BACKGROUND: This study investigates the association between frailty and mortality in Eastern European populations, which remains largely unexplored compared with Western Europe. The aim is to assess the risk of all-cause and cardiovascular mortality associated with varying levels of frailty. METHODS: A prospective multicentre cohort study was conducted, involving random population samples from the Czech Republic, Poland and Lithuania. The baseline survey (2002-2005) included 26 746 individuals aged 45-69 years, with an average follow-up of 13 years. Frailty was measured using a Comprehensive Geriatric Assessment (CGA)-based Frailty Index (FI), calculating the number of deficits in each domain. Cox proportional regression models and inverse probability weighting (IPW) were employed to account for risk factor differences among the frailty groups: robust, prefrail, mild, moderate and severe. RESULTS: The study included 14 287 people, among whom 891 were frail, with a total of 2402 deaths.Compared with non-frail persons, those with mild (IPW HR 2.06, 95% CI 1.60 to 2.66) and severe (IPW HR 2.71, 95% CI 1.45 to 5.07) frailty had more than twofold elevated risk of all-cause mortality. For cardiovascular mortality, the corresponding HRs were (IPW HR 3.05, 95% CI 2.14 to 4.35) and (IPW HR 3.88, 95% CI 1.95 to 7.74). Men exhibited a higher mortality risk at all frailty levels only in unweighted analysis. Country-specific differences were not significant. CONCLUSIONS: A CGA-based FI is an independent predictor of all-cause and cardiovascular mortality, with even mild frailty increasing the risk. Implementing frailty assessments can improve health risk prediction in older adults from Eastern Europe.

• Klíčová slova
• AGING, COHORT STUDIES, MORTALITY,
• MeSH
• geriatrické hodnocení * MeSH
• kardiovaskulární nemoci * mortalita   MeSH
• křehkost * mortalita   MeSH
• křehký senior * statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• příčina smrti MeSH
• proporcionální rizikové modely MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Litva epidemiologie   MeSH
• Polsko epidemiologie   MeSH
• východní Evropa epidemiologie   MeSH

OBJECTIVES: COVID-19 caused a global pandemic with millions of deaths. Fat mass and obesity-associated gene (FTO) (alias m6A RNA demethylase) and its functional rs17817449 polymorphism are candidates to influence COVID-19-associated mortality since methylation status of viral nucleic acids is an important factor influencing viral viability. METHODS: We tested a population-based cohort of 5233 subjects (aged 63-87 years in 2020) where 70 persons died from COVID-19 and 394 from other causes during the pandemic period. RESULTS: The frequency of GG homozygotes was higher among those who died from COVID-19 (34%) than among survivors (19%) or deaths from other causes (20%), P <0.005. After multiple adjustments, GG homozygotes had a higher risk of death from COVID-19 with odds ratio = 2.01 (95% confidence interval; 1.19-3.41, P <0.01) compared with carriers of at least one T allele. The FTO polymorphism was not associated with mortality from other causes. CONCLUSIONS: Our results suggest that FTO variability is a significant predictor of COVID-19-associated mortality in Caucasians.

• Klíčová slova
• COVID-19, FTO, Mortality, Polymorphism, SARS-CoV-2,
• MeSH
• alely MeSH
• COVID-19 * mortalita   genetika   virologie   MeSH
• gen pro FTO * genetika   MeSH
• genetická predispozice k nemoci MeSH
• jednonukleotidový polymorfismus * MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• SARS-CoV-2 fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• FTO protein, human MeSH Prohlížeč
• gen pro FTO * MeSH

AIMS: The 2021 European Society of Cardiology prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding initiation of prevention. We aimed to update and systematically recalibrate the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model to four European risk regions for the estimation of lifetime CVD risk for apparently healthy individuals. METHODS AND RESULTS: The updated LIFE-CVD (i.e. LIFE-CVD2) models were derived using individual participant data from 44 cohorts in 13 countries (687 135 individuals without established CVD, 30 939 CVD events in median 10.7 years of follow-up). LIFE-CVD2 uses sex-specific functions to estimate the lifetime risk of fatal and non-fatal CVD events with adjustment for the competing risk of non-CVD death and is systematically recalibrated to four distinct European risk regions. The updated models showed good discrimination in external validation among 1 657 707 individuals (61 311 CVD events) from eight additional European cohorts in seven countries, with a pooled C-index of 0.795 (95% confidence interval 0.767-0.822). Predicted and observed CVD event risks were well calibrated in population-wide electronic health records data in the UK (Clinical Practice Research Datalink) and the Netherlands (Extramural LUMC Academic Network). When using LIFE-CVD2 to estimate potential gain in CVD-free life expectancy from preventive therapy, projections varied by risk region reflecting important regional differences in absolute lifetime risk. For example, a 50-year-old smoking woman with a systolic blood pressure (SBP) of 140 mmHg was estimated to gain 0.9 years in the low-risk region vs. 1.6 years in the very high-risk region from lifelong 10 mmHg SBP reduction. The benefit of smoking cessation for this individual ranged from 3.6 years in the low-risk region to 4.8 years in the very high-risk region. CONCLUSION: By taking into account geographical differences in CVD incidence using contemporary representative data sources, the recalibrated LIFE-CVD2 model provides a more accurate tool for the prediction of lifetime risk and CVD-free life expectancy for individuals without previous CVD, facilitating shared decision-making for cardiovascular prevention as recommended by 2021 European guidelines.

The study introduces LIFE-CVD2, a new tool that helps predict the risk of heart disease over a person’s lifetime, and highlights how where you live in Europe can affect this risk.Using health information from over 687 000 people, LIFE-CVD2 looks at things like blood pressure and whether someone smokes to figure out their chance of having heart problems later in life. Health information from another 1.6 million people in seven different European countries was used to show that it did a good job of predicting who might develop heart disease.Knowing your heart disease risk over your whole life helps doctors give you the best advice to keep your heart healthy. Let us say there is a 50-year-old woman who smokes and has a bit high blood pressure. Right now, she might not look like she is in danger. But with the LIFE-CVD2 tool, doctors can show her how making changes today, like lowering her blood pressure or stopping smoking, could mean many more years without heart problems. These healthy changes can make a big difference over many years.

• Klíčová slova
• Cardiovascular disease, Lifetime, Prevention, Primary prevention, Risk prediction,
• MeSH
• časové faktory MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• kardiovaskulární nemoci * prevence a kontrola   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metody pro podporu rozhodování MeSH
• prognóza MeSH
• rizikové faktory kardiovaskulárních chorob * MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

AIMS: The Southern European Atlantic diet (SEAD) is the traditional dietary pattern of northwestern Spain and northern Portugal, but it may resemble that of central, eastern, and western European countries. The SEAD has been found associated with lower risk of myocardial infarction and mortality in older adults, but it is uncertain whether this association also exists in other European populations and if it is similar as that found in its countries of origin. METHODS AND RESULTS: We conducted a prospective analysis of four cohorts with 35 917 subjects aged 18-96 years: ENRICA (Spain), HAPIEE (Czechia and Poland), and Whitehall II (United Kingdom). The SEAD comprised fresh fish, cod, red meat and pork products, dairy, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and moderate wine consumption. Associations were adjusted for sociodemographic variables, energy intake, lifestyle, and morbidity. After a median follow-up of 13.6 years (range = 0-15), we recorded 4 973 all-cause, 1 581 cardiovascular, and 1 814 cancer deaths. Higher adherence to the SEAD was associated with lower mortality in the pooled sample. Fully adjusted hazard ratios and 95% confidence interval per 1-standard deviation increment in the SEAD were 0.92 (0.89, 0.95), 0.91 (0.86, 0.96), and 0.94 (0.89, 0.99) for all-cause, cardiovascular, and cancer mortality, respectively. The association of the SEAD with all-cause mortality was not significantly different between countries [Spain = 0.93 (0.88, 0.99), Czechia = 0.94 (0.89,0.99), Poland = 0.89 (0.85, 0.93), United Kingdom = 0.98 (0.89, 1.07); P for interaction = 0.16]. CONCLUSION: The SEAD was associated with lower all-cause, cardiovascular, and cancer mortality in southern, central, eastern, and western European populations. Associations were of similar magnitude as those found for existing healthy dietary patterns.

In this study of 35 917 subjects from southern, central, eastern, and western European countries, the Southern European Atlantic diet (traditional dietary pattern of northwestern Spain and northern Portugal) was associated with lower 13.6-year mortality from any cause, cardiovascular disease, and cancer. The associations of the Southern European Atlantic diet with lower mortality were not significantly different between countries (Spain, Czechia, Poland, and the United Kingdom). Study associations were similar as those found for existing healthy dietary patterns, suggesting that rather different diets could confer comparable benefits on health.

• Klíčová slova
• Alcohol, Coronary heart disease, Cox model, Death, Longitudinal, Mediterranean diet, Processed meat, Public health, Seafood, Stroke,
• MeSH
• dieta škodlivé účinky   MeSH
• infarkt myokardu * MeSH
• kardiovaskulární nemoci * diagnóza   MeSH
• lidé MeSH
• nádory * diagnóza   MeSH
• příčina smrti MeSH
• senioři MeSH
• zelenina MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Older age is associated with the deterioration of physical functioning (PF), and low PF is strongly related to poor quality of life among older people. We conducted a study to examine the trajectories of PF between middle and old age, considering sex differences as well as the association between socioeconomic status (SES) at different life stages and changes in PF. METHODS: We analyzed data from the Polish arm of the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study, including 1,116 men and 1,178 women aged 45-64 years at baseline. Adult and childhood SES and social mobility were assessed using a retrospectively focused questionnaire. PF was assessed using the 10-question SF-36 scale at baseline examination, face-to-face re-examination, and three postal surveys, covering up to 20 years (on average, 18 years). We employed Generalized Estimating Equations models to assess changes in PF scores over time and compare PF trajectories across different SES categories. RESULTS: After adjusting for age and other covariates, we found that, in both sexes, participants with always middle or high SES, as well as those who reported upward mobility, had higher PF scores at baseline compared to those with always low SES. A decline in PF between middle and old age was observed in all SES groups; however, the decline was slower in participants with always middle or high SES compared to those with always low SES. CONCLUSION: This cohort study revealed that lower SES and downward social mobility were cross-sectionally associated with poorer PF, while upward social mobility seemed to largely reverse the effect of low childhood SES. In addition to the cross-sectional associations observed at baseline, advantaged SES was also significantly associated with a slower decline in PF over an 18-year follow-up period.

• Klíčová slova
• aging, cohort study, physical functioning, social mobility, socioeconomic status,
• MeSH
• dítě MeSH
• dospělí MeSH
• kohortové studie MeSH
• kvalita života * MeSH
• lidé MeSH
• průřezové studie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• sociální mobilita * MeSH
• společenská třída MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

AIMS: Impaired lung function has been strongly associated with cardiovascular disease (CVD) events. We aimed to assess the additive prognostic value of spirometry indices to the risk estimation of CVD events in Eastern European populations in this study. METHODS: We randomly selected 14,061 individuals with a mean age of 59 ± 7.3 years without a previous history of cardiovascular and pulmonary diseases from population registers in the Czechia, Poland, and Lithuania. Predictive values of standardised Z-scores of forced expiratory volume measured in 1 s (FEV1), forced vital capacity (FVC), and FEV1 divided by height cubed (FEV1/ht3) were tested. Cox proportional hazards models were used to estimate hazard ratios (HRs) of CVD events of various spirometry indices over the Framingham Risk Score (FRS) model. The model performance was evaluated using Harrell's C-statistics, likelihood ratio tests, and Bayesian information criterion. RESULTS: All spirometry indices had a strong linear relation with the incidence of CVD events (HR ranged from 1.10 to 1.12 between indices). The model stratified by FEV1/ht3 tertiles had a stronger link with CVD events than FEV1 and FVC. The risk of CVD event for the lowest vs. highest FEV1/ht3 tertile among people with low FRS was higher (HR: 2.35; 95% confidence interval: 1.96-2.81) than among those with high FRS. The addition of spirometry indices showed a small but statistically significant improvement of the FRS model. CONCLUSIONS: The addition of spirometry indices might improve the prediction of incident CVD events particularly in the low-risk group. FEV1/ht3 is a more sensitive predictor compared to other spirometry indices.

• Klíčová slova
• cardiovascular disease, cohort studies, mortality, pulmonary function test, risk prediction model,
• Publikační typ
• časopisecké články MeSH

The Southern European Atlantic diet (SEAD) is the traditional dietary pattern of north-western Spain and northern Portugal, but it may resemble that of other European countries. The SEAD has been found associated with lower risk for myocardial infarction and mortality. Since dietary patterns may also influence mental health, we examined the association between the SEAD and depression risk in southern, central, eastern, and western European populations. We conducted a prospective analysis of five cohorts (13,297 participants aged 45-92 years, free of depression at baseline): Seniors-ENRICA-1 and Seniors-ENRICA-2 (Spain), HAPIEE (Czechia and Poland), and Whitehall-II (United Kingdom). The SEAD comprised cod, other fresh fish, red meat and pork products, dairy, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and moderate wine consumption. Depression at follow-up was defined according to presence of depressive symptoms (based on available scales), use of prescribed antidepressants, inpatient admissions, or self-reported diagnosis. Associations were adjusted for sociodemographic, lifestyle, and dietary variables. During a median follow-up of 3.9 years (interquartile range 3.4-4.9), there were 1437 new depression cases. Higher adherence to the SEAD was associated with lower depression risk in the pooled sample. Individual food groups showed a similar tendency, albeit non-significant. The fully adjusted odds ratio (95% confidence interval) per 1-standard deviation increment in the SEAD was 0.91 (0.86, 0.96). This association was rather consistent across countries [Spain = 0.86 (0.75, 0.99), Czechia = 0.86 (0.75, 0.99), Poland = 0.97 (0.89, 1.06), United Kingdom = 0.85 (0.75, 0.97); p for interaction = 0.24], and was of similar magnitude as that found for existing healthy dietary patterns. In conclusion, the SEAD was associated with lower depression risk across European populations. This may support the development of mood disorder guidelines for Southern European Atlantic regions based on their traditional diet, and for central, eastern, and western European populations based on the SEAD food groups that are culturally rooted in these places.

• MeSH
• deprese * epidemiologie   MeSH
• dieta MeSH
• lidé MeSH
• stravovací zvyklosti * MeSH
• zelenina MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Španělsko epidemiologie   MeSH

BACKGROUND: The ATHLOS consortium (Aging Trajectories of Health-Longitudinal Opportunities and Synergies) used data from several aging cohorts to develop a novel scale measuring healthy aging comprehensively and globally (ATHLOS Healthy Aging Scale). In the present study, we assessed the predictive performance of the ATHLOS Healthy Aging Scale for all-cause mortality in middle-aged and older adults. METHODS: Data from the Polish and Czech HAPIEE (Health Alcohol and Psychosocial factors In Eastern Europe) prospective cohorts were used. There were 10,728 Poles and 8,857 Czechs recruited. The ATHLOS Healthy Aging Scale score was calculated for all participants using data from the baseline examination carried out from 2002 to 2005. The follow-up for all-cause mortality was completed over 14 years. The associations between quintiles of the ATHLOS Healthy Aging Scale and all-cause mortality were estimated using Cox proportional hazards models. RESULTS: A total of 9,922 Polish and 8,518 Czech participants contributed ATHLOS Healthy Aging Scale and mortality data with 1,828 and 1,700 deaths, respectively. After controlling for age, the ATHLOS Healthy Aging Scale score was strongly associated with mortality in a graded fashion for both genders and countries (hazard ratios for lowest vs. highest quintile were 2.98 and 1.96 for Czech and Polish women and 2.83 and 2.66 for Czech and Polish men, respectively). The associations were only modestly attenuated by controlling for education, economic activity, and smoking, and there was further modest attenuation after additional adjustment for self-rated health. CONCLUSION: The novel ATHLOS Healthy Aging Scale is a good predictor of all-cause mortality in Central European urban populations, suggesting that this comprehensive measure is a useful tool for the assessment of the future health trajectories of older persons.

• Klíčová slova
• Central and Eastern Europe (CEE), aging, healthy aging, mortality, scale,
• MeSH
• lidé středního věku MeSH
• lidé MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• zdravé stárnutí * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Polsko epidemiologie   MeSH

Work stress has been extensively supported to predict health outcomes like health behaviors. Evidence has linked work stress and personality independently to health, but the interrelationships between work stress and personality and their joint effects on health might deserve more attention in research. This study attempts to integrate recent developments in psychological research (diverse roles of personality in stress processes) into the well-established Effort-Reward Imbalance (ERI) model for work stress. Based on the ERI model, this population-based cohort study aims to investigate the relationships between work stress, personality and alcohol consumption; it particularly focuses on potential roles of overcommitment (OC) personality in ERI-drinking relations, including modifying, antecedent, mediator or direct effects. This two-wave cohort study was conducted in population samples of 3782 men and 3731 women (aged 45-69 years) from Czech Republic, Poland and Russia. Alcohol consumption was assessed by three drinking outcomes: binge drinking, heavy drinking and problem drinking. To assess modifying effect of OC in ERI-drinking relations, logistic regression was used. To assess antecedent or mediator role of OC in ERI-drinking relations, path analysis with the autoregressive and cross-lagged model was conducted. The results showed that OC had no significantly modifying effect in ERI-drinking relations. OC and ERI might have bidirectional relationships in the average follow-up period of 3.5 years; the effect of OC on ERI was remarkably stronger than the reversed causation. Antecedent role of OC in ERI-drinking relationship was significant, but mediator role of OC was not. In conclusion, our findings imply that "antecedent role" of OC in ERI-drinking relations is significant and promising as a potential target for individual intervention; future interventions are suggested to identify and target potential cognitive-behavioral mechanisms via which personality might influence work stress and subsequently health behaviors.

• Klíčová slova
• Alcohol consumption, Drinking, ERI, Effort–Reward Imbalance, Effort–Reward Imbalance, OC, Overcommitment, Overcommitment, Personality, Work stress,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Numerous studies reported higher levels of mental health issues during the COVID-19 pandemic but only a minority used repeated measurements. We investigated change in depressive symptoms in the Czech ageing cohort and the impact of pre-existing and COVID-19-related stressors. METHODS: We used data on 2853 participants (mean age 73.4 years) from the Czech part of the prospective Health, Alcohol and Psychosocial factors In Eastern Europe cohort that participated in postal questionnaire surveys before (September 2017-June 2018) and during the pandemic (October 2020-April 2021). Participants reported their depressive symptoms using the Centre for Epidemiological Studies-Depression Scale including 10 (CESD-10) tool. A principal component analysis (PCA) was used to create representative components of the pandemic-related stressors. The impact of the stressors on change in depressive symptoms was tested using multivariable linear regression, after adjustment for age and potential confounders. RESULTS: Three patterns of the pandemic-related stressors ('financial stressors', 'social and perception stressors' and 'death and hospitalisation stressors') were extracted from the PCA. The mean CESD-10 score increased from 4.90 to 5.37 (p<0.001). In fully adjusted models, significantly larger increases in depression score were reported by older people (β=0.052; p=0.006), those with poor self-rated health (β=0.170; p<0.001), those who experienced death or hospitalisation of a close person (β=0.064; p<0.001), social deprivation (β=0.057; p<0.001), delays in healthcare (β=0.048; p=0.005) and those who suffered from COVID-19 (β=0.045; p=0.008). CONCLUSION: This study confirms an increase in depressive symptoms in older persons during the pandemic and identified several pandemic-related risk factors suggesting that public health policies should address this vulnerable group by adopting the preventing strategies.

• Klíčová slova
• COVID-19, aging, depression,
• MeSH
• COVID-19 * epidemiologie   MeSH
• deprese epidemiologie   MeSH
• kohortové studie MeSH
• lidé MeSH
• pandemie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH