perceptual and physical limitations. In addition, people may suffer from diseases with a neurological background or other (cardiopulmonary disease, obesity or diabetes). The partners in this project have expressed the need to survey the feasibility of ‘ambient intelligence’ technology for low-speed vehicles also addressing E-Health functions to bring people safely home or involve medical help in case of health-critical situations. The MAX Mobiel make their vehicle available for that, and will help to guard the elder customer demand. The HAN Automotive Research team carries out the research, in cooperation with the HAN professorship on E-Health. Hence, both the automotive technology part of the HAN University of Applied Sciences as well as expertise from the Health oriented part of the HAN are included, being essential to successfully extend the relevant technologies to a fully integrated elderly driver support system, in the future. Noldus Information Technology is involved on the basis of their knowledge in human monitoring (drive lab) and data synchronization. The St. Maartenskliniek (Nijmegen) brings in their experience with people being restricted in physical or neurological sense.
Overgewicht en obesitas komen vaak voor bij mensen met een motorische beperking, vooral bij personen met een dwarslaesie (PmeDl), bij wie de prevalentie meer dan 75% bedraagt. Obesitas leidt tot cardiovasculaire aandoeningen, doorzitwonden, conditieverlies, en verminderde participatie en kwaliteit van leven bij PmeDI, en levert hierdoor veel druk op het zorgsysteem. Algemene kennis en richtlijnen zijn vaak niet toepasbaar op PmeDl. Er zijn specifieke oplossingen nodig om obesitas bij PmeDI te voorkomen en hun gezondheid en kwaliteit van leven te verbeteren. De reguliere revalidatiezorg is niet effectief in het voorkomen van overgewicht of obesitas bij mensen met een dwarslaesie, noch in het bereiken van significante gewichtsvermindering. Eerstelijnszorgverleners, die de zorg voortzetten zodra patiënten weer thuis zijn, hebben vaak niet de benodigde kennis om deze diverse groep met complexe gezondheidsproblemen op leefstijl te coachen. Daarom wordt in het huidige RAAK-publiek project VIVENDI een transmuraal leefstijlcoachingspad ontwikkeld voor PmeDl. Dit pad bevat de online en vergoede gecombineerde leefstijlinterventie (GLI) CooL-MiGuide, aangepast voor PmeDl met een verhoogd gezondheidsrisico, en uitgebreid met een trainingsprogramma. Voortbouwend hierop onderzoekt het voorgestelde RAAK-PRO project STOP-ObeSCIty de effectiviteit en kosteneffectiviteit van dit nieuwe leefstijlcoachingspad voor PmeDI. STOP-ObeSCIty zal worden uitgevoerd door Hogeschool Inholland, Erasmus MC en de Vrije Universiteit, in samenwerking met de Hogeschool van Amsterdam, vier revalidatiecentra, leefstijl- en obesitasexperts en de patiëntenorganisatie Dwarslaesie Organisatie Nederland. Het hoofddoel van STOP-ObeSCIty is het implementeren en evalueren van de online GLI CooL-MiGuide, toegespitst op de doelgroep en uitgebreid met een trainingsprogramma, om gewichtsmanagement bij PmeDl met een verhoogd gezondheidsrisico te verbeteren. Secundaire doelen zijn het evalueren van bredere effecten op gezondheid en welzijn, de kosteneffectiviteit, en het identificeren van succesfactoren. Tenslotte levert dit project ook een blauwdruk en een stappenplan op voor het op maat maken en implementeren van een online GLI voor andere revalidatiegroepen met een motorische beperking.
