Skip to main content
Erschienen in: The journal of nutrition, health & aging 9/2019

13.09.2019

Factors Influencing Longitudinal Stair Climb Performance from Midlife to Early Late Life: The Study of Women’s Health Across the Nation Chicago and Michigan Sites

verfasst von: Brittney S. Lange-Maia, C. A. Karvonen-Gutierrez, E. S. Strotmeyer, E. F. Avery, B. M. Appelhans, S. L. Fitzpatrick, I. Janssen, S. A. Dugan, H. M. Kravitz

Erschienen in: The journal of nutrition, health & aging | Ausgabe 9/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To quantify the longitudinal change in stair climb performance (a measure indicative of both physical function and muscle power), determine whether physical activity is related to slower decline in performance, and to identify factors that modify the longitudinal change in performance among women from midlife to late life.

Design

Longitudinal cohort study with up to 15 study visits.

Setting

Two sites of the Study of Women’s Health Across the Nation.

Participants

Black (n=411) and white (N=419) women followed from median age 47.0 (44.6–49.6) to 62.0 (55.8–65.3) years.

Interventions

N/A.

Measurements

Performance on a stair climb test (ascend/descend 4 steps, 3 cycles) was timed. Physical activity (PA) was assessed using the Kaiser Physical Activity Survey (KPAS; possible range 0–15 points). Sociodemographic and health factors were assessed via self-report. BMI was calculated with measured height and weight. Mixed-effects regression modeled longitudinal change in stair climb performance.

Results

Average baseline stair climb time was 18.12 seconds (95% CI: 17.83–18.41), with 0.98% (95% CI: 0.84%–1.11%) annual slowing. In fully adjusted models, higher levels of PA were associated with faster stair climb times (2.09% faster per point higher, 95% CI: −2.87%–1.30%), and black women had 5.22% (95% CI: 2.43%–8.01%) slower performance compared to white women. Smoking, financial strain, diabetes, osteoarthritis, fair/poor health, and stroke were associated with 3.36% (95% CI: 0.07%–6.65%), 7.56% (95% CI: 4.75%–10.37%), 8.40% (95% CI: 2.89%–13.92%), 8.46% (95% CI: 5.12%–11.79%), 9.16% (95% CI: 4.72%–13.60%), and 16.94% (95% CI: 5.37%–28.51%) slower performance, respectively. In separate models, higher BMI (per 1-unit), osteoarthritis, fair/poor health, and diabetes, were each associated with 0.06% (95% CI:0.04%–0.08%), 0.48% (95% CI:0.12%–0.84%), 0.81% (95% CI:0.35%–1.28%), and 0.84% (95% CI:0.22%–1.46%), additional slowing per year over time.

Conclusion

Significant declines in function were evident as women transitioned from midlife to early late life. Declines were amplified by indicators of poor health, emphasizing the importance of health in midlife for promoting healthy aging.
Literatur
2.
Zurück zum Zitat Tseng LA, El Khoudary SR, Young EZ, et al. The association of menopause status with physical function: The study of women’s health across the nation. Menopause. 2012;19(11):1186–1192.PubMedPubMedCentralCrossRef Tseng LA, El Khoudary SR, Young EZ, et al. The association of menopause status with physical function: The study of women’s health across the nation. Menopause. 2012;19(11):1186–1192.PubMedPubMedCentralCrossRef
3.
Zurück zum Zitat Avis NE, Colvin A, Bromberger JT, et al. Change in health-related quality of life over the menopausal transition in a multiethnic cohort of middle-aged women: Study of Women’s Health Across the Nation. Menopause. 2009;16(5):860–869.PubMedPubMedCentralCrossRef Avis NE, Colvin A, Bromberger JT, et al. Change in health-related quality of life over the menopausal transition in a multiethnic cohort of middle-aged women: Study of Women’s Health Across the Nation. Menopause. 2009;16(5):860–869.PubMedPubMedCentralCrossRef
4.
Zurück zum Zitat El Khoudary SR, McClure CK, VoPham T, et al. Longitudinal assessment of the menopausal transition, endogenous sex hormones, and perception of physical functioning: The Study of Women’s Health across the Nation. J Gerontol A Biol Sci Med Sci. 2014;69(8):1011–1017.PubMedPubMedCentralCrossRef El Khoudary SR, McClure CK, VoPham T, et al. Longitudinal assessment of the menopausal transition, endogenous sex hormones, and perception of physical functioning: The Study of Women’s Health across the Nation. J Gerontol A Biol Sci Med Sci. 2014;69(8):1011–1017.PubMedPubMedCentralCrossRef
5.
Zurück zum Zitat Sowers M, Pope S, Welch G, Sternfeld B, Albrecht G. The association of menopause and physical functioning in women at midlife. J Am Geriatr Soc. 2001;49(11):1485–1492.PubMedCrossRef Sowers M, Pope S, Welch G, Sternfeld B, Albrecht G. The association of menopause and physical functioning in women at midlife. J Am Geriatr Soc. 2001;49(11):1485–1492.PubMedCrossRef
6.
Zurück zum Zitat Ylitalo KR, Herman WH, Harlow SD. Performance-based physical functioning and peripheral neruopathy in a population-based cohort of women at midlife. Am J Epidemiol. 2013;177(8):810–817.PubMedPubMedCentralCrossRef Ylitalo KR, Herman WH, Harlow SD. Performance-based physical functioning and peripheral neruopathy in a population-based cohort of women at midlife. Am J Epidemiol. 2013;177(8):810–817.PubMedPubMedCentralCrossRef
7.
Zurück zum Zitat Sowers M, Jannausch ML, Gross M, et al. Performance-based physical functioning in African-American and Caucasian Women at Midlife: Considering body composition, quadriceps strength, and knee osteoarthritis. Am J Epidemiol. 2006;163(10):950–958.PubMedCrossRef Sowers M, Jannausch ML, Gross M, et al. Performance-based physical functioning in African-American and Caucasian Women at Midlife: Considering body composition, quadriceps strength, and knee osteoarthritis. Am J Epidemiol. 2006;163(10):950–958.PubMedCrossRef
8.
Zurück zum Zitat Tomey K, Sowers MF, Harlow SD, Jannausch M, Zheng H, Bromberger J. Physical functioning among mid-life women: Associations with trajectory of depressive symptoms. Social Science & Medicine. 2010;71(2010):1259–1267.CrossRef Tomey K, Sowers MF, Harlow SD, Jannausch M, Zheng H, Bromberger J. Physical functioning among mid-life women: Associations with trajectory of depressive symptoms. Social Science & Medicine. 2010;71(2010):1259–1267.CrossRef
9.
Zurück zum Zitat Ylitalo KR, Karvonen-Gutierrez CA, Fitzgerald N, et al. Relationship of race-ethnicity, body mass index, and economic strain with longitudinal self-report of physical functioning: The Study of Women’s Health Across the Nation. Ann Epidemiol. 2013;23(7):401–408.PubMedPubMedCentralCrossRef Ylitalo KR, Karvonen-Gutierrez CA, Fitzgerald N, et al. Relationship of race-ethnicity, body mass index, and economic strain with longitudinal self-report of physical functioning: The Study of Women’s Health Across the Nation. Ann Epidemiol. 2013;23(7):401–408.PubMedPubMedCentralCrossRef
10.
Zurück zum Zitat Kirkness CS, Ren J. Race differences: Use of walking speed to identify community-dwelling women at risk for poor health outcomes—Osteoarthritis Initiative Study. Phys Ther. 2015;95(7):955–965.PubMedPubMedCentralCrossRef Kirkness CS, Ren J. Race differences: Use of walking speed to identify community-dwelling women at risk for poor health outcomes—Osteoarthritis Initiative Study. Phys Ther. 2015;95(7):955–965.PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat Colbert CJ, Almagor O, Chmiel JS, et al. Excess body weight and four-year function outcomes: Comparison of African Americans and whites in a prospective study of osteoarthritis. Arthritis Care Res (Hoboken). 2013;65(1):5–14.CrossRef Colbert CJ, Almagor O, Chmiel JS, et al. Excess body weight and four-year function outcomes: Comparison of African Americans and whites in a prospective study of osteoarthritis. Arthritis Care Res (Hoboken). 2013;65(1):5–14.CrossRef
13.
Zurück zum Zitat Sternfeld B, Colvin A, Stewart A, et al. The effect of a healthy lifestyle on future physical functioning in midlife women. Med Sci Sports Exerc. 2017;49(2):274–282.PubMedPubMedCentralCrossRef Sternfeld B, Colvin A, Stewart A, et al. The effect of a healthy lifestyle on future physical functioning in midlife women. Med Sci Sports Exerc. 2017;49(2):274–282.PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Dugan SA, Everson-Rose SA, Karavolos K, Sternfeld B, Wesley D, Powell LH. The impact of physical activity level on SF-36 role-physical and bodily pain indices in midlife women. J Phys Act Health. 2009;6(1):33–42.PubMedPubMedCentralCrossRef Dugan SA, Everson-Rose SA, Karavolos K, Sternfeld B, Wesley D, Powell LH. The impact of physical activity level on SF-36 role-physical and bodily pain indices in midlife women. J Phys Act Health. 2009;6(1):33–42.PubMedPubMedCentralCrossRef
15.
Zurück zum Zitat Pettee Gabriel K, Sternfeld B, Colvin A, et al. Physical activity trajectories during midlife and subsequent risk of physical functioning decline in late mid-life: The Study of Women’s Health across the Nation (SWAN). Prev Med. 2017;105:287–294.PubMedCrossRef Pettee Gabriel K, Sternfeld B, Colvin A, et al. Physical activity trajectories during midlife and subsequent risk of physical functioning decline in late mid-life: The Study of Women’s Health across the Nation (SWAN). Prev Med. 2017;105:287–294.PubMedCrossRef
16.
Zurück zum Zitat Adams PF, Marano MA. Current estimates from the National Health Interview Survey, 1994. Vital Health Stat 10. 1995;(193 Pt 1)(193 Pt 1):1–260. Adams PF, Marano MA. Current estimates from the National Health Interview Survey, 1994. Vital Health Stat 10. 1995;(193 Pt 1)(193 Pt 1):1–260.
17.
Zurück zum Zitat Wittink H, Rogers W, Sukiennik A, Carr DB. Physical functioning: Self-report and performance measures are related but distinct. Spine (Phila Pa 1976). 2003;28(20):2407–2413.CrossRef Wittink H, Rogers W, Sukiennik A, Carr DB. Physical functioning: Self-report and performance measures are related but distinct. Spine (Phila Pa 1976). 2003;28(20):2407–2413.CrossRef
18.
Zurück zum Zitat Bean JF, Olveczky DD, Kiely DK, LaRose SI, Jette AM. Performance-based versus patient-reported physical function: What are the underlying predictors? Phys Ther. 2011;91(12):1804–1811.PubMedPubMedCentralCrossRef Bean JF, Olveczky DD, Kiely DK, LaRose SI, Jette AM. Performance-based versus patient-reported physical function: What are the underlying predictors? Phys Ther. 2011;91(12):1804–1811.PubMedPubMedCentralCrossRef
19.
Zurück zum Zitat Guralnik JM, Branch LG, Cummings SR, Curb JD. Physical performance measures in aging research. J Gerontol. 1989;44(5):M141–6.PubMedCrossRef Guralnik JM, Branch LG, Cummings SR, Curb JD. Physical performance measures in aging research. J Gerontol. 1989;44(5):M141–6.PubMedCrossRef
20.
Zurück zum Zitat Cress ME, Schechtman KB, Mulrow CD, Fiatarone MA, Gerety MB, Buchner DM. Relationship between physical performance and self-perceived physical function. J Am Geriatr Soc. 1995;43(2):93–101.PubMedCrossRef Cress ME, Schechtman KB, Mulrow CD, Fiatarone MA, Gerety MB, Buchner DM. Relationship between physical performance and self-perceived physical function. J Am Geriatr Soc. 1995;43(2):93–101.PubMedCrossRef
21.
Zurück zum Zitat Oh-Park M, Wang C, Verghese J. Stair negotiation time in community-dwelling older adults: Normative values and association with functional decline. Arch Phys Med Rehabil. 2011;92(12):2006–2011.PubMedPubMedCentralCrossRef Oh-Park M, Wang C, Verghese J. Stair negotiation time in community-dwelling older adults: Normative values and association with functional decline. Arch Phys Med Rehabil. 2011;92(12):2006–2011.PubMedPubMedCentralCrossRef
22.
Zurück zum Zitat Bendayan R, Cooper R, Wloch EG, Hofer SM, Piccinin AM, Muniz-Terrera G. Hierarchy and speed of loss in physical functioning: A comparison across older U.S. and English men and women. J Gerontol A Biol Sci Med Sci. 2017;72(8):1117–1122.PubMed Bendayan R, Cooper R, Wloch EG, Hofer SM, Piccinin AM, Muniz-Terrera G. Hierarchy and speed of loss in physical functioning: A comparison across older U.S. and English men and women. J Gerontol A Biol Sci Med Sci. 2017;72(8):1117–1122.PubMed
23.
Zurück zum Zitat Chen HY, Wang CY, Lee MY, Tang PF, Chu YH, Suen MW. A hierarchical categorisation of tasks in mobility disability. Disabil Rehabil. 2010;32(19):1586–1593.PubMedCrossRef Chen HY, Wang CY, Lee MY, Tang PF, Chu YH, Suen MW. A hierarchical categorisation of tasks in mobility disability. Disabil Rehabil. 2010;32(19):1586–1593.PubMedCrossRef
24.
Zurück zum Zitat Weiss CO, Fried LP, Bandeen-Roche K. Exploring the hierarchy of mobility performance in high-functioning older women. J Gerontol A Biol Sci Med Sci. 2007;62(2):167–173.PubMedPubMedCentralCrossRef Weiss CO, Fried LP, Bandeen-Roche K. Exploring the hierarchy of mobility performance in high-functioning older women. J Gerontol A Biol Sci Med Sci. 2007;62(2):167–173.PubMedPubMedCentralCrossRef
25.
Zurück zum Zitat Sowers MF, Crawford SL, Sternfeld B, Morganstein D, Gold EB, Greendale GA. SWAN: A multi-center, multi-ethnic, community-based cohort study of women and the menopausal transition. In: Lobo RA, Kelsey J, Marcus R, eds. Menopause: Biology and pathobiology. San Diego, CA: Academic Press; 2000:175–188.CrossRef Sowers MF, Crawford SL, Sternfeld B, Morganstein D, Gold EB, Greendale GA. SWAN: A multi-center, multi-ethnic, community-based cohort study of women and the menopausal transition. In: Lobo RA, Kelsey J, Marcus R, eds. Menopause: Biology and pathobiology. San Diego, CA: Academic Press; 2000:175–188.CrossRef
26.
Zurück zum Zitat Kurina LM, Gulati M, Everson-Rose SA, et al. The effect of menopause on grip and pinch strength: results from the Chicago, Illinois, site of the Study of Women’s Health across the Nation. Am J Epidemiol. 2004;160:484–491.PubMedCrossRef Kurina LM, Gulati M, Everson-Rose SA, et al. The effect of menopause on grip and pinch strength: results from the Chicago, Illinois, site of the Study of Women’s Health across the Nation. Am J Epidemiol. 2004;160:484–491.PubMedCrossRef
27.
Zurück zum Zitat Sternfeld B, Ainsworth BE, Quesenberry CP. Physical activity patterns in a diverse population of women. Prev Med. 1999;28(3):313–323.PubMedCrossRef Sternfeld B, Ainsworth BE, Quesenberry CP. Physical activity patterns in a diverse population of women. Prev Med. 1999;28(3):313–323.PubMedCrossRef
28.
Zurück zum Zitat Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982;36(5):936–42.PubMedCrossRef Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982;36(5):936–42.PubMedCrossRef
29.
Zurück zum Zitat Radloff L. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.CrossRef Radloff L. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.CrossRef
30.
Zurück zum Zitat Boyd JH, Weissman MM, Thompson WD, Myers JK. Screening for depression in a community sample. understanding the discrepancies between depression symptom and diagnostic scales. Arch Gen Psychiatry. 1982;39(10):1195–1200.PubMedCrossRef Boyd JH, Weissman MM, Thompson WD, Myers JK. Screening for depression in a community sample. understanding the discrepancies between depression symptom and diagnostic scales. Arch Gen Psychiatry. 1982;39(10):1195–1200.PubMedCrossRef
31.
Zurück zum Zitat Mendes de Leon CF, Beckett LA, Fillenbaum GG, et al. Black-white differences in risk of becoming disabled and recovering from disability in old age: A longitudinal analysis of two EPESE populations. Am J Epidemiol. 1997;145(6):488–497.PubMedCrossRef Mendes de Leon CF, Beckett LA, Fillenbaum GG, et al. Black-white differences in risk of becoming disabled and recovering from disability in old age: A longitudinal analysis of two EPESE populations. Am J Epidemiol. 1997;145(6):488–497.PubMedCrossRef
32.
Zurück zum Zitat Mendes de Leon CF, Barnes LL, Bienias JL, Skarupski KA, Evans DA. Racial disparities in disability: Recent evidence from self-reported and performance-based disability measures in a population-based study of older adults. J Gerontol B Psychol Sci Soc Sci. 2005;60(5):S263–71.PubMedCrossRef Mendes de Leon CF, Barnes LL, Bienias JL, Skarupski KA, Evans DA. Racial disparities in disability: Recent evidence from self-reported and performance-based disability measures in a population-based study of older adults. J Gerontol B Psychol Sci Soc Sci. 2005;60(5):S263–71.PubMedCrossRef
33.
Zurück zum Zitat Thorpe RJ,Jr, Koster A, Kritchevsky SB, et al. Race, socioeconomic resources, and late life mobility and decline: Findings from the Health, Aging, and Body Composition Study. J Gerontol A Biol Sci Med Sci. 2011;66(10):1114–1123.PubMedCrossRef Thorpe RJ,Jr, Koster A, Kritchevsky SB, et al. Race, socioeconomic resources, and late life mobility and decline: Findings from the Health, Aging, and Body Composition Study. J Gerontol A Biol Sci Med Sci. 2011;66(10):1114–1123.PubMedCrossRef
34.
Zurück zum Zitat Thorpe RJ,Jr, Kasper JD, Szanton SL, Frick KD, Fried LP, Simonsick EM. Relationship of race and poverty to lower extremity function and decline: Findings from the Women’s Health and Aging Study. Soc Sci Med. 2008;66(4):811–821.PubMedCrossRef Thorpe RJ,Jr, Kasper JD, Szanton SL, Frick KD, Fried LP, Simonsick EM. Relationship of race and poverty to lower extremity function and decline: Findings from the Women’s Health and Aging Study. Soc Sci Med. 2008;66(4):811–821.PubMedCrossRef
35.
Zurück zum Zitat Lange-Maia B, Strotmeyer E, Harris T, et al. Physical activity and change in long distance corridor walk performance in the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2015;63(7):1348–54.PubMedPubMedCentralCrossRef Lange-Maia B, Strotmeyer E, Harris T, et al. Physical activity and change in long distance corridor walk performance in the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2015;63(7):1348–54.PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Fleg J, Morrell C, Bos A, et al. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112:674–682.PubMedCrossRef Fleg J, Morrell C, Bos A, et al. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112:674–682.PubMedCrossRef
37.
Zurück zum Zitat Chiu CJ, Wray LA. Physical disability trajectories in older Americans with and without diabetes: The role of age, gender, race or ethnicity, and education. Gerontologist. 2011;51(1):51–63.PubMedCrossRef Chiu CJ, Wray LA. Physical disability trajectories in older Americans with and without diabetes: The role of age, gender, race or ethnicity, and education. Gerontologist. 2011;51(1):51–63.PubMedCrossRef
38.
Zurück zum Zitat Houston DK, Ding J, Nicklas BJ, et al. Overweight and obesity over the adult life course and incident mobility limitation in older adults: The Health, Aging and Body Composition Study. Am J Epidemiol. 2009;169(8):927–936.PubMedPubMedCentralCrossRef Houston DK, Ding J, Nicklas BJ, et al. Overweight and obesity over the adult life course and incident mobility limitation in older adults: The Health, Aging and Body Composition Study. Am J Epidemiol. 2009;169(8):927–936.PubMedPubMedCentralCrossRef
39.
Zurück zum Zitat Nightingale EJ, Pourkazemi F, Hiller CE. Systematic review of timed stair tests. J Rehabil Res Dev. 2014;51(3):335–350.PubMedCrossRef Nightingale EJ, Pourkazemi F, Hiller CE. Systematic review of timed stair tests. J Rehabil Res Dev. 2014;51(3):335–350.PubMedCrossRef
40.
Zurück zum Zitat Oh-Park M, Perera S, Verghese J. Clinically meaningful change in stair negotiation performance in older adults. Gait Posture. 2012;36(3):532–536.PubMedPubMedCentralCrossRef Oh-Park M, Perera S, Verghese J. Clinically meaningful change in stair negotiation performance in older adults. Gait Posture. 2012;36(3):532–536.PubMedPubMedCentralCrossRef
41.
Zurück zum Zitat Bean JF, Kiely DK, LaRose S, Alian J, Frontera WR. Is stair climb power a clinically relevant measure of leg power impairments in at-risk older adults? Arch Phys Med Rehabil. 2007;88(5):604–9.PubMedCrossRef Bean JF, Kiely DK, LaRose S, Alian J, Frontera WR. Is stair climb power a clinically relevant measure of leg power impairments in at-risk older adults? Arch Phys Med Rehabil. 2007;88(5):604–9.PubMedCrossRef
42.
Zurück zum Zitat Ni M, Brown LG, Lawler D, Bean JF. Reliability, validity, and minimal detectable change of four-step stair climb power test in community-dwelling older adults. Phys Ther. 2017;97(7):767–773.PubMedPubMedCentralCrossRef Ni M, Brown LG, Lawler D, Bean JF. Reliability, validity, and minimal detectable change of four-step stair climb power test in community-dwelling older adults. Phys Ther. 2017;97(7):767–773.PubMedPubMedCentralCrossRef
43.
Zurück zum Zitat Silva AG, Queiros A, Cerqueira M, Rocha NP. Pain intensity is associated with both performance-based disability and self-reported disability in a sample of older adults attending primary health care centers. Disabil Health J. 2014;7(4):457–465.PubMedCrossRef Silva AG, Queiros A, Cerqueira M, Rocha NP. Pain intensity is associated with both performance-based disability and self-reported disability in a sample of older adults attending primary health care centers. Disabil Health J. 2014;7(4):457–465.PubMedCrossRef
44.
Zurück zum Zitat Scudds RJ, Østbye T. Pain and pain-related interference with function in older Canadians: The Canadian Study of Health and Aging. Disabil Rehabil. 2001;23(15):654–664.PubMedCrossRef Scudds RJ, Østbye T. Pain and pain-related interference with function in older Canadians: The Canadian Study of Health and Aging. Disabil Rehabil. 2001;23(15):654–664.PubMedCrossRef
45.
Zurück zum Zitat Weiner DK, Haggerty CL, Kritchevsky SB, et al. How does low back pain impact physical function in independent, well-functioning older adults? Evidence from the Health ABC cohort and implications for the future. Pain Med. 2003;4(4):311–320.PubMedCrossRef Weiner DK, Haggerty CL, Kritchevsky SB, et al. How does low back pain impact physical function in independent, well-functioning older adults? Evidence from the Health ABC cohort and implications for the future. Pain Med. 2003;4(4):311–320.PubMedCrossRef
Metadaten
Titel
Factors Influencing Longitudinal Stair Climb Performance from Midlife to Early Late Life: The Study of Women’s Health Across the Nation Chicago and Michigan Sites
verfasst von
Brittney S. Lange-Maia
C. A. Karvonen-Gutierrez
E. S. Strotmeyer
E. F. Avery
B. M. Appelhans
S. L. Fitzpatrick
I. Janssen
S. A. Dugan
H. M. Kravitz
Publikationsdatum
13.09.2019
Verlag
Springer Paris
Erschienen in
The journal of nutrition, health & aging / Ausgabe 9/2019
Print ISSN: 1279-7707
Elektronische ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-019-1254-2

Weitere Artikel der Ausgabe 9/2019

The journal of nutrition, health & aging 9/2019 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.