In the wake of the Scandinavian Simvastatin Survival Study trial.

Purpose Of Review: In 1994, the 4S trial was revolutionary by showing that cholesterol lowering with simvastatin reduced, not only atherosclerotic vascular disease (ASCVD) events, but also all-cause mortality as compared to placebo. During the following 30 years, statins have proved to be well tolerated and effective and also paved way for new innovations in the field of dyslipidaemia therapy.

Recent Findings: The aim of this review is to summarize current knowledge about statins and effects of cholesterol-lowering accumulated in the wake of 4S trial: both vascular and nonvascular benefits, adverse effects, adherence, and statin intolerance.

Weight Loss in Midlife, Chronic Disease Incidence, and All-Cause Mortality During Extended Follow-Up.

Importance: Few studies have examined long-term health benefits among individuals with sustained weight loss beyond its association with decreased diabetes risk.

Objective: To examine the long-term association of body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) changes during healthy midlife (ages 40-50 years) with later-life morbidity and mortality.

Design, Setting, And Participants: This cohort study analyzed data from 3 cohorts that included repeated height and weight measurements: the Whitehall II study (WHII; baseline, 1985-1988), Helsinki Businessmen Study (HBS; baseline, 1964-1973), and Finnish Public Sector study (FPS; baseline, 2000).

Changes in prevalence of loneliness among home-dwelling older adults over three decades and associated factors.

Background: Studies examining loneliness trends over several decades among comparable cohorts of older people are rare.

Objective: We evaluated how the prevalence of self-reported loneliness has changed over three decades among home-dwelling older people (75+ years), and factors associated with loneliness.

Methods: We used data from four waves of the Helsinki Aging Study (1989-present), a repeated cross-sectional cohort study.

Drugs for dyslipidaemia: the legacy effect of the Scandinavian Simvastatin Survival Study (4S).

Since the discovery of statins and the Scandinavian Simvastatin Survival Study (4S) results three decades ago, remarkable advances have been made in the treatment of dyslipidaemia, a major risk factor for atherosclerotic cardiovascular disease. Safe and effective statins remain the cornerstone of therapeutic approach for this indication, including for children with genetic dyslipidaemia, and are one of the most widely prescribed drugs in the world. However, despite the affordability of generic statins, they remain underutilised worldwide.

Heart-healthy diets including phytostanol ester consumption to reduce the risk of atherosclerotic cardiovascular diseases. A clinical review.

The risk of atherosclerotic cardiovascular diseases (ASCVDs) can be reduced by lowering low-density lipoprotein cholesterol (LDL-C) concentrations. Nevertheless, ASCVDs still cause most deaths worldwide. Here, we discuss the prevention of ASCVD and the event risk with a focus on heart-healthy diets, i.

Comparing Loneliness, Social Inactivity, and Social Isolation: Associations with Health-Related Quality of Life and Mortality among Home-Dwelling Older Adults.

Introduction: Loneliness, social inactivity, and social isolation are intertwined concepts. When assessed separately, they indicate poor well-being, adverse health effects, and increased mortality. Studies exploring overlapping and comparing the prognosis of these concepts are scarce.

Secular trends in frailty among community-dwelling 75-95-year-old cohorts over three decades in Helsinki, Finland.

Background: Frailty Index (FI) reflects health, functioning and well-being of older people. It is valuable to compare how frailty has changed over time in ageing cohorts. This study aims to examine trends in frailty among 75-95-year-old men and women over three decades.

Sleep duration in midlife and old age and risk of mortality over a 48-year follow-up: The Helsinki businessmen study (HBS) cohort.

Objectives: Both short and long sleep duration have been associated with increased mortality, but there are few truly long-term studies.

Study Design: This is a cohort study of 2504 men born between 1919 and 1934. In 1974-1975 (mean age 48), participants underwent baseline clinical examinations and sleep duration assessments.

The shared ancestry between the C9orf72 hexanucleotide repeat expansion and intermediate-length alleles using haplotype sharing trees and HAPTK.

The C9orf72 hexanucleotide repeat expansion (HRE) is a common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). The inheritance is autosomal dominant, but a high proportion of subjects with the mutation are simplex cases. One possible explanation is de novo expansions of unstable intermediate-length alleles (IAs).

Midlife cardiovascular health factors as predictors of retirement age, work-loss years, and years spent in retirement among older businessmen.

Cardiovascular disease (CVD) is one of the leading causes of premature retirement. However, the relationship between CVD risk factors and workforce participation is not well known. We studied the relationship between midlife CVD risk, age at retirement, work-loss years, and survival in retirement.

High cholesterol absorption: A risk factor of atherosclerotic cardiovascular diseases?

Lowering elevated low-density lipoprotein cholesterol (LDL-C) concentrations reduces the risk of atherosclerotic cardiovascular diseases (ASCVDs). However, increasing evidence suggests that cholesterol metabolism may also be involved in the risk reduction of ASCVD events. In this review, we discuss if the different profiles of cholesterol metabolism, with a focus on high cholesterol absorption, are atherogenic, and what could be the possible mechanisms.

hexanucleotide repeat allele tagging SNPs: Associations with ALS risk and longevity.

hexanucleotide repeat expansion is a common cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). The locus may harbor residual risk outside the hexanucleotide repeat expansion, but the evidence is conflicting. Here, we first compared 683 unrelated amyotrophic lateral sclerosis cases and 3,196 controls with Finnish ancestry to find best single nucleotide polymorphisms that tag the hexanucleotide repeat expansion and intermediate-length alleles.

Management of Older Patients with Head and Neck Cancer: A Comprehensive Review.

The projected increase in life expectancy over the next few decades is expected to result in a rise in age-related diseases, including cancer. Head and neck cancer (HNC) is a worldwide health problem with high rates of morbidity and mortality. In this report, we have critically reviewed the literature reporting the management of older patients with HNC.

Determinants of a sense of insecurity among home-dwelling older people.

A sense of insecurity may have an impact on older people's well-being and their courage to engage actively in meaningful activities. Studies on a sense of insecurity among older people are scarce. The aim of this study was to determine the extent to which home-dwelling older adults perceive their life as being insecure and how a sense of insecurity is associated with their health, functional status, active social engagement, well-being and perceptions of the societal treatment of older people.

Temporal Trends Over Two Decades in the Use of Anticholinergic Drugs Among Older Community-Dwelling People in Helsinki, Finland.

Background: Knowledge of the adverse effects of drugs with anticholinergic properties (DAPs) has increased in recent decades. However, research on the temporal trends of the clinical use of DAPs is still sparse.

Objectives: The aim of this study was to investigate the temporal trends of DAP use over two decades in the older community-dwelling population and to explore the medication classes contributing to the use of DAPs.

Plasma ceramides independently predict all-cause mortality in men aged 85.

Background: assessing cardiovascular and mortality risk with conventional biomarkers is challenging in oldest-old due to multimorbidity and polypharmacy. Ceramides are bioactive lipids shown to predict mortality in late middle-aged cohorts.

Objective: to assess whether plasma ceramides have independent prognostic value for mortality among oldest-old (85+).

Benefits and limitations of statin use in primary cardiovascular prevention: recent advances.

The status of low‑density lipoprotein (LDL) cholesterol is strong as an essential cause of atherosclerotic vascular disease (ASCVD) and primary target of lipid lowering. Drugs affecting primarily LDL choles-terol through an increase of LDL receptor expression are the backbone of current therapy, and generic statins are generally safe, effective, and inexpensive drugs serving this purpose. Statins are indicated for practically all patients in secondary prevention, whereas treatment in primary prevention (healthy individuals) is based on a calculated 10‑year risk of ASCVD.

Clinical trials in older people.

Randomised controlled trials (RCTs) usually provide the best evidence for treatments and management. Historically, older people have often been excluded from clinical medication trials due to age, multimorbidity and disabilities. The situation is improving, but still the external validity of many trials may be questioned.

Retirement as a predictor of physical functioning trajectories among older businessmen.

Background: Associations between retirement characteristics and consequent physical functioning (PF) are poorly understood, particularly in higher socioeconomic groups, where postponing retirement has had both positive and negative implications for PF.

Methods: Multiple assessments of PF, the first of which at the mean age of 73.3 years, were performed on 1709 men who were retired business executives and managers, using the RAND-36/SF-36 instrument, between 2000 and 2010.