Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 Hi : IMO they needed to differentiate between those who lost weight involuntarily, and those who lost weight only because they made strenuous efforts to do so. My bet is that had they made this distinction then they would have found that more than all the increased mortality in weight-losing men would have been among those who lost weight involuntarily, that is ......... while making no special effort to do so. I believe that any thoroughly healthy person will have a very healthy appetite that needs to be restrained in order to avoid weight gain. Anyone who loses weight without having to make a concerted effort, is, IMO, prima-facie, sick, by definition. It is this latter group that, I predict, contained the high mortality. A one year cut-off just doesn't handle this confounder. Jmo. Rodney. > " The relative risk (RR; 95% CI) for non-cancer mortality during > follow-up was higher in men with decreasing BMI in all subgroups: RR > 2.64 (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline > BMI 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(- 2)), > using BMI-stable men as reference group. " > > I wonder what is amiss here... > > The enigma of increased non-cancer mortality after weight loss in > healthy men who are overweight or obese. > > Nilsson PM, Nilsson JA, Hedblad B, Berglund G, Lindgarde F. > > Department of Internal Medicine, University Hospital, Malmo, Sweden. > peter.nilsson@m... > > OBJECTIVE: To study effects on non-cancer mortality of observational > weight loss in middle-aged men stratified for body mass index (BMI), > taking a wide range of possible confounders into account. DESIGN: > Prospective, population based study. SETTING: Male population of > Malmo, Sweden. PARTICIPANTS: In all 5722 men were screened twice with > a mean time interval of 6 years in Malmo, southern Sweden. They were > classified according to BMI category at baseline (<21, 22-25, > overweight: 26-30, and obesity: 30+ kg m(-2)) and weight change > category until second screening (weight stable men defined as having a > baseline BMI +/- 0.1 kg m(-2) year-1 at follow-up re-screening). MAIN > OUTCOME MEASURES: Non-cancer mortality calculated from national > registers during 16 years of follow-up after the second screening. > Data from the first year of follow-up were excluded to avoid bias by > mortality caused by subclinical disease at re-screening. RESULTS: The > relative risk (RR; 95% CI) for non-cancer mortality during follow-up > was higher in men with decreasing BMI in all subgroups: RR 2.64 > (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline BMI > 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(-2)), > using BMI-stable men as reference group. Correspondingly, the > non-cancer mortality was also higher in men with increasing BMI, but > only in the obese group (baseline BMI 26+ kg m(-2)) with RR 1.86 > (1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m(-2)) men > with decreased BMI had an increased non-cancer mortality compared with > BMI-stable obese men (Fischer's test: P=0.001). The mortality risk for > nonsmoking overweight men who increased their BMI compared with > BMI-stable men was also significant (P=0.006), but not in > corresponding obese men (P=0.094). CONCLUSIONS. Weight loss in > self-reported healthy but overweight middle-aged men, without serious > disease, is associated with an increased non-cancer mortality, which > seems even more pronounced in obese, nonsmoking men, as compared with > corresponding but weight-stable men. The explanation for these > observational findings is still enigmatic but could hypothetically be > because of premature ageing effects causing so-called weight loss of > involution. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 Hi : IMO they needed to differentiate between those who lost weight involuntarily, and those who lost weight only because they made strenuous efforts to do so. My bet is that had they made this distinction then they would have found that more than all the increased mortality in weight-losing men would have been among those who lost weight involuntarily, that is ......... while making no special effort to do so. I believe that any thoroughly healthy person will have a very healthy appetite that needs to be restrained in order to avoid weight gain. Anyone who loses weight without having to make a concerted effort, is, IMO, prima-facie, sick, by definition. It is this latter group that, I predict, contained the high mortality. A one year cut-off just doesn't handle this confounder. Jmo. Rodney. > " The relative risk (RR; 95% CI) for non-cancer mortality during > follow-up was higher in men with decreasing BMI in all subgroups: RR > 2.64 (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline > BMI 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(- 2)), > using BMI-stable men as reference group. " > > I wonder what is amiss here... > > The enigma of increased non-cancer mortality after weight loss in > healthy men who are overweight or obese. > > Nilsson PM, Nilsson JA, Hedblad B, Berglund G, Lindgarde F. > > Department of Internal Medicine, University Hospital, Malmo, Sweden. > peter.nilsson@m... > > OBJECTIVE: To study effects on non-cancer mortality of observational > weight loss in middle-aged men stratified for body mass index (BMI), > taking a wide range of possible confounders into account. DESIGN: > Prospective, population based study. SETTING: Male population of > Malmo, Sweden. PARTICIPANTS: In all 5722 men were screened twice with > a mean time interval of 6 years in Malmo, southern Sweden. They were > classified according to BMI category at baseline (<21, 22-25, > overweight: 26-30, and obesity: 30+ kg m(-2)) and weight change > category until second screening (weight stable men defined as having a > baseline BMI +/- 0.1 kg m(-2) year-1 at follow-up re-screening). MAIN > OUTCOME MEASURES: Non-cancer mortality calculated from national > registers during 16 years of follow-up after the second screening. > Data from the first year of follow-up were excluded to avoid bias by > mortality caused by subclinical disease at re-screening. RESULTS: The > relative risk (RR; 95% CI) for non-cancer mortality during follow-up > was higher in men with decreasing BMI in all subgroups: RR 2.64 > (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline BMI > 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(-2)), > using BMI-stable men as reference group. Correspondingly, the > non-cancer mortality was also higher in men with increasing BMI, but > only in the obese group (baseline BMI 26+ kg m(-2)) with RR 1.86 > (1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m(-2)) men > with decreased BMI had an increased non-cancer mortality compared with > BMI-stable obese men (Fischer's test: P=0.001). The mortality risk for > nonsmoking overweight men who increased their BMI compared with > BMI-stable men was also significant (P=0.006), but not in > corresponding obese men (P=0.094). CONCLUSIONS. Weight loss in > self-reported healthy but overweight middle-aged men, without serious > disease, is associated with an increased non-cancer mortality, which > seems even more pronounced in obese, nonsmoking men, as compared with > corresponding but weight-stable men. The explanation for these > observational findings is still enigmatic but could hypothetically be > because of premature ageing effects causing so-called weight loss of > involution. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 --- In , " Rodney " <perspect1111@y...> wrote: [snip] > I believe that any thoroughly healthy person will have a very healthy > appetite that needs to be restrained in order to avoid weight gain. > Anyone who loses weight without having to make a concerted effort, > is, IMO, prima-facie, sick, by definition. It is this latter group > that, I predict, contained the high mortality. > [snip] I think that the types of food that you eat determine whether you gain weight or not. I thought that my weight was steady at 149 lb, but I have lost two more pounds over the last six months. I now weigh 147 lb. I continue eating 2000 calories per day, but it is all healthy home cooking with plenty of non-starchy vegetables and sources of protein. I don't snack, so when I eat I am very hungry, but what I eat is very satiating. I would have to force myself to be able to eat more. I suppose that my body continues to adjust to the omission of pastries and sweet desserts which had always been a part of my diet. My BMI is 22.4, so I am not too worried. I will be more concerned if my BMI goes under 21. Tony Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 --- In , " Rodney " <perspect1111@y...> wrote: [snip] > I believe that any thoroughly healthy person will have a very healthy > appetite that needs to be restrained in order to avoid weight gain. > Anyone who loses weight without having to make a concerted effort, > is, IMO, prima-facie, sick, by definition. It is this latter group > that, I predict, contained the high mortality. > [snip] I think that the types of food that you eat determine whether you gain weight or not. I thought that my weight was steady at 149 lb, but I have lost two more pounds over the last six months. I now weigh 147 lb. I continue eating 2000 calories per day, but it is all healthy home cooking with plenty of non-starchy vegetables and sources of protein. I don't snack, so when I eat I am very hungry, but what I eat is very satiating. I would have to force myself to be able to eat more. I suppose that my body continues to adjust to the omission of pastries and sweet desserts which had always been a part of my diet. My BMI is 22.4, so I am not too worried. I will be more concerned if my BMI goes under 21. Tony Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 Hi Tony: Of course I agree with what you say. But the vast majority of the population doesn't eat this way. And I'd bet neither were the vast majority of the subjects in that study. So my point was that the majority who were losing weight in the study were losing weight because of some underlying, unhealthy, problem, which was the reason for their higher mortality. It was not their weight loss due to healthy eating that explained their higher mortality! Perhaps you realize that was what I meant. Rodney. > [snip] > > I believe that any thoroughly healthy person will have a very > healthy > > appetite that needs to be restrained in order to avoid weight gain. > > > Anyone who loses weight without having to make a concerted effort, > > is, IMO, prima-facie, sick, by definition. It is this latter group > > that, I predict, contained the high mortality. > > [snip] > > > I think that the types of food that you eat determine whether you gain > weight or not. I thought that my weight was steady at 149 lb, but I > have lost two more pounds over the last six months. I now weigh 147 > lb. I continue eating 2000 calories per day, but it is all healthy > home cooking with plenty of non-starchy vegetables and sources of > protein. I don't snack, so when I eat I am very hungry, but what I > eat is very satiating. I would have to force myself to be able to eat > more. I suppose that my body continues to adjust to the omission of > pastries and sweet desserts which had always been a part of my diet. > My BMI is 22.4, so I am not too worried. I will be more concerned if > my BMI goes under 21. > > Tony Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 Hi Tony: Of course I agree with what you say. But the vast majority of the population doesn't eat this way. And I'd bet neither were the vast majority of the subjects in that study. So my point was that the majority who were losing weight in the study were losing weight because of some underlying, unhealthy, problem, which was the reason for their higher mortality. It was not their weight loss due to healthy eating that explained their higher mortality! Perhaps you realize that was what I meant. Rodney. > [snip] > > I believe that any thoroughly healthy person will have a very > healthy > > appetite that needs to be restrained in order to avoid weight gain. > > > Anyone who loses weight without having to make a concerted effort, > > is, IMO, prima-facie, sick, by definition. It is this latter group > > that, I predict, contained the high mortality. > > [snip] > > > I think that the types of food that you eat determine whether you gain > weight or not. I thought that my weight was steady at 149 lb, but I > have lost two more pounds over the last six months. I now weigh 147 > lb. I continue eating 2000 calories per day, but it is all healthy > home cooking with plenty of non-starchy vegetables and sources of > protein. I don't snack, so when I eat I am very hungry, but what I > eat is very satiating. I would have to force myself to be able to eat > more. I suppose that my body continues to adjust to the omission of > pastries and sweet desserts which had always been a part of my diet. > My BMI is 22.4, so I am not too worried. I will be more concerned if > my BMI goes under 21. > > Tony Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 Do we know what is "weightloss of involution", exactly? It alludes to some new knowledge/unknown. Perhaps, it's the idea that people can have whatever BMI and still be malnourished (the body inside the mass). Regards. [ ] BMI & Mortality "The relative risk (RR; 95% CI) for non-cancer mortality duringfollow-up was higher in men with decreasing BMI in all subgroups: RR2.64 (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baselineBMI 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(-2)),using BMI-stable men as reference group."I wonder what is amiss here...The enigma of increased non-cancer mortality after weight loss inhealthy men who are overweight or obese.Nilsson PM, Nilsson JA, Hedblad B, Berglund G, Lindgarde F.Department of Internal Medicine, University Hospital, Malmo, Sweden.peter.nilsson@...OBJECTIVE: To study effects on non-cancer mortality of observationalweight loss in middle-aged men stratified for body mass index (BMI),taking a wide range of possible confounders into account. DESIGN:Prospective, population based study. SETTING: Male population ofMalmo, Sweden. PARTICIPANTS: In all 5722 men were screened twice witha mean time interval of 6 years in Malmo, southern Sweden. They wereclassified according to BMI category at baseline (<21, 22-25,overweight: 26-30, and obesity: 30+ kg m(-2)) and weight changecategory until second screening (weight stable men defined as having abaseline BMI +/- 0.1 kg m(-2) year-1 at follow-up re-screening). MAINOUTCOME MEASURES: Non-cancer mortality calculated from nationalregisters during 16 years of follow-up after the second screening.Data from the first year of follow-up were excluded to avoid bias bymortality caused by subclinical disease at re-screening. RESULTS: Therelative risk (RR; 95% CI) for non-cancer mortality during follow-upwas higher in men with decreasing BMI in all subgroups: RR 2.64(1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline BMI22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(-2)),using BMI-stable men as reference group. Correspondingly, thenon-cancer mortality was also higher in men with increasing BMI, butonly in the obese group (baseline BMI 26+ kg m(-2)) with RR 1.86(1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m(-2)) menwith decreased BMI had an increased non-cancer mortality compared withBMI-stable obese men (Fischer's test: P=0.001). The mortality risk fornonsmoking overweight men who increased their BMI compared withBMI-stable men was also significant (P=0.006), but not incorresponding obese men (P=0.094). CONCLUSIONS. Weight loss inself-reported healthy but overweight middle-aged men, without seriousdisease, is associated with an increased non-cancer mortality, whichseems even more pronounced in obese, nonsmoking men, as compared withcorresponding but weight-stable men. The explanation for theseobservational findings is still enigmatic but could hypothetically bebecause of premature ageing effects causing so-called weight loss ofinvolution. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 Hi JW: Here are three definitions of 'involution'. My guess is the last one applies in the case to which you are referring. " Main Entry: in·vo·lu·tion Pronunciation: in-v-lü-shn Function: noun 1 a : an inward curvature or penetration b : the formation of a gastrula by ingrowth of cells formed at the dorsal lip 2 : a shrinking or return to a former size <involution of the uterus after pregnancy> 3 : the regressive alterations of a body or its parts characteristic of the aging process; specifically : decline marked by a decrease of bodily vigor and in women by menopause. " Rodney. --- In , " jwwright " <jwwright@e...> wrote: > Do we know what is " weightloss of involution " , exactly? > It alludes to some new knowledge/unknown. > Perhaps, it's the idea that people can have whatever BMI and still be malnourished (the body inside the mass). > > Regards. > [ ] BMI & Mortality > > > " The relative risk (RR; 95% CI) for non-cancer mortality during > follow-up was higher in men with decreasing BMI in all subgroups: RR > 2.64 (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline > BMI 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(- 2)), > using BMI-stable men as reference group. " > > I wonder what is amiss here... > > The enigma of increased non-cancer mortality after weight loss in > healthy men who are overweight or obese. > > Nilsson PM, Nilsson JA, Hedblad B, Berglund G, Lindgarde F. > > Department of Internal Medicine, University Hospital, Malmo, Sweden. > peter.nilsson@m... > > OBJECTIVE: To study effects on non-cancer mortality of observational > weight loss in middle-aged men stratified for body mass index (BMI), > taking a wide range of possible confounders into account. DESIGN: > Prospective, population based study. SETTING: Male population of > Malmo, Sweden. PARTICIPANTS: In all 5722 men were screened twice with > a mean time interval of 6 years in Malmo, southern Sweden. They were > classified according to BMI category at baseline (<21, 22-25, > overweight: 26-30, and obesity: 30+ kg m(-2)) and weight change > category until second screening (weight stable men defined as having a > baseline BMI +/- 0.1 kg m(-2) year-1 at follow-up re-screening). MAIN > OUTCOME MEASURES: Non-cancer mortality calculated from national > registers during 16 years of follow-up after the second screening. > Data from the first year of follow-up were excluded to avoid bias by > mortality caused by subclinical disease at re-screening. RESULTS: The > relative risk (RR; 95% CI) for non-cancer mortality during follow- up > was higher in men with decreasing BMI in all subgroups: RR 2.64 > (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline BMI > 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(-2)), > using BMI-stable men as reference group. Correspondingly, the > non-cancer mortality was also higher in men with increasing BMI, but > only in the obese group (baseline BMI 26+ kg m(-2)) with RR 1.86 > (1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m(-2)) men > with decreased BMI had an increased non-cancer mortality compared with > BMI-stable obese men (Fischer's test: P=0.001). The mortality risk for > nonsmoking overweight men who increased their BMI compared with > BMI-stable men was also significant (P=0.006), but not in > corresponding obese men (P=0.094). CONCLUSIONS. Weight loss in > self-reported healthy but overweight middle-aged men, without serious > disease, is associated with an increased non-cancer mortality, which > seems even more pronounced in obese, nonsmoking men, as compared with > corresponding but weight-stable men. The explanation for these > observational findings is still enigmatic but could hypothetically be > because of premature ageing effects causing so-called weight loss of > involution. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 Hi JW: Here are three definitions of 'involution'. My guess is the last one applies in the case to which you are referring. " Main Entry: in·vo·lu·tion Pronunciation: in-v-lü-shn Function: noun 1 a : an inward curvature or penetration b : the formation of a gastrula by ingrowth of cells formed at the dorsal lip 2 : a shrinking or return to a former size <involution of the uterus after pregnancy> 3 : the regressive alterations of a body or its parts characteristic of the aging process; specifically : decline marked by a decrease of bodily vigor and in women by menopause. " Rodney. --- In , " jwwright " <jwwright@e...> wrote: > Do we know what is " weightloss of involution " , exactly? > It alludes to some new knowledge/unknown. > Perhaps, it's the idea that people can have whatever BMI and still be malnourished (the body inside the mass). > > Regards. > [ ] BMI & Mortality > > > " The relative risk (RR; 95% CI) for non-cancer mortality during > follow-up was higher in men with decreasing BMI in all subgroups: RR > 2.64 (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline > BMI 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(- 2)), > using BMI-stable men as reference group. " > > I wonder what is amiss here... > > The enigma of increased non-cancer mortality after weight loss in > healthy men who are overweight or obese. > > Nilsson PM, Nilsson JA, Hedblad B, Berglund G, Lindgarde F. > > Department of Internal Medicine, University Hospital, Malmo, Sweden. > peter.nilsson@m... > > OBJECTIVE: To study effects on non-cancer mortality of observational > weight loss in middle-aged men stratified for body mass index (BMI), > taking a wide range of possible confounders into account. DESIGN: > Prospective, population based study. SETTING: Male population of > Malmo, Sweden. PARTICIPANTS: In all 5722 men were screened twice with > a mean time interval of 6 years in Malmo, southern Sweden. They were > classified according to BMI category at baseline (<21, 22-25, > overweight: 26-30, and obesity: 30+ kg m(-2)) and weight change > category until second screening (weight stable men defined as having a > baseline BMI +/- 0.1 kg m(-2) year-1 at follow-up re-screening). MAIN > OUTCOME MEASURES: Non-cancer mortality calculated from national > registers during 16 years of follow-up after the second screening. > Data from the first year of follow-up were excluded to avoid bias by > mortality caused by subclinical disease at re-screening. RESULTS: The > relative risk (RR; 95% CI) for non-cancer mortality during follow- up > was higher in men with decreasing BMI in all subgroups: RR 2.64 > (1.46-4.71, baseline BMI <21 kg m(-2)), 1.39 (0.98-1.95, baseline BMI > 22-25 kg m(-2)), and 1.71 (1.18-2.47, baseline BMI 26+ kg m(-2)), > using BMI-stable men as reference group. Correspondingly, the > non-cancer mortality was also higher in men with increasing BMI, but > only in the obese group (baseline BMI 26+ kg m(-2)) with RR 1.86 > (1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m(-2)) men > with decreased BMI had an increased non-cancer mortality compared with > BMI-stable obese men (Fischer's test: P=0.001). The mortality risk for > nonsmoking overweight men who increased their BMI compared with > BMI-stable men was also significant (P=0.006), but not in > corresponding obese men (P=0.094). CONCLUSIONS. Weight loss in > self-reported healthy but overweight middle-aged men, without serious > disease, is associated with an increased non-cancer mortality, which > seems even more pronounced in obese, nonsmoking men, as compared with > corresponding but weight-stable men. The explanation for these > observational findings is still enigmatic but could hypothetically be > because of premature ageing effects causing so-called weight loss of > involution. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2005 Report Share Posted August 30, 2005 Re: [ ] BMI & Mortality >Do we know what is " weightloss of involution " , exactly? From The American Heritage Dictionary, 4th edition.. 6. Medicine. a. A decrease in size of an organ, as of the uterus following childbirth. b. A progressive decline or degeneration of normal physiological functioning occurring as a result of the aging process. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 31, 2005 Report Share Posted August 31, 2005 Thanks, Al, So we're left with a guess that the obesers invoke premature aging/mortality because they lost weight, which I think is contrary to previous ideas. It has been a concern to me the rate of weight loss is important. It's the idea that we lose a lot of muscle tissue with large quick drops in weight and that can be ANY muscle tissue. I don't recall any proof the nitrogen loss comes from only peripheral muscles, eg. I can't get to the full text, so I don't know how obese they were or their ages. Regards. Re: [ ] BMI & Mortality>Do we know what is "weightloss of involution", exactly?From The American Heritage Dictionary, 4th edition..6. Medicine.a. A decrease in size of an organ, as of the uterus following childbirth.b. A progressive decline or degeneration of normal physiological functioning occurring as a result of the aging process Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 31, 2005 Report Share Posted August 31, 2005 Thanks, Al, So we're left with a guess that the obesers invoke premature aging/mortality because they lost weight, which I think is contrary to previous ideas. It has been a concern to me the rate of weight loss is important. It's the idea that we lose a lot of muscle tissue with large quick drops in weight and that can be ANY muscle tissue. I don't recall any proof the nitrogen loss comes from only peripheral muscles, eg. I can't get to the full text, so I don't know how obese they were or their ages. Regards. Re: [ ] BMI & Mortality>Do we know what is "weightloss of involution", exactly?From The American Heritage Dictionary, 4th edition..6. Medicine.a. A decrease in size of an organ, as of the uterus following childbirth.b. A progressive decline or degeneration of normal physiological functioning occurring as a result of the aging process Quote Link to comment Share on other sites More sharing options...
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